Dave I have had top of the line Phonak's for the last 8 years for my severe/profound loss. But even with the most expensive latest technology, a hearing aid only can do so much. It primarily amplifies sound, but does not clarify what is said all of the time. You can get programs put on your hearing aid app on your phone by your audiologist that will help decrease some of the surrounding sound when you are in noisy situations. But the biggest help is when you use an assistive listening device (ALD) like the Roger On multi-purpose microphone or a partner mic. The ALD's are what really help with understanding what people are saying. But you will never get 20/20 hearing like you can with eye glasses for 20/20 vision.

I was getting ready to upgrade my Phonak's to the latest version this year, but when I had my hearing test, my speech recognition had dropped to 25% in my left ear and 50% in my right over the course of one year. So now I qualify for a CI and will be getting one in my left worst ear this summer. I am 66 and want to stay active and my frustration this past year with the decreased word recognition was really dragging me down. The CI is really the only option to improve my word recognition. It does require a surgery, but CI surgery has been done for over 30 years and I've talked to over 25 of my HLAA friends with CI's and each one of them say they were happy that they got the CI. Even people in there 70's and 80's.

Good luck with your decision.