May 03, 2010 Rosalyn Sutley

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1 May 03, 2010 May 03, 2010 Rosalyn Sutley

2 The Invisible Disability

3 Who Am I? Applies to any person who has a hearing loss Usual means of communication is spoken language 3

4 Who Am I? An individual who may have grown up hearing or hard of hearing but lose all hearing at some point. Usual means of communication is spoken language May also self identify as deafened or oral deaf 4

5 Who Am I? Used to describe those with early onset hearing loss who have little or no residual hearing Preferred mode of communication is speech and speechreading Many with cochlear implants fall into this category 5

6 Who Am I? These individuals are members of a sociolinguistic and cultural group whose preferred mode of communication is American Sign Language g 6

7 Hearing Impairment Denotes limitation of one or more basic components of the auditory system 7

8 Hearing Handicap Refers to social and environmental factors and results in disadvantage in areas such as education, employment, leisure and recreation 8

9 Hearing Disability Refers to the lack, loss or reduction of the ability to perform certain tasks such as listening, using the telephone and communicating 9

10 According to the Canadian Association of Speech Language Pathologists and Audiologists 20% of adults over 65 40% of adults over 75 80% nursing home residents Have significant hearing problems 10

11 According to Statistics Canada more than one million adults across the country reported td having a hearing related disability This is a number more than 50% greater than the number of people reporting problems with their eyesight 11

12 Hearing loss is the third most prevalent disability in older adults after arthritis and hypertension On average most people wait 5 to 7 years to get their hearing checked after they first start noticing changes in their hearing Hearing loss is affecting people at a younger and younger age because of noise pollution 12

13 Several clinics i (Manitoba) reported td prescribing an average of 5000 hearing aids per year Research by SMD found that ENT s, audiologists, and hearing instrument practitioners agree that there is a lack of support services, resources and specific expertise to meet the follow up needs of individuals recently diagnosed with hearing loss 13

14 Conductive Sound cannot get through the outer or middle ear Sensorineural Occurs when the nerve endings or fb fibres in the cochlea or auditory nerve cannot pick up or transmit information to the brain Mixed

15 I can hear you talking but I can t UNDERSTAND you! 15

16 Multidimensional disorder Impaired cochlea and Impaired central auditory system including the brain stem and auditory cortex Can vary in severity from mild to severe 16

will be greater than could be expected from hearing loss

17 Unable to hear the high frequency sounds People will sound as if they are mumbling Decline in understanding speech will be greater than could be expected from hearing loss alone because of the involvement of the central auditory system 17

18 More difficult to hear in noisy environments More difficult to comprehend rapid speech May have trouble remembering the entire sentence in multi phrase sentences This memory loss may be attributed to dementia or senility rather than hearing loss 18

19 Emotions wax and wane as hearing loss and/or lf life stages change Affects both hhearing and hard of hearing

20 Frustration ti Anger Grief Anxiety 20

21 Low self esteem Withdrawal Avoidance Isolation Depression

22 Personal variables: Current state of mental and emotional health May already be dealing with major life changing g events such as loss of loved one, retirement, empty nest syndrome 22

23 Physical health: Other chronic ailments have priority over hearing loss Rd Reduced d visual acuity Manual dexterity Dementia 23

24 Temperament More easy going and flexible an individual the easier time they will have coping with hearing loss More willing to try new options 24

25 Self sufficiency and independence The more an individual is charge of his/her life, the better able they are to manage their hearing loss The more help that is needed to manage every day communication needs the more it will impact their feelings of independence and self sufficiency 25

26 Self concept If they fear getting older they will tend to resist buying aids or assistive devices The more unrealistic their self assessment of their hearing loss is the less likely they will be to accept help 26

27 Social Circumstances Do they have family or friends and how often do they see them Living arrangements (alone, senior s building, nursing home) 27

28 Economic Living longer Cost of aids out of reach for many Little financial assistance available Minorities at greater disadvantage Rural population lack services 28

29 Technology Assistive devices and technology NOT available in Canada (telecommunication devices, cell phones) Cost of assistive technology out of reach for many No/little financial assistance or tax relief to obtain the devices that t are available Existing technology not being used to the extent it could (medical appointments made via )

30 Environment seniors residences, nursing homes etc. may be located in high traffic areas (noise) Common areas often near noisy areas such as laundry, kitchen facilities or front reception area Lighting inadequate or too bright 30

31 Public and Government Buildings, Places of Worship, Financial Institutions Architecturally acoustically unfriendly High ceilings, reverberant walls, bare floors Inadequate lighting (candlelight) (poor window coverings) Poor public address systems or no systems Excessive background noise (music) Limited signage 31

32 Health Care Policies and procedures for infectious control do not accommodate the speechreading needs of the hard of hearing Privacy laws can conflict with the needs of the hard of hearing Lack of personnel trained to recognize and communicate with the hard of hearing

33 Health Care The needs of the hard of hearing patient may be accommodated dbut what policies and procedures are in place to meet the needs of the hard of hearing care giver? Lack of assistive devices such as tty s or loop systems Video resources not captioned

34 Home Care Staff not trained to communicate with hard of hearing Lack of awareness of assistive devices for the hard of hearing or their care giver Impact these devices can provide in retaining independence is not understood by policy makers

35 Residency: Nursing Home Nursing home environment acoustically unfriendly No one staff or family member takes responsibility for hearing health of patient Hearing loss not seen as priority by staff and they lack the time to make it a priority Staff turnover makes training i difficult 35

36 Nursing Home No place to store aids and assistive devices Patient s behaviour attributed to dementia rather than hearing loss 36

37 Residency: Living with other family members May lack autonomy to make decisions about their hearing health Family has no or little understanding or support to help them cope with a hearing impaired family member May not want to invest time, money or effort in the problem (family and or hard of hearing) 37

38 The most crucial il gap is the lack of awareness of hearing loss issues by all parties involved: the hard of hearing their families hearing health care providers the community the government. 38

39 Lack of financial assistance for purchase of hearing aids and ALD s Lack of training on how to use or maintain devices Technology not utilized to degree it could be Lack of ALD s in public places (TTY s) 39

40 General physicians i do not routinely check for hearing loss People not aware of where or how to go about getting a hearing assessment Auditory Rehabilitation and other support services for hard of hearing and families is not seen as a priority by health care providers or the government Surgical procedures such as cochlear implants must be done out of province 40

41 Lack of services in other languages Lack of awareness of rights of h o h h Lack of captioned and visual resources in public places (health promotion how to s not captioned, lack of visual announcements in airports) Lack of services in rural areas 41

42 Society for Manitobans with ih Disabilities i LIVING with Hearing Loss Program a three level Auditory Rehabilitation Program for hard of hearing and deaf adults. This program is available in Winnipeg and some rural areas. SMD is currently looking to expand the program by training more instructors Canadian Hard of Hearing Association MB Chapter Information and advocacy

43 Hearing Aids Under the age of 18 when prescribed by a qualified doctor ENT, MB health pays 80% coverage for a new aid every 4 years or more if a doctor diagnoses changes in hearing No coverage is available for hearing aids for adults

44 Cochlear Implants Adult Program Surgery and device covered by MB Health but surgery conducted out of province Bilateral l surgeries not yet approved for coverage MB Health pays approximately 75% of cost of travel for patient and companion Does not cover accommodation dti expenses

45 BAHA Surgery Bone Anchored Hearing Aid surgery is available in Manitoba with full coverage Vibration i Soundbridge Surgery has been initiated within Manitoba for this device with ih full coverage. The first one was done June 26, 2009

Hearing Loss: What s in my toolbox? Provi Alvira, Au.D., CCC-A Sonus, Inc. 4160CORP

Hearing Loss: What s in my toolbox? Provi Alvira, Au.D., CCC-A 2009 Sonus, Inc. 4160CORP Introduction: Does this sound familiar? My hearing is fine.my wife just mumbles! My family says the TV is just too