information A Guide for New Hearing Aid Users Acknowledgements to Lee Gascoyne of Barnsley General Hospital, Photography by Paul Whiteside Author: Celia Whiteside Role: Hearing Therapist Date written: October 2004 Date last reviewed: March 2015 Review date: March 2018 Version: 2.1 Code: PI0092 If you need this information in another language or medium (audio, large print, etc) please contact the Customer Care Team on 0800 374208 email: customercare@salisbury.nhs. uk. You are entitled to a copy of any letter we write about you. Please ask if you want one when you come to the hospital. The evidence used in the preparation of this leafl et is available on request. Please email patient.information@salisbury.nhs.uk if you would like a reference list. Salisbury NHS Foundation Trust Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ OF03102 June 2010 www.salisbury.nhs.uk Audiology Department 01722 429335 01722 336262 ext. 4801 Fax: 01722 429336 Email: audiology@salisbury.nhs.uk Salisbury NHS Foundation Trust
A Guide for New Hearing Aid Users Important Points Your hearing aid is yours for as long as you need it and use it. If it is not in regular use, let us know why and give us the chance to improve things for you. Never wear your hearing aid switched off to save batteries. The batteries are free and generally last about 200 hours. You will be allocated two packs of batteries for each hearing aid. Don t forget to switch it off when not in use. Where are we? Audiology Department is part of Ear, Nose & Throat at Salisbury District Hospital. ENT is the first Clinic on the left after you enter the main doors. There is an administrative charge of 60 towards the cost of replacing lost or damaged digital hearing aids. Keep it in the box provided when not in use. 2 19
Your Hearing One in six of the population has a clinically significant hearing loss. This figure rises in people over the age of 70 to three out of four. Hearing loss that is part of the natural ageing process is a recognised condition called presbyacusis. Presbyacusis is not a disease, but a term that acknowledges the association between ageing and hearing loss. Presbyacusis occurs when tiny nerve endings in the cochlea (the part of the ear that processes sounds for your brain to interpret) erode. These nerve endings, known as cilia, cannot be replaced when they become lost or damaged, so eventually, as we get older and more erosion occurs, we notice that sounds are not as clear as they used to be. In Salisbury and the surrounding area, the most common cause of hearing loss after ageing is noise damage. This is because many people have been employed in agriculture, industry or military service. Exposure to loud noise over a number of years or to sudden very loud sounds can result in permanent damage to the cilia in the cochlea. The resulting hearing loss may develop very gradually over months or even years. There are other things that can cause damage to these cilia apart from ageing and noise damage. To establish the cause of a problem, a hearing test and detailed history will need to be taken. For many people with this type of hearing loss, it is the high frequency sounds that disappear first. Speech contains high frequency sounds, so the first sign that your hearing has 18 3
become less acute may be that you start to have difficulty understanding what people say, especially where there is background noise. If this sounds familiar, read on. Pure Tone Audiometry In Audiology we can test your hearing by measuring the quietest sound you can hear over a range of different frequencies. The results are plotted on to an Audiogram. A typical audiogram for someone with age related or noise induced hearing loss will look like this. It is sometimes known as a ski-slope loss because of its shape. Hearing Clearly Understanding and hearing speech clearly is a very important part of human hearing. The speech sounds with the highest frequencies are consonant sounds, e.g s, t, th, k, p, f, t. Consonant sounds are vital for understanding speech clearly, for defining speech. The type and degree of hearing loss you have will determine how clearly you can understand speech. 4 17
ready to listen Try to keep calm and do not panic If you don t catch what someone says at first, just ask them to repeat it or tell them what you have heard so that they can just clarify it for you If necessary, ask people to slow down Be kind to yourself. no one hears correctly all the time Have you thought about learning to lip read? Classes are often very helpful and give you hints about how to cope and improve your listening skills Contact us Telephone: 01722 429335 - direct line to Audiology Fax: 01722 429336 (during office hours) Post: Department of Audiology Salisbury District Hospital Salisbury, Wiltshire SP2 8BJ Email: audiology@salisbury.nhs.uk People often comment: I hear people talking, but I can t make out the words How will a hearing aid help? Hearing aids amplify all sounds including speech. Making things louder will make it easier for you to pick up what is being said and will increase your confidence in your ability to hear. Unfortunately a hearing aid cannot cure deafness but it can be helpful if used correctly. There will still be times when you will miss parts of speech. Although the aid can make things louder, if the cilia aren t working for certain sounds, then making them louder won t work for you. However, it is important that you have the right hearing aid for your hearing loss and that it is adjusted appropriately for you. What else can help me? A hearing aid can only be part of the solution to a hearing problem. It is literally an aid to hearing. But you may be helped by lip-reading It will help you to understand what people are saying if they are facing you. It is important that your family and friends understand about your hearing loss, as their help in speaking more clearly will make a big difference. If someone calls to you from another room, it may still be difficult to understand what they are saying. This can lead to frustration on both sides. Only about 40% of speech can be lip-read, so even the best lip-readers make mistakes, but 16 5
joining a class can be enjoyable and helpful. Environmental Equipment There are many devices that can be used to make day-to-day things easier. Many people find an amplified telephone or a special doorbell will solve a problem. A TV Listening aid or the use of subtitles may help you follow your favourite TV programme without the volume being too loud for others in your family. 6 Getting The Best From Your New Hearing Aid When you are first fitted with your hearing aid, you may experience some problems in getting used to wearing it. The main reason for this is because you will be so used to hearing sounds without the aid. Any change will inevitably sound strange to you. Don t worry. This is quite normal. Some points to remember Your hearing aid has been programmed specifically to match your hearing loss. This means that the hearing aid is constantly working hard to maintain a comfortable and realistic listening level for various situations. This does not mean that the aid will adjust itself to what you think it should sound like. The hearing aid is designed to maximise the potential for you to recognise and understand speech. If you cannot make sense of the sound coming from the aid, do not assume it is a fault with the aid. The hearing aid can only pick up sounds and amplify them. The remaining work still needs to be done by your own hearing system. The more you wear the aid, the more it Communication Tips If you are speaking to someone with a hearing impairment Make sure you have the person s attention before you start to speak Speak clearly, not too slowly. Use normal lip movements and natural gestures If someone doesn t understand what you have said, try saying it in a different way Keep voice at a normal level. Do not shout because it is uncomfortable for a hearing aid user and it looks aggressive Keep your face visible and ensure it is well lit Check that the person has followed the conversation. Give the person time to process what you have said Be patient. Remember that a hearing aid might amplify background noise as well The microphone of a hearing aid cannot amplify at a distance. So speaking from another room will be frustrating for both of you If you re deaf or hard of hearing Be open. Tell the person you re speaking to that you hear better when you can see them Ask people to get your attention first so that you re 15
as possible. When you contact us, you will need to give your name, that is your surname and your first name or your hospital number. It is helpful if you have some idea of when you would like to be seen so have your diary or calendar ready. You can usually be seen on the same day if you are prepared to travel to Salisbury. Remember: Phone first to arrange an appointment on 01722 429335 or 01722 336262 ext. 4801 or fax. 01722 429336 or email audiology@salisbury.nhs.uk Batteries can be issued by Reception Staff or Volunteers at various local centres, or by post: contact us for details. will help you get accustomed to a different way of hearing. The benefits increase as you acclimatise. Your new hearing aid may seem loud to you at first. This is because you are so used to sound being dull and muffled. In time, this will settle and become comfortable and acceptable to your hearing system. The foundation for correct use of any hearing aid is in the precise fitting of the ear mould. If you fail to fit the mould correctly, you will not achieve the desired result. It Is Very Important That You Wear The Aid Consistently. You must be realistic about the improvement your hearing aid can give you. It cannot filter out unwanted noise. You still have the task of distinguishing exactly what you are hearing. If you decide after you have been issued with your hearing aid that you do not want to wear it, please return it to Audiology so that it can be recycled for the use of someone else. Do not put it away and not wear it. Your Hearing Aid Cannot Listen For You It will take time for you to become familiar with your hearing aid, but this is to be expected. However, if you persevere, it will make a lot of difference to your communication patterns. It is precisely for this reason that it is worth making the effort to learn how to use it. These guidelines are here to help you, but if you are experiencing difficulties with your hearing aid, do contact 14 7
us and we shall make arrangements to see you as soon as possible to resolve the problem. In most cases hearing aids can be repaired or replaced very quickly. 8 Remember: Your Ears Do The Hearing, But Your Brain Interprets The Sound Open Ear fittings If you have a mild hearing loss, you may be suitable for an open ear fitting. Instead of an ear mould, the hearing aid is attached to a thin sound tube with a little dome at the end which fits into your ear canal. The main body of the hearing aid is still worn behind the ear. The tube must be cleaned regularly using a flex rod which is fed through the sound tube clearing any debris. Your audiologist will show you how to do this and will supply you with some flex rods designed for the purpose. Open ear fittings are usually only appropriate for fairly mild hearing losses. Thresholds in the low frequencies need to be close to the normal limits. Unfortunately, feedback may occur if the aid is required to respond to a more severe hearing loss. Take advice from your Audiologist. How To Clean Your Earmould The earmould of your hearing aid should be cleaned weekly. 1. Detach the earmould from the hearing aid; pull the tubing away from the elbow of the aid. The tubing should not be pulled out of the mould. If you have two aids, do them one at a time so you don t get them muddled. Remember they have each been programmed to suit your specific needs. to a specific speaker almost as if they were sitting on your shoulder. In Audiology, we have a range of catalogues on different types of listening devices including room loops and portable loop systems. We can also advise about amplified telephones, doorbells or personal communicators. The Hearing Therapists will be happy to advise and demonstrate a variety of equipment at the Audiology Department. We can refer you to the appropriate Social Services Equipment Officer who can visit to make a home assessment. Alternatively, if you decide to purchase equipment, we can make suggestions and recommendations. The Hearing Therapists can also advise about other related aspects of hearing such as tinnitus (noises in your head or ears) and balance problems. We can give you up to date information about Lip-reading classes in your area or how to improve conversation in social settings. Time can be allocated so that you can discuss your difficulties in confidence. Hearing Aid Service If you require assistance with managing your new aid or you think an adjustment is required, contact us for an appointment so that an Audiologist can spend some extra time with you. You can be seen at Salisbury District Hospital, Department of Audiology by appointment, if necessary, and if it is feasible, we may be able to offer you an appointment closer to your home. Every effort will be made to see you as soon 13
Hearing aid is whistling Is the tubing loose and needs renewing? 12 Have you fitted the mould properly or is it loose? Is your ear clear of wax, infection or other obstruction? If you are unsure, consult your GP s surgery. Not hearing well If you feel you are not hearing as well as you used to and have eliminated any medical cause by consulting your GP, e.g. congestion, ear infection, your GP can refer you for a reassessment of your hearing. However, we would not normally repeat a hearing test performed within the last 3 years. If you feel disappointed in the performance of your aid, go through the checklist above again. Other important points to remember are:- Your hearing aid is exactly what we say it is. An aid to hearing. It cannot restore your hearing to normal. Respect the limitations of the microphone. It cannot amplify at long distance or round corners. Environmental Equipment Your hearing aid will probably have been programmed to connect to a loop system. You will find loop systems in churches, theatres, across the counter in a bank, post office or other public buildings. This will help you to listen 2. Wash the mould in warm soapy water. Detergent should not be used. A nail brush or pin may be used to remove wax from the sound tube. 3. Rinse the earmould with clean water, leave in a warm place to dry. 4. The earmould should be reattached to the hearing aid with the curve of the mould matching the curve of the aid. 5. The hearing aid itself should be wiped with a dry cloth. Do not allow it to get wet. Left Note that the tubing is on the outer side Right These photos show what your hearing aid/s should look like after you have re-attached the hearing aid to your earmould. How To Re-tube Your Earmould Audiology Staff will be willing to demonstrate how to re-tube correctly. Once instructed, you may feel confident in doing this yourself. Fresh tubes are available from the Audiology Department. It will save you time and trouble if you are able to do this yourself. If you do not feel happy about 9
re-tubing, our Staff will gladly do it for you. The main thing is that you recognise that it needs to be done every 3 to 6 months. After a while, the tubing, which was at first soft and flexible, becomes brittle and discoloured. It will need replacing thus: in the mould. Cut off the excess tube at the tip. A sharp craft knife is best for this. 4. Now adjust the length of the other end of the tube to fit your ear by putting the old piece that you saved alongside the newly threaded mould. Measure and cut as shown. 1. Detach earmould and remove old tube. A confident tug should do it. Don t throw the old tubing away yet save it. 2. Take a pre-bent piece of tubing and taper the last inch of one end so that you can thread this right through the canal of the mould. Taper new tube & thread through top hole of mould. 3. Pull the point of the tubing which emerges at the tip until the bend in the tube coincides with the opening 5. Your new tube should look like this when it is threaded, measured and cut correctly. Attach your hearing aid. Hearing Aid Fault Check List No sound from the hearing aid Is the hearing aid switched on? Check the battery e.g. is it dead or in the wrong way? Check the earmould, is the tubing blocked or twisted? Is there condensation in the tube? 10 11