Hearing: The Basics. Claire Danks MSc Senior Clinical Scientist in Audiology Sandwell and West Birmingham NHS Trust

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1 Hearing: The Basics Claire Danks MSc Senior Clinical Scientist in Audiology Sandwell and West Birmingham NHS Trust

2 Hearing Loss: The Figures Estimated 11 million people in the UK have hearing loss Approximately 1 in every 1000 babies born have hearing loss 41.8% over 50 have hearing loss 71.1% over 70 have hearing loss By 2035 it is estimated that 1/5 th of the UK population will have some degree of hearing loss. Figures from Action on Hearing Loss

3 How Many People are Deafblind? According to the charity Sense: Approximately 250,000 people Of these 220,000 are over 70

4 How Do We Hear? Image edited from:

5 What Causes Hearing Problems Many and varied causes Can be congenital (from birth) or acquired. Potential causes: genetic infections during pregnancy lack of oxygen severe jaundice medicines used for life-threatening infections

6 Acquired Hearing Loss Bacterial meningitis Measles and mumps Auto-immune disorders Trauma e.g. head injury Interuption to blood supply Tumour Noise damage Aging

7 Presbyacusis Age-related hearing loss is by far the most common cause of hearing impairment. Hair cells in the cochlear wear out Noise damage accelerates this process Image:

8 How Can You Get Your Hearing Tested? Speak to your GP They will look in the ears and ensure they are clear of wax. The GP can then refer for a free hearing test. Or visit a private dispenser.

9 Having A Hearing Test Pure Tone Audiometry Listener sits in a soundproof booth Press a response button every time they hear a tone Audiologist finds the quietest level of sound that is audible 50% of the time for a range of different pitches

10 Types of Hearing Loss Sensorineural: Permanent loss caused by damage to the hair cells in the cochlea e.g. by wear-and-tear in presbyacusis Conductive: Temporary or permanent. Problem with the sound reaching the cochlea - outer or middle ear issue. Mixed: Bit of both! Outer and middle ear Inner ear

11 Hearing Test Results After the test you may get a copy of your results on an Audiogram. Hearing loss categorised as mild, moderate, severe or profound depending upon how loud the sounds needed to be before they were audible

12 NHS Hearing Aids NHS hearing aids are provided free of charge. All maintenance and batteries are also free. Audiologist will advise on the most suitable type of hearing aid for the individual s level of hearing loss and needs.

13 Types of Hearing Aid All digital aids this means they are programmed with a computer to the individual s prescription, based on hearing test results Usually described by the way they are worn. Types of aid provided may differ by NHS Trust. Usually in-the-ear or in-the-canal aids are dispensed privately. Trialed these aids on NHS too prone to breaking down and more limited amplification

14 Most Common Types of Hearing Aid Hearing aid with an earmould Hearing aid with an open fit tip

15 A Closer Look Should have a coloured marker to indicate which aid is for which ear red = right, blue = left Often small and difficult to see Could put a tactile sticker on the inner side of the aid instead

16 How They Work A hearing aid amplifies sound to a more audible level Like glasses are fitted to an eye test prescription, hearing aids are fitted to a hearing test prescription individual to the patient Digital processing of the sound and directional microphones help to improve speech perception Digital hearing aids can be set with different programmes such as listening in quiet, listening in noise, music, loop system Or they can be fully automatic so the user doesn t have to adjust them

17 Hearing Aids and Visual Impairment Hearing aids for people with visual impairment should have an omni-directional microphone. This should allow the listener to localise sounds important for judging direction and position. May need a programme with more low frequency amplification. The Audiologist should consider this. Within Sandwell and West Birmingham patient who are registered visually impaired can be issued a spare hearing aid if they only use one aid normally.

18 Common Misconception 1 Hearing aids put your hearing back to normal Hearing aids allow the listener to make the most of the hearing they have left They do not restore normal hearing Often people become frustrated when someone wearing hearing aids doesn t hear them they expect them to suddenly hear perfectly Still need to use good communication tactics

19 Common Misconception 2 Digital hearing aids are the little ones that go inside your ears All our NHS hearing aids are digital and have been for over 10 years. This aid is digital But so are all these! Digital, means that it can be programmed with a computer to that individual s hearing levels. It does not reflect how they look

20 Common Misconception 3 Waxy ears are dirty. They must be cleaned Wax is your ear s own protective coating. It helps to trap any dust or particles that may enter your ear. It is anti-bacterial Soft wax should move out of your ear naturally. Strongly recommend that nothing is poked into the ear e.g. cotton buds, hair grips etc. Just wipe around the outside part of the ear Olive oil drops can help loosen a large or hard buildup of ear wax

21 How to Change a Battery Inserting the battery with the sticker still in place and facing upwards means you can be sure the battery is the right way around. Peel the sticker off once the battery is in the drawer. Battery life depends on use, but on average should last about a week. Hearing aid will often beep when battery is running low. For NHS aid battery replacements are free and approximately 3 months supply will be issued at a time

22 How to Insert a Hearing Aid with an Earmould

23 How to Insert a Hearing Aid with an Open Fit Tip

24 How to Clean a Hearing Aid An earmould should be wiped daily with a wet wipe or tissue. The earmould can be disconnected from the hearing aid and washed, ideally once a week Must be fully dry before reconnecting to the hearing aid.

25 How to Clean a Hearing Aid Open fit tubes can be removed from the hearing aid pull or screw fitting A fine cleaning wire is passed through the tube to remove blockages This requires good vision and dexterity and sometimes a patient will not be fitted with this type of aid if they are unable to manage the cleaning or have support

26 Getting Used to Hearing Aids When a listener first wears a hearing aid it will sound strange They may notice many more sounds around them Their own voice may sound strange It can take several weeks to adjust to the new sound Many people fail to persist with the acclimatisation process and so never fully adjust to listening with the aids The aids are most beneficial when worn consistently

27 When Should Aids be Worn How often do you use your ears? Try to wear them all day, even if home alone Just wearing them for certain activities e.g. TV, going out etc stops full acclimatisation Take them out when showering/bathing or swimming Take them when go to bed

28 One Aid or Two? We have two ears for a reason! Hearing in both ears allows us to localise where a sound is coming from. This is particularly important for patients with visual impairment Hearing with both ears also gives us a binaural advantage when listening in background noise a situation which is often difficult for people with hearing loss.

29 Common Problems The aids are whistling Wax Incorrectly fitted mould The mould may be old/worn and a new one is required. The case of the aid or elbow may be broken/loose If the problem continues but the aid is inserted correctly attend your Audiology department repair service

30 Common Problems No output from the hearing aid Check whether the mould or tube is blocked Check the battery Check for moisture in the tube The NHS Audiology Service which provided the aid will provide a repair service. This may be a drop-in or booked service, check with your provider. There may also be a postal repair service.

31 Communication Tactics When speaking to someone with hearing loss: Even if they are wearing a hearing aid Make sure you have the person s attention before you speak Try to find somewhere good to talk good lighting, away from noise/distraction Face the listener Speak clearly not too slowly, use normal movement and gesture Make sure you are being understood Rephrase if someone doesn t understand Don t shout it distorts your lip patterns and looks aggressive

32 Communication Tactics If you have a hearing loss: Be open about it. Tell the person speaking. If necessary ask people to slow down. Keep calm - if you are anxious you might find it harder to listen. Remember, no-one hears perfectly all of the time.

33 Additional Equipment Personal listener e.g. Minitech. Can use with headphones or with a hearing aid Can be a hand-held listener Can attach microphone to the TV Can use a neck-loop and T- position on hearing aids rather than wear headphones.

34 Loop Systems A hearing loop helps the listener hear more clearly when there is background noise or at a distance. The hearing aids need to have the loop setting enabled. Find loops in public places such as banks, cinemas, supermarket check-outs

35 How Does the Loop Work? Loop systems have an amplifier that plugs into a microphone. A wire cable (loop) runs around the edge of the listening area. If you are in the listening (loop) area the electric current in the cable produces a magnetic field. This sends the sound directly to the hearing aid

36 Loop System

37 Additional Equipment Amplified phones Vibrating alerts for doorbells, alarm clocks, baby monitors The fire service will provide a vibrating smoke alarm Action on Hearing Loss: Solutions Catalogue

38 Any Questions?

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