Last reviewed 11 June 2013
In the second of this two-part article Martin Hodgson discusses hearing aids, equipment and support for service users with hearing loss.
A hearing aid is an electronic device consisting of a microphone, an amplifier, a loudspeaker and a battery. It fits in the ear and amplifies the sound coming in so that the person using it can hear. Most have volume controls and can be turned up or down. Many can be set up with different listening programmes depending on the environment they are used in, for example, when used with a loop system or amplified telephone.
Hearing aids are not a cure for deafness and are not suitable for everyone. They should be prescribed, fitted and adjusted by a professional. After a hearing aid has been fitted, most people will be offered a follow-up appointment to check it is working properly.
Modern hearing aids are mostly digital and offer an improvement on older analog models. The behind-the-ear form is the most common, consisting of an ear mould which sits inside the ear and a plastic body behind the ear. Other types fit inside the ear and are less visible, but may not be as effective for people with severe hearing loss.
Disposable hearing aids are available. These usually last for about 10 weeks, after which time the hearing aid is thrown away and replaced.
Bone conduction aids are recommended for people with conductive hearing loss or for those who cannot wear a more conventional type of hearing aid. Some bone conduction devices require an operation to fit, as do middle ear implants, which attach to the small hearing bones in the ear and make them vibrate.
Another type of surgical intervention is a cochlear implant, a small device fitted behind the ear which takes in sound, analyses it, and then converts it to signals, which are transmitted direct into the cochlea or inner ear. Such implants are sometimes recommended for adults or children who have profound sensorineural hearing loss in both ears, which is not helped by the use of hearing aids.
Many service users will be perfectly able to manage their hearing aids, but some may need assistance in fitting them, changing batteries and making adjustments. Older service users who are new to hearing aids may need considerable support. Where necessary, care workers should prompt service users to remember to wear their aids and should help them to check they are turned on and correctly adjusted. Attention should be paid to cleaning and maintaining hearing aids as a blocked or defective aid will be of little use.
Lip-reading and sign language
Many people with a hearing impairment learn to communicate in other ways instead of, or as well as, using the spoken word. Lip-reading is a useful skill that many people with a hearing impairment find useful.
Those who are born with a hearing impairment usually learn sign language, a form of communication that uses hand movements and facial expressions to convey meaning. The most common form in the UK is the British Sign Language (BSL).
Both lip-reading and sign language can be taught and learned, and courses are available for care staff where a care service identifies this as a training need.
Speaking on the telephone or using other forms of telecommunications equipment is important to most of us and enables people to remain in contact with friends and family. Technology in this area has improved in recent years and specialist advice should be obtained to help people with hearing loss to have full access.
For example, there are a number of different types of telephone designed for people with hearing loss. These include amplified telephones with voice modulation controls, which allow the user to adjust them. Most have adjustable ringer volumes or have bright visual ringers. Both mobile and landline phones are available with amplified features.
Also available are textphones, which allow people to type what they want to say. Their message and the reply appear on a screen.
Typetalk is the BT-funded national relay service that links textphone and voice phone users. The user calls a Typetalk operator who will read out the message to the person being called, and then types replies back to the caller.
SMS text messages and mobile phones provide a useful tool for people with hearing loss, while text messages can also be sent from a textphone.
Other equipment, adaptations and telecare
As well as hearing aids and telephones, a wide range of adaptations and equipment are available for people with hearing loss. People with hearing loss have every right under the Equality Act 2010 to engage fully in everyday life and to be able to live with dignity, autonomy and independence and, in many cases, new technology can help.
Aids and adaptations include:
loop hearing systems
personal TV listeners, such as headphones, a neckloop or an earloop
television with subtitles
assistive technology or “telecare”.
In a home care setting many of these aids can be deployed in order to help a service user to remain at home and retain their independence. Domiciliary care staff can help by providing whatever support they can and by ensuring that such equipment is made available and is properly fitted.
Care staff can also help to combat the social isolation that hearing impairments can cause by accompanying a service user in the community and by encouraging them to use equipment in shops and other premises such as induction loops.
Induction loops can be used to transmit speech by microphone to the individual’s hearing aid. These are particularly helpful in environments where background noise levels are high.
Places such as reception areas fitted with loop systems should have a standard loop sign clearly displayed. Many places in the community feature loop systems, including cinemas, theatres, meeting rooms and banks.
Telecare refers to equipment used to increase, maintain and improve the functional capabilities and independence of people with cognitive, physical or sensory impairments. Recent years have seen great technological advances, particularly computer and electronic technologies, and the world of telecare has seen many new items become available that can be of great use in supporting people with hearing loss.
Common forms of telecare include user-activated alarm calls (by push button, pendant or pull cord) to a control centre where a call handler can organise a response of some kind. Versions of contact device are available for people with hearing impairments which allow them to communicate with call handler.
Also available are alarms such as fire alarms and smoke, gas, heat and flood detectors which are also designed to enable people with hearing loss to be warned of dangers. These usually feature a vibrating or visual alert as well as an audible sound.
Pager systems can also be linked to devices including doorbells, textphones, smoke detectors and baby alarms. The user wears a small vibrating pager that is linked to a number of transmitters. When one of the devices is activated, it triggers a different vibration signal on the pager, alerting the wearer to a caller or danger.
Enabling computer access for service users with hearing loss should not be overlooked. Computers can be set to perform tasks without using sounds, and some videos or presentations can be watched with text captions or transcripts. However, this is an area where access issues remain a problem. Computer BSL programmes and remote interpreting services are also now more widely available. Some of these use webcam technology to enable wider access to interpreting.
Care and support
Care staff should be trained to be aware of the needs of service users with hearing loss and should be aware of how to provide understanding support, as well as help with equipment, such as hearing aids and hearing loops. Care managers should also consider the need for training staff in sign language.
When talking to someone with hearing loss, care staff should make sure they are facing the person and talk clearly at a normal volume. They should be taught to treat the person with respect and not to shout or talk in a slow, “oversimplified” or patronising way.
Action on Hearing Loss provides a wide range of information and advice about hearing loss via its website.