A society where all people are respected; have full access to communication; and are able to participate without social, economic, or emotional barriers.

A society where all people are respected; have full access to communication; and are able to participate without social, economic, or emotional barriers.

The Canadian Hearing Society is the leading provider of services, products, and information that:

Remove barriers to communication Advance hearing health Promote equity for people who are culturally Deaf, oral

deaf, deafened and hard of hearing.

Kim Hennessy, M.Sc.Hearing Care Counsellor

Divided into 3 parts:◦ Outer Ear◦ Middle Ear◦ Inner Ear

Ear Anatomy

Eardrum

PINNA ◦collects sound ◦funnels sound waves into canal (also holds hearing aids, earrings & glasses )

EAR CANAL◦directs sound waves inward◦produces wax◦curved

TYMPANIC MEMBRANE ◦partition between ear canal & middle ear cavity

◦sound waves contact and cause vibration

MIDDLE EAR CAVITY

◦air-filled space behind ear drum◦fluid and infections hide here

EUSTACHIAN TUBE◦passageway from the middle ear cavity to the throat (infection can travel here)

◦equalizes air pressure in the middle ear with atmospheric pressure

AUDITORY OSSICLES

◦ Malleus (hammer), Incus (anvil), & Stapes (stirrup)

◦ form a chain from the ear drum to the cochlea◦ transmits ear drum vibrations to the inner ear

COCHLEA ◦organ of hearing◦snail-shaped ◦fluid-filled◦stapes moves in and out of oval window like a piston

in an engine, creating waves

◦Contains thousands of hair cells (organ of corti) that are displaced in response to waves in the fluid

hair cells send an electrical impulse to the brain

◦Depending on the specific location in which this displacement occurs, we hear low or high pitched noises

◦Number of cells activated determines loudness of the noise

SEMICIRCULAR CANALS

◦organ of balance◦oriented in different planes and

work together to keep us balanced◦fluid-filled ◦this system responds to movement

in any direction

Hearing Loss

Conductive

Sensorineural

Result of any pathology within the outer ear or middle ear:- pinna and ear canal- middle ear cavity- tympanic membrane- ossicles - eustachian tube

Originates from pathology of the inner ear: ◦ the sensory cells in the cochlea ◦ the auditory nerve fibers of the VIII cranial nerve

When these structures are damaged their ability to transmit mechanical energy (vibrations) into electrical energy (nerve impulse) is reduced◦ the signal does not reach the brain

VS

Conductive Sensorineural- Abnormality of outer ear - Head trauma- Narrowing of canal (stenosis) - Noise exposure- Osscular discontinuity - Age-induced/presbycusis (bones do not form chain) - Acoustic Neuroma (tumor) - Middle ear infection (OM) - Congenital- Otosclerosis - Hereditary/Genetic(bony chain cannot move) - Meniere`s Disease - Perforated ear drum - Consequences of other - **Build up of ear wax** illness ex. Meningitis

- Ototoxic Medications (Dr. Timothy Hain’s website)

Only old people have hearing loss

Hearing Aids

1. Behind-the-ear (BTE)

Most seniors wear For severe losses Good for dexterity problems Usually have volume control and program button Custom ear mold – must be cleaned regularly!! Large tubing – must be cleaned and should

always be flexible (pinch to test) Battery located in bottom

BTE; Open-fit:

First time wearersMild-moderate loss Cosmetic appeal No occlusion

◦ Eliminates hollow sound◦ Voice sounds more natural

Air ventilation

BTE; Open-fit:

Battery still in bottomThin tubing

◦ Cleaning not as important (occasionally needs attention)◦ Flexibility not an issue – no pinch test required

Soft silicone dome◦ Fits mid-way down the ear canal◦ Domes (umbrella-looking piece) need to be cleaned◦ Domes need to be changed by audiologist every 6-12 months, depending on wax

accumulation◦ Tail is to keep dome in place – rest in concha

RITE – receiver in the ear

Open-fit aids can also be designed with a receiver (the speaker) placed at the end of the tube or in the ear…this delivers the sounds directly to the eardrum Tubing has thin wire insideCANNOT clean tubing!!!Often have custom tip

◦ If not, will have domes

2. In-the-ear (ITE)

Many seniors wear Custom made to fill concha Moderate to severe losses Large volume wheel and program button Good for dexterity problems Must be cleaned regularly Battery door located near volume wheel

3. In-the-canal (ITC)

Mild to moderate losses Less visible Custom made to fill acoustic meatus Must be cleaned regularly Insertion and volume controls require good dexterity Smaller volume wheel and sometimes program button Battery still near volume wheel

Newest Style

4. Completely-in-the canal (CIC)

Mild to moderate losses Low power & barely visible Fits just inside the proximal canal Good dexterity is needed for insertion No volume control or program buttons Must be cleaned regularly Batter often very small but placed in similar location

Hearing aids are uncomfortable

Hearing aids cost way too much & don’t work◦ “My sister has them and she never wears them.”◦ “Mine have been in my drawer for months.”◦ “There is so much noise when I wear them, I don’t bother.”

If someone sees that I wear a hearing aid, they look at me as incapable

If someone sees that I wear a hearing aid, they seem to think its ok to leave me out

If someone sees that I wear a hearing aid, they assume I can hear as if I have perfect hearing

…..and hearing aid manufactures are contributing to it

Red = Right Blue = Left Usually some sort of writing or coloured

section on HA Sometimes located inside battery door

◦ Any pain occurs◦ Hearing loss has worsened/communication breaking down◦ Ear mold is not fitting properly◦ Constant whistling occurring◦ After new battery installed, HA still not working◦ For thorough cleaning once every year

You can call and request:◦ Cleaning tools◦ New tubing & new domes◦ Wax guards

Fills the hole in HA that delivers amplified sound to the ear drum◦ If plugged with wax, sound waves can’t be easily transmitted

i.e. is distorted and decreased!◦ Common cause of complaining!

Usually small white circle in hole (or Red/Blue)

Must be changed every few months Almost never fully explained to the client

Hearing Aid Cleaning:◦ Wipe hearing aid/ear mold with tissue – do not use water

Good to do more often when sick◦ Wax removal is crucial to the function of aid(s)◦ Use tools provided by audiologist

Brush dead skin cells and wax off aid/ear mold Pick wax from holes Use vent cleaner for hole that goes all the way through aid/ear mold Change wax guards when plugged

Battery Details # 1 problem in long term care facilities is:

◦Wearing aids with dead batteries…basically wearing an ear plug!◦Quick test: cup hand over ear or enclose hearing aid in your cupped hands – should hear whistling sound

Yes = battery still has life No = dead battery = needs to be changed

TIPS: When inserting battery – flat side faces up Open battery door to prolong the life of the battery when not using ex. every night For reminders to change batteries, place sticky tab on calendar or charts when you replace them - Last 7-10 days When sticky tab is removed, battery begins to drain! Have a battery tester on hand

Feedback – sound waves are being amplified over and over again (like a microphone held near speaker)

◦ Common causes: Ear molds (BTE) or HA not inserted properly – air escapes Ear mold has shrunk and person needs new one (about $80/ear) Volume turned up too high Tubing is clogged

Occasionally, a person with hearing loss is wrongfully diagnosed with a degenerative condition due to poor communication, giving wrong answers or being non-responsive

Sometimes a person who always seems to be foul or who does not respond to you or whose communication has changed…could be living with:◦ An undiagnosed/untreated hearing loss ◦ Their hearing loss might have gotten worse ◦ Their HAs are not working properly**Their ear canals are impacted with wax!!!

Fatigue Isolation IrritabilityRejection Stress LonelinessAvoidance Anger FearGuilt Withdrawal FrustrationNegativism Embarrassment BluffingHeadaches Muscle tension Lowered Self-esteemFeel less independent and more limited

These psycho-social difficulties lead to reduction in quality of life and physical

health status

Can lead to higher incidence of: deterioration, sensory deprivation, arrhythmias, heart disease, hypertension, osteoarthritis, etc.

Communication Tips

Don’t shout – volume is not as important as you think◦ Shouting further distorts speech sounds

Speak clearly and at a moderate pace Put space between words not within them

◦ Do not exaggerate your mouth movements Get the person’s attention before speaking

◦ Tap on shoulder/flick lights/state their name Face the person when you speak to them

◦ Stop speaking if you need to turn around, then continue once you are facing them again

Don’t cover your mouth or chew gum Use facial expressions and gestures Gives clues when the subject changes

◦ State topic of conversation Be patient Avoid noisy background situations

◦ More to a quieter place if communication is difficult

Some background noises, such as loud stereos, machinery and traffic are obvious to everyone and people generally avoid trying to talk in these situations

For hard of hearing people, subtle sounds such as the hum of air conditioning, running water or wind can cause difficulties

In all these situations, hearing aids become a challenge to wear & this requires adjustment

With new technology we are better able to control background noises

Visual smoke/CO detectors Visual/tactile alarm clock and TTY in room Have at least one staff learn ASL LTC: Post activities in their room If 2 Deaf people in facility, seat them together Hospital: write down all important information,

especially upon discharge White board with markers available Always have CHS’s contact info. on hand

Communication DevicesProgram

Communication Devices Program at CHS

CHS offers a full range of assistive devices for:• Home• The workplace• Schools• Community facilities

Amplified Telephones & TTY’s Alerting Systems Personal Amplification Systems T.V. Listening Devices FM Systems Super Ringers/Visual Ringers Visual Alarm Clocks - with bed shaker Visual Smoke/Carbon Monoxide Detectors Sound Conditioners And more…

Amplify voices to 30, 40, 50, & 60 dB Provide increased clarity Tone and volume controls Bright visual ringer Memory storage Headset jack Hearing aid compatible

Read and Talk phone

TTY for Deaf individuals

For deafened individuals

These easy-to-use, portable amplifiers can improve your communication one-on-one, in

small groups, in the car, or when at important meetings etc.

Sennheiser

Audioport - $305

Serene Innovations

DT - $169.95

Williams Sound PocketTalker Pro

$250.005 year warranty

Notifies you when the phone rings, when someone is at your door, when the alarm clock goes off or if there are loud noises in the room◦ Other audio alarms can be added to the system and setup

beside your smoke detector etc.

Signals person using a flashing lamp and/or vibrating bed shaker ◦ Tactile portable pager can be added to the system

Infrared technology delivers sound from the television to headphones, within 100 ft. range

The headsets are wireless and have adjustable volume control

$385

$99.95

Questions??

For further information please contact;The Canadian Hearing Society

1300 Bath Road, Kingston(Frontenac Mall)

T: 1 877 347 3427 TTY: 1 877 216 7310

F: 416 928 2506

chs.ca