You’re Mumbling! The Impact of Hearing Loss on Communication

Transcript

• 00:10Hi. I'm Meg Wolhagen, and
• 00:12I'm a professor at the
• 00:13University of California in San
• 00:15Francisco in the School of
• 00:16Nursing. And I'm really pleased
• 00:18to be here to talk
• 00:19with you briefly
• 00:21about hearing loss and its
• 00:22effect on communication.
• 00:25I think it's this is
• 00:26sort of an introductory kind
• 00:27of webinar,
• 00:29and I look forward to
• 00:30hearing any comments or suggestions
• 00:32for future events. But I
• 00:34would love to talk more
• 00:35about interventions. The focus today
• 00:38is a little more direct
• 00:39on the impact of hearing
• 00:40loss on communication.
• 00:43This is a bit about
• 00:44me,
• 00:45but I've been, a nurse
• 00:46for a fair amount of
• 00:48time, initially graduating from St.
• 00:49Luke's Hospital in,
• 00:51New York City and then
• 00:53going on after working for
• 00:54years to get my master's
• 00:55and doctorate.
• 00:57But I have been focusing
• 00:58my work on hearing loss
• 00:59for quite some time.
• 01:02This is a disclaimer,
• 01:04in terms of the content
• 01:05of this particular webinar.
• 01:08And today, the focus is,
• 01:10looking at age related changes
• 01:12in hearing,
• 01:13trying to explain
• 01:15the impact of hearing impairment
• 01:17on speech
• 01:18and in speech understanding and
• 01:20why it's so important,
• 01:21and then discuss some communication
• 01:24strategies.
• 01:26Hearing
• 01:27is broad and it has
• 01:28many, many important functions.
• 01:31It of course, we always
• 01:32think about the importance of
• 01:34engagement with others in terms
• 01:35of social settings,
• 01:37the small talk that goes
• 01:38on. But it's also critically
• 01:40important to hearing sirens, hearing
• 01:42alarms,
• 01:43and cars. And we'll talk
• 01:44more when you realize the
• 01:46kind of hearing loss that
• 01:48occurs with aging, especially,
• 01:51that those become less,
• 01:53able for people to hear.
• 01:56It connects us to nature.
• 01:58Many of the times when
• 01:59I talk to individuals who
• 02:01get their hearing
• 02:03mitigated through hearing aids or
• 02:04other kinds of things, they
• 02:05talk about being able to
• 02:06hear the birds.
• 02:08So it keeps us grounded.
• 02:09It's important. And we know
• 02:10that isolation is a real
• 02:12problem for any of us
• 02:13in terms of not being
• 02:14able to engage in our
• 02:16environments.
• 02:17More and more, we realize
• 02:18the importance of cognitive stimulation,
• 02:21keeping the ear brain connection
• 02:23and the information exchange.
• 02:25And something that I've been
• 02:26very interested in over the
• 02:27years is safe communication
• 02:30in our health care setting.
• 02:32It's important that people don't
• 02:34misunderstand.
• 02:35They understand what we say
• 02:36in terms of treatment plans
• 02:38or what medications to use
• 02:39and why.
• 02:41It's also related to have
• 02:43to many negative outcomes.
• 02:46It's been a long time
• 02:47we know that it's related
• 02:48to depression and loneliness,
• 02:50low self esteem,
• 02:52isolation because people don't go
• 02:54out when they can't engage
• 02:55in your environment,
• 02:57altered and impaired relationships,
• 03:00delirium risk in the hospital
• 03:02setting,
• 03:03and functional changes in fall.
• 03:05And, of course, people do
• 03:06feel
• 03:07often the stigma. They're either
• 03:09feeling stigmatized themselves or they
• 03:11think their hearing aids are
• 03:12stigmatizing.
• 03:13And then more and more,
• 03:14as I mentioned,
• 03:15cognitive changes and cognitive impairment
• 03:18seems related or hearing loss
• 03:19is connected.
• 03:21The exact connection and why
• 03:22that's true, we're not always
• 03:24we don't clearly have a
• 03:25good idea at this point.
• 03:27It's only one of the
• 03:27many risk factors.
• 03:29But it's important to keep
• 03:30the brain stimulated
• 03:32through engaging in, conversations
• 03:34and learning.
• 03:37When we look at the
• 03:37ear,
• 03:39I find the ear just
• 03:40an absolutely remarkable,
• 03:42organ
• 03:43system.
• 03:44But you think about the
• 03:46air going in,
• 03:48and this is air conduction,
• 03:49if you will, it hits
• 03:50the trochanic membrane,
• 03:52stimulates these tiny little bones,
• 03:55pussicles
• 03:55in the middle ear that's
• 03:57mechanical. Now it's transferred then
• 03:59to the inner ear where
• 04:01now it's fluid. So it's
• 04:02moving the fluid in the
• 04:03ear that stimulates
• 04:05the hair cells.
• 04:07Using some examples of hair
• 04:08cells on the side, we
• 04:09have three outer hair cells,
• 04:11layers of outer hair cells
• 04:13that connect to inner hair
• 04:14cells
• 04:15that actually are connected to
• 04:16the auditory nerve that goes
• 04:19to the brain.
• 04:20And it's important to realize
• 04:22we hear in the brain.
• 04:24We don't hear just by
• 04:26peripheral types of things. But
• 04:28in order for the brain
• 04:29to understand what's being said,
• 04:31it has to get good
• 04:32signals.
• 04:33And if any of those
• 04:34hair cells are not functioning
• 04:36well, then
• 04:38we don't get good information
• 04:39to the brain, and we
• 04:41can misinterpret
• 04:42misinterpret
• 04:43the information that we're getting.
• 04:45But what is so remarkable
• 04:47is just how fast this
• 04:49happens.
• 04:50And you can think about
• 04:51anything that changes the processing
• 04:53will also affect how quickly
• 04:55we can listen to or
• 04:57understand information.
• 04:59So if the signals are
• 05:00not getting up there very
• 05:02well, it's gonna be more
• 05:03of a struggle.
• 05:04So when we think about
• 05:06the,
• 05:07actual way in which hearing
• 05:09occurs
• 05:10is that along that,
• 05:13the the cochlea,
• 05:15we have the hair cells
• 05:17are aligned,
• 05:19where high frequencies
• 05:21early, and then as you
• 05:22move into the cochlea, you
• 05:24have more low frequency
• 05:25sounds that are heard,
• 05:27or the,
• 05:29hair cells are more,
• 05:32sensitive to and responsive to
• 05:35different pitches depending on where
• 05:37you are in the cochlea.
• 05:38And it's similar in the
• 05:39brain. It's connected to a
• 05:41very similar organization
• 05:43in the brain.
• 05:45So when we think about,
• 05:47this is a schematic, an
• 05:49audiogram,
• 05:50where you have low frequency
• 05:51sounds to high frequency sounds.
• 05:54There's what they call the
• 05:56speech banana.
• 05:58But what's
• 05:59important to understand with age
• 06:01related, there are many kinds
• 06:02of hearing loss. We're focusing
• 06:03most on the kinds of,
• 06:05hearing
• 06:06impairment that we get as
• 06:07we get older.
• 06:09Usually, the common type of
• 06:10hearing loss is that low
• 06:13frequency sounds tend to be
• 06:14your a, e, I, o,
• 06:17u, the,
• 06:18vowel sounds.
• 06:19Whereas the high frequency sounds
• 06:22tend to be the ch
• 06:23ch, the consonants.
• 06:25Why that's important
• 06:27is that the consonants
• 06:29make language understandable.
• 06:32The vowels, the low frequency
• 06:33sounds tend to be more
• 06:35for audibility
• 06:36rather than
• 06:38understandable
• 06:39and have had audiologists share
• 06:41the idea that if you
• 06:42do a crossword puzzle
• 06:44and you get all the
• 06:45vowels,
• 06:46you may not be able
• 06:47to guess the word. But
• 06:48if you get the consonants,
• 06:50you often can. And in
• 06:52some ways, that's very similar
• 06:53to our understanding.
• 06:54So if you start losing
• 06:56those consonants,
• 06:57your understanding of speech becomes
• 07:00much more difficult.
• 07:01And what we see with
• 07:03aging
• 07:04is that in general,
• 07:06there's some loss potentially at
• 07:07the lower frequency,
• 07:09but much, much more loss
• 07:11at the higher frequencies,
• 07:13which means that you're cutting
• 07:15off some of those consonants.
• 07:17And what that means to
• 07:18hearing
• 07:19is you can misinterpret
• 07:21language.
• 07:22So it's really important to
• 07:24understand
• 07:25if you're hearing through the
• 07:27ears of someone who has
• 07:28hearing loss,
• 07:29it's not like wearing ear
• 07:31earplugs.
• 07:33It's a misconception
• 07:34that's usually
• 07:35an audibility
• 07:36type of a problem when
• 07:37you put in earplugs.
• 07:39It decreases the sound that
• 07:40you receive,
• 07:41but it doesn't distort
• 07:43the language the way that
• 07:44hearing loss does.
• 07:46Hearing loss is a distortion
• 07:48and a muffling of sound,
• 07:50not just a decrease in
• 07:51sound. So if you read
• 07:53this real quick, you'll probably
• 07:54have problems reading it because
• 07:56you've lost the consonant.
• 07:58And so
• 08:00individuals,
• 08:01when they try to hear
• 08:02and they listen really intently,
• 08:04they're trying to fill that
• 08:05in.
• 08:07Brain does that quite well
• 08:09often, but it can misinterpret.
• 08:11It gets the context and
• 08:12it'll think what's right, and
• 08:14so we end up with,
• 08:16what's often considered kind of
• 08:19funny things, but and then
• 08:21the other piece to to
• 08:22remember is that mask further
• 08:23muffled these sounds,
• 08:25especially filtering high frequency sounds.
• 08:29So it makes communication even
• 08:30more difficult.
• 08:32What we do sometimes is
• 08:34we make fun of these
• 08:35things. So you see this
• 08:36person, they say, it's windy
• 08:38today. No. It's Thursday. So
• 08:39am I. Let's have a
• 08:40beer. The idea that these
• 08:42individuals are misinterpreting
• 08:44what the other individuals say.
• 08:47People make jokes to this,
• 08:48but it's really not funny
• 08:50because so often, those situations
• 08:53can be very emotional. They
• 08:54misinterpret
• 08:55what the person is saying
• 08:58and what the person looks
• 08:59like they're happy or sad,
• 09:01and they respond inappropriately.
• 09:03And they may not even
• 09:04appreciate that they did it.
• 09:06But when they do, they're
• 09:07very embarrassed.
• 09:09And I've had multiple people
• 09:10talk about those experiences.
• 09:13And if it happens in
• 09:14a healthcare setting, that can
• 09:15be really critical because they
• 09:17may misinterpret
• 09:19the information,
• 09:20that they receive.
• 09:21And I know that in,
• 09:23some of our studies around
• 09:24palliative care, the people are
• 09:27often thought to be cognitively
• 09:28impaired or have other kinds
• 09:30of assessments,
• 09:31and they're not included in
• 09:33their discussions that they should
• 09:34be included on just because
• 09:36they can't hear and they
• 09:37haven't had their hearing assessed.
• 09:40So I think in terms
• 09:42of what's important and what
• 09:43I wanna emphasize so much
• 09:45today
• 09:46is the importance of assessment
• 09:48for hearing loss to really
• 09:50appreciate the fact that we
• 09:52need to think of this
• 09:54as part of our health
• 09:55care.
• 09:56You can use things like
• 09:58a single item question.
• 10:00Do you have difficulty hearing?
• 10:02You can use the Haynes
• 10:04uses statement that asks about
• 10:06best describing your hearing.
• 10:09Would you say your hearing
• 10:10is and then they give
• 10:11a list of things. Excellent.
• 10:12Good. That you have do
• 10:14you have trouble hearing? Did
• 10:15you have moderately trouble?
• 10:18There's, we are now trying
• 10:20to assess a single item
• 10:21to see how accurate it
• 10:22is.
• 10:23But this one from a
• 10:24Dutch study did one asking
• 10:26about, do you have difficulty
• 10:28with your hearing without hearing
• 10:29aids?
• 10:31And they talk about whether
• 10:32they do hear hearing loss
• 10:34or they sometimes don't hear
• 10:36everything or they do hear,
• 10:39or they almost never hear
• 10:40what's being said.
• 10:42The, the other piece that
• 10:44these are single item, and
• 10:45they're fairly if someone admits
• 10:48that they have some difficulty
• 10:49hearing, you can be pretty
• 10:50sure that it's true,
• 10:53and that that's an important
• 10:55piece in terms of being
• 10:56able to refer them. Unfortunately,
• 10:59individuals don't always realize
• 11:01because hearing loss comes on
• 11:02slowly.
• 11:03So sometimes we it is
• 11:05important to think about doing
• 11:06more of a an objective
• 11:08test.
• 11:09An objective test can be
• 11:11fairly simple.
• 11:13A finger rub test where
• 11:14you,
• 11:15have your hands just about,
• 11:17an arm's length out and
• 11:19sort of rubbing individually very
• 11:21hard,
• 11:23on each side individually
• 11:25with the person with their
• 11:26eyes closed
• 11:27and testing them. And usually
• 11:29do it, like, three times
• 11:30if they can't hear the
• 11:32rub, then you do it
• 11:33again. If they can't hear
• 11:35it, you do it a
• 11:36third time. They should get
• 11:37two out of three to
• 11:38be able to say that
• 11:39it's negative, that they actually
• 11:41seem to be able to
• 11:42hear. But it has to
• 11:43be standardized.
• 11:44And that's also true of,
• 11:45like, the whisper test. And
• 11:47the problem with many of
• 11:48these
• 11:49is that it's hard to
• 11:50be consistent,
• 11:52but it's a test. And
• 11:53I really emphasize the idea
• 11:55that doing some assessment
• 11:57is so important.
• 11:59But the other piece is
• 12:01now we have new apps
• 12:02for screening on the iPhone.
• 12:04There are telephone screeners like
• 12:06the Hear Who. People can
• 12:07call in and they hear
• 12:08digits,
• 12:09and that can tell them
• 12:11levels of hearing and give
• 12:12them a clue that maybe
• 12:13they do have some difficulty
• 12:15hearing.
• 12:16Obviously, it's important to assess
• 12:18for earwax.
• 12:19That's like an earplug.
• 12:21So it takes a fair
• 12:22amount of earwax to change
• 12:24the amount of hearing that
• 12:25we have, but
• 12:27earwax gets a little more
• 12:28common often than older adults.
• 12:30It gets drier. It can
• 12:32get impacted. Some people have
• 12:33more earwax production than others.
• 12:36So checking for earwax is
• 12:37certainly important.
• 12:39But what's also important and
• 12:41what, again, is being emphasized,
• 12:43at least in this short
• 12:44segment,
• 12:45is referring individuals. If you
• 12:47assess them and find out
• 12:49that they have difficulty hearing,
• 12:51you're doing several things. You're
• 12:53validating the hearing loss. You're
• 12:55educating them, or you can
• 12:56educate them, or give them
• 12:58information about hearing loss and
• 13:00why it's important to their
• 13:01health.
• 13:02And stimulate the idea that
• 13:04referral to follow-up so they
• 13:05get a good audiometric assessment,
• 13:08and they can get potentially
• 13:09hearing aids.
• 13:11And it does validate the
• 13:12importance. It's it's amazing how,
• 13:15strong health care practitioners,
• 13:18they're just saying something about
• 13:20hearing loss can really stimulate
• 13:22some individuals to get assessed.
• 13:24Just hearing it from, unfortunately,
• 13:26other family members doesn't always
• 13:28stimulate people to go and
• 13:30see someone.
• 13:31But by health care providers
• 13:34saying something about hearing and
• 13:35saying, you know, this is
• 13:36important to your health. I
• 13:37think you should get it
• 13:39checked can be really, really
• 13:40helpful.
• 13:43The other piece I wanna
• 13:45talk about just briefly is
• 13:46when you think about assessment,
• 13:48it's helpful to sort of
• 13:49include asking about tinnitus.
• 13:51Tinnitus is a subjective noise
• 13:53that the person themselves experienced.
• 13:56You can't hear it. There
• 13:58are a couple of types
• 13:59that are much less, much
• 14:01less common,
• 14:02that are objective, that can
• 14:04be heard by others. And
• 14:05those usually have an underlying
• 14:07cause that can be addressed.
• 14:09But generally speaking, tinnitus is
• 14:11a noise, a sound. It
• 14:13can be all kinds of
• 14:14things.
• 14:15But it is can be
• 14:16associated with hearing loss, but
• 14:17it can occur by itself
• 14:19or be a precursor to
• 14:21hearing loss. But it also
• 14:23can be a critical
• 14:25piece of
• 14:26the fact that the person
• 14:28becomes almost suicidal
• 14:30if it's really bad.
• 14:31Many times it's not very
• 14:33bad, and people can say,
• 14:34I can deal with this.
• 14:36It can get worse at
• 14:37night when there's no other
• 14:38sounds around. But there are
• 14:40things we can do for
• 14:41it. We can't cure it
• 14:42or there's no cure yet,
• 14:44but there are ways in
• 14:45which,
• 14:46both sound treatment
• 14:48and, cognitive behavioral therapy
• 14:50can help individuals
• 14:52deal with it. But it's
• 14:53not an insignificant
• 14:55problem, and it's much, much
• 14:56more common or has been
• 14:58in the veteran population
• 15:00partly
• 15:01mostly because of, blast,
• 15:04exposures and stuff like that.
• 15:07And years ago, of course,
• 15:08they didn't protect hearing as
• 15:09much,
• 15:10but you can
• 15:12we've heard much more about
• 15:14the fact that blast injuries
• 15:16can be a significant problem.
• 15:19When you think then about
• 15:21communication
• 15:22strategies,
• 15:23if you have someone and
• 15:25again, making clear on almost
• 15:26anyone if they can understand
• 15:28you is important, whether the
• 15:30person has hearing loss or
• 15:31not since we often deal
• 15:33with individuals in relatively stressful
• 15:35situations.
• 15:37And we all don't hear
• 15:38as well when we or
• 15:39we don't really hear or
• 15:41understand what people are saying
• 15:43when we get stressed.
• 15:45But facing a person with
• 15:47a hearing loss to get
• 15:48their attention,
• 15:49Making sure the lighting is
• 15:50adequate and not from behind.
• 15:53Often when you see this
• 15:55even on Zoom or other
• 15:56kinds of things, when people
• 15:57sit in front of a
• 15:59bright window, it washes out
• 16:01their face. So the speaker
• 16:02should have the light on
• 16:03their face so that you
• 16:05can see it and the
• 16:06person can see their lips.
• 16:08Don't cover your mouth or
• 16:09turn to the computer or
• 16:10look down.
• 16:12We do that automatically,
• 16:13but try to think about
• 16:15the fact that the person
• 16:16has to see your face
• 16:17in order to lip read.
• 16:19We all lip read even
• 16:21if we don't think we
• 16:21do. We may not lip
• 16:23read super well, and some
• 16:24people get really good at
• 16:26it, but we do lip
• 16:27read. So seeing a person's
• 16:29face, seeing the emotions, seeing
• 16:31the facial expressions does help.
• 16:33Speak at a normal rate.
• 16:35Lower your pitch slightly.
• 16:37Enunciate, but don't exaggerate.
• 16:39And don't shout. Because really
• 16:41what you're doing when you're
• 16:42shouting
• 16:43is you you're just increasing
• 16:46the mumbling.
• 16:47The person doesn't
• 16:48get more clarity,
• 16:50and your voice changes. We
• 16:51sound more angry when we
• 16:53raise our voices.
• 16:54So it helps to if
• 16:55you even
• 16:57lower your pitch slightly, maybe
• 16:59increase the tone just a
• 17:00little bit, but don't shout.
• 17:02And don't exaggerate because, again,
• 17:04that changes the the way
• 17:06in which your face facial
• 17:07expressions are.
• 17:09If you're asked to repeat,
• 17:11if someone says, what did
• 17:12you say?
• 17:13It may be helpful, especially
• 17:15if you repeat what you
• 17:16said and they still don't
• 17:17quite understand,
• 17:18is to rephrase because you're
• 17:20using different words, and that
• 17:22can be really helpful in
• 17:23terms of someone understanding.
• 17:26Introduce the topic so you
• 17:28know when you change it
• 17:29and write down information.
• 17:32So you say I'm talking
• 17:33about this now or then,
• 17:35let's talk about that now.
• 17:37So the person the context
• 17:38can help in terms of
• 17:39understanding
• 17:40or filling in or being
• 17:42able to,
• 17:43clearly understand what you're saying.
• 17:46Use assisted devices.
• 17:48We call them pocket talkers,
• 17:49but, basically, they're small amplifiers.
• 17:52Considering caption.
• 17:54Nowadays,
• 17:54on your cell phones, there's
• 17:56a lot of options, whether
• 17:57it's Ava, Otter,
• 17:59lot of different kinds of
• 18:00devices
• 18:01that
• 18:02that go from speech to
• 18:04text so that when you
• 18:06talk into the the microphone,
• 18:08the person can read it.
• 18:10And they can be very,
• 18:11very helpful.
• 18:13And I know that there
• 18:14are issues in clinical settings
• 18:17sometimes
• 18:17about HIPAA regulations.
• 18:19But if someone comes and
• 18:20they can't understand you and
• 18:21they're using your own things,
• 18:23you have to check. But
• 18:24generally speaking, at least that
• 18:25makes it clear because they're
• 18:27not gonna be understanding you
• 18:28very well if you're not
• 18:30using something that they can
• 18:32read or they can really
• 18:33truly hear.
• 18:36If using a hearing aids,
• 18:37if the person has a
• 18:38hearing aid, make sure it's
• 18:40in place and the batteries
• 18:41are working. Because when people
• 18:43use their hearing aids a
• 18:44lot, they go through batteries
• 18:46a lot. And some individuals,
• 18:47it they don't realize, they
• 18:49don't think about or if
• 18:50there's any change in cognition
• 18:52at all,
• 18:54they can forget that maybe
• 18:56they need to change the
• 18:57batteries more common.
• 18:59And find out because many
• 19:01times now,
• 19:02people have to call in
• 19:03for appointments. That doesn't work
• 19:05for people who have hearing
• 19:06loss. They may not be
• 19:08able to use the phone
• 19:09very effectively.
• 19:10Now it is important to
• 19:11know that you can get
• 19:13free
• 19:14captioning
• 19:15for individuals who have hearing
• 19:16loss. They can get a
• 19:17phone
• 19:18and a captioning service free.
• 19:21So it's important if you
• 19:22think someone
• 19:23is alone at home or
• 19:24can't deal with a phone,
• 19:26they can get these services,
• 19:27and they can be able
• 19:28to, again, have a real
• 19:30captioner,
• 19:32read
• 19:33or say or articulate
• 19:35what's being said,
• 19:37and captioning it, and the
• 19:39person can read it at
• 19:40the same time they're hearing
• 19:41it, and they can read
• 19:42it on the phone. So
• 19:44those services are free. We
• 19:45pay for it with our
• 19:46telephone bills. So think about
• 19:48that in certain situations.
• 19:50Always include the family as
• 19:51well if the person has
• 19:52a family to help them
• 19:54understand
• 19:55issues around,
• 19:56hearing loss and the need
• 19:58for them to use appropriate
• 20:00communication strategies as well.
• 20:03Tips to hear better. This
• 20:04is sort of the reverse.
• 20:06So if someone has some
• 20:08difficulty hearing,
• 20:10make sure that they know
• 20:11so that they should stand
• 20:13so this the speaker has
• 20:15the light on their face
• 20:17and is not in front
• 20:18of a window or a
• 20:19shadow.
• 20:19Let people know that you
• 20:21have hearing difficulty.
• 20:22Be self be a self
• 20:23advocate. That can be really
• 20:25important in many settings where
• 20:27people overlook it or don't
• 20:28think about it.
• 20:30Read lips and consider the
• 20:31context, and sit with your
• 20:33back to the wall in
• 20:34a restaurant or find a
• 20:35quiet place or a room,
• 20:37and use assistive devices yourself.
• 20:40Many people are resistant to
• 20:41this, and yet, in truth,
• 20:43it can be so helpful
• 20:44for their health care and
• 20:46well-being overall.
• 20:48If someone gets a hearing
• 20:50aid,
• 20:51this is something that can
• 20:52be anticipatory.
• 20:54They should be comfortable, but
• 20:55they're not like reading
• 20:58glasses. They you can't just
• 20:59suddenly hear.
• 21:01It takes a while for
• 21:02your brain to relearn how
• 21:03to listen. So if they
• 21:04get hearing aids, they have
• 21:06to realize that it takes
• 21:07some adaptation.
• 21:09They have to they may
• 21:11have to go back to
• 21:12the audiologist
• 21:13or the hearing specialist several
• 21:15times to get them adjusted
• 21:17because the person may not
• 21:18fit them to to the
• 21:19actual needs.
• 21:20They may want them to
• 21:21get used to it over
• 21:22time.
• 21:23So if you have problems
• 21:24with a hearing aid, you
• 21:25should always go back and
• 21:27make sure your questions are
• 21:28asked and make sure that
• 21:29you're using them effectively.
• 21:31And they also don't always
• 21:33work in every situation.
• 21:35Whether this situation has acoustics,
• 21:38you may need to have
• 21:39some other kinds of assisted
• 21:40devices along with them. Hearing
• 21:42aids are not perfect at
• 21:43all. They're much better in
• 21:45close situations. They can make
• 21:47listening much easier,
• 21:49but they are hearing aids.
• 21:52They're not they don't cure
• 21:53hearing loss, unfortunately.
• 21:55So people have to have
• 21:57realistic expectations,
• 21:59and that can be important.
• 22:00And it can be hard
• 22:01when you're paying a fair
• 22:02amount for a hearing aid.
• 22:03We now can get over
• 22:05the counter hearing aids, but
• 22:07people should explore those options
• 22:09to make sure that
• 22:10they have the most dexterity.
• 22:12Not everyone has the dexterity
• 22:14to use some of these
• 22:15devices where they have to
• 22:17adjust them themselves.
• 22:18So they may not be
• 22:20the best option.
• 22:21But they are. Some of
• 22:23them are less expensive, and
• 22:24they vary a great deal.
• 22:26So you need to understand
• 22:28what you're getting into
• 22:29if you're gonna get some,
• 22:32over the counter hearing aids.
• 22:34But you can use pocket
• 22:35talkers or other kinds of
• 22:36assisted devices,
• 22:38especially in situations where an
• 22:40individual may only wish to
• 22:41hear,
• 22:42or say get
• 22:44something just for their tele
• 22:45for their TV or something
• 22:47else if that individual
• 22:48is not going out or
• 22:49doing other kinds of things.
• 22:52And, of course, you always
• 22:54no matter where you are,
• 22:55always make sure your questions
• 22:56are asked, especially
• 22:58if you're paying for,
• 23:00hearing aids. And shop around
• 23:02because hearing aids do vary
• 23:03in terms of their cost
• 23:04and different providers.
• 23:06Make sure you're you go
• 23:08with the the information that
• 23:10you need to get to
• 23:11be able to clearly ask
• 23:12everything that you need.
• 23:15So in summary, in this
• 23:16brief session,
• 23:19we the emphasis is on
• 23:21the fact that hearing loss
• 23:23has a significant implication
• 23:25for health and well-being.
• 23:27Assessing for hearing loss
• 23:28should be a component of
• 23:30any health assessment.
• 23:32Assessing for hearing loss can
• 23:34value hearing as a component
• 23:36of health status, which I
• 23:38truly believe it is.
• 23:40And asking about and assessing
• 23:41for hearing can stimulate the
• 23:43individual
• 23:44to seek further evaluation and
• 23:45treatment.
• 23:47And I thank you then
• 23:48for your attention,
• 23:50and look forward to hearing
• 23:51from anyone who has questions.