Living with Hearing Loss Jennifer R. LaBorde, Au.D., CCC-A Doctor of Audiology and Hearing Aid User Accompanied by Garrett P. LaBorde, (Dr. LaBorde’s Husband and Hearing Partner)

Hearing Loss Humor There is no doubt that hearing loss affects not only the hard of hearing person, but those who live around them as well. Q. What are some fun stories you have about living with hearing loss?

HEARING LOSS: WHAT THIS MEANS TO YOU AND YOUR LIFE! And…. the People in It!

How Do We Define Hearing Loss?  Degree  Type  Configuration

 Conductive  Ear wax, Perforation of the eardrum, Middle Ear Fluid, Otosclerosis  Sensorineural  Inner ear/cochlear hearing loss due to aging, noise exposure, genetics, medical diagnosis, etc.  Involves a reduction in sound level, or ability to hear faint sounds, but also affects speech understanding, or ability to hear clearly.  Mixed  Combination of the above  Type

 Normal range or no hearing loss = 0 dB to 20 dB  Mild loss = 20 dB to40 dB  Moderate loss = 40 dB to 55 dB  Moderately-Severe loss = 55 dB to 70 dB  Severe Loss= dB  Profound loss = 90 dB or more  Degree

 The measurement of how much hearing loss is present at specific frequencies.  Sloping  Flat  Reverse Slope  Precipitously Sloping  Cookie Bite  Configuration  Other Descriptive Terms  Bilateral — both ears are affected.  Unilateral — only one ear is affected.  Symmetrical — degree & configuration of hearing loss are same in each ear.  Asymmetrical— degree and/or configuration of the loss is different for each ear.  Progressive/Late-onset — becomes increasingly worse over time.  Sudden hearing loss — occurs quickly, requires immediate medical attention to determine its cause and treatment.  Fluctuating — changes, sometimes getting better, sometimes getting worse.

HEARING LOSS SIMULATIONS Have you ever wondered, “What does his/her hearing loss really sound like?” or “I wish (insert person) knew what it was like to have hearing loss”….. NOW WE CAN SHOW THEM!

Hearing Loss Simulations  Normal Hearing in Quiet  Normal Hearing in Noise  Mild/Moderate Hearing Loss in Quiet  Mild/Moderate Hearing Loss in Noise VS.

When would this effect normal conversations?  DISTANCE LISTENING  POOR ACOUSTICS  LACK OF VISUAL CUES

WHAT CAN WE DO TO COMBAT HEARING LOSS?

Hearing Aids Alone………. Are Not Enough! Hearing Aids + Assistive Listening Devices + Speech-reading + Coping Strategies

If you only had one coping strategy to employ for better hearing that did not cost anything, what would the single most effective hearing loss coping strategy be?

It would be…… GET AS CLOSE AS YOU CAN!

How Distance Affects Hearing  Sounds Drop Off  At ear level, sound is at 100%.  At 2 feet away, sound is ¼ as loud  At 8 feet, this is 1/64 th as loud  At 20 feet (back of the room), the sound is 1/400 th as loud! What a difference it makes in volume!

What Else Does Distance Affect?  Increased Background Noise There is more between you and the speaker  Speech Becomes More Distorted  Speech Intelligence Drops Low Frequency sounds carry volume High Frequency sounds carry intelligence Because low frequencies travel well through air, you hear them better at greater distances. High frequency sounds attenuate faster so they disappear at distances

Make it Better with a Mini Mic Get Physically Closer to Each Other! Or if you’d rather…..

 VISUAL FACTORS/CUES “Hold on, I can’t hear you….let me get my glasses!” “It’s too dark in here! I just can’t hear you!”

Visual Cues are a Necessity  Lighting  Avoid having a backlit speaker (in front of a window)  Ceiling lights vs. table lights  Candles flickering/mood lighting…not our friend!  Speechreading  Almost all hard of hearing people speechread, whether they realize it or not. Lighting helps with this tremendously, as does getting close!

Coping Skills/Strategies for Hearing Loss  Be Your Own Advocate! Take Charge! If you don’t tell people what you need, how will anyone be able to help you?  Speak slower, speak louder, please come closer, let me come to you, please rephrase that  Let’s sit here, this is the best seat for me to hear better, sit away from the kitchen at a restaurant, sit where a server has to approach you

It takes Two to Tango… How this affects relationships

Communication is Essential to Relationships Hearing Loss is just that…..A Loss One that we must “grieve” and come to a certain level of acceptance about. Both people in a relationship must do this, so we cannot be each others’ support system in this process What do we grieve?  The loss of easy communication  The activities that we once enjoyed together  Independence as individuals in a relationship  Others????

Is This Bad News? Not Necessarily…. it is what we do with this news that makes the difference!

Communicating with People Who Have Hearing Loss  Face the person  Do NOT talk from Another Room  Speak clearly, slowly, distinctly, but NATURALLY without exaggerating mouth movements  Say the person’s name before talking  Avoid talking too fast  Keep your hands away from your face  Minimize extraneous noise  If one has difficulty, find a DIFFERENT WAY of saying the same thing  Acquaint the listener with the topic before speaking  It is harder to hear when ill or tired (mental fatigue)  Bite-sized conversations  Take turns speaking  Pay attention to the facial expressions of the listener

Realistic Expectations  In quiet settings, hearing should improve.  In moderate background noise, hearing should improve.  Hearing in noise is NOT as good as in quiet.  Hearing with LOUD background noise is NOT WORSE than without the hearing aids.  Soft speech is audible, average speech is comfortable, loud speech is not uncomfortable.  Hearing Aids should be comfortable.  Aids should allow listening with LESS effort.  Fatigue AND Stress make hearing worse!  Hearing Aids WILL NOT restore hearing to normal levels…Patience will always be needed!  Performance improves gradually.  Hearing Aids WILL NOT eliminate background noise, but technology has come a long way.

How Would We Expect Hearing Loss to Affect Relationships?  In a study of the impact of hearing loss on a spouse, therapists have asserted that communication difficulties related to hearing loss would likely weigh on couple relationships and influence their development negatively…. Aside from thinking you can grumble under your breath……

However, in contrast …..the couples in the study most often reported that they either did not think the hearing loss had affected their relationship development, or that it had influenced their relationship positively!!!!!

Now, you’re all set! Perfectly Happy Couples. Right?!?!

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