Glassman's Hearing Aid Service

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Helpful Hints for Hearing Aid Wearers

General Thoughts:
Because hearing aids amplify all sounds, you must relearn to filter out sounds you do not want to focus on, just as one does in normal hearing process.

Without making a show, inform those with whom you are communicating that you have a hearing problem. Be aggressive about your hearing. You may even want to make some basic suggestions to them, depending on the significance of the conversation. In turn, they will be noticeably more comfortable in your presence than they were when you could hear less adequately…and it will be a happy new life of better hearing for you. Above all, don’t give up. This is by far the best advice you will get.

Be realistic
If others, and you, expect the hearing aids to make everything sound as it used to, and that all the problems associated with your loss of hearing will be over, neither of you are being realistic.

Hearing Aid Use Tactics
The following “hearing tactics” are methods used to solve the difficulties encountered in your daily life- the practical, technical, and psychological concerns caused by the hearing loss. Such concerns may be individual ones, and you may have your own solution to resolving them. Yet, others are basic and common. These tactics are intended to help solve some of these. The information in this chapter should be combined with that of the next chapter to achieve maximum effectiveness with the suggestions.

How to listen with hearing aids
Consider the environment- hard surfaces reflect sound (walls, ceiling, and bare floors) and may make it much more difficult to listen. Certain features absorb sound (draperies, carpets, upholstered furniture, and open windows), and make it easier to listen. You may find that you may have to adjust the volume control of your hearing aids, and your hearing habits, to the environment. Eventually you and your dispenser will find a volume setting which will be comfortable for you under most conditions.

Be fair
When others make an effort to communicate with you, stop what you’re doing and listen to them. If not, you will reinforce their feelings that you really don’t care.

Be patient
REMEMBER, MANY OF THESE SITUATIONS ARE ALSO DIFFICULT FOR PEOPLE WITH NORMAL HEARING! Patience is the key in learning to use hearing aids.

As your listening skills adjust, noise and meaningful information will slowly sort themselves out, and within a month or two you will be using your hearing aids with maximum effectiveness.

Hard surfaces reflect sound and may make it more difficult to listen.

Patience is especially important in the early stages. Remember that just as hearing is not always lost overnight, it may take time to get used to the sounds hearing aids bring back. You will soon begin to respond automatically to the aids and regain a more natural ability to perceive both the direction and meaning of sounds, such as conversation, music, or traffic.

Soft surfaces and open spaces absorb sound and may make it easier to listen.

Don’t be afraid to ask for help.
Your friends, family, and associates have a stake in helping you adjust to the hearing aids. Refer them to the chapter on ”For Family, Friends, Associates, and Employers.” Learn to ask for help in ways that it doesn’t offend them. (1) Tell them what’s wrong, and (2) Tell them what you need.

Also, do the following:

• Ask your dispenser for help.
• Read this.

Do not say that you understand when you really do not. You may miss some of the words the first time around, but be patient. Listening with hearing aids is often a skill which must be acquired. You may even have to ask some people to speak less loudly now that you are wearing hearing aids (they have been used to talking to you without hearing aids and have been raising their voices to be heard.)

Don’t hesitate to ask the speaker to repeat. In doing so, you aren’t apologizing for your hearing, but are showing the speaker you are interested in what is being said. You will be respected for this

Speech repeats itself
Take advantage of the fact that much of speech can be predicted. For example: “Mary had a little _____.”

Remember, listening is far more difficult than talking.

• Consider the context of the conversation. Learn how to put different parts of speech together to make a whole.
• Observe body language.
• Concentrate on what is being said, not on what your response will be. Fortunately, most people say more than is necessary to convey their meaning. Missing a word here and there will still allow you to understand what is meant. Don’t try to listen to every word.
• Listen until the speaker is finished.
• Respond only when you are certain you understand.
• Sometimes, you may have to guess. Make your best guess and check it out.

Difficult Conversational Listening Situations
Sometimes nothing can be done to improve a difficult listening situation. The situation may just be too noisy for effective conversation. However, at other times relatively minor efforts on the part of you or the speaker could improve the situation. Following are some circumstances which make listening difficult:

• A number of conversations at the same time.
• When many people are talking to you at the same time.
• When the distance between you and the speaker increases.
• When the speaker enunciates poorly.
• When the speaker talks rapidly.
• When the speaker does not maintain facial contact while speaking.
• When the speaker talks while eating, smoking, or having hands around the mouth.
• Communicating while riding in a motorized vehicle.
• Some people have very soft voices- often women and children.
• When someone speaks to you unexpectedly.
• When the speaker does not have your attention before talking to you.
• People with accents are difficult to understand.
• Unusual dialogue it more confusing than everyday speech.
• Words spoken out of context are always more difficult to hear clearly than several statements in series about a known topic. For example, one line gags are difficult to understand.
• Words fade out as a speaker walks away, out of effective communication range.
• Whispers are difficult to hear and should be avoided.
• When a noise exists between you and the speaker.
• Yelling, or talking from a distance.
• Talking to you from another room.
• Some rooms may be more difficult to listen in than others because of room acoustics.
• If the speaker is talking to you and making noise at the same time.
• It is more difficult to understand if you have a visual problem.

The Most Serious Problems
The most serious problems arising from the hearing impairment, and which you may not be able to totally overcome, are hearing in noisy places, or listening when several people are talking at the same time- for instance, at parties, in crowds, groups, etc. Often you will have to surrender- partly because other people will not constantly repeat or explain words or sentences that you do not catch.

The hearing aid does not selectively amplify desired sounds (speech); it indiscriminately amplifies all sound (speech and background noise) at the same time. In contrast, a normal listener is able to “focus” hearing in order to increase the perception of selected sound in noise.

Additionally, determining where speech and sounds are coming from (localization) makes these environments even more difficult to listen in. This can be frustrating and often prevents you from turning directly toward the sound in order to hear better.

Hearing in small groups
Small group conversations are usually quite hectic. The conversation is usually a topic of interest and everyone is trying to jump in with a rapid comment. This leads to loud, rapid, and interrupted speech. You may really feel left out. Try to do the following: Try to get a little special time with each person to explain your hearing problem and let them know you are interested in the topic(s). Attempt this away from the group and in a quiet environment where you can hear. Because much of language is nonverbal, there is not reason to avoid these or other groups.

Hearing in large groups (parties, crowds)
Hearing speech clearly is likely to be your greatest problem. Although you may have little difficulty following a conversation among a few individuals who speak distinctly and are in a quiet environment, if the speaker or listening environment is less than ideal, you will probably encounter problems.

• Difficulty will be greatest when three or four people are speakingin a group at the same time. The fact that their voices are raised to overcome the noise adds to the general confusion.
• You may be discouraged when you first try to follow a conversation where there is a high level of background noise. But be patient. You probably can learn to separate speech from background noise, or one voice from a number of voices around you. If your loss is severe, however, even the best of hearing aids may not help you much in a noisy room.
• Sit facing or near the person who is the most difficult to hear, or to the person who dominates the conversation, so that understanding will be easier. Concentrate on facial expressions. Distractions become even more difficult is the conversation is jumping from one topic to another. Ask the speaker to let you know when the conversation topic is changing, and to what.
• If the noise is continuous, move closer to the speaker, or, move the conversation to a quieter place.
• If surrounding noise seems unusually loud, reduce the volume setting of your hearing aids slightly.
• If other people ask you to repeat frequently, you may not be talking loud enough. If, on the other hand, they shrink when you talk, you are talking too loud. Learn to control your voice level by their facial and body language reactions.

Hearing in restaurants
The noises of dishes, the cash register, and silverware can be disturbing.

• The best seat is one where your back will be to a wall, or facing the direction from which the waiter or waitress will come.
• Try sitting next to, rather than across from your companion.
• Study the menu before the order is taken. Then order everything you want clearly, to avoid the need for questions and answers from an order taker who may not speak clearly, or who has a soft voice.
• Make certain that good lighting is available so you can use as many visual communication clues as possible. However, you should not be looking directly into a bright light or into the sun.
• Request a seat away from the kitchen entrance or near the check-out area.
• Select fairly “quiet” restaurants, with no bands, music, TVs or adjacent to a bar area.
• When you find a restaurant table you like, request that table number the next time.

House of Worship
This can present problems because of the many variables involved. A wide range of sounds occur from very quiet to loud organ and choral music. Also, the acoustics can vary markedly from one section of a church to another and from church to church.

• Sit in front of the pulpit (or religious minister) and as close as you must to hear and see well. You will have to experiment with the distance.
• Try to have the best lighting on the minister’s face to help visual communication.
• Adjust the volume of the hearing aid to compensate for the distance between the minister and you if your aids have an adjustable control.
• Some facilities have audio loops which can be used with hearing aids having telephone switches, or may even have assistive listening devices. Check on this.
• Use the techniques for “Hearing in Public Halls” which follows:

Hearing in public halls
These facilities consist of such places as movies, stage plays, auditorium events, etc. In fact, sound effects, intended to enhance a presentation, may make it more difficult to understand the speakers. If the hall is large, does it have a loud speaker system?

• If it does, locate the loudspeakers and sit close to them, but not such that sound from the loudspeakers will pass right over you head.
• If not, sit near the front (not below a balcony), and away from pillars, the side or the back wall, but where you can hear and see the speaker’s face. Sound can reflect from them and make listening difficult.
• Turn up the volume on your aids as much as possible or change the setting options without making the background noises uncomfortably loud.
• If you have trouble hearing, try a different seat. Certain spots in some auditoriums, churches, and theaters are particularly bad for listening.
• Sit close enough so that you can take advantage of visual clues.
• Avoid sitting near youngsters because they tend to talk and move about more frequently.
• Have some idea of the plot, either from reviews or from actual reading of the book or play.

Traffic noises and Wind

• Wind noises of all kind can be difficult to listen in.
• When driving, traffic noises can be devastating. Be careful and try not to rely on too many visual clues, especially if you are the driver. If you can plan long and/or frequent drives, consider an assertive listening device so that you can hear the other passengers more easily.

Listening to the radio, Hi-Fi or television
Recorded or broadcast speech and music may present something or a problem. The double amplification-in your TV, radio, or Hi-Fi and in your hearing aids- may make music and voices sound “canned” or artificial. It can even be more difficult without the opportunity for good, visual clues.

• If your aids have a tone or other controls (for changing the pitch/sound), try a different settings.
• Sit about the same distance away from the loud speaker as will others who will be listening, and listen to the rhythm and pace of the sound. Soon you will be able to follow the action and the meaning with greater ease.
• Also, remember that some broadcast announcers speak more rapidly due to their time allotment.
• Broadcasters with accents are also more difficult to understand.
• Let normal listeners set the volume for the radio, TV, or Hi-Fi. You may not be a good judge of volume, so change the volume on your aids, or change your position.
• Sit closer to the TV and as far away as possible from other possible noise sources (kitchen, door, entryway).

If sounds continue to be unpleasant…
If you find that sounds continue to be unpleasant after a reasonable adjustment period, you should have the dispenser check your hearing aids. They may have some design fault which exaggerates the noises around you to an unbearable degree; you may be using more amplification than you need; or the ear piece may not fit properly, possibly because you are not inserting it the right way.

Listening on the Telephone
The following are ways you can use the telephone:

1. Use the telephone without hearing aids. This may require that you take a hearing aid off. For some people, this works well and telephone understanding is fine. If you do this and use a telephone in a noisy place, turn off the aid in the other ear- but there is not need to remove it.
2. Use an amplified telephone supplied from the telephone company or other source. These are quite efficient, and you can control the loudness to suit your needs. 3
3. Some people are able to use the telephone in a normal manner by holding the telephone up to the hearing aid at the ear. This is more true of completely-in-the-canal (CIC) hearing aids than fro behind-the-ear or other type hearing aids.
4.  Determine IF your hearing aids have a telephone pickup function:
   1. Not all hearing aids have a telephone switch. Most behind-the-ear hearing aids do. Very few in-the-ear and essentially no ITC or CIC hearing aids have this feature.
   2. The telephone switch is not as essential for persons with mild and moderate hearing losses as for individuals with sever hearing losses. However, even persons with mild and moderate losses who use assistive listening devices in group situations or large meeting areas to improve their ability to understand, could use this feature in their hearing aids.

If your hearing aids have a telephone pickup function:

• Move the switch to the “T” position before using the telephone. The important to remember is that the telephone receiver should be close to the hearing aid, rather than to your ear.
• Move the telephone receiver around the hearing aid case to obtain the strongest signal.
• On some aids you also may have to turn up the hearing aid volume when you use the telephone pickup feature.

Successful use depends on:

1. The telephone induction coil of the hearing aid must be strong enough.
2. The telephone must produce a strong magnetic field.
3. The location of the telephone pickup coil in the hearing aid must be properly oriented.
4. Interfering sources such as power lines, transformers, and florescent lights can make the use of this feature impossible.

• When you are finished using the telephone, move the switch to the “M” (microphone) position for normal hearing aid use. You may have to turn the hearing aid volume down also.

Speech reading (lip reading, visual communication)
Your eyes can contribute much to understanding speech. Many people receive only partial benefit from hearing aids and find this form of assistance to be helpful. We all practice visual communication to a certain extent whenever we face someone who is speaking. Facial expressions such as smiles, raised eyebrows and frowns convey information as do gestures made with the hands and sometimes with the whole body.

Although only 30-40% of speech is visible on the lips, many speech sounds that are difficult to distinguish through hearing aids may be more easily distinguished when coupled with speech reading. The higher development of this skill in those with a hearing loss makes it possible to fill in the gaps the ears miss.

Where hearing ability is not likely to improve, it is wise t consider speech reading classes. This can supplement, but cannot replace hearing. Even if you have only a moderate hearing impairment, a course in lip reading may well be worth the time, effort, and cost.

Consonants

Easily Seen on Lips
p, b, m, wh, w, f, v,sh, ch, j, s, z, l, zh, th, th (voiced), r

Often Obscure
t, d, n, l, r

Obscure
k, g, ng, h, y

Vowels

Easily Seen on Lips
ou, oi, aw, er (r),oo, a, u, o

Often Obscure
u, ah, oo, er (ur), i

Obscure
e, i, a, e

To help in speech reading:

• Position yourself so that you can see the speaker’s face clearly.
• Position yourself about three feet from the speaker, and above all, avoid darkened rooms.
• Listen with your eyes.
• Watch the lips, facial expressions, and gestures of the person you are listening to.
• Another person’s actions provide many clues about events taking place around you.

How to listen without hearing aids
What can I do to help my hearing problem, even without hearing aids?

What individuals affected by hearing impairments often develop as methods for coping with difficult listening situations:

• Ask speakers to repeat themselves.
• Turn the head to one side while listening to sounds or speakers.
• Turn up volume levels on TV, the telephone, radio, or stereo.
• Ask people to speak directly into your ear, in normal tones, without shouting.
• Cover telephone mouth piece while listening (to avoid surrounding sounds form being picked up and being amplified into the ear- creating a noise problem).
• Find quiet corners for conversation at parties.
• Cup their ear inconspicuously.

Instruction for Improving Communication
Some hearing impaired will benefit from individual or group instruction for improving communication. Check with local hearing centers, community colleges, and universities. The emphasis in these classes may vary. Some educate participants to understand their hearing loss, others, to understand the hearing aid, other for lip reading (as means to supplement but not replace hearing), others for aural rehabilitation, others to help the hearing impaired monitor their own voice or improve their speech, etc.

Contact Mark Glassman, and the team at Glassman's Hearing Aid Service.

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Glassman's Hearing Aid Service
Omaha
3015 N 90th St
Ph. 402-571-1207

Fremont
33 W 6th
Ph. 402-727-7866

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"My wife appreciates my hearing aids as much as I do. She claims it has helped my disposition. I know hearing aids have helped me enjoy my family and friends."

Chris Gutschow, Fremont, NE