Your hearing health explained

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Your step-by-step hearing health guide communication THE EAR check-upS hearing problems Safety risks appointmentS HEARING devices solutions tests assessments resources and more...

HEAR THE DIFFERENCE. FEEL THE DIFFERENCE. CLEAR HEARING EMPOWERS YOU TO LIVE LIFE TO THE FULL...

Being able to hear clearly empowers you, and can give you the confidence to feel free and live your life to the fullest. So hear the difference and feel the difference, with hearing devices so discreet no one will know you’re wearing one.

Request a FREE* hearing check-up today visit: www.hearinglife.com.au/request-an-appointment or CALL 1800 340 631 http://hearinglife.com.au/request-an-appointment/

The better you hear, the better you live Hearing is a sense, and it makes good sense to look after it.

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earing well is one of the essential tools to a good life. But most of us know very little about how we hear, until our ability to hear properly starts to decline. Hearing helps us communicate with those close to us and engage with the wider world. It enables us to listen to the radio, appreciate beautiful music and absorb the sounds of nature. And more and more, we’re relying on information obtained through sight/sound channels than on the written page.

It’s hard to imagine how most of us would cope without hearing, how cut-off we would be from the world around us.

hearing loss of around one in six Australians will rise to one in four by 2050, as our general population ages. But as a warning against complacency, it’s reckoned that nearly half of the Australians who are deaf or have hearing loss are of working age (15–64).

Despite these sobering figures, many Australians wait up to 10 years to address their hearing loss, while just one in five people with a hearing impairment actually wears a hearing device.

So take some time to read this free booklet and take up the free hearing check-up offer at the back. It’s your easy first step to better hearing health.

Hearing loss usually occurs gradually. People often try to compensate for the gradual decline and may not want to accept that there is a problem, and it’s often friends or family who persuade them to have a hearing test. By then, their hearing loss may be well advanced.

According to the National Acoustics Laboratories at Macquarie University in Sydney, hearing loss is Australia’s second-most common condition, while Access Economics reports that the current level of

There is no need to fall into this trap. Seeking professional assessment and advice as soon as you notice a problem will give you the best possible chance of rehabilitating your hearing.

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The amazing ear The ear is a wonderful piece of engineering, and understanding how it works will help you to recognise hearing problems earlier than later.

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earing is possibly the first sense we develop.

The ear is fully developed at birth, and even before birth, infants respond to sound.

And as with other sensory organs, the ear is a complex structure. It’s made up of three parts, each with its own role in helping you hear.

1. Outer ear This houses the pinna or auricle (the part you can see) and the ear canal.

Sound is caused by the vibration of air molecules making up a wave. The pinna’s shape helps collect these soundwaves and guide them into the ear canal. It also helps you determine the direction and source of sound.

Sound travels down the ear canal, strikes the eardrum and causes it to move or vibrate.

2. Middle ear Separated from the outer ear by the eardrum, the middle ear has a chain of three tiny bones called 4

ossicles, which amplify soundwaves. Vibrations from the eardrum also cause the ossicles to vibrate.

3. Inner ear This houses a snail-shaped structure called the cochlea, which contains fluid, along with hair cells that act as nerve receptors. The mechanical vibration sent from the middle ear pushes a membrane in the cochlea, forcing its fluid to move.

This in turn stimulates the hair cells, which vibrate, turning these signals into nerve (electrical) impulses.

These impulses are sent via the auditory nerve to a ‘relay station’ in the brain called the cochlear nucleus. The impulses are carried on to other pathways that arrive at the brain’s auditory cortex, which interprets them as sound.

Ingeniously, individual hair cells respond to specific sound frequencies so that only certain hair cells are stimulated, depending on the pitch of the sound.

Source: American Speech–Language–Hearing Association

YourLifeChoices Your hearing health explained October 2015

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What causes hearing loss Much of the hearing loss in Australians is preventable, but where should you start to protect your hearing?

The facts: • some people have hearing loss from birth – about one in every 1000 Australians • others acquire it through infection or injury • more than a third of hearing loss cases in Australia are due to preventable exposure to excessive noise • others lose hearing as they age, with at least half the population aged over 60 suffering some form of hearing loss.

Types of hearing loss Conductive hearing loss is caused by disorders of the outer and/or middle ear. Physical blockages or abnormalities may prevent or reduce the effectiveness of soundwaves reaching hearing nerves deep in your ear. The result is an overall lowering of volume and an inability to hear faint sounds.

Conductive hearing losses are usually temporary and can sometimes be reduced or resolved by medical or surgical intervention.

Sensorineural hearing loss occurs when damage or trauma affects the nerve endings in the inner ear or along the nerve pathways to the brain. Some causes include overexposure to noise, the ageing process and certain medicines. The damage reduces your overall hearing level, and can affect your ability to understand speech and hear certain frequencies.

Most sensorineural hearing loss is permanent, and is usually addressed by fitting hearing devices.

Mixed hearing loss results from conductive and sensorineural factors, and is usually addressed by fitting hearing devices.

The danger spots The noise level above which excessive exposure will damage your hearing is 85dB (decibels). Heavy traffic can create this level of noise.

By comparison, using a vacuum cleaner (around 65dB) is unlikely to damage hearing, but listening to a portable music player at 94dB for an hour will.

According to Audiology Australia, the national body of hearing health professionals, the average noise volume at popular public venues in Australia are: • night clubs 97dB • sporting events 93dB • live music venues 92dB At times, the noise levels in the likes of gyms and fitness clubs can be as high as 97dB, almost matched by pubs and bars at 96dB. For those who are exposed to excessive noise, HearingLife offers custom noise protection.

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Hearing loss and you Bad hearing affects you in many different ways and may even be putting you at risk of injury.

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earing loss can cause difficulty in a wide range of everyday situations that require listening and communicating. You may experience: • difficulty in hearing background noise • a sensation that people are mumbling • needing the TV or radio volume louder than others do • problems hearing on the phone • having to ask people to repeat what they’re saying • friends or family reporting you aren’t hearing them properly • difficulty hearing at meetings or at church • avoiding social situations because it is too hard to hear.* In the early stages of hearing loss, you may try to compensate by asking people to repeat themselves, concentrating extra hard on what others are saying or avoiding situations with a lot of background noise.

Safety risks As time goes on, compensating becomes harder.

When you’re driving or walking, you may miss sounds, such as a siren or an approaching vehicle, increasing your risk of danger.

Tensions at home Relationships with family members could suffer. You – and they – may become increasingly frustrated by your inability to pick up on what’s being said and participate fully in conversations.

Your family may grow tired of repeating themselves.

Younger family members, such as grandchildren, could begin to feel awkward around you and avoid conversing with you.

Problems at work Your hearing loss may begin to affect your working life, as you find it harder to follow discussions in meetings or on the phone. You may use email when 6

a phone call would be more appropriate or efficient.

At worst, you may misinterpret a vital instruction from your boss or colleague, potentially affecting their livelihood as well as your own.

What’s more, long-term untreated hearing loss may affect your brain function. A recent study of almost 2000 older adults by Johns Hopkins University in the US found that those who had hearing loss experienced a faster decline in memory and thinking than people who didn’t.**

Shrinking horizons, dwindling confidence You may give up on some of the things you love doing, such as going to the theatre or playing team sport, because it’s just too hard to follow what’s happening.

As your social horizons shrink, you may have less to look forward to in your daily life. You may also become less confident and more withdrawn, increasing the likelihood of mental health problems.

According to beyondblue, health issues and longterm social isolation are key factors in mental health conditions such as depression.

As hard as it may be, admitting you have a hearing problem and taking action by consulting a hearing professional could pay huge dividends to your quality of life, now and in the future. * Source: Audiology Australia ** Source: Harvard Health Publications, Harvard Medical School

YourLifeChoices Your hearing health explained October 2015

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Take this simple test

If you think you may be experiencing hearing loss, why not take this simple one-minute test to check your hearing health?

Yes

No

Do you find it difficult to follow a conversation in a noisy restaurant or crowded room?

Do you sometimes feel that people are mumbling or not speaking clearly?

Do you experience difficulty following dialogue in the cinema or theatre?

Do you sometimes find it difficult to understand a speaker at a public meeting?

Do you find yourself asking people to speak up or repeat themselves?

Do you find men’s voices easier to understand than women’s or children’s?

Has anybody said to you that they think you might have a hearing loss?

If you answered yes to any of the above questions, then it’s time to have your hearing properly checked.

Make an appointment at your local HearingLife clinic, or as a first step, you can take HearingLife’s online hearing test.

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How to hear better

Hearing device technology helps to connect to the everyday world around us. You may be able to get by with a little help from these connected technologies.

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earing devices are often the best way to counteract hearing loss – but in some situations, all you may need is an extra boost. The technology within hearing devices can help you communicate with family, friends and colleagues, or enjoy your music, television, radio or trips to the movies.

Loop technology Working in a similar way to wifi, telecoil technology enables sound to be directed to a hearing device, in a loop. The distracting background noise that is often present in public spaces is eliminated. This technology is available in many locations around Australia, such 8

as train stations, and allows the wearer of a hearing device to hear announcements clearly.

Bluetooth technology Enabling the linking of two devices, wirelessly, bluetooth technology enables hearing devices to be linked directly to televisions, home phones and mobile phones, making communication much clearer and easier. The absence of wires means that people can remain active around their own home, as long as they are within range of the bluetooth transmitter.

Tinnitus relief and general relaxation Tinnitus can be an indicator of hearing loss. Its persistent ringing, hissing or roaring sound can be distressing and difficult to ignore. Using recordings designed by world-renowned sleep experts to mask tinnitus noise, the Sound Oasis Tinnitus and Sleep Sound Therapy System can help you achieve a better night’s sleep, or help you focus and relax during the day. Products to help manage tinnitus are now available through HearingLife clinics.

YourLifeChoices Your hearing health explained October 2015

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What to expect at a hearing test

Tests of any kind can make people nervous, and a hearing test is no different. But if you know what to expect, all you have to do is sit back and listen.

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here’s nothing to be worried about when taking a hearing test – it’s merely an assessment of what your hearing abilities are.

It’s also an easy first step for improving your hearing performance, which is something that will benefit not only you but also your family and friends.

Before you arrive at your appointment, have some notes prepared about your hearing history, as this will help your hearing professional with where you are having difficulty. If you wish, keep a simple hearing diary over the course of a week or so, citing examples of issues with your ears or hearing – such as problems with hearing the phone, talking to others in public or crowded spaces or picking up the direction of a particular noise (an ambulance siren, for instance).

You might also want to state what expectations you have of the consultation – e.g. what result would you want from having your hearing checked.

And you can even bring along a family member to the appointment, so they can let the hearing professional know how your hearing issues affect others, as well as helping you through the stages of the process.

At the consultation, a clinician will follow any or all of these four steps: 1. A physical examination of your ears. They will check for any blockages, such as earwax or physical objects.

2. Sound levels. You will be asked to sit in a quiet room and put on a pair of headphones, through which a series of sounds will be sent. The clinician will then assess which levels and tones of sound are and aren’t determined by your hearing.

3. Speech. An important part of any hearing test is how well you hear and understand speech, and this test can be conducted both with and without background noise.

4. A physical assessment of the function of your middle ear. A machine called a tympanometer records how well your eardrums react to changes in air pressure, as well as whether your middle ear is clear of fluid.

The test results will be discussed with you, and all your options for better hearing solutions will be explored.

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Your hearing questions answered There are many common questions about hearing loss. Here we answer eight to help give you a better understanding.

1. At what age does hearing loss most commonly occur?

Hearing impairment is a condition affecting almost one in every six Australians. While as many as half the people over the age of 60 experience some form of hearing impairment, it is certainly not a condition confined to later life.

2. How much do hearing devices cost?

The price of a hearing device depends on the model, as well as your individual situation. If you haven't already, please call HearingLife on 1800 340 631 to find out which types and options are best for you.

3. I am a pensioner, so can I get help with the cost of my hearing devices?

There are options available to help fund the supply of a hearing device. Please contact your nearest HearingLife clinic on 1800 340 631 to discuss the Government Hearing Services Program.

should be set at a moderate level and you should avoid turning the volume up too high.

6. What are some things my family can do to help me hear better?

You family can help make communication easier.

Here are some tips for them: • gain attention of the person with hearing loss first • be on the same level • avoid background noise where possible • speak slowly and clearly but don't shout • use simple, well-articulated words.

• be understanding, and repeat and rephrase as required.

7. Is it true that certain painkillers can contribute to hearing loss?

A Harvard Medical School study that found that analgesic medicines could contribute to hearing loss in men prompted a similar study in women.

It was discovered that women who take ibuprofen or paracetamol four or five days a week increase their risk of hearing loss by 21 per cent. Taking the drugs two or three times a week increases the risk of hearing loss by 10 per cent over those who use them less than once a week.

4. Can I get a small, discreet hearing device?

Yes, some devices are now so small that they are practically invisible. Digital technology has allowed even the smallest hearing devices to be powerful, and they include advanced features such as multiple programs, directional microphones, feedback cancellation and noise reduction.

Source: American Journal of Epidemiology

5. I don't think I have hearing loss but want to try to prevent it. What are some of the things I can do?

The most obvious way to protect your hearing is to avoid loud sounds. Sudden and very loud sounds are particularly dangerous and hearing protection should be worn when exposed to these types of sounds, such as rifle ranges, jet aircraft and heavy power tools. If you regularly attend loud music events, you should consider wearing ear plugs and limiting the time you spend in very noisy places. Personal stereos

8. Will wearing a hearing device completely restore my hearing?

While no hearing device will restore your hearing to normal (except in cases of very mild hearing loss), a range of devices are available that can significantly improve your hearing. These allow you to hear soft sounds you couldn't hear before, while at the same time making sure loud sounds are not uncomfortable for you. They are also designed to improve your ability to understand speech, even in noisy environments.

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YourLifeChoices Your hearing health explained October 2015

The latest solutions

Modern hearing devices are sleek, smart and so discreet that no one will notice you’re wearing one.

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f you’ve noticed someone with a hearing device, chances are they’re not wearing the latest in hearing technology, because modern devices are small, discreet and very clever. All the smart electronic thinking isn’t just going into mobile phones.

Even the smallest-model hearing devices are powerful and include advanced features such as multiple programs, directional microphones, feedback cancellation and noise reduction.

Behind-the-ear (BTE). The size and elegance of this device belies its superior performance. The electronics sit in a compact case behind the ear, and the earpiece is sized to suit the wearer’s needs and comfort. The individual size does depend on the power performance required, but the colours can match a wearer’s hair or skin tone.

You can see more about these devices at HearingLife.

These are the four types of devices that clinicians are using today to give people better hearing ability.

Invisible-in-the-canal (IIC). These are individually tailored to fit the wearer’s ear and are almost invisible once fitted. But their use depends on the size of the ear canal, and, as such, they only suit 15–20 per cent of people.

In-the-ear / in-the-canal / completely-in-the-canal (ITE, ITC, CIC). Each of these three styles is custom made so they’re individually moulded to the wearer’s ear. There are no wires or tubes involved, and they’re easier to manage than the IIC models, and often have a longer battery life. These are suitable for those with moderate-to-severe hearing loss.

Receiver-in-the-ear (RITE, RIC). These are popular due to their very small size, lightweight and wearer comfort. The sound is amplified into the receiver that sits inside the ear, and the amount of natural sound entering the ear can also be controlled to keep the total sound comfortable, giving a more natural sound quality. And they come in various colours, although some models are still almost invisible.

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Where to get help The first step is just a phone call or a click of the mouse.

Here are some useful resources to which you can refer.

HearingLife resources Make an appointment

To ask about a free hearing test at your closest clinic, call HearingLife on 1800 340 631 or visit hearinglife.com.au.

Free hearing services: find out if you qualify

Published by: Indigo Arch Pty Ltd Publisher: Kaye Fallick Editor: Debbie McTaggart Assistant Editor: Lesh Karan Designer: Word-of-Mouth Creative Phone: 61 3 9885 4935 Email: admin@yourlifechoices.com.au Web: www.yourlifechoices.com.au All rights reserved, no parts of this book may be printed, reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, recording or otherwise, without the permission in writing from the publisher, with the exception of short extractions for review purposes.

IMPORTANT DISCLAIMER No person should rely on the contents of this publication without first obtaining advice from a qualified professional person. This publication is distributed on the terms and understanding that (1) the publisher, authors, consultants and editors are not responsible for the results of any actions taken on the basis of information in this publication, nor for any omission from this publication; and (2) the publisher is not engaged in rendering legal, accounting, financial, professional or other advice or services. The publisher and the authors, consultants and editors expressly disclaim all and any liability and responsibility to any person, whether a subscriber or reader of this publication or not, in respect of anything, and of the consequences of anything done or omitted to be done by any such person in reliance, whether wholly or partially, upon the whole or any part of the contents of this publication. Without limiting the generality of the above, no publisher, author, consultant or editor shall have any responsibility for any act of omission of any author, consultant or editor.

Copyright Indigo Arch Pty Ltd 2015

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HearingLife is accredited to provide subsidised hearing services under the Australian Government Hearing Services Program. The Program aims to ensure that all qualifying pensioners and veterans have access to hearing services, including a hearing test and basic digital hearing devices, free of charge.

Who is eligible for the Program?

You may be eligible if you are an Australian citizen or permanent resident, over 21, and hold or receive a: • Centrelink Pensioner Concession Card • Centrelink Sickness Allowance • Gold Health Repatriation Card • White Health Repatriation Card (specifying hearing loss).

You may also be eligible if you are: • a dependant of someone in a category above • an active member of the Australian Defence Force • a client of CRS Australia (formerly Commonwealth Rehabilitation Services) referred by a case manager and attending doctor.

How do I apply for the Program?

Call HearingLife on 1800 340 631, or visit your local HearingLife clinic.

Independent resources Audiology Australia Professional audiologists’ organisation www.audiology.asn.au

Australian Government Hearing Services Program Free hearing services for eligible pensioners and veterans www.health.gov.au/hear

YourLifeChoices Your hearing health explained October 2015