Audiology

A Guide to your Hearing Aid

Patient information

We put our patients first by working as one team;leading and listening, and striving for the best.

Together, we make the difference.

Musgrove Park Hospital is part of Taunton and Somerset NHS Foundation Trust

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Introduction

We hope you are happy with your new hearing aid(s). At the fitting appointment your audiologist will have instructed you on how to use, care for and get used to your hearing aid. This booklet aims to refresh and build on the information covered during your hearing aid fitting.

What to expect when you first wear your hearing aid

It is completely normal to find your hearing aid strange initially. The following are common things you may notice when first wearing your hearing aid:

My own voice sounds strange - your ear is now blocked with your earpiece. This creates an occlusion which can make your voice sound hollow, like an echo. As you get used to your hearing aid, this effect should gradually fade.

It sounds tinny – Age-related hearing loss often affects our hearing of high-pitched sounds. Therefore hearing aids often amplify high-pitched sounds more so than anything else. Although these high pitches can sound tinny initially they will improve the clarity of speech.

Background sounds are loud - You will be able to hear lots of background sounds that you may not have heard for a long time. Your brain will initially be very alert to these sounds. The more you wear your hearing aid and expose your brain to these sounds, the less alert it will become. A person with normal hearing will also hear these sounds but their brain is able to ignore them as they hear them every day. Providing you wear your hearing aid regularly you will acclimatise to background sounds and pay less attention to them.

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Acclimatisation

This is the process in which your brain gets used to the sound of your hearing aid. The more you expose your brain to hearing with your hearing aid the quicker you will acclimatise to it. Sounds like the kettle boiling, the toilet flushing, the fridge humming and paper rustling may sound very loud initially. Your brain may not have heard these sounds at this level for a long time. It will need to re-learn what’s important and what’s not before being able to ignore these sorts of sounds.

You can build up the use of your hearing aid gradually. On the first day wear it for at least an hour in a quiet situation, for example, at home. Gradually increase the length of time you wear your aid each day and begin to wear it in noisier situations. Eventually you will build up use until you are able to put your hearing aid in in the morning and leave it in until you go to bed at night.

You will gain the most benefit from your hearing aid when you are wearing it all day.

It is likely to take perseverance on your part when getting used to your hearing aid. It takes everyone different amounts of time to adjust. If you stop wearing your hearing aid regularly, it is likely to be strange again when you put it back in.

So don’t give up, stay positive and persevere. Once you adjust to the sound of your hearing aid you will receive the full benefit of it.

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Hearing aids have both benefits and limitations

Your hearing aid aims to ease your hearing difficulties by improving your understanding of speech and your ability to hear everyday sounds. Your hearing aid will not give you perfect hearing; it is purely an aid helping you to make the most of the hearing you have got. You must have realistic expectations of what your hearing aid can do. There may still be some situations where you have difficulty, for example, in very noisy/crowded places. This situation is also difficult for people with normal hearing as background sounds will overpower speech. Make use of communication tactics in these situations.

Communication/hearing tactics• Make the most of visual information by watching people’s

mouths, we use some level of lipreading without realising

• Ensure the person you are listening to is facing you and in good lighting

• Reduce as much unnecessary background noise as possible e.g. turn off the radio/TV

• Watch the speaker’s facial expressions and hand gestures

• Do not be embarrassed to ask the speaker to repeat themselves

• How well you hear will be largely dependent on the speaker; by speaking clearly and slightly slower they will help you understand

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Your hearing aid set up

Your audiologist will have set your hearing aid to suit your hearing loss and your hearing needs. Sometimes hearing aids are set to be completely automatic and sometimes they are set with different programmes and/or volume control which you can change yourself.

Your hearing aid will either have an ear mould or a thin tube delivering sound into your ear. This is determined by the level and type of your hearing loss and by your manual dexterity.

What do I have? (please tick)

m Automatic m Programmes m Volume control m Ear mould m Thin tube

You will have been provided with an instruction booklet from your hearing aid manufacturer. Please refer to this for more detailed information on how to use these controls. Hearing aids are often set as automatic to begin with. If you would like to have controls added to your hearing aid, please tell your audiologist

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• Hold the ear mould at the back with your index finger and thumb, as shown in the picture

• Generally the right hand should be used to insert a right hearing aid and the left hand to insert a left hearing aid.

• Insert the bottom process into your ear canal and the top process under the fold of skin located above

Putting your hearing aid on (with an ear mould)

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• Push the part of the mould you have been holding in to ear, as shown in the picture

• It may help to use your other hand to gently pull down on your ear lobe

• Tuck the hearing aid behind your ear to achieve a correctly fitted ear mould and hearing aid

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• Start by placing your hearing aid behind your ear

• Next you need to get a hold of the bend of the tube

• Hold it between your thumb and index finger

Putting your hearing aid on (with a thin tube)

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• You will be directing the dome of the hearing aid towards the ear canal

• Gently push the dome into the ear canal until the tube of the hearing aid sits close to the side of your head

• If the tube is not sitting close to your head you have not pushed the dome in far enough

• Finally you will need to push the

ear grip into the concha of your ear

ear grip

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concha

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Batteries

Each hearing aid battery should last between 7 and 10 days (depending on how often it is used). You will have been provided with a full packet of batteries at your hearing aid fitting. Batteries are currently free of charge and can be collected from the following places on presentation of your brown battery book/ record card.

Musgrove Park Hospital - Audiology Reception

Bridgwater Hospital - Main Reception

Burnham on Sea Hospital - Main Reception

Chard Hospital - Main Reception

Minehead Hospital - Main Reception

West Mendip Hospital - Main Reception

Wellington Community Hospital - Main Reception

North Curry Health Centre, Greenway, North Curry, Taunton

Cheddar Medical Centre, Roynon Way, Cheddar

Edington Surgery, Quarry Ground, Edington

Wedmore Surgery, St. Medard Road, Wedmore

Axbridge Surgery, Houlgate Way, Axbridge

Summervale Medical Centre, Canal Way, Ilminster

The Meadows Surgery (formerly North Street Surgery), Canal Way, Ilminster

Essex House Medical Centre, 59 Fore Street, Chard

Exmoor Medical Centre, Oldberry House, Fishers Mead, Dulverton

Dunster and Porlock Surgeries, 3 Park Street, Dunster

Vine Surgery, Hindhayes Lane, Street

Glastonbury Surgery, Feversham Lane, Glastonbury

Priory House Medical Centre, Glastonbury Road, Wells

Crown Medical Centre, Venture Way, Taunton

Warwick House Medical Centre, Upper Holway Road, Taunton

Taunton Road Medical Centre, Taunton Road, Bridgwater

Williton Community Hospital, North Road, Williton

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Alternatively you can request new batteries through the post. Post your brown book or green record card and a large letter stamp to the Audiology department in Musgrove Park Hospital. When we receive it we will post it back to you with fresh batteries.

Maintenance and cleaning Ear mouldsIt is important to keep your ear mould clean. Wipe your ear mould with a wet wipe or wet flannel on a daily basis. If you want to give your ear mould a more thorough clean you are able to detach it from the hearing aid to do this:

• Pull the soft tube gently away from the harder plastic hook of your hearing aid

• Wash the mould and soft tube in warm soapy water

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• Rinse the mould and soft tube thoroughly

• Reattach the soft tube to the hearing aid, making sure it is completely dry before you do so. We recommend that you wash your mould before going to bed and leave it in a warm safe place to dry overnight.

The tube on your hearing aid will become hard and brittle over time. It will need to be replaced every six months. This can be done by your audiologist. It is important to have your hearing aid re-tubed regularly as it will improve the sound quality and prevent the tube from snapping/ breaking. If you would like to learn how to re-tube your hearing aid yourself please ask your audiologist for a demonstration.

Thin tubesTo clean your thin tube, wipe the dome with a wet wipe or wet flannel. If you think there may be a blockage in the tube, thread your cleaning wire through the tube.

RepairsAs of April 2017 all Audiology drop in clinics for hearing aid repairs will end and an appointment only system will be in place. To book an appointment for hearing aid repairs, re-tubes or mould appointments please ring 01823 342186 or email hearingaid@tst.nhs.uk.

Common problems and home solutions There is often a simple solution to hearing aid faults that can be completed at home. If you feel your hearing aid is not working or sounding quieter than usual, try the following checks if you are happy and confident to do so.

• Make sure the battery is sitting the right way round - positive side facing up at you

Correct Incorrect • Make sure the battery drawer is closed fully • Try a fresh battery

Check that the tubing is not blocked with wax or debris. Use an object small and safe enough to remove the blockage (for example, a cocktail stick, a brush bristle)

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If the blockage is in the part of the tube surrounded by the ear mould it can be difficult to see and remove. Wash your mould according to the instructions described earlier in this booklet, or replace the tubing if you have learnt how to do so.

• Check for moisture in the tubing. If a droplet of moisture is present in the tube it can completely stop the sound from being delivered to your ear and your hearing aid may work intermittently. If moisture is present squeeze and shake the tubing to dissipate the moisture.

• Make sure the instrument is not covered in dirt/debris. This will clog up the hearing aid microphones. You can use a dry cloth to wipe the surface of the hearing aid.

If the checks have been made and the hearing aid is still not working, the filter in the ear hook may be blocked. You can pierce the filter with a pin. This is a quick fix; you will need to book an appointment to have a new filter put in.

Please note – not all hearing aids have filters

If these solutions are unsuccessful please contact us to arrange an appointment so a member of the audiology team can check your hearing aid.

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What to do if your hearing aid is whistling

It is normal for your hearing aid to whistle when your hand is covering it. This is simply feedback from the microphones. If your hearing aid is whistling when it is in your ear and not covered it could be caused by one or more of the following things:

• Excess wax in your ears can cause your hearing aid to whistle. Have your ears checked by your GP or practice nurse for wax

• Check the ear mould is inserted correctly in your ear. If it isn’t there will be a gap through which sound can escape and re-enter the microphones. This will cause a whistle.

• Check your ear mould is not loose in your ear. Our ears constantly change shape and over time your mould can become loose. You will need to book an appointment for an impression for a new ear mould.

Please note—your ear needs to be clear of wax for an impression

• Check the tubing for splits. If present a new tube may resolve the whistling

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Using your hearing aid with the telephone

Telephone conversations can be very difficult for those with hearing loss as you can no longer use visual cues and lipreading to assist your hearing. Below are some suggestions to help you make the most of your hearing aid whilst on the telephone.

Remember, if the speaker is speaking too quickly do not be afraid to ask them to slow down and repeat themselves.

Telephones without a loop systemLeave your hearing aid in place on a setting that you would use to pick up ordinary everyday sound. Rather than holding the telephone to the opening of your ear you will need to hold it close to the top of your hearing aid, where the microphones are located (as shown in the picture).

If you are experiencing feedback you may be holding the phone too close to the hearing aid. You will need to experiment to find a position that suits you best. If possible, get a family member or friend to ring you so you have time to experiment and practice.

If you continue to struggle to hear on the telephone despite following this advice you may benefit from having a specific programme on your hearing aid to use with the phone, for example, an acoustic programme or a loop system. This programme will need to be added to your hearing aid—please tell your audiologist if you require this. The audiologist will instruct you on how to use the programme.

Telephones designed for people with hearing loss are available from various places including action on hearing loss (A.O.H.L). These phones may have a built-in loop system or an amplifier. You can pick up an A.O.H.L catalogue from your audiology department or visit their website. You can find their contact details at the end of this booklet.

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Telephones with a built in loop system If you have a telephone with a loop system, switch your hearing aid on to the loop setting and hold the telephone receiver close to the hearing aid. This should improve the sound reception further.

The loop system Loop systems are found in public places including the bank, post office, church, theatre and cinema. They are designed to help you hear the speaker more clearly.Loops systems can also be installed at home for use with the telephone and television. Care Direct can assess your need for a loop system at home (contact details at the end of this booklet).

Wireless devices

There are now devices available for you to purchase from hearing aid companies or shops that allow you to stream sound from devices such as mobile phones directly to your hearing aid(s). If you want to purchase such devices we will need to supply you with a wireless version of your hearing aid(s). For more information please ask your audiologist.

Lost and damaged hearing aids

Your hearing aid is on loan from the NHS. If you lose the hearing aid or damage it through carelessness you will be charged £100.00 per replacement hearing aid. You will need to pay this charge before we can replace your hearing aid. A member of the audiology team can provide you with instructions on how to pay this fee.

Please note, this charge is liable to change in the future. 17

Reassessments

Generally we will need to reassess your hearing every three and a half years. You will need to tell your audiologist when you are ready for a reassessment. If you notice significant deterioration in your hearing before this time please tell your GP or audiologist. If you experience a sudden loss of hearing seek immediate medical advice.

Common questions

Q. Can I wear my hearing aid on a plane?A. It is perfectly safe to wear hearing aids which do not use wireless technology on a plane. If you have wireless hearing aids please refer to the instructions in your manufacturer’s instruction booklet for switching your hearing aid to flight mode. If you are not sure if your hearing aids are wireless or not please ask your audiologist.

Q. Are there any places I shouldn’t wear my hearing aid?A. Take your hearing aid out when having a bath/ shower or anywhere it is likely to get wet. We recommend you take your hearing aid out to go to bed.

Q. Can I wear my hearing aid in the hairdressers?A. Yes, but take it out if you think it will get wet or covered in hairspray/product.

Q. Will wearing a hearing aid make my hearing worse when I take it out?A. No your hearing aid should never make your natural hearing any worse. If you find your natural hearing dull when you take your hearing aid out, it is only because you have become used to hearing better when it’s in.

Q. I only have one hearing aid, should I have two?A. This will mainly depend on your hearing levels in each ear. If you have an aid-able hearing loss in both ears wearing two hearing aids can offer many benefits. You need to be willing to wear the two hearing aids as a pair every day. A number of our patients will begin with one hearing aid to assess its benefit. If you wear your hearing aid regularly, have an aid-able hearing loss in your other ear and feel you require a second hearing aid please tell your audiologist.

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Q. Can I get a hearing aid that goes completely in my ear? A. We routinely fit behind-the-ear digital hearing aids only. Alternative styles including in-the-ear hearing aids can be purchased privately from hearing aid dispensers. The only instance in which we will fit an alternative style of hearing aid is when there is a genuine medical requirement for it.

Useful links

Action on hearing loss (formerly known as RNID)Telephone 0808 808 0123 (freephone)Textphone 0808 808 9000 (freephone)Website www.actiononhearingloss.org.ukSMS 0780 0000 36

Hearing Link - UK based organisation for people with hearing loss and their families Website www.hearinglink.org

Connevans – Equipment for deaf and hard of hearing peopleTelephone 01737 247571Text/ minicom 01737 644016Website www.connevans.co.ukEmail info@connevans.com

Somerset Direct (care direct) - Community service for adultsTelephone 0300 123 224Textphone 07781482858Website www.somerset.gov.ukEmail generalenquiries@somerset.gov.uk

The British Tinnitus Association (BTA) - Guidance and information about tinnitus Website www.tinnitus.org.ukTelephone 0800 018 0527Email info@tinnitus.org.uk

Menieres Society - Information and support for people with vestibular conditions causing dizziness and imbalanceTelephone 01306 876 883Email info@menieres.org.ukWebsite www.menieres.org.uk

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L Price/ Dec16review Dec18