Better Hearing Endorsed by New logo here. RNID LOGO The information in this leaflet is endorsed by RNID and is correct at the time of printing in October 2007. -------------------------------------------------------------------------------- Contents Section 1. What to do if you think you have a hearing loss Section 2. What do hearing aids do? Section 3. Different types of hearing aids Section 4. How much help will I get from hearing aids? Section 5. How to get hearing aids Section 6. Choosing hearing aids Section 7. Buying hearing aids Section 8. Other helpful equipment Section 9. Lipreading Section 10. Tinnitus: what it is and what help is available Section 11. Useful contacts It’s easy to take good hearing for granted. You probably know what it’s like to have ‘blocked’ ears with a bad cold – everything sounds muffled and you may have to ask people to repeat things. Fortunately, hearing usually returns to normal after a cold. But, like many people, you might find it harder to hear as you get older. Gradual hearing loss is a natural part of ageing although you may not notice it until you are in your 60s or 70s. More than half of people over the age of 60 have some sort of hearing loss. But surprisingly most people who could benefit from a hearing aid don’t have one. Are you wondering if your hearing is as good as you used to be? Here is a checklist to help you decide. If you answer ‘yes’ to any of the following questions, you may have a hearing loss. * Do you have to turn up the television or radio more than you used to, or does your family complain that the sound is too loud? * Does it seem like people are mumbling, rather than speaking clearly? * Do you often find yourself asking people to repeat things? * Do you find it difficult to hear at social gatherings, in places of worship, or when there is some background noise, even though other people manage to have conversations? * Do you ever have difficulty hearing the doorbell or telephone ring, or hearing people on the telephone? * Do you ever miss your name being called: for example, at the doctor’s surgery? -------------------------------------------------------------------------------- Section 1. What to do if you think you have a hearing loss Tell your doctor your concerns about your hearing. Make a list of situations where you have had difficulty hearing. There could be many different reasons why you aren’t hearing as well as you used to. There may be a build-up of wax in your ears or an infection that your doctor can treat. However, if your doctor can find no obvious cause for your hearing loss, they will refer you to the audiology clinic or ear, nose and throat (ENT) department of your local hospital to have hearing tests. If you are over 60, your doctor may refer you directly to the audiology department rather than ENT first. After the hearing tests, the audiologist will explain your test results and discuss whether hearing aids are likely to help you, or whether you could need some other form of treatment. If the audiologist says you need hearing aids, it is a good idea to try them. You may find that you get on better with two – one for each ear. You can get free hearing aids on the NHS. If you need a hearing aid, you will have a mould of your ear taken. Once the earmould is ready you will be fitted with the hearing aid. Hearing aids, batteries, repairs and servicing will all be provided free of charge. Contact the hearing aid clinic or place where you bought it from if you have any problems using your aid. It may be able to adjust the aid, change it for a different model or advise you about getting used to it. You can try RNID’s telephone hearing check by phoning 0845 600 55 55 (local rate). This will give you an indication of whether you have a hearing loss. If it appears that there is some level of hearing loss, you will be advised to go to your doctor. -------------------------------------------------------------------------------- Section 2. What do hearing aids do? A hearing aid makes sounds louder so that you can hear them. It is battery-operated and you put it in or around your ear. Hearing aids are available in different shapes, sizes and types. However, all hearing aids work in a similar way. The type of hearing aid you get will depend on your hearing loss and what you find comfortable. A hearing aid will not give you perfect hearing, but it will make sounds louder and may help you to hear on the telephone and make conversations easier. There are many different models of hearing aid, for all types of hearing loss. Hearing aids are available either through the National Health Service (NHS), or privately from a hearing aid dispenser. ------------------------------------------------------------------------------- Section 3. Different types of hearing aids There are a number of different types of hearing aid to choose from, although not all will necessarily be suitable for you. Behind-the-ear (BTE) Behind-the-ear hearing aids with an open ear fitting have a small earpiece at the tip of the tubing instead of earmould. This type of fitting can be less noticeable than an earmould but it is only suitable if your hearing loss is mild or moderate. It can give you a very natural sound. These types of aids are available both through the NHS and privately. They are worn with an earmould made especially for you, which feeds sounds into your ear and keeps the hearing aid in place, over or behind your ear. There are models of behind-the-ear hearing aids to suit nearly all types and degrees of hearing loss. In-the-ear (ITE) and in-the-canal (ITC) These hearing aids have their working parts in the earmould so the whole aid fits into your ear. They tend to need repairing more often than behind-the-ear aids. Some in-the-ear aids can be seen from the side. The smallest in-the-ear aids fit inside your ear canal, where they cannot be seen. If you have severe hearing loss, small ear canals or trouble using small controls, these aids may not suit you. These types of hearing aid are not usually available on the NHS. Body-worn aids Body-worn aids have a small box (about the size of a matchbox), which you clip to your belt or pocket, with a lead connecting it to an earphone and earmould. They are the most powerful hearing aids available and may be more suitable for people with sight problems and/or problems using their hands. Digital hearing aids Digital hearing aids can be behind-the-ear or in-the-ear and can look just like analogue hearing aids, but they process sound using a tiny computer inside the aid. This means they can be customised to suit your individual hearing loss. They also process sounds to suit various situations – many adjust automatically. Some digital hearing aids are designed to reduce steady kinds of background noise such as the rumble of traffic or the whirr of a fan. You can now get digital hearing aids for free on the NHS or buy them privately. -------------------------------------------------------------------------------- Section 4. How much help will I get from hearing aids? A hearing aid will not give you perfect hearing, but it will make sounds louder and may help you to hear on the telephone. After you first get a hearing aid, you will need to gradually build the amount of time you wear the aid so that you can get used to the new sounds and the feeling of wearing it in your ear. It may be two to three months before you are able to wear a hearing aid for most of the day comfortably. If you are having any problems with your hearing aid, you should always speak with the person who supplied you with the aid for further advice. If this was the audiology department at your hospital, go back to speak to them, with the hearing aid. Public places such as theatres and stations often have ‘loop’ systems fitted. Loop systems can help you to hear what is being said on stage, or spoken into the counter microphone through your hearing aid, without picking up background noise. You may see a sign like this one, which indicates that a loop system is fitted. All public phones are also fitted with a tiny loop. You can only use a loop if you are able to switch your hearing aid to the ‘T’ setting. Almost all NHS aids have this setting, but some aids bought privately do not. Remember to check this if you are buying an aid. If you don’t wear a hearing aid, you can still use a loop, but you will need a hand-held, battery-operated listening device that has a loop listening facility. -------------------------------------------------------------------------------- Section 5. How to get hearing aids You can get hearing aids free from the NHS or you can buy them from a private hearing aid dispenser. You should always visit your doctor first if you think you have a hearing loss, even if you are thinking of buying a hearing aid privately. Although the current NHS range can cater for most types of hearing loss, there are more models available privately. RNID produces useful factsheets on digital hearing aids and the NHS hearing aid service. See the Useful contacts section, starting on section 11 for RNID’s contact details. Obtaining NHS hearing aids It is a good idea to make a special visit to your doctor to discuss any concerns about your hearing. Ask your doctor to refer you to an ENT specialist or hearing aid clinic. Arrangements differ slightly from one area to another, and waiting times also vary; sometimes they can be long. Most doctors will be happy to refer you, once they have examined your ears and checked that they can’t offer treatment. If you are over 60, your doctor may be able to refer you straight to an audiology or hearing aid clinic without seeing an ENT specialist. ------------------------------------------------------------------------------ Section 6. Choosing hearing aids Most people need some guidance when getting hearing aids. RNID publishes a free leaflet called Getting a hearing aid which answers some of the most common queries. Here are a few points that you may wish to think about when you are deciding what sort of hearing aids you might want. * You may wonder whether to buy an aid or get one through the NHS. Many people choose to get their first aid through the NHS, especially if they are happy to use a behind-the-ear aid, the usual type supplied. In some areas, however, you may have to wait several weeks, or even months, for a first appointment. After that you may have to wait again, for a few weeks, before you have your aid fitted. * Remember that there are a range of NHS aids. If the first aid you are fitted with is not quite as helpful as you’d hoped, you should return to the audiology department. The staff may be able to adjust your aid or change it for a different model. * Remember that in-the-ear hearing aids can be fiddly to adjust, because of the very small controls. If you have arthritis in your fingers, or poor sight, this could be a problem for you. On the other hand, in-the-ear aids are usually easy to insert in your ear. * Be aware that the claims made in some hearing aid advertisements can be misleading. Be especially cautious about claims that a particular hearing aid will cure the problems of unwanted background noise. This still remains the major problem for hearing aid manufacturers and users, although some hearing aids have special features to help with this. * If you decide to buy an aid, you can expect it to last around two to three years. But, of course, if your hearing gets worse, you may need to replace the aid with a more powerful model, which you will have to buy. You will also have to pay for batteries and repairs. * Owning a private hearing aid does not affect your right to a NHS aid. ---------------------------------------------------------------------------- Section 7. Buying hearing aids If you decide to buy a hearing aid you could ask a friend or relative if they can recommend a private hearing aid dispenser. All dispensers must be registered with the Hearing Aid Council (HAC) and have to follow the HAC Code of Practice. However, services do vary, so you need to be careful in your choice of dispenser. If you have any problems with an aid you have bought privately, first talk to the dispenser who sold you the aid. If you are still unhappy you might want to contact the Hearing Aid Council about your concerns. If you decide to buy an aid, the following tips may help. * Do use a dispenser who has been recommended by a friend or a relative. * Do use a dispenser who is based locally. It will be easier to take it back and talk to the dispenser about any problems you are having. * Do take a friend or relative who has good hearing with you. * Do visit two or three hearing aid dispensers to find out about the types of hearing aid they sell and the cost of the hearing aids. Prices do vary from dispenser to dispenser. * Don’t buy hearing aids at an exhibition, or on the ‘spur of the moment’. If you are considering buying hearing aids privately, book an appointment with a dispenser in advance. * Do make sure that you get a money back guarantee with enough time (at least 28 days) to try the aid and decide whether you want to keep it. You need to use it in a variety of situations to see whether it really helps you. Each hearing aid can cost between £600 and £3,500, so you need to be sure that what you buy is right for you. * Do read any document you are asked to sign carefully. By signing an agreement to buy an aid, you are entering into a legal contract. If you are unsure about anything in the contract, don’t sign! RNID’s factsheet, Buying a Hearing Aid?, gives more information on this. See section 11 for its contact details. ---------------------------------------------------------------------------- Section 8. Other helpful equipment Some people with a hearing loss use special equipment as well as their hearing aids. Special equipment can help you to hear particular sounds around the home. For example, maybe you have difficulty hearing the telephone and doorbell. Or perhaps you can only hear the television or radio if the volume is turned up very high. Television and radio You can get specially designed equipment to make the sound from your television and radio louder. Or you could use a home loop system together with your hearing aid. Telephones Telephones often have a volume button so you can increase the loudness of the caller’s voice. Some are fitted with an ‘inductive coupler’ – a small loop (called a T loop) which can be used by hearing aid users who have a ‘T’ switch on their aid. More information is given in the RNID factsheet, Telephones. Doorbells If you have difficulty hearing your doorbell, there is equipment that will make your doorbell louder. There are also vibrating pads and flashing lights that let you know somebody is at your door. Where to get this equipment This type of equipment is often available on free loan through your local social services department. Ask to speak to the social worker for deaf people. If you prefer to buy the equipment yourself, contact RNID for information. It has a catalogue of equipment which deaf or hard of hearing people may find useful. ---------------------------------------------------------------------------- Section 9. Lipreading Lipreading is a skill that most people use to some degree without realising. We usually focus on another person’s face and lips if we are having difficulty hearing what they are saying (often because of background noise). We do this in an attempt to search for visual clues that will help us work out what the speaker is saying. If you have a hearing loss, lipreading can be a very useful aid to hearing. Going to a local lipreading class may improve your skills, and your confidence. Find out about local classes through your library, RNID or Hearing Concern. ----------------------------------------------------------------------------- Section 10. Tinnitus: what it is and what help is available What it is Tinnitus is a medical term to explain noise(s) that people hear in one ear, both ears, or in their head. It is possible to hear a variety of sounds including: ringing, whistling, buzzing or hissing. If you have tinnitus, you may find that you have it all the time or you may find that it will come and go. Tinnitus is quite common and can affect people of all ages. It can be caused by a number of things, including hearing loss, exposure to loud noise, ear or head injuries, ear infections and as a side effect of some medications. Getting help You may find that tinnitus causes you distress, especially if you have it a lot of the time. Although there is currently no cure for tinnitus, there is help available to help you manage it. Your doctor can help you. They will make sure that your ears are free from wax and infection and may refer you to the ENT department at your hospital for further examination. The ENT department can provide help in a number of ways. It can provide: * relaxation or sound therapy; * hearing aid(s), if you have a hearing loss * counselling; and * referral to a tinnitus clinic (if there is one in your area). Relaxation and sound therapy can help you manage tinnitus. Many people find that they notice their tinnitus most when it is quiet, such as at night. Tuning into other sounds can help distract you from tinnitus: for example, you might find it relaxing to listen to therapeutic sounds such as tranquil music. Talking about your tinnitus or seeking counselling, to help you understand it further, can be helpful. For more information about tinnitus, contact RNID Tinnitus Helpline (freephone) on tel: 0808 808 6666; textphone: 0808 808 0007. It also produces a range of factsheets on tinnitus. See the Useful contacts section in section 11 for its contact details. RNID also has a website about tinnitus at www.tuneouttinnitus.org.uk -------------------------------------------------------------------------------- Section 11. Useful contacts RNID 19–23 Featherstone Street London EC1Y 8SL Tel: 0808 808 0123 (freephone) Text: 0808 808 9000 (freephone) Fax: 020 7296 8199 Email:informationline@rnid.org.uk Web: www.rnid.org.uk RNID is the largest charity working to change the world for the 9 million deaf and hard of hearing people in the UK. As a membership charity, it aims to achieve a radically better quality of life for deaf and hard of hearing people. It does this by campaigning and lobbying vigorously, by raising awareness of deafness and hearing loss, by providing services and through social, medical and technical research. Hearing Concern 95 Gray’s Inn Road London WC1X 8TX Helpline (Telephone and Text): 0845 0744 600 (local rate) Web: www.hearingconcern.org.uk Hearing Concern is a national charity whose main objectives are to provide information, advice and support for people who have a hearing loss, to promote communication access and to raise public and professional awareness of the issues associated with hearing loss. The Hearing Aid Council 70 St. Mary Axe London EC3A 8BD Tel: 020 3102 4030 Fax: 020 3102 4476 Web: www.thehearingaidcouncil.org.uk The Hearing Aid Council sets and maintains professional standards of competence and conduct among Registered Hearing Aid Dispensers (RHADs) and their employers. If you have a complaint about a private hearing aid dispenser, or their employers, you can complain to The Hearing Aid Council.