Monday, 13 January 2020

The Importance of Hearing Aids - Getting the message across to CCGs 2020

The Importance of Hearing Aids

Getting the Message Across to Clinical Commissioning Groups

***** On 15th February 2017 Action on Hearing Loss asked me to answer some questions about my experiences of hearing loss on BBC Radio 4’s Woman’s Hour.  Following this I was asked if I would allow Action on Hearing Loss to quote from this blog post in a presentation designed to help people understand hearing loss.  I am really pleased that I seem to be on the right track. *****

The following article was originally written for - and published on - Action on Hearing Loss’s website. https://www.actiononhearingloss.org.uk/community/blogs/our-guest-blog/the-importance-of-hearing-aids.aspx The letters and sounds that someone with ‘mild’ high frequency hearing loss (most often associated with age/noise related hearing loss) might struggle to hear have been removed in an attempt to offer some insight into the difficulties those with impaired hearing might face.  It should be remembered that whilst readers can read and work out meaning at their own individual pace people do not enjoy that luxury in real time verbal conversations.  Lipreading is not a substitute for hearing. Much of it is guesswork - filling in the gaps left by sounds made without moving the lips.  Add the distraction of background noise to the mix and for many the struggle becomes too great.  Isolation, depression and dementia (perceived or real) are very significant threats.

Please read on.  At the end there are a few questions you may like to ponder and answer.

I am a -earing aid wearer wi-- mild to modera-e, -igh -re-uen-y -earing lo--.  I -ave worn digi-al N-- -earing aid- -or --e la-- -our-een year-.  -o -ay --a- --ey -ave -ran--ormed my li-e i- no e-aggera---n.  

Loo-ing ba-- over my -re--earing aid year- I wonder -ow I managed.  A- a middle ---ool -ea--er in charge of the -E de-ar-men- but -ea--ing -al- my -ime-able in -la--room -ubje--- I --ru--led -on--an-ly.  -earing what --ildren were -aying in the gym or on --e -ield wa- a -er-e-ual -roblem and I wa- re-ea-edly -om-laining about --ildren mumbling and --ea-ing indi--in---y in the -la--room.  --a-- mee-ing- were a nigh-mare.  My brain -ad to wor- over-ime to -ry to -ee- tra-- of di--u----ns --at I wa- too o-ten relu--an- -o join in a- I -ould not be -ure wha- -ad been -aid.  Al--ough I did not reali-e i- at --e -ime i- -a- be-ome a--aren- --a- --e --eer e--or- of ma-ing -en-e of -onver-a---n --roughou- --e day wa- what -au-ed me to -lum- into a -oma-li-e -lee- every evening - --u- robbing me of -rue re-- and rela-a-ion a--ivi-ie-.  On o--a-ion- when I --ar-ed wa---ing a -elevi---n -ro-ramme I o-ten had to a-- family member- what had been -aid only to be -old --at I --ould -ay -ull a--en--on.  I rarely -aw --e end- of -ro-ramme-.

I- i- only in re-irement -in-e re-eiving my -ir-- N-- -earing aid- --at I -ully a--re-iate ju-- -ow -ard --e --ru--le wa- during my wor-ing year-.  No lon-er do I need --e -ub-i-le- when wa---ing -elevi---n.  Now I -an enjoy -onver-a---n- wi-- -amily member-, -riend- and a--uain-an-e- wi--out re-ea-edly -aving to a-- for re-e-i---n and -u--ering --e en-uing embarra--men- of --ill no- -aving -eard -ro-erly.  --ere are only -o many -ime- one -an a-- for re-e-i---n and --ere i- alway- --e added worry of ini-ia-ing t-e o-ten u--ered di-mi--ive re--on-e, "Oh! It doe-n'- ma--er." Only re-i-ien-- of --o-e -ew word- will -ruly under--and --e -ru--ra---n --ey -au-e.  --e -on--ant worry about being -il-ered out of --e -rou- whil-- al-o dealing wi-- --e --rain of -rying to --ay -onne--ed i- now -one.  

The --rain on -amily member- and other- --ould not be undere--imated.  A -riend -old me --a- -eo-le wi-- -earing lo-- --ould do -ome--ing abou- i- a- i- wa- e--remely -ru--ra-ing -o have -o re-ea- --ing- -o much.  I wa- an-ry wi-- her a- --e -ime but on re-le---on --e did me a -avour.  -onver-a---n i- de-igned to -low and re-ea-ed re-e-i---n --oil- --e -low.  I- i- diffi-ult to move on when -on--antly moving ba--.  -on-inui-y is di-ru--ed and bo-- --e -earing and the -earing im-aired be-ome -ru--ra-ed.  --i- i- e--a-erba-ed on --e -ele--one - a -om-le-e nigh-mare -or --e -ard of -earing and --o-e -rying to -ommuni-a-e wi-- --em.

Re-irement o--ers relea-e from a li-e-ime of -lo-ely --ru--ured a--ivi-ie- but al-o -re-en-- challenge- o- i-- own. -ow will we ju-ti-y our -ontinued e-i-ten-e in --e world?  I de-ided to be-ome involved in lo-al -a---n--' -om-i--ee-.  Why -u- my-elf --rough --e a-ony o- ye- more mee-ing-?  I am a -ommuni-a-or and I wan-ed -o -on-inue to -on-ribu-e to -o-ie-y.  De--i-e -ur--er de-eriora---n in my -earing my N-- -earing aid- allow me to do ju-- --a-.  Deva--a-ed i- a mu-- overu-ed word --e-e day- but i- -ully de--ribe- -ow I would -eel wi--ou- my -earing aid-.  -o---l out-a-- would not be too --ro-- a de--rip---n.  (I a--ually --ough- one o- my -even -rand--ildren had a -eriou- --ee-- im-edimen- a- I -ould not under--and any--ing he -aid.  --i- -ear -roved un-ounded on-e I re-eived my -earing aid-.)   

A- a wal-er and a -y-li-t I rely on my -earing aid- to help aler- me to -o-en---l -azard-
a--o-ia-ed wi-- tho-e a--ivi-ie-.  In addi---n devi-e- -u-- a- doorbell-, -imer- and alarm- would be inaudible wi--ou- --em.

I -eel driven to -ee- u- --e-igh- again-- any -o-en---l -u-- in N-- -earing -ervice-.  I, and -o many like me, would become -eriou-ly -o--ally i-ola-ed and vulnerable wi-- all --e o--er -roblem-
a--o-ia-ed wi-- bei-- ex-luded from normal everyday a--ivi-ie- --at --o-e wi--ou- -earing -roblem- -a-e -or -ran-ed.

  1. How far did you get?   
    1. If you gave up part way through could you explain why?
  2. How do you feel?
  3. Were you able to read at your normal pace?
  4. Would you like all your reading matter to be like this?
  5. If the answers to 3 and 4 were, “No,” would you welcome help to overcome these problems?
    1. For your convenience the full text of this article with all the gaps filled in is printed below or can be seen here: https://www.actiononhearingloss.org.uk/community/blogs/our-guest-blog/the-importance-of-hearing-aids.aspx
    2. During conversation people with hearing loss rely on their hearing aids to help fill in the gaps.
    3. Without hearing aids whilst the brain struggles to decipher words orally the conversation may be moving on resulting in further gaps in comprehension.  Eventually the effort becomes too great and many are reduced to smiling and nodding - or, worse, total withdrawal.  Isolation.

Hearing loss is a complex issue.  It is not just about turning up the volume. People who seek help  need help.  Please let patients and audiologists decide who will benefit from hearing aids.
Kathleen Hill
Member of:
GP PPG, Wyre Forest Patients’ Group,
NHS Wyre Forest CCG Membership Scheme
Action on Hearing Loss https://www.actiononhearingloss.org.uk/ (Formerly the RNID) Volunteer

Updated 13th January 2020

The Importance of Hearing Aids
Original Action on Hearing Loss Blog Article Posted on: Monday, February 2, 2015 by Lola Olson

I am a hearing aid wearer with mild to moderate, high frequency hearing loss.  I have worn digital NHS hearing aids for the last eight years.  To say that they have transformed my life is no exaggeration.  

Looking back over my pre-hearing aid years I wonder how I managed.  As a middle school teacher in charge of the PE department but teaching half my timetable in classroom subjects I struggled constantly.  Hearing what children were saying in the gym or on the field was a perpetual problem and I was repeatedly complaining about children mumbling and speaking indistinctly in the classroom.  Staff meetings were a nightmare.  My brain had to work overtime to try to keep track of discussions that I was too often reluctant to join in as I could not be sure what had been said.  Although I did not realise it at the time it has become apparent that the sheer effort of making sense of conversation throughout the day was what caused me to slump into a coma-like sleep every evening - thus robbing me of true rest and relaxation activities.  On occasions when I started watching a television programme I often had to ask family members what had been said only to be told that I should pay full attention.  I rarely saw the end of programmes.

It is only in retirement since receiving my first NHS hearing aids that I fully appreciate just how hard the struggle was during my working years.  No longer do I need the subtitles when watching television.  Now I can enjoy conversations with family members, friends and acquaintances without repeatedly having to ask for repetition and suffering the ensuing embarrassment of still not having heard properly.  There are only so many times one can ask for repetition and there is always the added worry of instigating the often uttered dismissive response, "Oh! It doesn't matter."  Only recipients of those few words will truly understand the frustration they cause.  The constant worry about being filtered out of the group whilst also dealing with the strain of trying to stay connected is now gone.  

The strain on family members and others should not be underestimated.  A friend told me that people with hearing loss should do something about it as it was extremely frustrating to have to repeat things so much.  I was angry with her at the time but on reflection she did me a favour.  Conversation is designed to flow and repeated repetition spoils the flow.  It is difficult to move on when constantly moving back.  Continuity is disrupted and both the hearing and the hearing impaired become frustrated.  This is exacerbated on the telephone - a complete nightmare for the hard of hearing and those trying to communicate with them.

Retirement offers release from a lifetime of closely structured activities but also presents challenges of its own. How will we justify our continued existence in the world?  I decided to become involved in local patients' committees.  Why put myself through the agony of yet more meetings?  I am a communicator and I wanted to continue to contribute to society.  Despite further deterioration in my hearing my NHS hearing aids allow me to do just that.  Devastated is a much overused word these days but it fully describes how I would feel without my hearing aids.  Social outcast would not be too strong a description.  (I actually thought one of my seven grandchildren had a serious speech impediment as I could not understand anything he said.  This fear proved unfounded once I received my hearing aids.)    
As a walker and a cyclist I rely on my hearing aids to help alert me to potential hazards associated with those activities.  In addition devices such as doorbells, timers and alarms would be inaudible without them.

I feel driven to keep up the fight against any potential cuts in NHS hearing services.  I, and so many like me, would become seriously socially isolated and vulnerable with all the other problems associated with being excluded from normal everyday activities that those without hearing problems take for granted.
Kathleen Hill
Member of GP PPG, Wyre Forest Patients’ Group,
NHS Wyre Forest CCG Membership Scheme
Action on Hearing Loss https://www.actiononhearingloss.org.uk/ (Formerly the RNID) Volunteer

The above articles and other items concerning hearing loss can be found here:  
Kathleen can be followed on:
Twitter @kathleenlhill

Minor updates 19.06.2017

Please help someone else understand hearing loss by passing this on when you have finished with it.

Wednesday, 8 January 2020

Points made in Staffordshire Survey Jan 2020

Staffordshire Clinical Commissioning Groups are inviting people to give their views in a survey about making difficult decisions.  One of the services being consulted about is Hearing Loss in Adults.  North Staffordshire ceased provision of hearing aids for adults with mild hearing loss in 2015.  I worry that this will spread to the other Staffordshire CCGs.  I filled in the survey and the comments I put in the boxes provided are below.
"As you have stated NICE have said that audiogram thresholds should not be the only factor used to determine whether or not people can benefit from hearing aids.  Hearing loss is complex. Clarity of speech depends on many things including which frequencies the patient has most difficulty with. Patients should be treated individually according to their needs.  One single average dB reading is a nonsense as hearing loss is usually different at different frequencies. People with high frequency loss are likely to have problems with some consonants. Consonants give speech its meaning.  Try this:  

I am a -earing aid wearer wi-- mild to moderate, -igh -re-uen-y -earing lo--.  I -ave worn digi-al N-- -earing aid- -or --e la-t twelve year-. To -ay --at --ey -ave tran--ormed my li-e i- no e-aggeration.  

Loo-ing ba-- over my -re--earing aid year- I wonder -ow I managed.  A- a middle ---ool tea--er in charge of the -E de-artment but tea--ing -al- my timetable in -la--room -ubje-t- I -tru--led -on-tantly.  -earing what --ildren were -aying in the gym or on --e -ield wa- a -er-etual -roblem and I wa- re-eatedly -om-laining about --ildren mumbling and --ea-ing indi-tin-tly in the -la--room.  -ta-- meeting- were a nightmare. My brain -ad to wor- overtime to try to -ee- tra-- of di--u----ns --at I wa- too o-ten relu-tant to join in a- I -ould not be -ure what -ad been -aid. Al--ough I did not reali-e it at --e time it -a- be-ome a--arent --at --e --eer e--ort of ma-ing -en-e of -onver-a---n --roughout --e day wa- what -au-ed me to -lum- into a -oma-li-e -lee- every evening - --u- robbing me of true re-t and rela-ation a-tivitie-.  On o--a-ion- when I -tarted wat--ing a televi---n -ro-ramme I o-ten had to a-- family member- what had been -aid only to be told --at I --ould -ay -ull atten--on. I rarely -aw --e end- of -ro-ramme-. 

That is what someone with mild hearing loss might hear.  Would you like all your printed material written in this fashion?  People with hearing loss have no alternative to hearing that unless they are provided with hearing aids.  The full article can be viewed here:" https://bliss2hear.blogspot.com/2017/01/making-sense-of-speech.html

"Patients should be treated as individuals.  Only they can tell if hearing aids are helpful to them.  One senior audiologist told me that she could have two patients with exactly the same audiogram readings but the impact on their lives could be entirely different."

"NICE states that hearing loss can lead to isolation - depression and accelerated development of dementia.  There is a proven link between hearing loss and dementia and there is currently much research being carried out on this subject.  There is an old saying, "a stitch in time saves nine." Treat mild hearing loss and you could save money in the long run by reducing the need to treat depression and dementia."

"The social impact of hearing loss should not be underestimated.  I give talks and host information stands for Action on Hearing Loss and speak to many people with hearing loss - and their nearest and dearest.  The impact on the latter should not be underestimated. It is extremely frustrating to try to hold a conversation with someone who has difficulty hearing.  If the person with hearing loss has not already isolated themselves other people may do so. I have seen this happen many times. It is very sad to see someone in a room with others but not being involved in the conversation.  Please do not remove these lifelines for those of us who are aurally challenged."