Download Caring for older people with hearing loss

FACTSHEET
Caring for older
people with
hearing loss
A factsheet for staff members, volunteers and carers working
in sheltered housing, and residential and nursing homes for
older people.
If people do not have the right support to manage their hearing loss effectively, it can
have a significant impact on their life. This information aims to make it easier for you to
support residents who have hearing loss, so they can manage their condition, maintain
their independence and play an active part in their community.
All of the Action on Hearing Loss publications referred to in this factsheet are available
to view and download on our website at www.actiononhearingloss.org.uk/factsheets
Alternatively, you can order printed copies from our Information Line (see last page
for contact details).
To read our report A World of Silence: The case for tackling hearing loss in
care homes, which informs the key recommendations in this factsheet, visit
www.actiononhearingloss.org.uk/aworldofsilence
If you would like this factsheet in large print, Braille or audio format,
please contact our helpline (see last page for contact details).
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Caring for older people with hearing loss
Contents
• The need for action........................................................................................................................................... 3
• About hearing loss............................................................................................................................................ 3
• How to identify hearing loss.......................................................................................................................... 5
• How to improve communication.................................................................................................................6
• All about hearing aids...................................................................................................................................... 8
• Equipment to help with everyday living..................................................................................................12
• Welfare benefits................................................................................................................................................ 14
• How to assess your home............................................................................................................................. 14
• Where can I get further support?..............................................................................................................15
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Caring for older people with hearing loss
The need for action
About hearing loss
Hearing loss is a major public health issue
affecting more than 10 million people in
the UK – that’s one in six of the population.
By 2031, the number of people experiencing
hearing loss is expected to reach 14.5 million.
Hearing loss is usually described in terms of
severity: mild, moderate, severe or profound.
The most common type of hearing loss is
called ‘presbyacusis’ or ‘age-related hearing
loss’. It develops gradually with age (see below,
right). Around 70% of people aged over 70,
and more than 90% of people aged over 80,
are living with hearing loss.
This means that a large proportion of people
living in sheltered housing and residential
and nursing homes for older people will
have a hearing loss, whether or not they
have recognised it or sought help. It is vital
that these people are supported to manage
their hearing loss effectively, to minimise the
impact on their quality of life.
By 2031, the number
of people experiencing
hearing loss is expected
to reach 14.5 million
As a result of our recent research into how
hearing loss is managed in care homes, we
have identified three key recommendations
for everyone involved, directly or indirectly,
in providing care and support to residents:
1 Intervene earlier in hearing loss.
2 Meet communication needs.
3 Improve hearing aid use and management.
This factsheet explains how you can take action
in these key areas, and others, to support your
residents to enjoy a good quality of life.
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If someone has a mild hearing loss, they
will have some difficulty following speech,
especially in noisy environments. They
may wear hearing aids – if their hearing loss
has been diagnosed – and find lipreading
useful. They will nearly always use speech
to communicate.
Someone with a moderate hearing loss will
find it difficult to follow speech, especially in
noisy environments. They will probably wear
hearing aids and/or lipread (see page 6).
A person with a severe hearing loss may have
difficulty following speech, even with hearing
aids. They may lipread and/or use British Sign
Language (BSL) and communication support
(see page 7).
Someone with a profound hearing loss may
use BSL as their first or preferred language,
or lipread. People who use BSL often consider
themselves to be part of the Deaf community.
There are around 23,000 people in the
UK who are deafblind – that is, they have
a combined hearing and sight loss. Many
people who are deafblind have some hearing
and vision. Others will be totally deaf and/or
totally blind.
Age-related hearing loss
The most common type of hearing loss is
linked to the ageing process. To understand it
better, it is useful to know what happens in the
normal hearing process.
The ear is made up of three parts: the outer,
middle and inner ear. The outer part of the ear
directs sound into the ear canal towards the
eardrum, making it vibrate. These vibrations
are passed to three small linked bones (the
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Caring for older people with hearing loss
ossicles) in the middle ear. These bones
in turn send the vibrations into the cochlea
(the hearing organ in the inner ear) and the
fluid within it. Movement in this fluid bends
the tiny hair-like cells within the cochlea, and
this generates electric signals in the auditory
nerve (hearing nerve). These signals travel
along the nerve to the brain, where they are
interpreted as sound. Deafness can be caused
by problems in any part of this system.
Everyone loses hair cells in the cochlea as
they get older, and, gradually, their hearing
deteriorates and becomes less sharp. People
with age-related hearing loss find that others
seem to mumble. They often find it difficult
to understand what people say, especially in
noisy places, or when the TV or radio is on in
the background.
See our leaflet Understanding your ears
for more information.
The impact of hearing loss
If people are not supported to manage their
hearing loss effectively, it can lead to:
• communication difficulties
• social isolation
• anger and frustration
• low confidence, especially in social settings
• depression
• stress and anxiety.
Some people with age-related hearing loss
feel that it’s a normal part of ageing that they
just have to put up with. They quietly resign
themselves, completely unnecessarily, to a life
without active participation, perhaps believing
that there’s nothing that can be done about
it, or because they don’t want to make a fuss.
Others may want to seek help but may be
unsure of what they can do.
Recent research has also shown that there
is a link between hearing loss and dementia.
People with mild hearing loss have nearly
Everyone loses hair cells
in the cochlea as they get
older, and, gradually, their
hearing deteriorates and
becomes less sharp
twice the chance of going on to develop
dementia as people without any hearing loss.
The risk increases to threefold for those with
moderate, and fivefold for those with severe,
hearing loss.
Hearing and sight loss
As people get older, their sight, as well
as their hearing, begins to worsen. People
with a combined hearing and sight loss will
find communicating effectively especially
challenging. They may have problems reading,
getting around and carrying out simple
tasks without help. Sometimes, they may not
answer questions appropriately, which could
be misinterpreted as an early sign of dementia.
Older people with hearing and sight loss may
easily become withdrawn and depressed.
Their isolation may also have a negative effect
on their relationships with family and friends,
especially if they don’t visit very often.
See page 6 to find out how you can
communicate more effectively. You may also
find our factsheet Deafblindness useful.
Tinnitus
Tinnitus is a medical term to describe noise
that can be heard in one or both ears, or
inside the head, which has no external source.
It can be continuous or it may come and go.
The type and volume of sound can vary
greatly; some people experience a ringing,
others compare it to the sound of a train or a
short piece of music. The impact that tinnitus
has on someone’s life can also vary greatly
and is often underestimated. For some people,
tinnitus can lead to depression, anxiety, stress
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Caring for older people with hearing loss
and sleep problems. And, unfortunately, stress
and anxiety can make it seem worse. There
are several ways that someone with tinnitus
can try to minimise the impact that it has on
their life. The following may be used alone or
in combination:
• Therapies, including counselling, tinnitus
retraining therapy, cognitive behavioural
therapy, clinical psychology and/or
complementary therapies.
A delayed diagnosis of hearing loss has
significant and sad consequences: many
people miss out on getting hearing aids
who could benefit from them hugely.
How to recognise the signs
People with age-related hearing loss often:
• complain about others mumbling
• need to have things repeated several times
• Specialist tinnitus products, which generate
soothing sounds to distract people from
focusing on their tinnitus.
• complain that they cannot hear as well as
they used to
• Hearing aids – these may help people who
also have hearing loss, as hearing better
may distract them from their tinnitus.
• struggle to hear on the telephone
Read our leaflet Tuning out tinnitus
for more information or visit
www.actiononhearingloss/tinnitus
• fail to follow conversation in noisy places.
On average, there is a
10-year delay between
people identifying that
they may have a hearing
loss and seeking help
How to identify
hearing loss
Research shows that, currently, hearing loss
diagnosis is opportunistic and ad hoc – on
average, there is a 10-year delay between
people identifying that they may have a
hearing loss and seeking help.
Age-related hearing loss can often go
unnoticed for some time, as its signs can
be misunderstood. For example, if a resident
is unresponsive or confused, this may be
identified as a sign of dementia or a mental
health condition, rather than hearing loss.
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• don’t react to you
• have the TV or radio on very loud
You might also notice a change in behaviour
in residents. They could be more withdrawn or
stop taking part in conversation and activities.
This might be because of hearing loss.
What to do if a resident’s behaviour
suggests they may have a hearing loss
If you notice a resident struggling to hear, it is
best to discuss this with them. It could be that
they haven’t recognised it themselves, or they
may be unaware of the easy steps to take to
get a hearing loss diagnosed and treated.
The Action on Hearing Loss Hearing Check
As a first step, our Hearing Check can help
you to identify people who have hearing loss
and encourage them to take action. It’s a
quick and simple test that can be taken over
the phone or online. It’s not a full hearing test,
but it can indicate whether someone has a
hearing loss and whether they should go to
their GP for further tests.
To use the Hearing Check, call 0844 800 3838
(calls from a BT landline cost up to 5p per
minute. Other providers’ charges may vary, a
connection charge may apply) or visit www.
actiononhearingloss.org.uk/hearingcheck
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
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Caring for older people with hearing loss
Hearing loss can have
a big impact on a person’s
ability to communicate
and, therefore, their
quality of life
Diagnosis and treatment
If a resident thinks they have, or shows the
signs of, hearing loss or tinnitus, you should
arrange an appointment with their GP, who
will check for any underlying cause for hearing
loss, such as infections or wax, which may
be treated easily.
Good-quality digital hearing aids are free
as standard on the NHS and can also be
bought privately. If the resident wishes to
see an audiologist on the NHS, they will need
a referral from their GP. They do not need a
referral to see a private audiologist, but they
will have to pay for hearing aids.
We recommend that the resident visits their
GP first, even if they are considering seeing
an audiologist privately, to ensure that there
is no underlying cause of their hearing loss.
The resident and their family need also to be
aware of the options available when it comes
to hearing aids (see page 8).
Whether the resident sees an audiologist
on the NHS or privately, they will be asked
a series of questions about their hearing
loss, and the impact that it is having on their
life, and routine hearing tests will be carried
out. These tests will provide the audiologist
with vital information about whether there
is hearing loss and, if so, what type. From
this, they can establish what management is
needed – for example, hearing aids (see page 8).
For some types of hearing loss, surgery may
be an option. Some people will need to see
other specialists, such as an ear, nose and
throat doctor, for further investigation into
the cause of their hearing loss, tinnitus or
balance disorder.
Any Qualified Provider (AQP)
The government launched the AQP
scheme in some areas of England in 2012.
This means that any healthcare provider,
including the NHS, third-sector organisations
and private companies, can deliver adult
NHS audiology services – providing they
meet NHS quality requirements, prices and
contracts – with all services remaining free
to the patient. To find out more, see our
factsheet Everything you need to know
about getting hearing aids.
How to improve
communication
Hearing loss can have a big impact on a
person’s ability to communicate and, therefore,
their quality of life. There are simple things you
can do to aid effective communication:
Make lipreading easier
When we communicate face to face, facial
expressions, lip shapes and body language are
important. It’s likely that people with hearing
loss will rely on these visual clues even more
to help them follow what someone is saying,
even if they don’t realise it. Your residents with
hearing loss may benefit from attending a
local lipreading class, so you could see what’s
available. When someone is lipreading you:
• find a suitable environment with good
lighting, away from noise and distractions
• sit or stand at the same level and 3-6ft
away from the lipreader
• face the light, or your face will be in shadow
• make sure the lipreader is looking at
you before you speak
• introduce the topic of conversation
• speak clearly at a moderate pace, without
raising your voice.
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Caring for older people with hearing loss
• Use natural body language.
• Keep your face visible.
• Check that the lipreader is following you.
• Be patient and take time to communicate.
See our leaflet Learning to lipread for
more information.
Write down key words
• If you can’t make yourself understood, write
down key words (not everything) and then
continue the conversation.
• If the person has sight problems, use a
thicker pen or a different colour pen or
paper, and make your writing bigger. Work
together to find out what will help the most.
• Avoid using CAPITAL LETTERS. It’s the
written equivalent of shouting and doesn’t
actually make things clearer.
Use body language to convey meaning
• Point to objects, pictures or people that
you are talking about.
• Use facial expressions to show how you feel.
• Use objects to represent specific people,
things or activities. Place the object in
the person’s hand so they can feel or
smell it. This is often a good method for
communicating with deafblind people, or
people with learning disabilities or dementia.
For instance, you could place a tea cup in
their hand for “Would you like some tea?”
Help with communication support
If a resident’s family member is unable to
accompany them to a medical appointment
to lend support and help with communication,
you may need to go along instead. It is,
therefore, vital that you understand the
individual’s communication, or other, needs.
During an appointment, you may need to write
some things down if it’s clear that the resident
didn’t hear or understand something. Notes are
also useful for family members who can’t attend.
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You may need to
write some things
down if it’s clear that
the resident didn’t hear
or understand something
The resident may receive written information
from their healthcare professional before and
after an appointment. They can also ask to be
copied into any letters between healthcare
professionals, so that they are aware of what
was discussed during their appointment and
any onward referrals that have been made.
Professional communication support for
medical appointments can be booked and
paid for by the NHS; however, there may be
limited availability for some types (see below).
The GP should make it clear in new referral
letters that someone requires communication
support, so it can be booked in advance.
However, it’s a good idea to call the
department or service ahead of the resident’s
appointment, to check that they are aware
of the individual’s communication needs.
Communication professionals include sign
language interpreters, lipspeakers, notetakers
and speech-to-text reporters. For more
information, see our ‘Communications’
range of factsheets.
Create a comfortable environment
The physical environment has a considerable
impact on how easy it is for someone with a
hearing loss to communicate. There are many
simple things you can do to improve the
listening environment.
Decoration
• Consider replacing wooden flooring with
carpet, as this helps to absorb noise.
• Use soft furnishings, as these reduce sound
reverberation and echo.
• Avoid busy/bold patterns on walls and
curtains, as they can be distracting.
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Caring for older people with hearing loss
• Make sure there is good lighting in all areas,
without any glare or shadows.
Behind-the-ear (BTE) hearing aids
These rest behind the ear and send sound into
the ear in one of three different ways:
Dining room
• Use padded tablecloths to reduce the
clatter of cutlery and crockery.
• Introduce round dining tables, so everyone
can see each other.
A
Communication
• Reduce background noise whenever
possible. For example, turn off the TV if
no-one is watching, or turn on the subtitles.
• When using notice boards, type up notices
using lower-case letters and large print.
• If there are communal lounges, make sure
there are quiet areas so that people can talk
without the distraction of background noise.
• Contact Action on Hearing Loss to see
what deaf awareness training we can offer.
• Consider any additional needs of
your residents and consult specialist
organisations or charities for advice.
• Ask residents for feedback on the changes.
All about hearing aids
Many people with hearing loss find hearing
aids very helpful. But it can take some time for
people to adjust to their hearing aids and it’s
important that they get the support to make
the most of them.
Digital hearing aids are free on the NHS and
they can also be bought privately. Digital
means that the audiologist can fine-tune them
to match a person’s hearing loss and needs.
Different types of hearing aid
There are several different types of digital
hearing aid available. The audiologist will
advise which type is best according to
the individual’s hearing loss and lifestyle.
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a) Through a piece of clear,
flexible tubing connected
to an earmould, which fits
inside the ear. Most people
who get NHS hearing aids
have this type (see picture 1).
b) Through very thin, clear
tubing connected to a small,
soft earpiece at the tip of
the tubing, which sits inside
the ear canal (see picture 2).
This type is called an ‘open
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ear fitting’ and can be less
noticeable than an earmould. It can give a
very natural sound but is only suitable for
people with mild to moderate hearing loss.
c) Through a clear tube
with a wire inside, which
runs from the hearing aid to
a tiny loudspeaker held in
the ear by a soft earpiece
(see picture 3). These are
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most commonly known as
‘receiver in the ear’ or ‘loudspeaker in the ear’
hearing aids and they are now available from
some NHS audiology services.
In-the-ear (ITE) and in-the-canal (ITC) aids
These have their working
parts in the earmould so the
whole aid fits into the ear (see
picture 4). They tend to need
repairing more often than
BTE aids and can be fiddly.
4
Body-worn hearing aids
These have a small box
that clips to clothes or can
be put in a pocket (see
picture 5). This is connected
by a lead to an earphone
and earmould. Body-worn
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Caring for older people with hearing loss
hearing aids are very powerful and may be
more suitable for people who have sight
problems and/or problems using their hands.
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1 Hold the earmould at the
back with your finger and
thumb. Pull it back past
the ear.
See our factsheet Everything you need to
know about getting hearing aids to find out
more, and for information on bone-conduction
and CROS/BiCROS hearing aids.
Hearing aid settings
Many digital hearing aids have settings for
different listening conditions. Some adjust
automatically in response to different sound
environments; others will have to be activated
manually (by hand).
If a resident is going through the process of
getting hearing aids, tell the audiologist about
any particular difficulties that they may have
been experiencing or activities they regularly
take part in. A choice of listening programmes
may be of benefit to them in these situations.
The audiologist will discuss how to use the
hearing aids and any particular settings that
may be of benefit.
The ‘loop’ setting (formerly the ‘T’ setting)
Most hearing aids have a loop setting. This lets
them pick up sound from listening equipment,
such as hearing loop systems, which can
be found in public places such as cinemas,
theatres and banks, and can help people to
hear more clearly over background noise. You
can also get loops for home use (see ‘What is
a hearing loop?’, page 12). Ask the resident’s
audiologist about the loop setting.
2 Put the part that goes
down the ear canal
into position.
3 Then put in place the bit
that goes into the crease at
the top of the ear.
4 Use your other hand
to pull down the earlobe.
Push the earmould firmly
into position.
5 Correctly fitted
hearing aid.
Fitting a BTE hearing aid with an
earmould – see guide opposite
The earmould is the part of the hearing aid
that goes inside the ear. The hearing aid
tube then hooks around the top of the ear,
sitting snugly behind the ear. If a person has a
hearing aid for each ear, there will usually be
some marker so you can tell which aid is for
each ear – for example, a red mark on the aid
for the right ear. If in doubt, check with the
person who fitted the hearing aids.
6 Incorrectly fitted hearing
aid – the top part of the
earmould is not properly
tucked into the crease at
the top of the ear.
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Caring for older people with hearing loss
Fitting a BTE hearing aid with
an open ear fitting
1 Hold the hearing aid
behind the ear with the
soft tip facing towards
the head.
2 Place the soft tip in the
ear with the tail facing
backwards. Push the tip
in as far as it will
comfortably go.
Tips for cleaning BTE hearing aids
with an earmould
• Clean the main part of the hearing aid by
wiping it with a soft, dry cloth or tissue.
Take care not to get it wet.
• Wipe the earmould with a soft, dry cloth or
tissue every night. Don’t use any chemicals
as they could damage it. Use a pin or similar
item to remove any wax or debris that
has got into the channel that goes through
the earmould.
• About once a week, you should separate
the earmould from the hearing aid and
wash it. However, you should check this
with the audiologist first.
Follow the instructions below for washing
the earmould:
3 Fold the tail backwards
into the bowl of the ear.
Sometimes, when it’s new,
the tail does not stay in
place, but after a few days
it should mould itself to the
shape of the ear.
4 Correctly fitted
hearing aid.
Ask the audiologist if you want to find out
about fitting other types of hearing aid.
Cleaning BTE hearing aids
When someone has their hearing aids fitted,
they should be given written instructions
about how to look after them. If you are not
sure about any of the information, or do not
have access to it, ask the resident’s audiologist
for advice.
Cleaning is different depending on whether
someone has an earmould, open fitting or
receiver-in-the-canal hearing aid.
1 Gently pull the soft
tubing off the hooked
part of the hearing aid by
holding onto the tubing
with one hand and the
hook of the aid with the
other and tugging gently.
Don’t pull the tubing out
of the earmould as you
won’t get it back in.
2 Wash the earmould
(with its tubing still in
place) in warm, soapy
water. Use a nailbrush
or a vent cleaner (or
both) to remove any
wax. Rinse it well, blow
down the tubing to get
the water out and leave
it to dry overnight. Then
push the tubing back
onto the hearing aid.
3 Make sure the curve of
the earmould goes the
same way as the curve
of the hearing aid, as
shown in the picture on
the right.
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Caring for older people with hearing loss
Cleaning BTE hearing aids with an
open ear fitting
The step-by-step guide below shows you how
to clean the tubing of an open-ear-fitting
hearing aid. You will need a very thin cleaning
tube to help you clean the dome and tube –
this should be issued by the audiologist.
The way you take off the tubing for cleaning
is a bit different from one model to another.
So, before you start, you’ll have to check the
instructions you have been given.
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2
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Need a little extra help?
The Action on Hearing Loss Hear to Help
hearing aid support service helps people
to manage and maintain their NHS hearing
aids through home visits and drop-in
services. It is run by Community Support
Officers and volunteers, who can:
• replace hearing aid tubing
• make minor repairs
• show you how to clean earmoulds
and tubes
• show you how to replace your hearing
aid battery
• provide basic training and tips on how
to get the most from hearing aids
• provide information on other equipment
and services.
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As yet, the service doesn’t cover the whole
of the UK but it’s growing all the time.
Call our Information Line (see bottom of
page for contact details) to find out if there
is a Hear to Help service in your area.
For information about cleaning receiver-inthe-ear hearing aids, and other types, see
our leaflet Adjusting to your hearing aids.
How to replace hearing aid batteries
Hearing aid batteries need to be changed
regularly. It’s unlikely that they will last much
longer than a week to 10 days if someone
wears them continuously. Someone with
NHS hearing aids can get free batteries from
any hospital audiology or ENT department
that has a battery service. Some local health
centres supply batteries, and pharmacies
also sell them. You can also order batteries
from local health centres and audiology
departments by post.
You will usually need to take the resident’s
hearing aid record book to the hospital
department to pick up the batteries, or
include the record book in the envelope if
you are requesting batteries by post. The
record book will help staff at the audiology
department find the right type of battery for
the hearing aid.
To save the batteries, make sure that hearing
aids are turned off at night and turned on
again in the morning. Most hearing aids will
be set to beep when their batteries are about
to run out, but this will only be heard by the
person wearing the hearing aids.
If you care for several people who wear hearing
aids, have a set time each week to help them
change their batteries (if necessary) and
to check their aids for wear and tear. This
could be particularly useful if they have sight
problems and/or problems with their hands,
and find cleaning their hearing aids difficult.
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Caring for older people with hearing loss
When supporting people
with hearing aids...
Equipment to help
with everyday living
• Check and record every day that your
residents’ hearing aids are working and
that they are wearing them correctly.
There are three main categories of equipment
designed for people with hearing loss:
• Know how to use the ‘loop’ setting and
different controls on the hearing aids,
how to change the batteries and how
to clean the hearing aids.
• Make sure that there are adequate
arrangements for hearing aid re-tubing,
repairs and battery replacement.
• Make sure that there are adequate
arrangements to minimise the number
of lost hearing aids, and to make sure
that lost hearing aids are replaced quickly.
• On the medication checklist, put a
reminder to change hearing aid batteries
weekly and make sure care plans have
information on each resident’s hearing
aid needs.
• Understand that other long-term
conditions may have an impact on
hearing aid use; for instance, people
with dementia may forget that they have
hearing aids.
• If someone is having problems with their
hearing aid, check that all the parts are
fitted correctly, that there aren’t any
obvious signs of damage (for example,
split tubing), and that it’s on the right
setting. If you’re not sure how to fix the
problem, contact the audiologist.
• Know who to consult (for example, a GP
or nurse) to examine ears for wax and to
arrange ear syringing, where appropriate.
For materials to help you support residents
with hearing aids, including a care plan
that you can use to ensure battery changes
are done regularly and logged, and a
troubleshooting guide, visit our website
at www.actiononhearingloss.org.uk/
helpingyoucare
• alerting equipment
• listening equipment
• telephones.
Alerting equipment
This includes alarm clocks, smoke alarms,
doorbells and other devices. They make a
louder noise, flash and/or vibrate to alert a
person with a hearing loss. In a residential
home they can help people maintain their
independence and privacy.
We recommend you install
hearing loop systems in
the TV rooms, communal
rooms and reception areas
of your home
Listening equipment
This amplifies sound (makes it louder) and
reduces background noise. Most listening
equipment can be used to listen to speech
and can also be connected to a TV, radio or
music system (with cables or through wireless
technology). People who do not wear hearing
aids can use the equipment with headphones.
Those with hearing aids will need to wear
either a neckloop or ear hooks and set their
aids to the loop setting to listen.
What is a hearing loop?
Loop systems usually consist of an amplifier
and a wire cable (loop) that goes around
the listening area and plugs back into the
amplifier. The amplifier then plugs into audio
equipment, such as a microphone or TV. The
electric current in the loop produces
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
Caring for older people with hearing loss
a magnetic field that sends sound directly to
people’s hearing aids when they’re on the loop
setting, helping them to hear more clearly.
People who don’t wear hearing aids can
benefit from loop systems by using a loop
listener, a portable device that has earphones
or headphones.
We recommend you install hearing loop
systems in the TV rooms, communal rooms
and reception areas of your home, to let
your residents with hearing loss join in social
activities. See ‘How to get equipment’, right.
Social services is
responsible for assessing
the home equipment needs
of people with a disability
Telephone equipment
If turning up the volume of the ringer on
your existing telephone, or changing its pitch,
doesn’t make it easier for people with hearing
loss to hear, and use, the phone, you could
try a telephone amplifier (this only works on
phones that have the dialling pad on the base
unit). Or, you could add an extension bell or
flashing light in one or more rooms. You can
also buy phones that have a built-in amplifier
and/or flashing light, and some phones have
a built-in hearing loop, so they can be used
with hearing aids set to the loop setting.
A textphone has a keyboard and a display
screen. Instead of speaking into a telephone
mouthpiece, the person types what they want
to say using the keyboard. Someone who
uses a textphone can use Text Relay, a service
that relays conversations between people
who use textphones and those who use voice
telephones (see page 18 for contact details).
See our ‘Equipment’ range of factsheets for
more information.
13
How to get equipment
Social services is responsible for assessing
the home equipment needs of people with a
disability. Sensory support staff are trained to
understand the needs of people with hearing
loss and will be able to tell you what support
is available, so do get in touch with your local
social services department.
Equipment is supplied on a loan basis and
eligibility is based on hearing loss rather
than being means tested. Equipment is also
available for people with a sight loss.
Try before you buy
If you think that someone in your care could
benefit from equipment, you can also buy
products privately. But make sure you try
them out first. Many audiology clinics, hearing
therapists, hearing resource centres and
social services departments have equipment
for people to try out. Normally, you have to
make an appointment to do this. Contact our
Information Line (see bottom of page) to find
the resource centre nearest to you.
Specialist suppliers
There are a number of suppliers that sell
equipment for people with hearing loss.
Action on Hearing Loss is the only UK charity
with a full range of products for people with
hearing loss and/or tinnitus, so we are full
of impartial advice. Contact us (see ‘Action
on Hearing Loss Products’, page 16) for our
catalogue, Solutions, or shop online
at www.actiononhearingloss.org.uk/shop
When buying equipment, look out for:
• a 21-day or 28-day money-back guarantee –
so you can return goods if they are
not helpful.
• a VAT exemption certificate – some
products can be bought without having
to pay VAT. The certificate is a simple form
saying that the person has a hearing loss
and is claiming exemption.
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
14
Caring for older people with hearing loss
Welfare benefits
How to assess your home
There are several benefits that people with
hearing loss may be entitled to, such as:
Please use this checklist to assess how well
your home supports residents who have
hearing loss, and to work out what action
you need to take.
Attendance Allowance (AA)
Adults aged over 65 can claim AA if they have
a disability that affects their everyday life.
People with hearing loss may qualify if they
need help with communication every day, or
if they have other disabilities.
Disability Living Allowance (DLA) /
Personal Independence Payment (PIP)
Adults up to the age of 64 can claim DLA
if they need support to communicate, or if
they have mobility problems as a result of
hearing loss or physical limitations. However,
the government is replacing DLA with a
new benefit called Personal Independence
Payment (PIP). From June 2013, no new
claims for DLA will be accepted (this is from
April 2013 in certain areas). People currently
receiving DLA will have to apply for PIP from
October 2015.
Disabled person’s railcard
People who are registered deaf or use an
NHS hearing aid, or who receive benefits
such as AA, can qualify for a disabled person’s
railcard. See page 17 for details of where you
can find out more.
War-related benefits
People whose hearing was affected by
service in the armed forces may be able to
claim War Disablement Pension or Armed
Forces Compensation, but very strict rules
apply. Some civilians disabled during wartime
are also covered.
For more information about the benefits that
people with hearing loss, and their carers,
may be entitled to, see our ‘Benefits’ range
of factsheets.
Deaf awareness
• Have all of the staff and volunteers
who work in your home had deaf
awareness training?
• Has there been any staff turnover since
your last deaf awareness training session?
• Have you ever invited Action on Hearing
Loss to give a talk to your staff?
Communication
• Are staff members aware of communication
techniques for people with hearing loss, and
do they use them?
• Do staff members communicate clearly?
• Do staff members take steps to stimulate
conversation among people in your home?
• Do you know which of your residents have
hearing difficulties or have ever been issued
with a hearing aid?
• Have you ever referred anyone for a
hearing test?
• Do staff members know about the
communication support, such as a sign
language interpreter, that is available to
residents who would benefit from it?
• Do staff members understand how people
can use listening equipment, such as
hearing loops, in order to manage their
hearing loss?
• Have staff members been trained to look
after hearing aids, including cleaning?
• Do you have procedures to alert everyone
to a possible fire in the night?
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
Caring for older people with hearing loss
The living environment
• Does your home have:
–– telephones that are fitted with a hearing
loop or are specially designed for people
with hearing loss?
–– textphones (if residents can’t use
amplified telephones)?
–– a hearing loop or infrared system in
TV rooms, communal rooms and
reception areas?
–– clear procedures for checking that all
hearing loop or infrared systems are
checked and maintained regularly?
–– flashing smoke alarms?
–– accessible entry systems, or
alternative procedures?
–– accessible lifts with visual indicators?
–– good lighting in all areas?
–– TVs with digital subtitles?
–– reserved quiet areas, without TVs,
where residents can go to chat?
–– procedures in place to minimise the
amount of background noise; for instance,
are table cloths are used to dampen the
sound of cutlery at meal times?
–– a notice board in a good position?
–– a seating arrangement that is helpful
for communication?
• Do you include relevant information in your
prospectus for potential residents with
hearing loss and their families?
Louder than Words
You could work towards the Action on
Hearing Loss Louder than Words best
practice charter to demonstrate your
commitment to providing the best level
of service and accessibility to residents
with hearing loss and staff.
To find out more, contact our
Information Line (see bottom of page)
or visit www.actiononhearingloss.org.uk/
louderthanwords
Where can I get
further support?
Action on Hearing Loss
We are the largest charity in the UK
tackling hearing loss and making
hearing matter.
• We give advice and information.
• We provide services and develop
technologies to improve the lives of
people with hearing loss and/or tinnitus.
Information
• We conduct research and run campaigns
to understand and change people’s
attitudes to hearing loss.
• Do you ensure that residents are able
to access audiology departments,
when appropriate?
Action on Hearing Loss
Information Line
• Are staff members aware of services
available, such as our Hear to Help hearing
aid support sessions (see box, page 11), and
do they facilitate residents’ use of these
services, where appropriate?
• Do you access and make available external
sources of information, such as our
factsheets and leaflets about hearing aids,
to residents and their families?
15
Our Information Line is a great place to start if
you want more information on hearing loss or
tinnitus, or about the work we do.
Telephone 0808 808 0123
Textphone 0808 808 9000
SMS 0780 000 0360
Email [email protected]
19-23 Featherstone Street, London EC1Y 8SL
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
16
Caring for older people with hearing loss
Free support and information
We produce a wide range of free publications.
Our leaflets give you concise introductions to
various aspects of hearing loss and tinnitus,
and our factsheets go into more detail.
You can order these from our Information Line
(see page 15) or download them from our
website at www.actiononhearingloss.org.uk/
factsheets
Action on Hearing Loss website
Visit our website – www.actiononhearingloss.
org.uk – for information about hearing loss
and tinnitus, the latest news stories, details
of our services, campaigns, research, website
forums and much more.
Action on Hearing Loss Products
We sell equipment that can improve the
everyday lives of people with hearing loss.
Visit our online shop to see our full range
of products for people with tinnitus and/or
hearing loss at www.actiononhearingloss.
org.uk/shop. Or you can request a copy of
our Solutions catalogue by contacting our
Customer Services team directly:
1 Haddonbrook Business Centre,
Orton Southgate, Peterborough PE2 6YX
Telephone 01733 361 199
Textphone 01733 238 020
Fax 01733 361 161
[email protected]
Action on Hearing Loss Care Services
We provide high-quality residential care and
community services. This includes supported
housing and outreach for people who have
hearing loss and additional special needs.
We aim to maximise the quality of life of
the people who use our services and help
them to reach their highest possible level
of independence. Our services are mainly
purchased by local authorities and health
agencies across the UK.
Action on Hearing Loss Care Services
Tel/textphone 01225 485761
Email [email protected]
Other organisations
Age UK
The UK’s largest organisation working with
and for older people.
Telephone 0800 169 6565
www.ageuk.org.uk
Association of Teachers of
Lipreading to Adults (ATLA)
Provides details of local lipreading classes.
ATLA c/o Hearing Link
27-28 The Waterfront
Eastbourne
East Sussex BN23 5UZ
[email protected]
www.lipreading.org.uk
British Deaf Association (BDA)
The organisation representing the sign
language community.
BDA Head Office
18 Leather Lane
London EC1N 7SU
[email protected]
www.bda.org.uk
Benefit Enquiry Line
Provides confidential advice and information
for people with disabilities, and their carers
and representatives, about social security
benefits and how to claim them.
Telephone 0800 88 22 00
Textphone 0800 24 33 55
For specific information about Attendance
Allowance and Disability Living Allowance,
contact the Disability and Carers Service:
Telephone 08457 123 456
Textphone 08457 224 433
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
Caring for older people with hearing loss
For Carer’s Allowance, contact the
Carer’s Allowance Unit of the Disability
and Carers Service:
Telephone 01253 856 123
Textphone 01772 899 489
For pension credit applications:
Telephone 0800 99 12 34
Textphone 0800 169 01 33
British Tinnitus Association (BTA)
Provides support, advice and information
about tinnitus.
BTA
Ground Floor, Unit 5
Acorn Business Park
Woodseats Close
Sheffield S8 0TB
Telephone 0800 018 0527
Textphone 0114 258 5694
Fax 0114 258 2279
[email protected]
www.tinnitus.org.uk
Citizens Advice Bureau (CAB)
Helps people resolve their legal, money
and other problems by providing free,
independent and confidential advice. Find
details of your local office in the telephone
directory or visit www.citizensadvice.org.uk
Deafblind UK
Provides services and support for
deafblind people.
Deafblind UK Head Office
National Centre for Deafblindness
John and Lucille van Geest Place
Cygnet Road
Hampton PE7 8FD
Tel/textphone 01733 358 100
Fax 01733 358 356
Email [email protected]
www.deafblind.org.uk
17
Disabled person’s railcard
Apply online for money off rail travel in Britain.
Telephone 0845 605 0525
Textphone 0845 601 0132
www.disabledpersons-railcard.co.uk
Health Care and Professions Council
Responsible for the regulation of health,
psychological and social work professionals,
including hearing aid dispensers.
Telephone 0845 300 6184
Fax 020 7820 9684
www.hpc-uk.org
Hearing Link
Provides a variety of services for people
who are deafened, their families and the
professionals who work with them.
Hearing Link Head Office
27-28 The Waterfront
Eastbourne BN23 5UZ
Telephone 0300 111 1113
SMS 07526 123 255
[email protected]
www.hearinglink.org
Hearing Dogs for Deaf People
Trains dogs to alert severely and profoundly
deaf people to specific sounds, whether in the
home, the workplace or public buildings.
The Grange
Wycombe Road
Saunderton
Princes Risborough HP27 9NS
Tel/textphone 01844 348100
Fax 01844 348101
[email protected]
www.hearing-dogs.org.uk
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
18
Caring for older people with hearing loss
National Association for
Deafened People (NADP)
The national representative organisation
for deafened people.
NADP
Dalton House
60 Windsor Avenue
London SW19 2RR
Telephone 0845 055 9663 (answerphone –
they will get back to you as soon as possible)
SMS 07527 211 348
www.nadp.org.uk
RNIB
Offers information, support and advice to
people with sight problems.
RNIB Headquarters
105 Judd Street
London WC1H 9NE
Telephone 0303 123 9999
[email protected]
www.rnib.org.uk
Sense
The UK’s largest organisation for deafblind
children and adults.
Telephone 020 7520 0999
Fax 020 7520 0958
[email protected]
www.sense.org.uk
Signature
Campaigns to improve the standards of
communication with deaf and deafblind people.
Mersey House
Mandale Business Park
Belmont
Durham DH1 1TH
Telephone 0191 383 1155
Textphone 07974 121594
Fax 0191 383 7914
[email protected]
www.signature.org.uk
Sign Health
The national society for mental health
and deafness.
Sign Health
5 Baring Road
Beaconsfield HP9 2NB
Telephone 01494 687 600
SMS 07966 976749
Fax 01494 687 622
[email protected]
www.signhealth.org.uk
Text Relay
The national telephone relay service
for people with hearing loss.
Text Relay Team
c/o Internal Box 14
Telephone House
170-175 Moor Lane
Preston PR1 1BA
Telephone 0800 7311 888
Textphone 0800 500 888
[email protected]
www.textrelay.org
We welcome
your feedback
If you have any comments or suggestions
relating to this factsheet, or if you’re interested
in joining our Readers’ Review Panel, we’d love
to hear from you. Your honest feedback will
help us to improve our information.
To find out more, or to provide us with
your comments, please email us at
[email protected] or write
to Information and Publications, Action on
Hearing Loss, 19-23 Featherstone Street,
London EC1Y 8SL.
Free Information Line: 0808 808 0123 (telephone) / 0808 808 9000 (textphone)
We’re Action on Hearing Loss, the charity working
for a world where hearing loss doesn’t limit or
label people, where tinnitus is silenced – and
where people value and look after their hearing.
We provide care, support and information; raise
awareness of hearing loss issues; campaign and
lobby to change public policy; and fund research
into a cure for hearing loss and tinnitus.
To find out more, visit
www.actiononhearingloss.org.uk
Our friendly helpline team is waiting
to answer your call or email:
Telephone 0808 808 0123
Textphone0808 808 9000
SMS
0780 000 0360
(standard text message rates apply)
Email [email protected]
© Action on Hearing Loss
Caring for older people with hearing loss, version 01, published March 2013.
This information will be updated and reviewed in March 2014.
Action
on Hearing
Loss is the
trading
name
The Royal
National/Institute
for Deaf
Free
Tinnitus
Information
Line:
0808
808of
6666
(telephone)
0808 808
9000People.
(textphone)
A registered charity in England and Wales (207720) and Scotland (SC038926) A0615/0313