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Transcript
Care & Usage of Hearing Instruments in a Skilled Nursing Facility Statistical Information • As many as 70-80% of nursing home residents may have some degree of hearing loss. • In residents with hearing aids, approximately 50% will have hearing aids that are malfunctioning or are in need of repair. Role of the CNA • As the caregiver who has the most frequent contact with the resident, it is important that the CNA: – recognize the symptoms of hearing loss – understand how a hearing aid works – know how to keep hearing aids working – learn how to troubleshoot hearing aid problems – know how to effectively and appropriately communicate with the hearing impaired resident Lesson Instructions • Use the Table of Contents on the next two slides to hyperlink to the various components of this lesson. Click on the icon next to each topic. • When you have completed the lesson, see your instructor in order to complete the practical demonstration and the written test. Table of Contents Table of Contents (continued) Anatomy of the Ear Three parts of the human ear: • Outer ear • Middle ear • Inner ear Anatomy of the Ear Outer Ear Middle Ear Inner Ear Outer Ear • Auricle or pinna • External auditory canal Outer Ear Auricle (pinna) External auditory canal Middle Ear • Tympanic membrane (ear drum) • Three bones: – Malleus – Incus – Stapes Middle Ear Tympanic membrane Inner Ear • • • • • Semicircular canals Cochlea Auditory nerve Round window Eustachian tube Inner Ear Semicircular canals Auditory nerve Round window Eustachian tube Anatomy of the Ear Auricle (pinna) Semicircular canals Auditory nerve External auditory canal Tympanic membrane Round window Eustachian tube Return to Table of Contents Types & Causes of Hearing Loss Hearing loss can occur in any or all parts of the ear. Types of Hearing Loss • Conductive – problem with conduction, or the transfer of sound, through outer or middle ear • Sensori-neural – dysfunction of inner ear; involves problem with nerve and/or sound interpretation • Mixed – combination of conductive and sensori-neural hearing loss Some Causes of Conductive Hearing Loss • Debris blocking ear canal (example: wax or other foreign objects) • Fluid build-up behind ear drum (example: otitis media) • Perforated ear drum Some causes of Sensori-neural Hearing Loss • Dysfunction of inner ear related to: – – – – aging process (presbycsis) chronic noise exposure toxic medications viral infections (mumps; meningitis) Example of Mixed Hearing Loss • Hearing loss related to aging, plus hearing loss related to infection and fluid behind the ear drum. Return to Table of Contents Symptoms of Hearing Loss • • • • High volume on TV, radio Talking loudly Frequently asking to have things repeated Complaints of not understanding what has been said • Intently watching face of speaker More Signs of Hearing Loss • Cupping the ear • Lack of response to questions • Frequent inappropriate or incorrect answers to questions • Frustration; anger • Confusion • Withdrawal Return to Table of Contents Types of Hearing Aids • • • • Completely-in-the-canal (CIC) In-the-canal (ITC) (half shell) In-the-ear (ITE) (full shell) Behind-the-ear (BTE) In the ear (half shell) (full shell) Behind the ear Return to Table of Contents How a Hearing Aid Works • Power source = battery • Microphone - receives sound wave and converts it into an electrical signal • Amplifier - increases intensity of incoming sound • Receiver - converts electrical signal back into audible sound wave that can be heard Return to Table of Contents Identifying Parts of the Hearing Aid Behind-the-ear ear-piece Volume control Tubing OTM switch Battery door Canal portion Ear mold (body) Identifying Hearing Aid Parts • O-T-M switch -- turns hearing aid on and off, and adjusts for use on telephone. O=Off T=Telephone M= (microphone) On • Volume Control - permits the user to increase or decrease loudness of sound Return to Table of Contents Care of Hearing Aids • Store in a labeled • Cleaning container, away from – Clean regularly moisture/heat – Wipe off accumulated debris from ear mold • Remove battery when with kleenex not in use for – Use wax pick , extended period of toothpick or small time brush to remove ear wax • DO NOT DROP Care of Hearing Aids • Test hearing aid battery at least every 2 weeks. • Battery should register 1.4 on the tester. • Replace battery as needed. • A “listening check” of hearing aid should be done regularly. To reduce risk of choking, swallowing, KEEP BATTERIES OUT OF RESIDENT’S REACH Return to Table of Contents Troubleshooting Hearing Aid Problems Potential Problems • No amplification or sound • Weak/reduced sound • Whistling • Buzzing • Static Troubleshooting Hearing Aid Problems • • • • • Turn OTM switch to “M” Adjust volume Check battery position Test battery Replace battery, if needed • Clean / Remove wax • Check hearing aid for damaged/broken parts • Notify your supervisor Return to Table of Contents Communicating with the Hearing Impaired • Speak at slightly • greater intensity. DO NOT YELL. • Speak at normal pace -- not too rapidly. • Speak from a distance • not greater than 6 feet; but, preferably, not less than 3 feet. Make sure you are visible to resident when speaking so that your facial expressions and gestures can be seen. Try to reduce environmental noise. Communicating with the Hearing Impaired • NEVER speak directly into • Rephrase, rather than person ‘s ear. (Clarity just repeat, your may be lost as loudness statement or question is increased; and when it appears that a resident can’t make use resident doesn’t of visual cues.) understand. • Do not over-articulate. • Treat all residents with This distorts sound as courtesy and respect. well as facial expressions. End of Presentation • You have now completed the Lesson on Care & Usage of Hearing Instruments in a Skilled Nursing Facility. • See your instructor for a practical demonstration on hearing aids, and to complete the written test.