Coronavirus Got You Stuck at Home? It’s a Good Time to Improve Your Hearing.

Social Isolation can get awfully boring. Many of us find ourselves with not much to do except anxiously watch TV. Here’s a suggestion: make the most of house arrest by tackling one the online auditory rehabilitation programs. virus-4835736_1920-1

Working on hearing better during this period has an added benefit. Since you are probably isolated and not talking to many people, it can help keep the hearing parts of your brain limber.

Essentially, rehab is a way to train your brain to recognize the signals coming via a hearing aid or cochlear implant as specific sounds: rehab focuses on speech sounds primarily, but also helps you to distinguish the sound of banging the lid on a trash can from the bark of a dog or a human shout. Here’s a good explanation from the HLAA website.)

Most of the online programs offer targeted training, like listening to music, as well as basic training that exposes the listener to speech in noise, gradually increasing the ratio of noise to speech. Training can teach you how to focus on one speaker when others are talking, how to retrieve the one word in a sentence you may have missed, how to improve speech-reading, and other general strategies for maximizing your hearing. These are all similar to clinician-based programs, but they are done at home.

After training, scientists can actually see differences in the way the brain responds to trained and untrained sounds, according to Kelly Tremblay, an audiologist and auditory neuroscientist, formerly on the faculty of the University of Washington and a member of the Board of Directors of the Hearing Loss Association of America. In her research, Dr. Tremblay has shown that it doesn’t really matter what specific type of training you do. There is no one-size-fits-all. Even passively listening to sound changes brain activity, including listening to recorded books.

Formal hearing rehabilitation programs are scarce. Fortunately, hearing rehab can be done at home on your own. Quite a few programs can be found online. Most are designed for recipients of cochlear implants, but they can also be useful for new and longtime hearing aid users.

One place to start is with the websites of the three companies licensed in the United States to provide cochlear implants. These programs are free: The Listening Room (Advanced Bionics), Soundscape (Med-El),  The Communication Corner (Cochlear).

Programs independent of the cochlear implant companies include Neurotone’s online LACE (Listening and Communication Enhancement) Listening Program, which was developed by two UCSF audiologists. LACE is available in three increasingly sophisticated levels, with programs for both PC and Mac, as well as DVD. The cost for the program varies but is generally less than $100.

Read My Quips (or RMQ ) is a kind of crossword puzzle. A man and a woman alternately recite lines that take an unexpected twist at the end. You listen as many times as necessary to fill in the crossword blanks. The idea is to be able to understand in louder and louder background noise. An article on the Starkey hearing-aid site is a useful guide to rehab and RMQ: Training the Brain: Hearing Aids and RMQ. (I’m including RMQ in this post because I enjoyed using it in the past, but I have been unable to sign on to their website, so it may no longer be available.)

For further reading, The website for Cochlear Americas also includes an excellent article, Cochlear Implant Rehabilitation: It’s Not Just for Kids! by Donna L. Sorkin and Nancy Caleffe-Schenk.  The Hearing Loss Association of America also offers a guide to listening training programs.

You can also read my 2018 post Learn How to Listen, which discusses some of these same technologies and a few others.

My two previous posts suggested ways for the deaf and hard of hearing to stay in touch  during this period: The first was Coronavirus Concerns for People with Hearing Loss: It’s Not Just the Disease).  The second, written as the pandemic worsened and rules for social isolation quickly changed, was I Take It All Back!

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For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

 

 

 

I Take It All Back!

 

Well, not all of it. But some of what I said last week — “Coronavirus Concerns for People with Hearing Loss. It’s not just the disease” — is already out of date. This is a very fast-moving story.

 

Resist isolation. Get outside. Take a walk, I said. Wrong.

A week later, it’s clear that’s not a good idea, especially for older people. Unless you live in a private home, to get outside you have to walk through a public space, a lobby perhaps, and maybe take an elevator. The coronavirus lasts a long time on dry surfaces and so just pushing an elevator button or opening a door can expose you. One solution is to wear gloves and make sure that you don’t touch the palms when you take them off. Nitrile or latex disposable gloves are the best, but they are probably in short supply by now. These are single use gloves and your conscience may rebel at the environmental impact. But it’s your life you’re talking about.

     Have a friend for lunch. Wrong.

“One of you is unlikely to infect the other if you both feel well,” I wrote. That was last week. This week we know that anyone can be an invisible and unaware carrier. It’s not worth it if you’re in a high-risk category. Learn to use FaceTime or Skype to keep in touch with family and friends. Here’s a very good article in The Atlantic on the subject.

     Videoconferencing. I was right about this one. 

Video or audio sessions, sometimes over FaceTime or Skype, quickly became the norm for psychotherapists and for anyone who conducts one on one counseling or informational sessions as part of their work. It happened practically overnight. With doctors, it’s called telemedicine. Telemedicine, incidentally, is a technology that is increasingly useful for people with hearing loss who live in areas where there aren’t many audiologists. Hearing aids can be programmed remotely these days. If coronavirus forces us to use telemedicine, it’s probably for the longterm good for hearing-aid users.

     The telephone. This is still a good choice.

But my recommendation to get a captioned landline from Captel or CaptionCall or one of the other companies may have to be put on hold. If you have a smart phone, definitely try Innocaption+. You can download it for free on the App store. The instructions that come with the app are clear and easy to follow. Innocaption+ support is available by email or by phone. I’ve always found them responsive.

     Chat electronically.

You can do this as email or text, or in various chat and message programs. If you’re not comfortable typing, dictate your messages. Just press the microphone icon below or to the left of the keyboard on either Apple or Android message/phone apps. There will be some garble but it’s much easier to go back and correct than it is to type the whole thing.

     Virtual Chapter meetings.

Most HLAA chapter meetings around the country have been canceled for the foreseeable future. HLAA already has a setup for virtual chapters, including one for veterans. Those of us who are #HLAA chapter leaders (I’m the President of the New York City Chapter) should put our heads together and figure out how to have an interactive meeting virtually. I’m sure HLAA can help us but I’d love suggestions from people with more tech expertise than I have about webinars and web-ex meetings.

 

For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

 

 

 

Coronavirus Concerns for People with Hearing Loss. It’s not just the disease.

[This is a repost that contains new information on surgical masks.]

The new coronavirus COVID-19 is an equal opportunity infector, affecting rich and poor, young and old, healthy and sickly. Among the more prominent victims is an attendee at the annual Conservative Public Action Conference (CPAC), exposure to whom has led President Trump’s new chief of staff to self-quarantine. The head of New York’s Port Authority and his socialite wife, the head of the Central Park Conservancy, are infected. There’s been less focus on the poor, virus-4835736_1920-1although in the past day or so people have begun to realize that those in homeless shelters, where beds may be only two feet apart, are at risk.

The old are at higher risk but the young are not exempt. People with chronic conditions like diabetes, lung disease and immune-suppressing conditions are also at higher risk, but many victims so far have been healthy adults.

  • People with hearing loss may be affected in less obvious ways. What serves as protection to one individual acts as a barrier to communication to another.

Surgical masks. A lot of people are wearing surgical masks these days, and it makes communication difficult for the hard of hearing. Almost all of us instinctively supplement our hearing with speechreading. If we can’t read your lips, we can’t understand what you’re saying. There are several varieties of clear surgical masks on the market and some health professionals will wear them on request from a hard of hearing patient, but the majority of masks obscure everything except the eyes. (For more information about see-through masks, click here.)

The six-foot rule. Experts recommend staying at least six feet away from other people in public places. The problem is that many people with hearing loss can’t hear at that distance, especially in a public venue with other conversations going on. A request to step a little closer can result in a brushoff during these paranoid times.

Isolation. People with hearing loss need to stay socially involved. Otherwise their unused hearing deteriorates even further as the brain gets less accustomed to working with sounds. Staying home may seem like a wise move, but it’s good to go out, even if just to wave and say hello to your next door neighbor. Isolation leads to depression. Depression makes it harder to make yourself get up and out. It’s a vicious cycle.  Many members of our New York City Chapter of HLAA come to our monthly meetings at least in part to be with other people. Our next meeting isn’t for four weeks. I hope the virus will have come and gone by then, but if necessary we’ll cancel, reluctantly.

Being older. Youth is no protection against hearing loss, but it is true that the older you get the more severe the loss may become. We see a disproportionate number of older people at hearing-loss events. Unfortunately, these same people, especially if they have other coexisting conditions (coexisting with age, that is) are more vulnerable to coronavirus, not to mention the flu and other conditions that can be deadly in someone with compromised health.

  • What’s the solution?   With no end in sight, people with hearing loss need to come up with workable runarounds. Here are a few. 

Take a walk. Keep your distance from others but get out in the spring sunshine and communicate visually if not aurally.

Have a friend for lunch. One of you is unlikely to infect the other if you both feel well. Make sure guests wash their hands thoroughly the minute they arrive. If they have to take public transportation encourage portable hand sanitizers. I use nitrile gloves on public transit. They are a one-use product and environmentally wasteful, but if you’re going to visit an at-risk older or health-compromised person, the priorities seem clear to me. Wear the gloves, take them off and throw them away when you get there. Then wash your hands. Gloves have the added advantage of keeping you from touching your face: who wants to touch their face with dirty gloves that have been holding onto the subway pole.

Encourage videoconferencing. As an advocate for people with hearing loss, I attend many meetings on issues applicable to people with disabilities. In the past week or two, many have been cancelled but increasingly the organizers are setting up videoconferencing, with CART captioning. The week after next I’m going to be part of a conference in London in which people from many different countries will be attending by video. I’d love to have gone to London but I’m glad not to miss the meeting altogether.

The telephone. For years I avoided the telephone. It was just too difficult. Then captioned phones came on the market. At first I had a captioned phone on my home landline. Manufacturers like Captel and Caption Call offer these phones free to those with documented hearing loss. When I got my Caption Call phone, an installer came to the house to set it up. (You do need wi-fi, so this might be the time to get that as well.) These days, I use my cell phone more often than my captioned landline, thanks to Innocaption+, an iPhone and Android app that lets me receive and make calls (using my own telephone number) with near perfect captioning.

Nothing beats social interaction. But if doing it in person puts you at risk, think creatively about other ways to stay involved with others. These are just a few suggestions. If readers have others, I hope they’ll share. And wash your hands!  

 

For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

Surgical Masks and Coronavirus – an Update

I heard from so many people today about my column on the extra-medical consequences of corona panic for people with hearing loss that I want to link to this excellent article from Johns Hopkins about see through surgical masks.

“Transparent Surgical Mask to Improve Communication with Patients.” 

Maybe this is something #HLAA should get behind. Any patient with communication difficulties would benefit from this patient-centered innovation.

I believe there may also be other brands. Please comment if you’ve tried them and found them successful.

Coronavirus and People with Hearing Loss

The new coronavirus COVID-19 is an equal opportunity infector, affecting rich and poor, young and old, healthy and sickly. Among the more prominent victims is an attendee at the annual Conservative Public Action Conference (CPAC), exposure to whom has led President Trump’s new chief of staff to self-quarantine. The head of New York’s Port Authority and his socialite wife, the head of the Central Park Conservancy, are infected. There’s been less focus on the poor, virus-4835736_1920-1although in the past day or so people have begun to realize that those in homeless shelters, where beds may be only two feet apart, are at risk.

The old are at higher risk but the young are not exempt. People with chronic conditions like diabetes, lung disease and immune-suppressing conditions are also at higher risk, but many victims so far have been healthy adults.

  • People with hearing loss may be affected in less obvious ways. What serves as protection to one individual acts as a barrier to communication to another.

Surgical masks. A lot of people are wearing surgical masks these days, and it makes communication difficult for the hard of hearing. Almost all of us instinctively supplement our hearing with speechreading. If we can’t read your lips, we can’t understand what you’re saying. There are several varieties of clear surgical masks on the market and some health professionals will wear them on request from a hard of hearing patient, but the majority of masks obscure everything except the eyes. (For more information about see-through masks, click here.)

The six-foot rule. Experts recommend staying at least six feet away from other people in public places. The problem is that many people with hearing loss can’t hear at that distance, especially in a public venue with other conversations going on. A request to step a little closer can result in a brushoff during these paranoid times.

Isolation. People with hearing loss need to stay socially involved. Otherwise their unused hearing deteriorates even further as the brain gets less accustomed to working with sounds. Staying home may seem like a wise move, but it’s good to go out, even if just to wave and say hello to your next door neighbor. Isolation leads to depression. Depression makes it harder to make yourself get up and out. It’s a vicious cycle.  Many members of our New York City Chapter of HLAA come to our monthly meetings at least in part to be with other people. Our next meeting isn’t for four weeks. I hope the virus will have come and gone by then, but if necessary we’ll cancel, reluctantly.

Being older. Youth is no protection against hearing loss, but it is true that the older you get the more severe the loss may become. We see a disproportionate number of older people at hearing-loss events. Unfortunately, these same people, especially if they have other coexisting conditions (coexisting with age, that is) are more vulnerable to coronavirus, not to mention the flu and other conditions that can be deadly in someone with compromised health.

  • What’s the solution?   With no end in sight, people with hearing loss need to come up with workable runarounds. Here are a few. 

Take a walk. Keep your distance from others but get out in the spring sunshine and communicate visually if not aurally.

Have a friend for lunch. One of you is unlikely to infect the other if you both feel well. Make sure guests wash their hands thoroughly the minute they arrive. If they have to take public transportation encourage portable hand sanitizers. I use nitrile gloves on public transit. They are a one-use product and environmentally wasteful, but if you’re going to visit an at-risk older or health-compromised person, the priorities seem clear to me. Wear the gloves, take them off and throw them away when you get there. Then wash your hands. Gloves have the added advantage of keeping you from touching your face: who wants to touch their face with dirty gloves that have been holding onto the subway pole.

Encourage videoconferencing. As an advocate for people with hearing loss, I attend many meetings on issues applicable to people with disabilities. In the past week or two, many have been cancelled but increasingly the organizers are setting up videoconferencing, with CART captioning. The week after next I’m going to be part of a conference in London in which people from many different countries will be attending by video. I’d love to have gone to London but I’m glad not to miss the meeting altogether.

The telephone. For years I avoided the telephone. It was just too difficult. Then captioned phones came on the market. At first I had a captioned phone on my home landline. Manufacturers like Captel and Caption Call offer these phones free to those with documented hearing loss. When I got my Caption Call phone, an installer came to the house to set it up. (You do need wi-fi, so this might be the time to get that as well.) These days, I use my cell phone more often than my captioned landline, thanks to Innocaption+, an iPhone and Android app that lets me receive and make calls (using my own telephone number) with near perfect captioning.

Nothing beats social interaction. But if doing it in person puts you at risk, think creatively about other ways to stay involved with others. These are just a few suggestions. If readers have others, I hope they’ll share. And wash your hands!  

 

For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If they’re not there, ask for them.

 

 

 

How Fit is Your Hearing?

Recently, a prominent researcher in the field of hearing loss suggested a simple change in the way we talk about hearing loss. Rather than frame it as a disability, said Dr. Justin Golub of Columbia University Irving Medical Center, “I like the idea of hearing fitness.”

images“Hearing loss” is a negative term. For people who don’t want to admit they have hearing trouble, it invites the dismissive response: “I’m fine.”  But who wouldn’t want to be as fit as possible, especially if it takes little to no work on their part?

Dr. Golub is the lead author on a November 2019 paper in JAMA Otolaryngology-Head Neck Surgery, which found an association between cognitive impairment and what is generally considered “normal” hearing. In 2011, Johns Hopkins’ researchers led by Frank Lin, published the result of a longitudinal study on a large cohort of older adults showing that those with moderate or more severe hearing loss were at a greater risk of dementia. The greater the hearing deficit, that study found, the greater the risk of developing dementia. What Golub and his colleagues have now found is that even minor loss, within the so-called normal range  of 25 dB or less, is associated with lower cognition.

Using two major national databases as their source, the Golub team studied data on hearing and cognitive performance in 6451 people age 50 and over. This study, unlike previous studies of hearing loss and cognition, focused on people with hearing loss in the range usually considered normal. They considered all levels of hearing in that category, down to what would be considered “perfect” hearing, the ability to hear at zero decibels. (Dogs can hear at -5 to -15 decibels.)

After adjusting for demographics and cardiovascular disease, the study found that decreased hearing was independently associated with decreased cognition. The study did not look at whether hearing loss causes cognitive decline. Nor did it look at whether correcting hearing loss with hearing aids offsets the correlation.

“Can Hearing Aids Help Prevent Dementia?” That question was the title of the article in The New York Times Magazine where Golub’s hearing fitness quote appeared. We don’t have an answer yet but Frank Lin and colleagues will conclude what is expected to be the definitive study on hearing aids and their deterrent effect on cognitive decline in 2022. (For those who are interested in learning more about the study, Aging and Cognitive Health Evaluation in Elders (ACHIEVE), funded by the National Institute on Aging, here’s a link to an interview in AudiologyOnline on the study and other hearing-related public-health issues.)

Speaking to the Times Magazine, Golub mused, “We always frame [hearing loss] as a disability.” Telling college students that blasting their ears with loud noise is going to make them more susceptible to dementia 50 years later, he said, isn’t going to be much of a deterrent. “But if you say, ‘Hey, hearing is good for your brain, the more hearing you have the better,” that has immediate implications.”

“Hearing Fitness” is good for people at any age. Whatever it is about hearing loss that aligns it with an increased risk of dementia is of course of paramount interest. But poor hearing has a host of other physical and psychological ramifications, some of which themselves are a risk factor for cognitive decline.

Hearing fitness means taking care of the hearing that you have, whatever your age. And if it begins to decline, as it often does with age, correcting it. Cost has been a prohibitive factor for many up till now, but this year the FDA will announce guidelines for an over-the-counter hearing aid that will cost a fraction of existing FDA-approved hearing aids. Hearing aid companies and the consumer electronics industry are already offering products that are as good as some hearing aids at even cheaper prices. Costco is reportedly the nation’s largest hearing aid dealer (except for the VA), with volume permitting lower prices. Having hearing professionals on staff insures responsible service. Insurance companies are increasingly covering hearing aids, finally understanding their role in healthy aging. In some states, Medicaid covers hearing aids. Even that dinosaur Medicare may soon revise its hearing aid policies.

Tuesday March 3 is World Hearing Day. Although hearing fitness may be a distant goal for the half a billion people worldwide with disabling hearing loss, those of us in prosperous countries can make a start by taking care of our hearing, and by treating it promptly when problems develop. Hearing help comes in all price ranges. Keep your hearing fit!

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For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If it’s not there, ask for it!

 

 

 

He Doesn’t Look Disabled.

How many times have those of us with hearing loss been told that we don’t look deaf, whatever “looking” deaf means. It’s hard enough to make people recognize invisible disabilities. but today’s New York Times has an Op-Ed that suggests it’s okay to question the disabled status even of someone with visible disabilities.

photo of pwd sign
Photo by Ann H on Pexels.com

In “The Truth About Harvey Weinstein’s Walker,” Jasmine E. Harris, a professor at the law school of the University of California, Davis, argues that the “‘aesthetics of disability’ produce visceral responses in jurors and the public that can lead them to be more (or less) sympathetic when weighing a defendant’s liability, public responsibility and, in the end, punishment.”

While not outright accusing Weinstein and his attorneys of manipulating a perception of disability, Ms. Harris does say conclusively that this has been done by others: “Or the truth might be that he, like many others before him, will hope the benefit of disability aesthetics will help him in the courtroom.” (Italics mine.)

Readers quickly picked up on his rumpled clothes and slippers as further proof of his phony disability, but don’t forget that Weinstein seemed to spend much of his time in a bathrobe even in so-called business meetings. (I have zero sympathy for Weinstein, so don’t misconstrue my argument.)

Weinstein may be exaggerating his inability walk unaided, but I’m shocked that a professor of  law would suggest that we doubt someone’s else’s disability. It’s hard enough for those with disabilities to get the aid and services they need — or even a seat on the bus or the subway — without someone with Ms. Harris’s credentials suggesting that it’s okay to question someone’s right to their disability status.

It may be a clever legal strategy, but it undermines the credibility of all people with disabilities. Truthfully, I don’t think this was Ms. Harris’s intention, but it certainly lends itself to the argument that, like the welfare queens of the ’60’s, some people with disabilities just want favored treatment.

For more about living with hearing loss, read my books, available at Amazon.com and maybe at your favorite bookstore or library. If it’s not there, ask for it!

Smart Hearing Cover final

 

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