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Independent Living for the Hearing Impaired

Many Services and Home Modifications Can Increase Freedom and Security
By: CaregiverZone

Hearing loss can leave a person feeling disconnected from their surroundings. An elderly person with hearing loss may feel vulnerable, isolated, and depressed. Fortunately, there are a number of home modifications that will help people with hearing loss regain control over their surroundings.

Create a quiet environment

Background sound is one of the most significant problems for the hearing impaired, according to Sara Ashburn, an audiologist at the UCSF Stanford Otolaryngology, Cochlear Implant Project. She recommends removing noisy household appliances, equipment, and utilities and replacing them with quieter versions. For example, a central air system is quieter than a room air conditioner.

Sound reverberation is also a major contributor to background noise, and the reechoing of sounds is a definite hardship for those hard of hearing. According to Valerie R. Saul, director of the California Ear Institute at Stanford, sound reverberation frustrates people trying to lip-read, and also dramatically reduces the benefits of hearing aids. To reduce reverberation you can install:

  • Lined drapery or cellular window shades

  • Double-paned windows

  • Carpeting

  • Acoustical wall and ceiling panels

To further reduce reverberation it is important to remove or cover hard, shiny surfaces such as glass, mirrors, and metal sheeting.

If you can't adapt the whole house, try to set up quiet places throughout the home so that those who are hard of hearing can always find a room or section of the house that is friendly to their needs.

Rearrange furniture; add some light

Moving the furniture can make a big difference. Create smaller, more intimate conversational groupings with your furniture. In her book "Elderdesign," Rosemary Bakker recommends arranging seating at 90-degree angles. Mealtime conversation can be improved by using a round dinner table, especially when it is located away from the noisy kitchen. Finally, when it's time for entertainment, move seating closer to the TV.

Bright lighting enhances communication because it allows listeners to clearly see a speaker's facial expressions and lip movements.

Customize your TV

In addition to sitting closer to the TV, getting a TV with closed-captioning will enhance the viewing experience for a hearing-impaired person. Closed captions can be viewed on your television in two ways: by using an external decoder, or by using a television with a built-in decoder. All televisions manufactured in the United States after July 1993 must contain a built-in caption decoder if the picture tube is 13 inches or larger.

External decoders are available from several sources, including the National Captioning Institute. Personal transmitters and headsets that allow a listener to increase the volume without affecting others in the room are also helpful.

Install special safety aids

Hearing impairment can jeopardize a person's feelings of safety and security. The following tips can help the hearing-impaired (and the caregiver) feel safer:

Install easily seen fire alarms, smoke detectors, and alerting devices equipped with visual (strobe light) and audible warning systems. This may mean installing more than one alarm, according to Rex Pace of the Center for Universal Design at North Carolina State University. The Alertmaster, an all-in-one system (not attached to the alarm system) uses a flashing lamp, bed or furniture shaker, and a panel of lights to alert you to different sounds. It is activated by a telephone ring, an alarm clock, a knock on the door, or a loud noise such as an in-room smoke detector. You may want to install extra outlets in the bedroom for the alarms to leave other outlets free for typical uses. General alarm systems can also be modified to include strobe lights.

Install a 911 light. This device automatically flashes a powerful light out a window to alert emergency vehicles after you telephone 911. This can be useful for all caregivers, whether or not the person they are caring for is hearing-impaired.

Install alerting devices

Alerting devices use visual and tactile cues to let hearing-impaired people know that some event has occurred, such as the telephone ringing or a person knocking on the door. These devices can greatly increase a hearing-impaired person's sense of independence. Here are some examples:

  • Flashing door beacons that let people know a visitor is knocking. For safety, be sure to put in door peepholes so visitors can be identified without opening the door.

  • Vibrating alarm clocks.

  • Pagers that vibrate whenever a sound transmitter detects the doorbell or telephone.

Assistance dogs

Specially trained dogs can also alert a hearing-impaired person. These dogs also provide companionship and a sense of security. Canine Companions for Independence will provide highly trained assistance dogs to people with disabilities and to professional caregivers. People who can demonstrate that a Canine Companion will further their independence are eligible for the service.

Modify the telephone

Once you have alerting devices so that the person can tell the phone is ringing, you will want to purchase a telephone with adjustable volume so that the sound can be amplified. Anne Seltz, MA, CCC-A, a consulting audiologist cautions to always ask if the phone is compatible with hearing aids. This feature, unknown to many, allows the hearing aid user to use the phone directly with their personal hearing aid without acoustic feedback. If hearing loss is significant, Julie Overton of the Andrus Gerontology Program at USC recommends using TTY, which is a teletype machine that works much like a computer by transmitting text over the phone line.

Do you need a hearing aid?

Amazingly, 75 percent of people who could benefit from hearing aids are not using them. Hearing impairment is the most prevalent disability in our country. Encourage people in your care to have a baseline audiogram taken either with an ENT specialist or an audiologist. Although a third of people over 65 suffer from some type of hearing impairment, most have never asked for a professional assessment of their hearing.

Other resources

Canine Companions for Independence Program
National Headquarters
PO Box 446, Santa Rosa, CA 95402-0446
phone: (800) 572-2275

Ameriphone Alertmaster
(800) 874-3005

National Captioning Institute

Maxi Aids
Maxi Aids offers accessories for the physically challenged and hearing impaired.
(800) 522-6294

Free Telephone Equipment Loan Programs
For a state by state guide, visit Casa Futura Technologies and on the opening page, click the "telephone company programs" link in their Subsidies section.

Programs are available in thirty-five states, and provide assistance for devices such as teletype machines and phones with loud ringers and amplified handsets.

© CaregiverZone