Hearing impairment and communicationContributed by Joy Victory, managing editor, Healthy Hearing
Last updated November 16, 2020
Even without the added issue of hearing loss, conversations require a lot of focus, energy and patience. For people with hearing loss or other hearing impairments, a noisy environment or friends who speak too quickly can make communication extra challenging.

Restaurant background noise is one of the
most common challenges when talking to
someone with hearing loss.Below are some things that you can do to help facilitate communication when someone has hearing loss, whether that person is you—or a loved one, friend, or coworker.
Please note this article is for people who have mild to moderate hearing loss. People who have untreated profound hearing loss, or are Deaf, have different communication methods that will be more effective than the ones discussed below. More on degrees of hearing loss.
How to talk to someone with hearing lossSome environments are much easier for communication for people who are hearing impaired. Here are some things you can do to ensure the environment is perfect for communication:

• Make sure the room has enough lighting. People with hearing loss often rely upon lip reading, facial expressions, speech reading, body language and gestures to supplement their remaining hearing and improve communication. 
• Pick a place that has minimum background noise. Though our ears and brain are able to filter out background noise in most situations, people with hearing loss often have a difficult time hearing over excessive noise. Keep in mind that small rooms with no carpeting or curtains tend to have poor acoustics and can distort voices.
• Make it easy to see everyone's faces. If you will be in a group setting, choose a location—or if you're at a restaurant, a round table —where the person with hearing loss will have visual access to everyone's faces to facilitate better communication. 

Here are a few examples of using the above tips to pick an appropriate environment for communication:

• If you're planning a dinner out, pick a restaurant that you know has ample lighting, does not play loud music and has decent acoustics. Choose a restaurant that you have been to before, where you know the noise levels do not get too loud. Another good tactic is to select an off-time: Rather than having dinner at 7 p.m. on Friday or Saturday night—the busiest dinner hours—opt instead for a late lunch or early dinner, between the hours of 3 p.m. and 5 p.m. when restaurants are likely to be the least busy.
• During a group gathering at your home, if you'd like to have a conversation with a friend or family member with hearing loss, invite him or her to speak in a different, quieter room. Turn off the TV and any other sources of noise.

 “Reprinted with permission. Copyright Healthy Hearing (www.healthyhearing.com). Original article: [https://www.healthyhearing.com/report/51744-Communication-strategies-when-talking-to-individuals-with-hearing-loss]

Why is Communication Important for the Hearing Part of Your Brain?Over the past decade, there have been more evidential conclusions or studies related to hearing loss and cognitive decline. Study reveals that older adults with hearing loss are significantly more likely to suffer from dementia than those who retain their hearing. When there is auditory deprivation, there is a significant strain on the area of the brain that processes communication. This area of the temporal lobe is called the primary auditory cortex and it not only controls hearing, but also the way language is processed. Individuals that struggle with hearing often become less social, and therefore their cognitive decline is affected by less interaction and less mental processing.
Hearing loss and increased gray matter
A recent study looked at the effects of high and low frequency hearing loss and the degree of gray matter and communication disruptions in various areas of the brain. The subjects were screened with brain scans and hearing tests to measure the degree of cog­nitive disorder with and without hearing devices.
The results of this study are consistent with the premise that high frequency hearing loss has cascad­ing effects throughout the auditory system in older adults.1 High frequency hearing loss was associated with lower auditory cortex gray matter volume and increased cerebrospinal fluid (CSF) in the same region, suggesting that auditory cortex is atrophying with hearing loss.1 These effects were present even after controlling for age and gender effects, thereby provid­ing additional support for direct effects of hearing loss on auditory cortex morphology.1
“Communication is crucial to keep the brain active and reduce the risk of cognitive decline. Less interaction means less brain function, and more likelihood for degenerative changes” explains Dr. Wazen, Ear Research Foundation, Director of Research. He urges that despite the stay at home orders, those suffering from hearing loss should continue to stay connected whether it is by using online platforms like Zoom, FaceTime or other video chatting platforms. Long term hearing deprivation can impact cognitive performance by decreasing the quality communication leading to social isolation and depression. Treating your hearing loss does not prevent cognitive disorders like Alzheimer’s or dementia, but if you do have such disorders, it is always important to maintain your brain stimulated.
How do I keep the hearing part of my brain (auditory cortex) active despite the stay at home orders?
If hearing loss is treated with hearing devices, the cognitive decline can be thwarted in many cases and it seems as though it might reverse some damage. The important point is to wear the hearing devices regularly on a daily basis.
1. Wear your hearing aids or implant processors despite being alone at home.
It is more critical for you to wear your hearing aids now than any other time. Hearing aids are not treating your ear; they are treating your brain by keeping it active.
It is important if you have hearing loss or have a history of brain disease to manage your hearing to at least prevent the hearing part of your brain degeneration. Effective intervention with hearing aids or cochlear implants may improve social and emotional function, communication, cognitive function, and quality of life
2. Have a face time or a zoom call with family member.
Social distancing does not mean you should stop your social interactions. With today’s technology, you can socialize at a distance. Make sure to pick up your smartphone and talk to someone at least once a day. If you do not hear, you tend to withdraw, you tend not to communicate, and that withdrawal will lead into more possibility of brain degeneration.
3. Listen to podcasts
Our hearing advocate Bill Fellows shares, “With time on my hands as a result of pandemic isolation, I have discovered the wide world of Podcasts. It is amazing the variety of helpful, educational, and entertaining Podcasts that are available. I am fortunate to have hearing devices that link to my phone allowing me to hear every word crystal clear. Try it..”
What to do if your loved ones suffer from hearing loss?
Make sure you check in and talk with your loved ones at least once a day and be patient. When people struggle to hear, communication can be difficult. Thus, social disengagement follows. If in person visits are not possible, make a phone or video call regularly.
Are you a healthy hearing advocate?
Wear this communicator clear face mask in public to help the hearing impaired communicate better.
These masks are made with:
. a clear window panel to assist in lip reading
. double layered fabric surrounding anti-fogging PET (CDC recommends at least two layers)
. tie around the head to reduce the risk of losing hearing aids.
Join Ear Research Foundation’s Hearing Advocate’s Coalition as a founding member with a monthly donation of only $5, $10 or more! Approximately 48,975 adults in Sarasota County are living with hearing loss, and 5,975 of those are living in poverty. The group was initiated to raise money for under-insured patients that need care during these trying times. Upon donating, you will receive a clear face mask as a gift.
Call Jodel Velarde at (941) 556 4219 or visit www.EarRF.org/HAC to advocate for healthy hearing with your mask!
Ear Research Foundation
In 1979, the Ear Research Foundation was established in Sarasota, Florida by President and Founder, Dr. Herbert Silverstein. The Foundation was created out of his desire to continue research and development, and to contribute to medical education in a private setting. In the field of Otolaryngology. A non-profit 5O1C-3 organization, Ear Research provides essential and innovative research, educational sessions to inform the community about hearing health and to train professionals in the field, and community care for people in need of hearing devices and care who could not otherwise afford it. Vital to the Ear Research Foundation is the strong partnership with Silverstein Institute.
Silverstein Institute
The Silverstein Institute has locations in Sarasota, Venice, and Lakewood Ranch. An internationally respected physicians’ practice dedicated to diseases and surgery of the ears, nose, and throat. Silverstein Institute provides innovative, high quality patient care. A state-of-the-art organization, the staff and physicians work together every day to improve the health and well-being of their patients.
Jack J. Wazen, MD, FACS
Director of Research for Ear Research Foundation
Dr. Wazen, American Boards of Otolaryngology, Head and Neck Surgery, and Neurotology Recognized repeatedly as one of Sarasota, New York, and American’s “Best Doctors”.
Dr. Wazen is one of the nation’s leading authorities on hearing and balance disorders, pioneering new research that expanded treatments for people with single­sided deafness and complex cases of hearing loss. He also is author of the seminal book, Dizzy, pro­viding new treatment options and hope for people affected by balance and hearing disorders. Last Tuesday, October 22, 2020, he was named Chief of Staff of the Sarasota Memorial, serving as the top representative the hospital’s more than 1,400 medical staff members and advanced practice providers.
Start your path to better hearing, please contact the Silverstein Institute to schedule your appoint­ment today.
Ear Research Foundation
(941) 365-0367 | www.earrf.org
1901 Floyd Street, Sarasota, FL 34239


References:
1. M. Eckert, Auditory Cortex Signs of Age-Related Hearing Loss, J Assoc Res Otolaryngol. 2012 Oct; 13(5): 703–713. Published online 2012 May 23. doi: 10.1007/s10162-012-0332-5https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441956/

Debra Bergeron is a wife and caretaker of her terminally ill husband, Ron Bergeron. She is also deaf. And Ron has been relentlessly sought help for her to hear his voice before he passes. Debra received a fundamental surgery in October 2020, followed by the activation of her cochlear implant -- a surgically implanted hearing device sometimes referred to as a bionic ear -- the following November. It is said to provide sound for people suffering from sensorineural hearing loss in both ears by bypassing the damaged hair cells in the cochlea and transmitting sound directly to the auditory nerve and on to the brain. Debra was already profoundly deaf in her right ear; her left ear went deaf while waiting nine months for new hearing aids. Debra cannot benefit from a hearing aid any longer because of the severity of her hearing loss and aids not being able to amplify adequately to give her speech understanding. She became a cochlear implant candidate. 
The cochlear implant costs about $30,000. With no health insurance of her own, and her husband on full disability, fear creeped in for the Sarasota couple. “My biggest fear was who would take care of my husband," she shares. "If something should happen to him, I would not be able to hear him."  Ron expressed fears in the wake of his diagnosis of a terminal disease as well, but more for his wife, than for himself. “I was very fearful of her not being able to function alone," he says. So, he called various institutions for help and was finally referred to Sarasota's Ear Research Foundation, founded by Dr. Herbert Silverstein. The 501C-3 provides medical education in an Otology Clinical Fellowship training program in a private setting all while expanding its programs to include an ear clinic for indigent patients.
The foundation’s team worked tirelessly to coordinate both party's wishes and ease both their fears the past few months. Dr. Jack Wazen and Dr. Sharon Rende, AuD agreed to donate their professional services. In a concerted effort to contribute due to the heartwarming local story, Sarasota Memorial Hospital generously offered a reduced cost. However, more funding was still needed. When the cost of the surgery, hospital and follow-up care are factored in, the expense is upwards of $100,000.  “It’s truly wonderful to witness how foundations from different states stepped up and made the gift of hearing possible for Mrs. Bergeron,” says Jodel Velarde, Ear Research Foundation Coordinator.
Still, no one entity had the remaining resources and extensive funds to foot the hefty aforementioned price tag of this particular surgery.  Fortunately, Eileen Jones, founder of the former Gift of Hearing Foundation in MA, shared an organization called Jacob’s Ride for Hearing of Annapolis, MD. “Jacob’s Ride worked directly with the hospital to provide resources to help cover the expenses of the surgery and then we worked with an anonymous third-party charity that provides the cochlear implant equipment," says Randy Landis, Executive Director of Jacob’s Ride for Hearing. "In this case, we were fortunate to have a private foundation donate the equipment."
To guide Debra into entering a world of sounds, the Ear Research Foundation will continue to provide post-operative care and give additional financial support through the Help Us Hear program. “I’ve been doing the cochlear implant cases for more than twenty years. 1998 was my first one and it is still just as exciting today as it was then” says Dr. Sharon Rende, Silverstein Institute’s Director of Audiology.
Debra, who turned 62 early October shares, “I was given the best birthday gift anyone could ask for. This will change our lives drastically. Everything that has been done for us has been a godsend.”
For more information or to donate for Debra’s continuing care or help other people like her, please see contact Jodel Velarde, Development Coordinator, 941-556-4219, jvelarde@EarRF.org.

While the Department of Health advises wearing face masks in public and social distancing to prevent the spread of COVID-19 disease, this practice creates further communication difficulties, especially for people who are hard of hearing. The Silverstein Institute and Ear Research Foundation physicians and audiologists strongly suggest taking appropriate measures to interact and connect with people suffering from this disability.

Even before the social distancing orders began, Ms. Maloney, one of our Help Us Hear (HUH) hearing aid recipients, avoided social events with friends and family. She has a litany of excuses prepared to avoid the potentially embarrassing events. Hearing loss is an isolating disability. With the stay at home orders in place, the social disengagement that the hearing-impaired community experiences have compounded. “It’s difficult to talk to people when they’re wearing masks. I would ask them to repeat what they said once or twice. After a while, it can get very embarrassing.” says Ms. McLaren, another HUH patient. Our Help Us Hear program is aimed at providing hearing aids to under-insured patients.

Dr. Rende, The Silverstein Institute’s Director of Audiology and an Ear Research Foundation Volunteer Audiologist, ensures that her audiology team wears clear face masks to assist with patient interaction. “Most of these individuals rely on lipreading, and facial expression as an effective form of communication.” she explains. Masks can distort the sound or the quality of speech, and social distancing at least 6 feet away makes it even more difficult for them to hear or be heard. She further states that the practice also has an increasing number of patients that come for repairs and/or replacement of hearing devices due to ear-loop face masks.

The doctors urge patients to consider the use of newer technology:
Speech to Text Applications – You can download speech-to-text apps smartphone apps that can provide live transcription of conversation to assist the hearing impaired while communicating in public
Hand-Help Amplification – there are handheld devices such as Pocket Talker or SuperEar that allow users to use headphones to amplify sound to their desired volume
Get a hearing help! – Effective intervention with hearing aids or cochlear implants may improve social and emotional function, communication, cognitive function, and quality of life

Contributed by Lisa Packer
Last updated July 2, 2019 
Copyright Healthy Hearing (www.healthyhearing.com)

When you think of celebrating Independence Day, the first thing that comes to mind is probably fireworks. After spending the day swimming, playing and barbecuing, many of those in the United States will soon be heading out to ooh and aah over a display of colorful and exciting pyrotechnics. But whether you are watching a professional show or have purchased your own fireworks, hearing loss is a real risk. 

Why are fireworks so loud?

Always keep a safe distance from fireworks.

​It all comes down to the chemical reaction that happens after the fuse is lit. The burning gunpowder releases hot gas that expands rapidly; when the gas expands to the point that it runs out of room within the firework, the resulting explosion causes a blast wave. The vibrations from that blast wave have the potential to cause permanent damage to the delicate hair cells of the inner ear.

Yes, they're exciting, but the problem is the excitement is often measured by the “loudness factor." For some people, the louder the better. And those loud explosions have the potential to reach levels between 150 and 175 decibels at close range. When it comes to fireworks, the World Health Organization recommends the maximum safe decibel level for adults is 140 decibels, and for children only 120 decibels.

Infants should not be exposed at all; an infant’s ear canal is much smaller than an older child's or an adult's, so the sound pressure entering the ear is greater. What might not sound that loud to an adult actually sounds up to 20 decibels louder to an infant. Infants should not be exposed at all—their ear anatomy is too delicate.

5 ways to protect your hearing

1. Keep a safe distance
One way is to maintain a safe distance from the display. The farther you are from the sound, the less harmful the sound is to your ears, so your distance from the sound of the fireworks can make all of the difference in terms of decibel level and hearing safety. A distance of around 500 feet will still give you a great view, but without the sound pressure that can damage the tiny hair cells in the inner ear.

2. Skip the home displays
Where you view your fireworks can also affect your hearing. Experts recommend attending a community display rather than setting off your own fireworks at home. Not only are fireworks dangerous and best left to trained professionals, but there is usually a roped off area located a safe viewing (and listening) distance away from the show.

3. Bring earplugs and earmuffs
If you intend to sit as close to the action as possible, or if you are determined to create your own display, protect your hearing and that of your children. Inexpensive foam earplugs can be found in drugstores and pharmacies, and work well for adults; earmuffs (basically foam-filled cups that cover the ears) are better for small children because earplugs sometimes don’t fit and can be a choking hazard.

4. If you buy your own fireworks, buy these
If you are planning your own fireworks display, the good news is you can customize your selection for reduced noise. All fireworks come with a noise level rating, so selecting quieter fireworks will not only preserve a good relationship with your neighbors, it will protect your hearing as well. Quieter options include fountains, wheels, falling leaves and comets. While not completely silent, they crackle and whistle instead of creating a loud, explosive boom. All are created for spectacular visual display but less noise. If you buy fireworks, your fireworks provider should be able to direct you to those that are lower on the noise rating scale.

5. And avoid these
 What to avoid? Rockets, mines and any fireworks that have many blasts strung together tightly. These fireworks are created to make as much noise as possible.
Noise-induced hearing lossAccording to the National Institutes of Health, more than 30 million people in the U.S. are at risk of noise-induced hearing loss.  Exposure to noises such as loud fireworks can result in:

• Tinnitus
• Slight temporary hearing loss (less than 24 hours)
• Permanent hearing loss
• Eardrum perforation (rare)

If you think you have temporary hearing loss after attending a fireworks display, see a hearing care professional—you can find a clinic in our extensive consumer-reviewed directory. And don’t worry; you can still have fun this Fourth of July while protecting your hearing from the eardrum-shattering booms. Protecting your hearing now will enable you to enjoy the sounds of the fireworks for years to come.


Reproduced with permission. Copyright Healthy Hearing (www.healthyhearing.com). Original article: [https://www.healthyhearing.com/report/52478-How-to-protect-your-hearing-this-fourth-of-july].

Originally Published at SW Florida Health and Wellness Magazine