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The Hearing Aid's Best Helper: Stage Managing |
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Hearing aids, marvelous, miniature technological marvels, often need help in this noisy world we live in. The microphones on hearing aids are limited as to how far they will pick up sound clearly. Even when they are ordered "directional" to help combat the commotion around us, the din of daily life can overwhelm these sensitive microphones. Digital hearing aids with noise suppression circuits or speech recognition technology can be besieged by a boisterous listening environment which people with normal hearing take for granted. Recently, I was asked to speak to a Self Help for Hard of Hearing (SHHH) group in Chattanooga about assistive listening devices. The room was full of people and assistive listening equipment so that they could discuss and communicate easily. However, after the meeting, everyone began talking at the same time the conversational confusion made it very difficult for us to communicate one-on-one. I pulled one young man aside to answer his questions. Then, I gave him some pointers in "stage managing." He stopped me cold with a question, "Why didn't somebody tell me these things sooner?" When hearing with an impaired listening system, we have to be aware of an acoustic phenomenon called the "signal to noise ratio" or SNR. The "signal" is what we want to listen to and the "noise" is what we don't. If the signal is a few decibels louder than the noise, we do better at understanding the signal. But if the signal and the noise are at same loudness levels, communication becomes very difficult. Sometimes, the signal and noise can even change according to our listening preferences. For example, if I come to your house and you are watching the news on television and you want to hear the news, my speaking to you is "noise." But if you want to hear my speech, then the television has turned into "noise." This is the reason why the assistive technology industry was born: to get the signal to the ear or to the microphone of the hearing aid with as little noise as possible interfering. When in Public Places, ASK To prepare for the meeting in Chattanooga, I asked AUDEX (tm), a manufacturer of assistive listening equipment to send me some different listening equipment for people to try in the meeting. Stroud Morton, one of the sound engineers told me his frustrations. "We have put assistive listening equipment into theaters, auditoriums, airports and stores. But the very people who need them, don't request them or don't use them. That lack of use causes very little incentive for public places to install them, although mandated by law." On a recent trip to England, I found taxi cabs were installed with assistive listening devices placed there by public demand not law. So, we can help ourselves by requesting these wonderful devices. Invest in the Technology That Will Help Many hearing aid manufacturers have remote, wireless microphones available. These fantastic devices, coupled with a compact "boot" or shoe which slips on the bottom of a behind the ear hearing aid, allows you to put the microphone next to what you want to hear. One patient of mine, who is also a student at the University of Tennessee, hands the remote microphone to her professors and hears probably better than her normal hearing peers seated next to her. She likes her remote microphone so much that she places it on the visor of her car. "Then, I can hear my friends in the car easily," she reported. Once she said that she placed the remote wireless microphone against the TV speaker; reduced the volume on the TV, increased the volume on her hearing aid, and watched her favorite show after her family had gone to bed. Another couple, who ride motorcycles as a hobby, investigated this wireless microphone technology so that she, who rode behind and had the hearing loss, could hear her husband in front. She doesn't have to take off her hearing aid; yet she can hear him clearly within all the noise of the wind and traffic. "I didn't want behind the ear hearing aids until I tried this wireless microphone," she said. "But this technology really works!" When assistive listening technology is not around or when you are having trouble hearing, here are some stage managing maneuvers which will help. Repeat/Restate If we say, "huh?" or "what?", frequently, we will receive this response from the speaker, "oh, forget it," or "never mind!" But if we restate what we thought we heard, such as, "What I thought you told me was........" People will either agree or they will say, "No, what I said was....." and then they will repeat the message so we have another shot at understanding the message. Often, when I miss something I want to hear, I will simply make up something outlandish; such as, " I heard you tell me that "all vacuum cleaners fly'." The speaker will usually laugh and say, "no, no, what I said was..." and they repeat the message so I get another opportunity to understand. Get the Signal Close to Your Ear Sounds tend to dissipate as they go through air. They become softer. If a competing sound signal is in the same place at the same time, we simply don't get enough clues to understand the message we want to hear. To keep the person you want to hear within the "golden circle of three feet" (the best listening for most hearing aid microphones), simply shake hands with the person you want to talk to but keep holding on! That simple gesture, often mistaken for friendliness, keeps the speaker's voice about three feet from your ears and your hearing aid's microphone. Or use a beckoning forefinger: This, too, will get the person you want to hear close to you. Make Communication Rules In my office, I often give families a communication guide with suggestions on how to best communicate with their hearing-impaired family member. One lady thought the suggestions were such a good idea that she framed them and placed them in her bathroom. "That way, visitors to my home have better ideas on how to communicate with me." She laughed and continued, "best of all, they have stopped raising their voice to me!" Liz Carpenter, social secretary to Lady Bird Johnson, had a severe hearing loss which interfered with her favorite social occasions: dinner parties. Her solution was a neatly printed sign placed in the center of the table which read, "Only one person speak at a time, please." She found that when her guests knew how to speak to her; they were very willing to make the accommodation which increased all of their pleasure. Manage Your Listening Environment Turn off the noise, turn down the TV, turn off the running water, walk away from the air conditioner, shut the door. Such behaviors reduce the competing noise. When you can't change the noise around you, change where you are. For example, one of my patients told me that her favorite activity at church was in the foyer after the services. "I can get caught up on all the news," she said. "But with everybody talking at the same time, I simply can't understand anybody." Her solution? She told me that she selects the person that she wants to talk to, takes them by the arm, and escorts them into a quiet room so that they could talk. "Once, I took the preacher by the arm and just escorted him outside so I could understand him!" She didn't fight the hubbub of everybody talking; she simply defeated it by leaving it behind. Don't Apologize for Misunderstanding Hearing loss nearly always makes us misunderstand what people say. Our ears are not working as well as they should. It is not our fault. Be assertive about your hearing loss by clearly stating, "I don't hear clearly. Please speak a bit slower and face me. I want to understand what you say." If we apologize, we might feel that our hearing difficulty is shameful or something to be hidden. The truth of the matter is that most people know we can't hear well long before they notice that we wear a hearing aid. When we take an active stand regarding our hearing problems, most people are relieved and happy to help us understand. When we "stage manage" our listening environment, we can comprehend much better in this noisy world we all share.
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