Baby’s cry

Alarm clock

Timers and signals on appliances

Automobile turn signals

A recent research study showed that the typical sound signal used by conventional smoke alarms (a 3,100-Hz tone) failed to wake many people with hearing loss, even though they could hear that particular signal when they were awake.11 Although strobe lights were useful for alerting people who were awake, they also failed to wake many people. The signal found to be most effective was a 520-Hz square wave, a signal that contains a range of frequency components starting at approximately 500 Hz (remember, low-frequency signals tend to be easiest to hear). Bed and pillow shakers were also highly effective but still less effective than the 520-Hz square wave. Unfortunately, few emergency products with low-frequency signals are available at the present time. Nonetheless, when looking for smoke alarms, carbon monoxide alarms, and other emergency equipment, be sure to look for products with low-frequency alerting signals. Until those products are readily available, bed and pillow shakers are a better choice than conventional alarms.

Some alerting units are portable and work well for travel. In addition, hotels and motels are required by the ADA to provide alerting devices on request. Some offer kits to their visitors who are hard of hearing or deaf. The kit may include a TTY, a telephone signaler, a telephone amplifier, a door knock signaler, a visual/audio smoke detector, and/or a wake-up system (like a bed shaker).

HEARING SERVICE DOGS

Hearing service dogs are specially trained to assist their deaf or hard of hearing companions by alerting them to sounds they cannot hear. These sounds might include the sound of a smoke detector, doorbell, crying baby, knock at the door, telephone, alarm clock, timing device, or intruder in the house. Hearing dogs can also let a companion know when her name is being called or an object drops to the floor. Most hearing dogs make physical contact with their companions and then lead them to the source of the sound. The friendship, sense of security, and increased independence that hearing dogs provide is especially helpful to people who live alone. Some agencies provide hearing dogs free of charge.

My Dad

One evening my mother went out to play bridge and forgot her house key. When she came home, she rang the doorbell, but my

dad was watching TV and didn’t hear it. She went to a neighbor’s house and called him, but he didn’t hear the telephone ring either. When she rapped on a window in the room where he was sitting, he didn’t hear her, but he saw her. Looks like it’s time for an alerting device.

CHAPTER 10

Take Charge: Don’t Let Hearing Problems Get the Best of You

Listening is not merely not talking . . . it means taking a vigorous human interest in what is being told to us.

A. D. Miller

The preceding chapters have addressed technical solutions for hearing loss: hearing aids, cochlear implants, and hearing assistance technology. As we begin this chapter, remember that the goal is to minimize the impact of your hearing loss and maximize the quality of your life. In that effort, hearing technology is a tremendous tool—it can dramatically improve your ability to hear sound. But we understand sound with our brains, not with our ears, so technology can’t be the entire solution. In other words, technology is necessary, but it might not be sufficient. The missing piece is hearing rehabilitation, the subject of this chapter. Although people with milder degrees of hearing loss may not require a hearing rehabilitation program, nearly everyone can benefit from one.

HEARING REHABILITATION

If your audiologist has told you that hearing aids can help, trying them is the essential first step. If you can’t hear speech, then you have no hope of understanding it. Simply buying hearing aids doesn’t ensure an improved quality of life, however. To achieve that goal, you have to take full advantage of your hearing aids and develop strategies that complement aided hearing. And that’s the purpose of hearing rehabilitation. Hearing rehabilitation is a collection of services designed to help you use hearing technology to its greatest advantage, develop skills that can maximize your

ability to communicate, and learn how to cope with hearing loss. Hearing aids are just one part of the larger hearing rehabilitation process. To avoid confusion, hearing rehabilitation is the same as aural rehabilitation (aural rehab), and audiologic rehabilitation.

Virtually all audiologists provide an orientation as part of a hearing aid fitting. All too often, however, this is where hearing rehabilitation ends, when it’s really where it should begin. Think about it. If you were getting a prosthetic device like an artificial leg, you wouldn’t expect to put it on, receive instructions, and then start using it all day long. You’d expect to receive physical therapy and counseling over a series of sessions. In short, you’d expect a rehabilitation program. After spending what seems like a small fortune on hearing aids, people are often disappointed to learn that a commitment to rehabilitation is necessary for optimal success. But a hearing aid is a very sophisticated prosthetic device. Like a prosthetic limb, it shouldn’t be something you simply start wearing and hope for the best. Learning to use it effectively requires guidance, practice, and support.

Ideally, hearing rehabilitation occurs in a structured program that’s broad in its approach, combining information about hearing aids with information about a wider range of topics. This information can be presented in individual sessions, group sessions, or a combination of the two. Group sessions offer extra benefits, because they allow participants to share wisdom and support one another. More experienced participants provide encouragement to newer participants as they become accustomed to living with hearing loss and wearing hearing aids. Group interactions also provide ready-made opportunities to practice the communication strategies that are discussed as part of the program.

Whenever possible, spouses and significant others also should participate in the hearing rehabilitation program. Communication is a two-way street; you need to learn what you can do to improve communication, and significant others need to learn what they can do. Working together makes you allies as you address hearing-related issues. In a group program, family members gain insight into what it’s like to have a hearing loss. At the same time, you can gain insight into what it’s like to live with someone who has a hearing loss. Hearing rehabilitation groups can be sources of much-needed support for better-hearing spouses and family members.

A hearing rehabilitation program—whether it’s structured or unstructured; short-term or long-term; carried out in individual sessions, group sessions, or both—should address the communication difficulties that you experience at home, work, and play. Finding solutions to these problems should be the program’s ultimate goal and the measure of its success. Possible solutions should be developed, practiced, tweaked, practiced again, and then generalized to other situations.

Although the benefits of participating in a hearing rehabilitation program are clear, too few audiologists offer programs that go beyond informal