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March 20, 2004

Deaf ear turned to hearing aids

From: The Australian - Australia - Mar 20, 2004

By Emily Smith

IT wasn't until Len Madden could no longer hear the voice on the other end of the phone that he thought to have his hearing checked.

That was 10 years ago. Now the 79-year-old former motor mechanic from Liverpool in Sydney's southwest wears two hearing aids and says he relies on them to get on with life.

"Without them I can't hear much at all," Madden says. "But they take a bit of getting used to; they still muck up sometimes."

Madden is among the growing number of Australians who rely on hearing aids to fill in the gaps where sound has been lost.

Causes for hearing loss vary from injury to illnesses such as meningitis, but by far the largest contributor is age-related prebysicus; a gradual but permanent loss of neural sensitivity.

As we age, the small neural hairs in the inner ear that pick up the high-pitched sounds begin to lose sensitivity. Consonants like "s", "f" and "t" begin to fade, leading to poor speech discrimination.

People also become less tolerant to loud sounds as the ear loses its ability to adjust to sound levels

The number of Australians with hearing loss is on the rise. More than 50 per cent of people aged between 60 and 70 suffer some form of hearing loss, and this figure jumps to more than 70 per cent for those over 70.

Sharan Westcott is the principle audiologist for Australian Hearing, a public provider of hearing aids.

She says a common misconception is that hearing loss is a simple decrease in volume.

"Hearing loss happens slowly, you don't notice the loss of small environmental sounds," Westcott says. "People often complain that 'everybody mumbles these days'.

"This is why it can take time for people to recognise they have a hearing problem."

About 400,000 Australians have hearing aids, but according to research from Australian Hearing it is estimated that a further 1 million could benefit from using one. As hearing deteriorates, the individual usually learns ways to cope, lip reading or avoiding situations where there is a lot of background noise.

"People often delay asking for help because they have a poor perception of the benefit of a hearing aid or have difficulty in accepting they have a hearing problem," Westcott says.

"And once they have it they don't realise it takes time to learn how to hear again."

Often it is the patients with mild hearing loss who give up, with many only wearing it for a few hours a day in noisy situations.

"We tell them to wear it all the time and try and teach them to listen out for all the sounds that they have gotten used to not hearing, like the exhaust fan in the fridge. Then they will be better prepared when they go out," Westcott says.

Putting off wearing an aid can not only be putting people in danger in situations such as driving or crossing a road, it can also cause problems with the auditory cortex of the brain.

The longer a hearing loss is left unattended, the longer it takes for the brain to reacclimatise when a hearing aid is fitted.

Partial or complete recovery from auditory deprivation usually occurs once sound is reintroduced, but Westcott had one patient who left it to the point where she was profoundly deaf.

"By then there was nothing I could do for her," she says.

There are two main types of hearing aids. In-the-ear (ITE), a small mould that sits inside the ear canal, and behind-the-ear (BTE), usually reserved for more severe hearing loss, where the microphone for the hearing aid sits over the ear and is attached to a plastic custom-made earmould inside the ear.

A common problem with the ITE aids is the "whistle", Westcott explains.

"The microphone and the speaker are too close together and cannot take the same levels of amplification as the larger aids. If you are turning your volume up all the time it is probably time to get a larger aid."

Advances in digital technology mean that hearing aids can now be programmed to analyse the sounds around us and decide when to amplify and by how much, but the cost of aids varies.

The federal Government spent $189 million last financial year on the Hearing Services Program, subsidising hearing services for pensioners, veterans and children.

These aids are worth $1000 for a set of two but there is also the option of "top-ups" or more advanced technologies that can see the cost of rise to $5000 for two.

Madden first went on the Hearing Services Program 10 years ago when he was fitted with ITE aids.

But four years later, Madden's wife had a stroke and he again found he was having trouble hearing, this time with the doctors explaining his wife's condition.

He was rediagnosed with severe hearing loss and fitted with BTE aids.

"With the small ones you could put them in and not even know they were there," he says. "I'd be working under a truck and one would fall out and I wouldn't even notice."

Madden said the ITE aids made it difficult to hear speech, unless the person speaking was standing in front of him, and were also more difficult to adjust.

"With the smaller ones you had to take them out and the switch was too small," he says.

Surgery such as a cochlear implant is an option for people with severe to profound hearing loss, but is usually reserved for patients no longer receiving benefits from a hearing aid.

Westcott says she urges patients not to give up on hearing aids.

"People have to realise that hearing aids are an aid and not a cure.

"Even the best hearing aids will never completely restore hearing, and if you want to be rehabilitated you need to be motivated."

© The Australian