Clarisound Professional Hearing Care

What are the characteristics of a good dispenser?

Beyond the minimum skill and service provided to hearing aid clients, the “good” dispenser
focuses on being a health care provider, rather than the seller of a product. You should look for a hearing care professional who will take the time to find out about how your hearing affects your lifestyle, figure out which of the many hearing aid options best fits your needs, and stay with you for as long as it takes to make your hearing aid work right for you.

What will happen when you get your hearing tested?

The dispenser examining your hearing will first ask you a number of open-ended questions
about how hearing loss affects your life every day; try to be as specific about your hearing requirements and hearing problem as possible. You and your family may have filled in a self-assessment questionnaire before your first visit. The dispenser will inquire about how you spend your day and where you notice the most difficulty in hearing. He or she will want to observe your dexterity in handling aids and batteries. Expect other questions about medications, pain, drainage, surgery, dizziness, ringing in your ears, family history of hearing problems, and prior experience with aids.

Testing

The dispenser will conduct a series of tests to determine the type and extent of your hearing loss. You will sit in a sound-controlled booth and wear earphones. The dispenser will ask you to push a button or raise your hand when you hear a tone or a word. Typical tests include pure tone air conduction, speech reception threshold, and sometimes word recognition tests.

One typical test that you will take on your first visit is the pure tone air conduction audiometry. This test determines how well you hear at different frequencies. The audiometer produces a range of pure tones of varying frequency [or pitch, called Hertz (Hz)] and intensity [loudness, called decibels (dB)].

The bone conduction test is a painless vibration of your skull that goes directly to the inner ear.
The dispenser will put an instrument against the mastoid bone behind your ear and present the same frequencies as in the pure tone test.

The speech reception threshold test shows at what decibel you start to understand speech. You will listen for two-syllable words spoken at increasingly softer volumes until you can no longer repeat correctly the words spoken.

During the speech discrimination test, you will repeat what is being said to tell how well you will do with a hearing aid.

The most comfortable loudness level tells the dispenser at which volume you can hear more comfortably what is said, while the loudness discomfort level indicates how loud a sound you can tolerate.

Your test results are recorded on a graph called an audiogram. If your hearing is normal,
your audiogram would show a fairly straight line across the top, from 250 Hz (low bass sounds) to 8000 Hz (high treble sounds). The typical audiogram for someone with age-related hearing loss slopes downward to the right, usually at about the 1000 Hz level, indicating that the greatest hearing loss is in the higher ranges.

Do not hesitate to ask the purpose of each test before you receive it and for an explanation
of all test results.

Depending on the style of hearing aids that are recommended, the dispenser may also take an ear impression by inserting a soft plastic mould in your ear canal. This mould, indicating the exact conformation of your ear canal, is used to shape your hearing aid.

Evaluation

After conducting the assessment tests, the dispenser will meet with you and your family to review the test findings and identify areas where you have difficulty hearing. The dispenser will talk with you about what you can realistically expect from a hearing aid, as well as explain any limits that can’t be helped even with an aid.

What else can you expect?

There is more to a successful hearing aid fitting than just selling you a product. After your dispenser tests your hearing, recommends a specific hearing aid, and adjusts it to your hearing pattern, you should expect the dispenser to teach you how to insert your aid, turn it on, set the volume, use it with the telephone, listen to television or hear in different listening environments, take it out, clean and store it, and change the batteries.

You will also get clear instructions—orally and in writing— on how many hours per day you should wear your new aid initially and how to handle any problems. Your family should learn how to assist you as a new user. You should also be given information on assistive listening devices, your choices of batteries, manufacturer’s warranty, and repair costs.

Aid recommendation

Be sure you understand why the hearing care professional recommends a particular type of hearing aid. Make sure it has the features you need and that you will be completely trained to use them.

Follow-up care

Understand all follow-up care instructions and schedule follow-up visits.

Schedule a follow-up visit to make sure you have a satisfactory fit. During this session, the specialist will make any adjustments, and answer any questions. You should always keep your half yearly appointments to ensure the aid is working well and is still effective for your hearing loss which may change over the years.

Hearing Aids

HOW HEARING AIDS WORK:

Essentially, hearing aids are electronic devices that pick up sound waves with microphones, which then process that sound through an amplifier, then send the processed sound into the eardrum with a speaker (receiver).
The simplicity and complexity with which this is achieved depends on the type of instrument that is used.
For instance, the newest, digital hearing aids contain very sophisticated and powerful processors and are able to sample the sound environment, manipulate the wanted and unwanted sounds all in times measured in milliseconds. The end result is clearer sound, with minimal distortion.
Simpler hearing aids, while still effective, do not process sound as effectively as digital instruments.
It’s important to note that hearing improvement with any instrument depends on the type and degree of hearing loss, proper diagnostic testing and the fitting of the hearing aid. No hearing aid can restore normal hearing and not everyone benefits equally, but they can provide a significant improvement to those who have sustained hearing loss.

DIFFERENT TYPES OF HEARING AIDS:
Hearing aids come in five main types:

Behind-The-Ear (BTE) – This hearing device is housed in a curved shell that sits behind each ear and delivers sound through a clear tube normally via a custom made earmould.
In-The-Ear (ITE) – Easy to operate, even for users with poor dexterity, ITE devices are housed in a custom-made shell that fits comfortably inside each ear
In-The-Canal (ITC) – Barely visible, ITC devices are housed in a custom-made shell that fits comfortably in each ear canal, delivering sound directly to the ear. Though small, ITC devices are easy to operate, even for users with poor dexterity.
Completely-In-Canal (CIC) – Fitted inside each ear canal, CIC devices are all but invisible from the outside. These miniature instruments are both powerful and cosmetically appealing, but due to their small size they may sacrifice some features such as multiple program options and manual volume controls.
Open-Ear-Fitting (OEF) – A radical advance in hearing aid design, these ultra-small ear canal devices use sophisticated sound processing technology to set a new standard in aesthetics and comfort. These are replacing many of the above styles due to their high performance and superb comfort as well as cosmetic acceptability.

TECHNOLOGY

Conventional hearing aids satisfy the basic need of the hearing impaired by simply making all sounds louder. Conventional hearing aid users are able to manually adjust the volume control to hear incoming sounds at a desirable level. For example: if I wore a conventional hearing aid and set the volume control to a level suitable for this conversation, I would have adjust it if I were to go to a food court or a busy shopping centre because the level of amplification would then be too high. Most major manufacturers have stopped production of this kind of instrument in many countries.

Programmable digital hearing aids contain more sophisticated technology, which allow them to automatically adjust the level of amplification depending on the environment the wearer is in. Combined with a selection of the appropriate sound processing technology, the hearing aid can be programmed to adjust to a wide range of real-life listening situations.

Assistive Devices are available for many hearing aids, for example Bluetooth connections for mobile phones and FM systems for TV and difficult listening situations. These devices are designed specifically for use with hearing aids and should be considered for situations where even the best hearing aids have problems.

IMPORTANT FEATURES TO LOOK FOR WHEN SELECTING A HEARING AID:

First and foremost, hearing aids should be selected by professional and reputable hearing aid dispensers/audiologists who are will base their recommendations on your specific hearing loss, lifestyle and budget. Look for a company that has qualified audiologists on staff!

The service a customer receives during the purchase is crucial. A good hearing aid is not an impulse buy and the decision to purchase one is made after much consideration. The hearing care consultant should treat this experience with an equal amount of care and consideration, rather than attempt to sell you the most expensive product in the store. No matter how much you spend on a hearing aid, a proper fitting is essential if it is to function properly. If the fitting is not conducted by a professional hearing care consultant, and a customer ends up with a hearing aid that does not fit properly, the entire process of deciding to purchase a hearing aid will have been wasted, the device will not benefit the customer and they will continue suffering from an inability to communicate and interact with the world around them.

Most importantly, however, is the aftercare service, since hearing aids are a long-term investment. A good hearing care centre should offer a complete aftercare programme to ensure customers experience the maximum benefits from their hearing aid through proper maintenance and handling.

Price – Not all hearing aids are the same! The price is determined by a number of factors, the design as well as the desired level of performance and sophistication. The needs of the individual should be assessed carefully by the person fitting the aid. Prices vary enormously depending on the level of technology. They start from around RM900 up to around RM11 000 for the most sophisticated.

One or two hearing aids? As a general rule of thumb it is best to use two hearing aids if there is a hearing loss in both ears – however each person needs to be assessed individually and once again their precise needs identified before benefit can be determined.

Be as educated as possible – there is a wealth of information available on hearing loss and hearing aids – particularly on the internet. Try to avoid company websites as they are marketing their own products and use those from research institutes, hearing aid user forums and NGO’s.