Communication choices: your hearing, your life - BT Plc

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Communication choices:

your hearing, your life

In association with

Introduction Millions of people are affected by hearing loss – whether it’s through experiencing it themselves, or knowing a friend, colleague or family member who does. One in six adults in Britain currently lives with some degree of hearing loss. Hearing loss can have a big impact on a person’s life. It’s not uncommon for people to become withdrawn and isolated as communication becomes harder. Work and social life can get more difficult. A change in hearing can leave some people feeling excluded from everyday sounds like music, traffic, and voices – which can create a sense of being permanently on the outside, or perhaps not even safe.

1 in 6 adults

has some hearing loss

BT and Hearing Link have put together this guide to help you decide what might help as your hearing changes. It’s aimed at people with hearing loss, but we hope it’ll also be useful for your family, friends and colleagues. We’ve included quotes from people who have been supported by Hearing Link in the past. Although hearing loss is common, it’s not always easy to know where to look for help. There’s a whole range of things you can investigate including technology, social support and the way you think about your hearing. Everyone with hearing loss experiences it in different ways, so the ways they choose to address it will be different too.

You’ll find advice here on different options for equipment, from hearing aids to phones and apps. But living with hearing loss isn’t just about getting some new kit. It’s also about learning new skills – like lipreading or some basic sign language – and understanding the emotional changes that come with hearing loss. So we’ve also included advice on things like classes and social groups – and on where you can find support. If you’re just beginning to notice that your hearing’s changing, you’ll find sections one and two useful. If you know you have difficulty hearing and want to do something about it, try sections three and four. And if you’ve already been diagnosed with hearing loss and want to find out about things that could help, then take a look at sections five to seven. The step-by-step diagram on pages 4–5 is a good place to start if you’re not sure where you are on your journey.

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Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Your hearing, your life . . . . . . . . . . . . . . 4 1 Before you realise . . . . . . . . . . . . . . . . . . 6 Don’t suffer in silence

Positioning your home phone or mobile when you’re using hearing aids Whistling Sending SMS text messages from a landline with BT Text Communicating using the internet Finding the right equipment Learning new skills

2 Noticing hearing loss. . . . . . . . . . . . . 9 Why is my hearing changing?

Financial support

What technology might help?

Your rights

3 Taking action . . . . . . . . . . . . . . . . . . . . . . . . 14 What can I do?

Finding a therapist

4 Getting a diagnosis. . . . . . . . . . . . . . 17 Seeing a GP Seeing a private audiologist Getting the most from your appointment

5 Your plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Assistive equipment

6 Getting on with life. . . . . . . . . . . . . . 38 Hearing loss and your emotions

NHS or private?

Surgically implanted devices

Hearing loss at work Communication support

Developing good phone technique

What technology might help?

Social groups

Hearing loss at work The Equality and Human Rights Acts

7 How’s it working out?. . . . . . . . . 41 Getting in touch . . . . . . . . . . . . . . . . . . . . . . . 44 Hearing Link BT Organisations that can help

Using the phone with hearing aids Mobile phones

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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Your hearing, your life

1 Before you realise

2 Noticing hearing loss

It can be hard to notice when you start to lose your hearing – you can still get by, even though some things (like following conversations in a crowd) are becoming more difficult. Here are some signs you might recognise:

As you become conscious of a problem, you may become withdrawn and feel vulnerable, anxious or angry. You may find yourself:

• • • • •

avoiding some situations (not going out as much) turning up the volume on your TV, phone, or radio frustration – blaming others for not speaking clearly feeling bewildered, uncertain or a little fearful being nagged by friends and family to see someone about your hearing • thinking the issue lies elsewhere if others suggest you seek help

• having trouble communicating effectively • noticing other symptoms, like tiredness, headaches and stress • trying online hearing tests, worrying about the causes and how things will turn out.

3 Taking action

4 Getting a diagnosis

It can take up to ten years from the time people first notice that they have a hearing loss before they do anything about it. It’s better to take action as soon as you can, by:

You now move on to seeking professional advice about your situation by visiting a doctor or audiologist. At this point you might be:

• discussing your hearing loss with friends and family • researching your options online (but be aware of advertising disguised as advice) • approaching a doctor or audiologist • taking advantage of personal or professional referrals and advice.

• thinking about how to communicate your problems to professionals • going through hearing tests and examinations • receiving advice and recommendations.

5 Your plan

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Not all hearing loss is the same, and it affects everyone in different ways. Here, you’ll be looking for ways to live better with your hearing loss through making adjustments, therapy, technology, improving your skills and dealing with the emotional impact. This could include:

6 Getting on with life

• getting hearing aids or surgically implanted devices fitted (with ongoing tweaks and checks) • finding other equipment that can help • developing specific communication skills (like lipreading and finger-spelling) • getting ongoing help from professionals (like an audiologist or hearing therapist) • arranging counselling or emotional support from an individual, charity or peer support group • joining a local hearing support group • applying for financial support.

Daily life resumes, as you get used to living with your level of hearing. This stage might involve: • adapting to change, including the impact on your home, work and social life • identifying new problems and thinking of ways to fix them • there’s a danger that people who find it hard to accept the reality of hearing loss may shut down, becoming isolated and possibly depressed – don’t let this happen to you.

Your hearing, your life

7 How’s it working out? Every now and again, perhaps when your hearing or your circumstances change, it’ll be time to look back on how far you’ve come. You might find you’re comfortable with your hearing loss and plans for managing it, or you may want to make some further changes.

Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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1 Before you realise



It’s not always easy to accept that your hearing has changed:

You don’t really want to admit that you need help, that’s the hardest bit. I was fighting a battle trying to cover up that I needed help. — Shona



What is hearing loss? Hearing loss is defined as ‘a decrease in a person’s sensitivity to sound’. Put simply, you don’t hear as well as you did. • It has four clinical levels (mild, moderate, severe, and profound). • It can happen gradually or suddenly. • It can affect one or both ears. • It can develop with age, as a result of repeated exposure to loud noise or for other reasons, like illness. It’s not always easy to tell when hearing loss is happening. Sometimes when people begin to lose their hearing, they can still get by. They might not even realise that some things are becoming more of a struggle. It’s possible that people around you might recognise the signs before you notice them yourself. Facing up to change can be a bit daunting and it’s natural to hope the problem lies elsewhere. But it’s worth considering whether your hearing has changed. Once you know what you’re dealing with, you’ll find there are lots of things you can do to make life easier.

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Before you realise

It could be a good idea to consider whether your hearing is changing if: • you’re finding it more difficult to hear in some places (like a busy restaurant) • you’re avoiding some situations – perhaps without realising • you’re turning up the volume on the phone, TV or radio • you feel that you’re being nagged by friends and family about paying attention • it seems that people are mumbling or not speaking clearly.

Speaking clearly to someone with hearing loss If someone’s finding it hard to hear you, follow these simple tips to help you communicate clearly: • don’t make exaggerated lip movements. • don’t shout. • make sure the person you’re talking to can see your face clearly (this helps with lipreading and other cues). • limit background noise. • avoid visual distractions. • don’t stand with a light source behind you. There’s lots more advice on speaking clearly to someone with hearing loss on the Hearing Link website: hearinglink.org/speaking-clearly

On the phone

When you’re calling someone with hearing loss, using a good phone technique will help them hear as much as possible. Make sure you speak directly into the phone’s mouthpiece (but don’t hold it too close – see page 28), and remove as much background noise as you can.

Don’t suffer in silence If you think you could have a problem with your hearing, it’s a good idea to sit down and have an honest conversation with your family and friends. Let them know how you’re finding things and ask whether they’ve noticed any changes. Support from trusted people can really help you as you start to think about what’s happening to your hearing and how it might affect you. If the people you chat to have hearing loss themselves, they can share their own experiences. And if they don’t, then it can still helpful to talk about what actions might be best for you. Lots of people find it helpful to take a ‘buddy’ with them to consultations and follow-up appointments. Sometimes it’s the simplest things that help the most.

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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Where can I find help? Hearing Link

When you have a lot of questions, it can be difficult to know where to turn. Hearing Link is a UK-wide charity (active in England, Scotland, Wales and Northern Ireland) for people with hearing loss, their families and friends. It helps people manage the practical and emotional challenges that hearing loss can bring. Their helpdesk team will be happy to listen to you, offer advice and point you in the right direction. Lots of them have personal experience of hearing loss. You can get in touch by: • calling 0300 111 1113 • emailing [email protected] • texting 07526 123 255 • filling in the online form at hearinglink.org/helpdesk-enquiry Hearing Link also offers: • specialist courses and support for individuals and families • ongoing one-to-one and group contact – by email, phone and in person • access to groups, clubs and organisations • ways to connect with others who live with hearing loss • a website and magazine • opportunities for getting involved locally and nationally, including becoming a volunteer. And remember – there’s lots of helpful information on the website at hearinglink.org

Other organisations

For information on phones and services that might help, take a look at BT’s website at bt.com/includingyou Or search for ‘hearing loss’ on the NHS Choices website at nhs.uk You may also find it helpful to talk to: • friends with hearing loss • your GP • hearing loss organisations near you (Hearing Link’s helpdesk can help you find them).

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Before you realise

2 Noticing hearing loss



A change in your hearing naturally leads to a lot of questions, as you realise the impact on your life:

Being hard of hearing, or deaf, can leave you feeling that you can’t socialise like other people. You can’t go to the pub – you’re not going to hear anything. Goodbye cinema – it’s not subtitled. Theatre, finished. Restaurant, too noisy. But I learned that with the right support, I can still do all of those things. — Emmanuelle



Noticing that you’re losing your hearing can be a shock to the system. You realise that you won’t necessarily be able to communicate in the ways you’ve always done before. You might start to find things difficult that up until now, you’ve taken for granted. People react in different ways to noticing hearing loss. Some are keen to research information online while others may feel vulnerable, worried or angry. Some people have symptoms like tiredness, headaches, or stress, or become withdrawn. You’ll probably have a lot of questions – like what you can do to improve things, and what the future will hold. Some people wonder what’s causing their hearing loss and whether they’ll have to wear hearing aids. Not to mention how it will affect their family, work and social life. The good news is that there are lots of practical steps you can take to get a better understanding of what you’re going through, and keep doing things that are important to you. Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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Common signs of hearing loss • Not hearing other people clearly or understanding what they say (especially in group situations). • Asking people to repeat themselves. • Listening to music or watching TV with the volume higher than other people need. • Having trouble hearing the phone or doorbell. • Finding it hard to tell where noise is coming from. • Often feeling tired or stressed (from having to concentrate when you listen). • A buzzing or whistling sound in your ears (this could be a sign of tinnitus, which is often linked to hearing loss).

Why is my hearing changing? Hearing loss happens when sound signals can’t reach your brain. There are two main types: Sensorineural hearing loss is caused by damage to the hairs inside the inner ear or the nerve which takes sounds from the ear to the brain (the auditory nerve). It often comes with age (see presbycusis) but can also happen through injury, or an illness (like meningitis). Presbycusis, or age-related hearing loss, is a common kind of sensorineural hearing loss. Usually, it affects higher sounds, and happens equally in both ears. Conductive hearing loss happens when sounds can’t pass from your outer ear to your inner ear. This often happens temporarily because of a blockage like earwax or a treatable middle ear infection, but this kind of hearing loss can also occur permanently through injury or as a result of certain conditions.

TIP: always repeat back the information you’ve heard to make sure you’ve got it right.

Developing good phone technique Everyone finds it difficult to hear on the phone sometimes, and developing a good phone technique can really help you take in information, whatever your level of hearing. Here are some simple tips to help you hear better on the phone:

Hold the phone directly over your ear

Whether you’re using a landline or mobile phone, you’ll see holes or slots where the sound comes from. Make sure that you hold the phone so that these are directly over the opening of your ear. Just getting it slightly off centre can make a huge difference to what you can hear.

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Noticing hearing loss

Nestle the phone comfortably against your ear

When you hold the phone to your ear, press firmly (but not so firmly that it’s uncomfortable). You should form a good seal between your ear and the phone. Even a one centimetre gap can reduce the volume by more than half and affect the sound quality. A gap will also let in surrounding noise and mask incoming speech.

Remove or reduce other sounds

Reducing background noise will help you hear better. Make sure you’ve closed any windows that let in sound and turned off the TV and radio. Before you make a call, you could test the sound you’re getting on your phone by calling a familiar voice, listening to voicemail or dialling a free phone number.

TIP: when you’re on the phone, try shutting your eyes – it’ll help your brain focus on the sound.

What technology might help? Finding the right phone

There are so many different kinds of phone that it’s worth having a look around to find the best one for you. You’ll find helpful features on both corded and cordless phones. And you might want to compare landlines and mobiles to see which you find easiest to use, and which gives you the clearest sound. Here are some things to look out for that might help: • incoming speech amplification • tone and volume control • hands-free capability • visual call indicator (flashing light that lets you know when the phone’s ringing).

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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If you’re not sure what someone has said, ask them to: • repeat the sentence • say the sentence in a different way • spell important words • say the alphabet and stop at the correct letter or, if you’re having a problem with a number or date, count from number one and stop at the correct number.

Phone amplifiers

A phone with a built-in amplifier is a simple way to help you hear better. But if you don’t want to change the phone you use at the moment, you can also get a separate amplifier to attach to your phone. Most of these are designed to plug into a corded phone between the base and the handset. You can also get amplifiers that attach to a phone’s earpiece.

Images courtesy of Sarabec Ltd

To find the right phone amplifier for you, it’s best to do some research and look around for the best one. If you aren’t sure where to start, get in touch with the Hearing Link helpdesk (find out how on page 8).

Using text to communicate

If hearing loss makes using the phone a challenge, you might want to think about using text more to communicate. Mobile phones (and some landlines) will let you send and receive text messages (SMS). The internet gives you lots of other options like email, Skype, and instant messenger. You can use these from a desktop computer, laptop, smartphone or tablet. The Next Generation Text Service can help you to make phone calls, even if hearing on the phone is very challenging. There’s more about this service on page 33.

Making it easier to watch TV

There are lots of things you can do to make watching TV more comfortable. Here are some ideas: • turning on the subtitles (also available on some on-demand content) • changing the bass and treble settings • using a personal loop system that plugs into the back of your TV or set top box • using headphones (so you can have the volume higher than other people – you’ll need to have a separate ‘audio out’ socket) • trying different speakers or a soundbar – sometimes it’s the amplification, rather than the TV, that’s the problem • using a tablet or PC to watch TV online – so you can set it up the way you prefer.

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Noticing hearing loss

Where can I find help? If you’ve got any questions about hearing loss and want to discuss it with someone who understands, contact the Hearing Link helpdesk. Friendly, trained can answer your questions and point you in the right direction. Phone: 0300 111 1113 Email: [email protected] SMS text: 07526 123255 You can find out more about hearing loss at bt.com/hearinghealth For detailed information on different kinds of hearing loss, go to nhs.uk For more about phones to help people with hearing loss, see page 27 or go to the Products & Services section of BT’s Including You website at bt.com/includingyou Find out about TV features that could help at bt.com/tvaccessibility And to learn about getting online, go to bt.com/getonline

Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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3 Taking action



It’s normal to feel mixed emotions when you start to look for help with the changes in your hearing:

I felt relief that I was finally getting some proper help. At the same time I was absolutely terrified. — Craig



It can take a long time between first noticing hearing loss and acting on it. In fact, research shows that it can be as long as ten years. Don’t wait this long. There’s overwhelming evidence that the earlier you take action, the more it helps. For example, if you find that hearing aids would help, then the earlier you start using them, the better you can adjust to them – which helps you stay connected and avoid isolation. When you decide to take action, you might discuss your changed hearing with friends and family, asking them for recommendations and advice. You might also look for help online, or by approaching your doctor or an audiologist.

What is an audiologist? An audiologist is a healthcare professional working in NHS or private practice. Audiologists specialise in diagnosing and managing hearing and balance problems, and dispense hearing aids. Audiologists working privately are sometimes called hearing care specialists, private audiologists, hearing aid audiologists, independent audiologists or hearing aid dispensers.

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Taking action

What can I do? If you’re concerned about your hearing, a key step is booking an appointment with a professional for a test. They can then assess your hearing and decide whether hearing aids would help. They might also make other recommendations to help you live with hearing loss.

Online hearing screening

Although online tests are not a replacement for a full hearing test, taking one can give you an idea of your level of hearing. You might find this useful or reassuring before asking for a hearing test with a professional. Just search online for a test that suits you. Online screening tests might not pick up fluctuating hearing losses or the different levels of hearing in each ear – so if you think you have a hearing problem, don’t delay asking for professional help.

Will I need to wear hearing aids?

Lots of people wonder what equipment (like hearing aids) they might need to use to help them hear better. And they wonder what it will look and feel like. To know what will work best for you, you need to understand what kind of hearing loss you have. So the first step is to book an appointment!

NHS or private? You can either get to grips with a change in your hearing through the NHS or privately. It’s a personal choice and there are advantages to both approaches. Whichever route you take, you should expect to be professionally assessed and you should be able to get equipment that works for you, if you need it. But it’s worth doing a little thinking ahead, because there are a few differences – particularly to do with hearing aids.

NHS

NHS hearing aids are free at the point of issue. There are a range of aids to suit different types of hearing loss. Your audiologist will work with you to find the best choice. If you want to get your hearing tested through the NHS, the first step is to visit your GP. If your GP thinks that you might have hearing loss, they’ll refer you to see an NHS audiologist.

Private audiology

A private audiologist might offer more options, including access to newer technology or a broader range of suppliers and devices. They can talk you through what’s best for you and what would be included in the cost.

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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Most private audiologists provide free hearing tests, though you’ll need to pay later if you carry on using their services. Some people find they get through the process more quickly when they choose a private audiologist. Sometimes a GP can refer you to a private audiologist for NHS treatment. This depends on the area you live in – your doctor will be able to explain the local situation. If you visit a private audiologist, we recommend you choose a member of a professional body like the British Society of Hearing Aid Audiologists (BSHAA) or the Association of Independent Hearing Healthcare Practitioners (AIHHP). If the audiologist suspects a particular medical condition, they will refer you back to your GP.

Support from friends and family

Discussing your questions and concerns with friends and family is always a good idea. You should treat advice about hearing aids carefully, though – whether it comes from friends or online research. Everyone experiences hearing loss differently, so what worked for someone else might not be right for you. The audiologist you see will advise you on what’s best for your own situation. A lot of people find it reassuring for someone they know to accompany them during their hearing aid consultation. Your audiologist will give you information to take home, but there can be a lot to remember.

Where can I find help? Visit your GP

They’ll be able to refer you to an NHS audiologist.

Find a registered private audiologist

British Society of Hearing Aid Audiologists: bshaa.com Association of Independent Hearing Healthcare Professionals: aihhp.org

Not sure what to do?

If you aren’t sure about what the right next step is for you, Hearing Link can help. Call the helpdesk on 0300 111 1113 or see page 8 for other ways to get in touch.

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Taking action

4 Getting a diagnosis



When you see the audiologist, they’ll carry out some tests and examinations and then make recommendations. Many people find that getting an idea of what the next steps are is very reassuring:

When I realised that my hearing loss was becoming a problem, going for my first hearing test made me anxious and stressed as I had no idea what the diagnosis was going to be. But it was also the time for me to ask questions about how I could manage my hearing loss by getting information and support. — Margaret



Seeing a GP First your GP, or another member of the NHS staff team, will check your ears for any blockage or infections. They may then: • carry out a hearing screening test (a short test to decide whether you need a full hearing test) • refer you for a hearing screening test • refer you for a full hearing test. If your ears aren’t clear, you’ll need to deal with this first. For example, you might need to have wax removed or clear an infection. Your GP might refer you to your nearest hospital’s Ear, Nose and Throat (ENT) department if you have an issue that needs investigating further.

Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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What if my GP won’t refer me for a test? It is possible that your GP will say that your hearing doesn’t need to be tested. They may even say that hearing loss is inevitable and that you should learn to live with it. Stand your ground! If you think you have a problem with your hearing, then you do. Ask for a referral for a full hearing test. If you’re still not happy with your GP’s assessment, you can ask another doctor for a second opinion. You could also book a hearing test with a private audiologist (lots of places can provide a free initial test, so you can check whether anything’s wrong).

Seeing a private audiologist If you visit a private audiologist, they’ll carry out a full hearing test. If they think you might have a medical issue (like an infection) that needs clearing, they’ll ask you to see your GP first.

Getting the most from your appointment At your appointment, you should talk about all of the issues you have with your hearing and whether you also experience other problems often associated with hearing loss. These might include tinnitus (noises in the head or ears), trouble with balance (the hearing and balance centres in the brain are connected), or pain in your ears. It’s important to talk about the different situations where you find it difficult to hear clearly. After your hearing’s been tested, you should be given the option to discuss the results so that you understand your hearing loss. • If you can’t hear what your doctor or audiologist is saying, ask them write down the key points, or type them on a screen. (It can also help if they look directly at you when speaking (rather than at their computer screen). You might also want to check with the receptionist how they’ll contact you for your appointment. • It might be useful to take someone else with you to this appointment. There is often a lot to remember and two heads are better than one!

What happens in a hearing test?

Wherever you have your hearing assessed, the kind of tests you’ll do are likely to be similar. The first tests used are called audiometry and take about 20 minutes. They’ll include being played clicks or other sounds through a headset and measuring your ear’s response. This is done with one ear and then the other, as the results can be different. You may also have sensors placed on your head and neck to check the response of nerves. There may be other tests after this.

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Getting a diagnosis

Your hearing test results

Sound is measured in two key ways: • volume – measured in decibels (dB) • pitch (whether it’s high or low) – measured in hertz (Hz) Your audiologist will probably refer to these two things when they explain the results of your test to you. The test results will be plotted on a graph called an audiogram. You may not be shown your audiogram and (and you don’t need to worry about understanding it if you are). If you do want to see yours, it’s best to ask on the day of your test. Your hearing threshold is the quietest sound you can hear. It’s measured in decibels (dB). Take a look at the table below to see how different levels of hearing loss are defined:

Hearing level

Threshold

Examples

Normal hearing

-10 to 20 dB

Rustling leaves, quiet whispering

Mild hearing loss

21 to 40 dB

Computer fan, loud whispering

Moderate hearing loss

41 to 70 dB

Rainfall, normal conversation

Severe hearing loss

71 to 95 dB

Vacuum cleaner, smoke alarm, lawn mower, shouting

Profound hearing loss

96 dB or higher

An orchestra playing loudly

Where can I find help? You can learn more about different kinds of hearing tests at nhs.uk To find out about communications support, go to hearinglink.org/communication-support And read about audiograms on the Hearing Link website at hearinglink.org/what-is-an-audiogram

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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5 Your plan



Once a professional has assessed your hearing, you’re ready to find ways to live life to the full:

Getting diagnosed is just the start. Don’t just lock yourself away. Find out how to change your life and do it. — Ann

2 million people have hearing aids

4 million people would benefit from using hearing aids, but don’t

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Your plan



There’s a whole range of different things that can help you live with a hearing loss, and hearing aids are just one of them. Other things you can think about include: • finding different ways to communicate and developing new skills • seeking counselling or advice from a charity or peer support group • joining local hard of hearing groups or a lipreading class • getting a new phone with features to help you hear better • using the internet to communicate (either with voice or text or by adding a face to the voice) • getting financial support through the government’s Access to Work scheme • benefiting from the support of a hearing therapist • getting ongoing support and advice about assistive equipment from an audiologist.

What technology might help? Hearing aids and other hearing devices

Hearing aids help you hear better by taking in sound through a microphone, then boosting and modifying it before sending it to your ear canal. The audiologist who tests your hearing will discuss whether hearing aids would help. There are lots of different kinds, so they’ll also be able to recommend the type that would be best for you. Whether you go through the NHS or a private dispenser, all new hearing aids are digital – although some people do still use analogue hearing aids. It takes time to get used to new hearing aids, and you will probably need to have your hearing professional fine-tune them once you’ve got used to wearing them. Most digital hearing aids can be programmed to have different settings for different environments, like in a group, a one-to-one conversation, in a quiet room or a busy shopping centre. They might also have a ‘T’ (telecoil) setting or programme for using with a hearing loop (see page 26). Your audiologist should explain how it all works when they fit the aids.

TIP: All NHS and some privately supplied hearing aids are fitted with a telecoil.

When you get hearing aids fitted, make sure your audiologist programmes them so that the ‘T’ setting is activated. This will mean you can use them with hearing loops in public places and phones that have an inductive coupler. If your hearing aids don’t have a ‘T’ setting, ask about the best setting to use when you’re on the phone.

Types of hearing aid

There are lots of different types of hearing aid. The right kind for you will partly depend on what kind of hearing loss you have, but there are other things to think about, too. For example, some people like to let others know about their hearing loss – or make a fashion statement – with a clearly visible aid. Others prefer a more discreet aid that few will notice. A behind the ear (BTE) aid has two parts: the main part goes behind your ear. This is connected by a tube or microtube to an ear mould, tip or cone that sits inside your ear. A receiver in the canal (RIC) aid is like a BTE aid but smaller. An almost invisible wire connects the microphone to the other part, which goes inside your ear canal. An in the ear (ITE) aid sits completely inside your ear. A completely in the canal (CIC) hearing aid goes deep inside your ear canal, making it invisible. This is the most discreet kind of hearing aid. Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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Watch out for automatic volume control Some hearing aids have a volume control. Others automatically adjust their volume depending on how noisy your surroundings are. This could be a drawback when you’re on the phone, because the aid might try to make the phone’s sound quieter. If you get this problem, let your audiologist know and they should be able fix things by adjusting the settings. You could also try using the phone in hands-free mode.

Choosing the right hearing aids

There are so many different hearing aids around, that you should be able to find something to suit you. Different types of aid suit different types of hearing loss and there are a lot of things to think about, so building a good relationship with your audiologist is important. They’ll be able to recommend hearing aids that suit your level of hearing. Not all providers can offer you every type of hearing aid. If you get hearing aids from the NHS, you’ll usually (but not always) be offered behind the ear aids. They’ll be loaned to you for free, but will still be the property of the NHS. If you see a private audiologist, you might be able to choose from a bigger range – including smaller in-the-ear models. Some providers may have arrangements with particular brands, but it’s unusual for a private audiologist to sell only one company’s hearing aids. Most think it’s important to offer products from several companies, so they have a wide choice to make recommendations from. Find out more at hearinglink.org

Adjusting to new hearing aids

It can take up to three months to get used to new hearing aids. What you experience will depend on your hearing loss and how much you wear your hearing aids. Your brain will begin to register sounds that it has not heard well for some time. So you might feel tired by listening or overwhelmed by new noises. But as you carry on using your new hearing aids, your brain learns to recognise the new sounds and they become more acceptable. It’s important to keep going. You should talk about what to expect with your audiologist. They’ll be able give you advice on the best technique for getting used to your hearing aids.

How much do hearing aids cost?

The NHS can provide hearing aids at no charge on a long-term loan. And all the extra support (appointments, tests, and consultations) is also free. You can usually get replacement batteries free of charge from your audiology clinic. You might be charged for lost or damaged hearing aids. 22

Your plan

The cost of hearing aids and professional services from a private audiologist can vary a lot, depending on the technology, fitting style, accessories and your individual needs. It could be anywhere from £300 to £3,000. Your audiologist will give you a breakdown of the cost. Most professional services and aftercare are included in the cost of hearing aids from private audiologists.

Make sure you compare like with like

It’s important to make sure that any price comparisons between different dispensers are like for like. Some professionals include a wider range of services than others and it’s particularly important to know what services you’ll have access to after your hearing aid has been fitted.

Can I order hearing aids online? It’s possible to get hearing aids by ordering them online or through the post. These are usually basic amplifiers that come in standard settings. They won’t be tailored to your individual hearing loss. It’s usually better to have a face-to-face consultation where you can discuss your particular needs and be properly diagnosed.

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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Surgically implanted devices Some people can’t use ordinary hearing aids because their type of impairment means that sounds can’t get through to the inner ear. In these situations there are other devices that can help, by transporting the sound in another way. Here are two common examples: A Bone-Anchored Hearing Aid (BAHA) works by conducting the sound through your skull bone. You’ll need to have an operation for one to be fitted. Some people find a Bone-Anchored Hearing Aid more comfortable because they don’t have an ear mould. And some people say they get a more natural sound, too. The NHS will usually only provide boneanchored hearing aids to people who aren’t able to wear conventional hearing aids that use an ear mould. You can also get bone-conduction hearing aids that work in the same way but aren’t surgically implanted.

Images courtesy of Cochlear Limited

A Cochlear implant (CI) is another kind of device that needs to be surgically implanted. It helps people with severe or profound hearing loss to hear and understand speech, by completely by-passing the normal hearing mechanism and stimulating the auditory nerve directly. You can find out more about cochlear implants on the Hearing Link website or from the National Cochlear Implant Users Association (NCIUA) at nciua.org.uk New technology: some private companies now offer ‘extended wear’ hearing devices. These are placed close to the eardrum using a non-surgical procedure and can be worn continuously for several months. To find out more, contact Hearing Link.

Should I insure my hearing aids? Make sure that your hearing aid is covered for loss when you’re away from home. Most dispensers can arrange insurance cover for you – but you might be able to include your hearing aids in an existing policy – such as one covering your household contents. The best advice is to discuss insurance cover with your registered hearing aid audiologist and/or your home insurer. Some companies offer stand-alone insurance specifically for hearing aids. Search online or contact the Hearing Link helpdesk to find out more. Hearing aids prescribed on the NHS can sometimes be insured – check with your audiologist or local clinic staff.

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Your plan

Assistive equipment Hearing aids are crucial for many people, but lots of other equipment can work with, or alongside, them to help you with different parts of your life – from feeling safe at home to listening to music and watching TV. The range of different equipment on offer can seem quite daunting at first. It’s worth asking for some suggestions from your audiologist.

Here are some things that people find useful: Alerters for doorbells or phones – these help draw your attention by making an additional sound, having flashing lights, or vibrating (or a combination of these). (You can also get alarm clocks with a vibrating pad or flashing light.) If you’re a BT customer and find it difficult to hear the phone ring, BT can provide you with one ToneCaller II (which makes an extra sound when the phone rings) free of charge. To find out more, call 0800 800 150 or go to bt.com/includingyou

It’s reassuring to know that I won’t miss the postman “when he rings the doorbell with a parcel. My alerter flashes to let me know someone’s there — Marc ” Paging systems – you can set up these to get alerts from a range of different devices (like a smoke alarm and alarm clock as well as the doorbell and phone) using radio signals. You can get different kinds of receiver – including ones you can clip to your clothes, wear on your wrist or even put under your pillow.

I need to know when my daughter wakes up after taking a nap. “The baby monitor links to my pager and buzzes on my wrist to let me know I’m needed! — Sarah ” FM systems (personal listeners) – an FM system picks up the speaker’s voice through a microphone that they wear, and then sends a wireless radio signal to a small receiver attached to the hearing aid, so you’ll get a clearer sound.

I was beginning to find group meetings at work difficult “and stressful, with too many people speaking at once.

Finding out about a personal listener was like a revelation. I can tune in to what’s being said much better. — Lyndon



Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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Hearing loops – a hearing loop system gives you a clearer sound with less interference and background noise. It works by sending out a magnetic wireless signal from a microphone near the sound source that’s picked up by hearing aids when they’re set to the ‘T’ (telecoil) setting. Using a hearing loop with the ‘T’ setting on your hearing aids can be useful in all kinds of situations, like on the phone (where it’s often called an inductive coupler) in your home (for example, to help you hear the TV) and in public places where you see the hearing loop symbol. Image courtesy of Contacta

You can find out more about hearing loops on the Hearing Link website at hearinglink.org/loops

I use the hearing loop at the counter at the bank and at the “supermarket, so I tried plugging a loop system into my TV too. It makes a massive difference. And my husband has stopped complaining about the TV being too loud! — Joyce



Streamers – a streamer is a small device you wear around your neck on a cord. It connects the sound wirelessly from an mp3 player, mobile phone, laptop, TV adaptor or other device to your hearing aids, helping you hear more clearly.

Image courtesy of Phonak

A streaming device will need to be compatible with your hearing aid, so it’s best to check what’s available – with your audiologist, the Hearing Link helpdesk, or online.

I had to do some investigating, but I’ve found a brilliant streamer “that works with my mp3 player and my phone. I don’t even have to bother getting my phone out of my pocket when it rings, so I can answer it and talk easily. — Phil



A Bluetooth neckloop – this is like a streamer, but it’s compatible with any kind of mobile phone, and with most hearing aids that have a ‘T’ setting. They use Bluetooth technology to connect to the phone and then the ‘T’ switch in your hearing picks up the sounds of the call from the loop.

Image courtesy of Phonak

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Your plan

Both Bluetooth neckloops and streaming devices are small (smaller than a mobile phone) and fit comfortably around your neck. They can be tucked under clothes for extra privacy if required!

Headphones – you can plug headphones into your TV, phone or other device to get the sound directly into your ears.

The headset lets me hear the TV at the right “volume, without affecting everyone else in the room. I take my hearing aid out and listen through the earpieces. — Carol



There are always new pieces of kit being developed, from alarm clocks to doorbells and flashing fire alarms, as well as hearing aid compatible technology. It can be hard to keep up. Using the contacts in this guide and talking to friends in the same boat can make a big difference. If you’ve got a question about technology, Hearing Link can help point you in the right direction (see the contact details on page 8).

TIP: sometimes local authorities will provide you with free equipment – often

through a sensory services team. You might be able to get financial support with the cost of assistive equipment, courses or professional help. For more advice, contact the Hearing Link helpdesk (see page 8 for details).

What is a hearing therapist? Hearing therapists use lots of different techniques and skills to help people adjust to the effects of hearing loss, balance issues or tinnitus. This can include teaching communication tactics, lipreading skills or relaxation techniques. They may offer counselling to help you come to terms with hearing loss. Most hearing therapists work for the NHS and are connected to audiology services. Availability will depend on the area you live in.

Using the phone with hearing aids Using the phone with hearing aids can mean some extra things to think about, from the kind of phone you have to the way you use it.

Phone features

Lots of home phones and mobiles have features that can help people who have hearing loss or use a hearing aid. These include: Inductive coupler – this works like a hearing loop by making a wireless magnetic connection to your hearing aid when it’s on the ‘T’ setting to cut out interference and give you a clearer sound (for more detailed information and advice on using the phone with an inductive coupler, see page 30). Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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Hands free – a hands free (loudspeaker) function means you don’t need to hold the phone as close to your hearing aid (or you may prefer to take out your aids). It’s useful if you wear two hearing aids because the sound will go to both ears – as if you’re chatting to another person in the same room. Amplification – boosts the volume coming from the phone (so you may be able to use it without the aid). Amplification on cordless phones may not be very strong. Visual call indicator – flashing light to let you know when the phone’s ringing. SMS text messaging – you can send and receive SMS text messages from phones with this feature. You’ll also need caller display for this to work (see below for more details). Caller display – see who’s calling on the phone’s display (you’ll need a caller ID service from your provider – charges may apply). This helps you to be prepared for the voice of the speaker, or decide whether to answer. Two-way record facility – record your calls so you can go back and listen to them. Answering machine with slow playback – play back messages and recorded calls slowly so you catch everything. This is available on the BT4500 Big Button – find out more at bt.com/includingyou Headset socket – plug in a headset or neck loop. (Using a neck loop might help reduce any interference you might get from a cordless phone). Internet – so you can use social media, email, apps and voice or video calls to communicate. For more information on phones that can help with hearing loss, go to bt.com/includingyou

REMEMBER: cordless phones won’t work during power cuts because they need a

power supply – so it’s worth having a simple corded or mobile phone for emergencies.

TIP: to help people hear what you’re saying on the phone, hold the mouthpiece below your bottom lip, in front of your chin. Modern mouthpieces are very sensitive and holding them too near to your mouth can distort what you’re saying.

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Your plan

Mobile phones All mobile phones are digital which used to cause problems with interference. But newer technology means that you should be able to use a mobile phone with your digital hearing aids. If you use analogue hearing aids, you might get interference when you hold the phone up to the microphone or use the ‘T’ setting. Looking for the right mobile phone? The Global Accessibility Reporting Initiative (GARI) is a project designed to help you find mobiles (as well as tablets and apps) with features that might help. It’s based in the USA but it includes some phones that are available in the UK. Find out more at gari.info Lots of mobile phones have a loudspeaker, sometimes called ‘hands free’. This could be enough for you to be able to hold the mobile phone far enough away from your hearing aids to avoid interference. You might also be able to buy an inductive neck loop for your mobile phone. This either goes around your neck or hooks discreetly over your ear (next to a behind the ear hearing aid). They plug into the phone and come with a microphone that you can keep away from your hearing aids to avoid interference. Image courtesy of Phonak The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc.

Bluetooth® inductive loops can be a bit pricey, but they should work with any Bluetooth-enabled mobile – so you don’t need to get a new loop or adapter if you change your mobile phone.

Made for iPhone hearing aids Some hearing aids have a Made for iPhone (MFi) option. This uses a wireless connection to give you a clear sound when you use them with an Apple device like an iPhone or iPad (you can’t use this option with other phones). Contact Apple Support to find out more.

emergencySMS The emergencySMS service lets deaf, hard of hearing and speech-impaired people in the UK send an SMS text message to the UK 999 service, who’ll pass it to the police, ambulance, fire rescue, or coastguard. This service is free but you need to register your mobile phone to use it. Find out more at emergencysms.org.uk

Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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Positioning your home phone or mobile when you’re using hearing aids When you’re on the phone, you need to make sure that the sound reaches your ear canal by moving it as close to the hearing aid microphone as possible. The best way to do this will depend on the kind of hearing aids you have. It’s a good idea to ask your audiologist. Try holding the handset in different positions to find out what suits you best. One way of doing this is to listen to the dialling tone or a recorded announcement on a free phone number.

TIP: some people prefer to take out their hearing aid and use a phone with an amplifier. If you do this, the general tips on page 10 will help.

Inductive couplers and the ‘T’ setting

A telecoil is a small part of a hearing aid that picks up magnetic signals from a hearing loop and converts the signals back into sound. This process doesn’t amplify the background noise, so you’ll get a clearer sound with less interference. A hearing loop in a phone is often called an inductive coupler. Hearing aids with a hearing loop will work like this when they’re on the ‘T’ setting (‘T’ stands for ‘telecoil’) or loop programme.

How do inductive couplers help?

An inductive coupler can reduce background noise and eliminate the feedback (squealing or whistling) that you sometimes get when you hold a phone next to your hearing aid.

How to tell if your phone has an inductive coupler

On your phone’s box it should say ‘hearing aid compatible’, ‘inductive coupler’ or ‘hearing loop’ and show an ‘ear’ symbol. All BT corded phones with amplification also have inductive couplers. The amplifier can also be used to boost the speech volume when using your hearing aid on the ‘T’ setting. Some digital cordless phones also have inductive couplers.

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Your plan

Using an inductive coupler with hearing aids

The sound from a phone earpiece comes from the holes in the centre, but the inductive coupler (an electromagnet) is usually fitted around the rim of the earpiece. It’s often about a centimetre back from the holes. It’s important to hold the rim of the earpiece as close as possible to the magnetic pick-up in your hearing aid – maybe even touching your hearing aid. You’ll need to experiment to find the best position for the handset and adjust the volume on the hearing aid or phone (or both) to a comfortable level. The magnetic coils in the phone and hearing aid work best if they’re aligned in the same direction. Most hearing aid manufacturers try to make the angle of the telecoil suit both phone and room loop use – but you could try rotating the phone to see if the sound gets better. Some hearing aids have a combined microphone and telecoil option (an ‘MT’ position) that picks up the sound coming both from the microphone and the inductive coupler. Some people like to use this option, because it boosts the overall sound. But if you’re in a busy place, it’s probably best to choose telecoil only, to keep background noise down. You can find more about using a phone with a hearing aid on the Making calling easier pages at bt.com/includingyou

Programmable telecoil option (PTO)

Some hearing aids have a programmable telecoil option (PTO). This can automatically choose the programmed setting (telecoil, microphone or microphone and telecoil) that you prefer for using the phone. With some hearing aids, it’s triggered automatically by your phone’s magnetic field.

Whistling If your hearing aids whistle, it’s usually caused by feedback, when the microphone picks up the sounds going into your ear and amplifies them again. If you find you’re getting a whistling sound, here are some things to check. • Is the mould or tip/dome fitted in your ear properly? If it needs to be changed, a visit to your audiologist will probably fix things. • Is your hearing aid volume too high (this also distorts the speech)? Try using a phone with an amplifier so you can turn down the hearing aid’s volume and turn up the phone’s incoming speech volume. Try not to have it too loud though, or you’ll hear the whistling you’re trying to avoid. Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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• Twist the handset so that one edge of the earpiece is turned away from your ear. This will direct the sound away from the aid’s microphone, helping to stop the feedback cycle. • Move the earpiece around until you find the place just before the whistling starts – this will help you get the loudest sound.

Using the phone with bone-anchored hearing aids or cochlear implants

In terms of positioning, bone-anchored hearing aids, cochlear implants, and nonimplanted bone conduction hearing aids, are a bit different to conventional hearing aids. But the general principles of good phone technique are the same. Depending on your hearing aid, the tips on page 30 still apply, and they’ll help you find out if you’re likely to get interference when you’re using a cordless or a mobile phone. The hands free feature on some phones (see page 28) can be really useful, but remember to turn down the volume to the lowest comfortable level, to minimise distortion. This is especially important if you’re using a digital cordless phone – where the hands free amplification is built into the handset itself. With newer cochlear implants, you can use your phone with either the microphone or the telecoil, or both. As with other hearing aids, you’ll need to experiment to find the best place and position to hold your phone.

Sending SMS text messages from a landline with BT Text Text messaging (SMS) can be a great way to stay in touch. You can easily text from a mobile phone and, with BT Text and a compatible phone, you can do the same from your landline. To send and receive texts on your BT line, you’ll need an SMS compatible phone and BT Caller Display (which you may be charged for). Text messages sent to standard phones or to lines without Caller Display will be delivered as voice messages. • For charges and more information, go to bt.com/callingfeatures

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Your plan

Communicating using the internet The internet can help, perhaps in ways that you don’t automatically think of. For example, you can: • make phone or video calls • stay in touch using social media and instant messenger services • use fingerspelling or gesturing with a webcam. You can make voice calls over the internet – for example, by using Skype and Viber. These are called Voice over Internet Protocol (VoIP) programs or apps. Some programmes also let you send instant text messages, make video calls, or both (lots of laptops, tablets and smartphones have built-in cameras that you can use for video calls). The quality of these types of call can vary depending on how good your internet connection is – so you might find it more difficult to hear clearly on some calls. It’s also worth remembering that VoIP calls won’t work if you have a power cut, so it’s worth having a simple corded or mobile phone for emergencies.

Social media

When you join a social network like Facebook or Twitter you become part of an online community where you can share text updates, photos, videos and more. You’ll find more information and help with the internet in the ‘Getting online’ pages at bt.com/getonline

REMEMBER: to set up your privacy settings on social media so you only share

information with people you know. This will help protect you from unwanted calls and scams. For more information, go to bt.com/scams

Next Generation Text (NGT)

If you struggle to hear or speak on the phone, The Next Generation Text (NGT) Service and NGT Lite app can really help. If it’s hearing on the phone that you have difficulty with, a relay assistant will type what the other person is saying, so that you can read their words in real time. And if you have difficulty speaking on the phone, a relay assistant will speak the words you type, so the other person can hear your words in real time.

Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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The free NGT Lite app works with smartphones, tablets, laptops and desktop computers, so you can use NGT wherever you can get an internet connection. You can download the app from Apple’s App Store, the Google Play Store or from the NGT website. NGT is the replacement for the old Text Relay service. You can also still use a textphone with NGT if you prefer. Find out more at ngts.org.uk

I hadn’t made a phone call for years “and I was nervous about trying NGT, so it was thrilling to have my first conversation at work using my smartphone. As soon as I hung up, I started waving my arms about in excitement! — Emmanuelle



More useful apps

There are lots of apps that can help people with hearing loss. Here are some examples: uHear – a screening tool that lets you to test your hearing to help you decide whether you might have hearing loss. You can assess your hearing in less than five minutes, using up to three simple tests. Available from the Apple App Store. BioAid – an experimental ‘hearing aid’ designed by hearing scientists. It takes sound in through your smartphone’s microphone, adapts it using an algorithm to make the sound better, and then plays it to you through headphones in real time. Available from the Apple App Store. TapTap – lets you know when a loud noise has been made nearby – useful in all kinds of situations. Available from the Apple App Store. Finger spelling – some apps let you learn and practice finger spelling at your own pace. Available from the Apple App Store and other online stores. Voice recognition – apps like Dragon Dictation (available from the Apple App Store) can recognise the words you or someone else is saying, and transcribe them into text. Video communication: apps like Skype and Apple’s FaceTime mean that you can see the person you’re talking to, so you can lipread (you can also use Skype on a desktop or laptop computer – go to page 33 for more information). Instant messaging – alongside standard SMS text messaging, there are lots of textbased instant messaging apps like Whatsapp (available from the Apple App Store and Google Play). 34

Your plan

Where can I find help? Hearing Link’s friendly helpdesk can put you in touch with local teams to help you find the right assistive equipment for you. You could also try doing an online search for local hearing loss organisations or sensory services teams (these are run by local authorities).

Finding the right equipment Try Before You Buy centres

Working with third-party Try Before You Buy (TBYB) centres, BT provides over 200 places where you can see, handle and try out phones and equipment to make sure it’s right for you – without being pressurised by sales people. To find your nearest Try Before You Buy centre, go to bt.com/tbyb

Assistive equipment

Lots of private hearing care centres and some NHS audiology clinics have assistive equipment displays. There are also several companies that supply equipment to help people with hearing loss by post. They can all provide advice about equipment through their helplines, and may be able to send you a catalogue. They might offer a money back guarantee – so that you can try the product to make sure it works well for you.

Connevans

Website: deafequipment.co.uk Customer services: 01737 247571 Email: [email protected]

Sarabec Website: sarabec.com Customer services: 01642 247789 Email: [email protected]

Geemarc Website: geemarc.com Customer services: 01707 372372 Email: [email protected]

Action on Hearing Loss Website: actiononhearingloss.org.uk/shop Customer services: 01733 361199 Email: [email protected]

Confused? Try the equipment forum

Action on Hearing Loss has an online equipment forum where you can discuss products and share experiences to help you through the maze: actiononhearingloss.org.uk/community/forums.aspx

Continued > Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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Learning new skills Lipreading classes

Lipreading tutors teach lipreading to people who have begun to lose their hearing. Some lipreading tutors teach in adult education centres, with courses usually run during the autumn, spring and summer educational terms. Other classes are attached to local hearing loss organisations or community groups. A lipreading class is full of people who have lost their hearing as adults. There’s no age limit and you don’t need any qualifications. Lots of people find that going to a lipreading class is a good way to find out more about local services and support, as well as making new friends. Contact Hearing Link for help finding a class close to you. Here are some other suggestions: • the Association of Teachers of Lipreading to Adults (ATLA) has a list of classes by ATLA registered teachers. Find out more at atlalipreading.org.uk/learn-to-lipread • try contacting your local adult education centre, or searching for online lip reading courses. • there’s lots of free material at lipreadingpractice.co.uk

Social groups Joining a social group, run locally by and for people with hearing loss, is a great way to stay connected and develop a support network. Groups, clubs and associations arrange activities or social events like lipreading classes, outings, parties, and trips to the theatre. Venues include community halls, pubs, cafés and members’ homes. We’ve brought together information about lots of local groups, clubs and associations on the Hearing Link website at hearinglink.org/groups-and-clubs Hearing Link works with adults. If you’re looking for advice for someone who’s under 18, get in touch with The National Deaf Children’s Society (NDCS) at ndcs.org.uk

Hearing loss at work 37% of people with hearing loss are working age – that’s around 10% of working age people in the UK. If you have hearing loss, you may need to make some adjustments at work. You should talk to your manager about what your needs are, and make sure that people you work with are aware of any adjustments they need to make. You might find it useful to talk to the Hearing Link helpdesk first to get an idea of options and helpful strategies before speaking to your employer.

Continued > 36

Your plan

Communication support Communication support is when a trained professional helps you communicate in a situation like a work meeting, job interview, GP visit, or a courtroom. There are lots of different kinds of communication support professionals to suit different situations or communication needs. These include:

Verbatim speech-to-text reporters (STTR)

Using a special phonetic keyboard linked to a laptop computer, these transform speech into text, which is often displayed on a computer screen or a large screen at the front of the meeting. An STTR works quickly, so the odd imperfection will creep in. They will also include any relevant sounds (like laughter or a door opening). STTRs are sometimes called palantypists.

Manual note-takers

These often work with deaf and hard of hearing students in classrooms and lecture theatres. They take handwritten notes, providing a summary of what is said rather than a verbatim report.

Electronic note-takers

These provide a summary of the proceedings using laptop computers. They can often type faster than someone can write using a pen and, of course, the printed version is sometimes easier to read than handwriting.

Sign Language Interpreters

These interpret between people who use British Sign Language or Irish Sign Language and people who use spoken English.

Lipspeakers

These repeat the speaker’s message by moving their lips but without using their voices. They reproduce the shape of the words with greater clarity, using the rhythm and stress of natural speech. Lipspeakers also use facial expression and fingerspelling. Find out more on the Hearing Link website at hearinglink.org/communication-support

Financial support If hearing loss affects your ability to do your job or means you have extra costs related to your work, you might be able to apply for financial support, for example from the government’s Access to Work scheme. Find out more on page 43.

Your rights By law, your employer must make reasonable adjustments to allow you to work. For advice on your rights at work, see page 40. All service providers have to make reasonable adjustments to allow you to access their services. Some examples might be quiet areas, a hearing loop system, or specialist trained staff.

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

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6 Getting on with life



Getting to grips with a change in your hearing involves a lot of different emotions, but making progress can be very satisfying:

When I accepted hearing loss and put a name on all the emotion, I could stop regretting. And after that, I could live again. It’s an unbelievable change from the despair I once felt. — Emmanuelle



Living with hearing loss means adapting to lots of new challenges, both at work and with friends and family. There’s a lot to think about, but at some point you’ll reach the stage where it becomes a normal part of your life. Of course, there’ll always new things that need your attention – and it’s natural to find this frustrating sometimes. But it’s always better to face up to challenges. When people don’t, there’s a danger that they can shut down and isolate themselves – which can lead to depression. If you have hearing loss and you work then it’s likely that you and your colleagues will need to make some adjustments. It can be difficult to know how much information to share with colleagues, and how. Some people might find it hard to understand your situation, and there’s a chance you may face discrimination. It can be tricky situation to negotiate but don’t worry – Hearing Link can point you towards lots of other organisations who can help.

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Getting on with life

Hearing loss and your emotions Hearing loss often means making a lot of changes to your life. It’s important to think about how this affects your emotions, and whether it might help to get some support to discuss and manage them.

Relaxation

Taking care of all the extra things you need to think about because of your hearing loss can mean increased stress, which can in turn lead to symptoms like fatigue and headaches. It’s important to find ways to unwind. For some ideas, go to hearinglink.org/emotions

Talking therapies

Talking about your thoughts and feelings can help you work out what’s bothering you and how you might be able to address it. There are lots of different kinds of talking therapies, and some people find that these help them adjust to hearing loss. It’s government policy to make talking treatments like counselling more easily available on the NHS. Your GP can help you find if there’s anything suitable for you by telling you what’s on offer locally, and they can refer you for a short course of free talking treatment. Find out more about talking therapies on the NHS at nhs.uk

Where can I find help? Finding a therapist There are lots of different approaches to therapy, but research has shown that the quality of the relationship between you and the therapist is more important than the method they use. You’ll need to consider seeing a therapist privately if you want to choose who you see. The following professional bodies have registers of therapists who have signed up to their codes of ethics: The British Association for Counselling & Psychotherapy (BACP): itsgoodtotalk.org.uk/therapists The British Psychological Society: bps.org.uk

The UK Council for Psychotherapy (UKCP): psychotherapy.org.uk

Finding support if you feel depressed

If you feel depressed, you should get help as soon as possible. There are lots of effective treatments and lots of organisations that can help: The Samaritans (UK): samaritans.org

C.A.L.L.(Wales): callhelpline.org.uk

MIND (England): mind.org.uk

Breathing Space (Scotland): breathingspace.scot

Lifeline (NI): lifelinehelpline.info

Continued >

Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

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Hearing loss at work

For an overview of things you might need to think about when you have hearing loss at work, a good place to start is the Hearing Link website: hearinglink.org/work-and-education

Worried about discrimination? Your rights and the law

The Equality Advisory Support Service provide information advice and support on discrimination and human rights issues to people in England, Scotland and Wales. You can find out more at www.equalityadvisoryservice.com In Northern Ireland you can find out more from The Equality Commission for Northern Ireland at equalityni.org Advice Now is an independent website run by a charity providing advice on rights and the law. Go to advicenow.org.uk The Citizens Advice Bureau has information on discrimination because of a disability at citizensadvice.org.uk

The Equality and Human Rights Acts

A new Equality Act came into force on 1 October 2010, bringing together over 116 separate pieces of older legislation. The Act protects people from unfair treatment and promotes a fair and more equal society. The Equality Act, together with the Human Rights Act 1998, means that your employer cannot treat you unfavourably because of hearing loss, and must make reasonable adjustments to allow you to work.

Noise at work

The Health and Safety Executive has some helpful information on noise safety at work. Go to hse.gov.uk/noise

Compensation claims

If your hearing loss was caused by an injury or excessive noise at work (including the emergency and armed services) you might be able to claim compensation. You can find companies to help with this by searching online.

Resolving disputes

The Advisory, Conciliation and Arbitration Service (ACAS) provide free impartial advice on resolving disputes at work, as well as mediation. Go to www.acas.org.uk

Finding work

A Disability Employment Advisor (DEA) at your local Jobcentre can help you look for a job, gain new skills and tell you about suitable employers in your area. Go to gov.uk/looking-for-work-if-disabled/looking-for-a-job Access to Work (A2W) is available in England, Scotland and Wales (see page 43). For more information, go to gov.uk/access-to-work Access to Work (NI) is available in Northern Ireland. To find out more, go to nidirect.gov.uk/access-to-work-practical-help-at-work

40

Getting on with life

7 How’s it working out?



Finding out ways to help you live with your level of hearing can be very satisfying:

It can take a while to work out what’s best for you, but it’s worth it. For me, joining a Hearing Link programme has been fantastic. By just listening to other stories, other testimonies, by just reporting my own experiences, I’ve been able to get in touch with myself and all these feelings I didn’t even know I had, which is very liberating. — Heather



After you’ve been managing your hearing loss for some time, you begin to get to grips with the way things are. But life never stays the same. Your hearing may change over time, or other circumstances might change – and technology is always developing too. So there will be lots of opportunities along the way to rethink the way you do things. When they take stock and reflect on where they’ve got to, some people accept their hearing loss and the decisions they’ve taken to address it. Others want to take a step back and rethink some things. Hearing loss is different for everyone and it can take a while to figure out what’s best for you. There are lots of different things that can help (including benefits and other financial support), so even when you feel things aren’t working out, it’s really worth trying new approaches.

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

41

Return visits to the audiologist

For lots of people, a first visit to the audiologist is just the start. You may well need to go back for a return appointment – to see how you’ve been getting on and to make any adjustments to the original settings. The process of setting up a return visit is usually simple – whether it’s booking an appointment or simply dropping in. Everyone’s hearing changes throughout their lives, so even once you’re happy with your hearing aid, you’ll need to carry on checking your hearing on a regular basis – often every few years. Your audiologist will let you know how often you should be re-tested.

Where can I find help? Hearing Link runs specialist services for people with all levels of hearing loss and their families. Personalised support can help you to adjust to the social, psychological and emotional challenges that hearing loss can bring.

One-to-one support

Community Support Volunteers work across the UK providing personalised support and practical advice for people with hearing loss and their families.

Intensive rehabilitation programmes (IRPs)

IRPs are for people who have experienced sudden or severe hearing loss. They are run as residential programmes and partners, family members or friends are encouraged to attend.

Self-management programmes (SMPs)

SMPs are for people with any level of hearing loss. They are non-residential and run by volunteers with experience of hearing loss, over three one-day sessions. An SMP will develop your knowledge, confidence and skills so you can better manage the challenges that hearing loss can bring. Partners and adult family members can attend too.

Link up programmes (LUPs)

LUPs are for people who already have an understanding of how to manage hearing loss. They are usually run over a single weekend with an overnight stay. Partners and family members are encouraged to attend too. An LUP is an opportunity to build on your current skills, confidence and knowledge, and to increase your network of contacts so you can support each other as you work towards personal goals. To find out more about any of these services, contact the Hearing Link helpdesk (to find out how, go to page 8).

Continued > 42

How’s it working out?

Balance problems

Some people with hearing loss have problems with balance. If you experience this, then visiting your GP would definitely be a good idea. You can also find out helpful information from: • the Hearing Link website at hearinglink.org/balance-disorders • the Ménière’s Society at menieres.org.uk

Benefits and financial support

If you have hearing loss, or care for someone who does, then you might be able to apply for benefits. There are lots of different benefits that could help, depending on your own finances and how hearing loss affects you (or the person you care for).

Access to Work scheme

If hearing loss affects your ability to do your job or means you have extra costs related to your work, you might be able to apply for a grant from the government’s Access to Work scheme. It can help with all kinds of things like funding the services of a communication professional or equipment like a phone amplifier, a new mobile phone, or a speech-to-text captioning programme. To use Access to Work, your employer must be based in England, Scotland or Wales. Find out more at gov.uk/access-to-work Northern Ireland has a similar scheme called Access to Work (NI). Find out more at nidirect.gov.uk/access-to-work-practical-help-at-work Here are some places where you can find out more information about financial support: Hearing Link: hearinglink.org/rights-and-benefits Gov.uk: gov.uk/financial-help-disabled Citizens Advice: citizensadvice.org.uk Action on Hearing Loss have factsheets on a whole range of subjects around benefits and support. Go to actiononhearingloss.org.uk/supportingyou

The Disability Living Allowance (DLA) and Personal Independence Payment

For most people, the DLA has now been replaced by the PIP. To find out more about the change, go to gov.uk/pip-checker Benefits and Work, an independent members’ organisation, has a forum where subscribing members can share experiences and information about claiming benefits. Take a look at benefitsandwork.co.uk

Get in touch with Hearing Link on 0300 111 1113 or go to hearinglink.org

43

Getting in touch Hearing Link At home, at work, socially – lots of things can change when you develop hearing loss. Hearing Link understands the impact and the challenges for you, your family and your friends. You can get in touch by: • filling in the online form at hearinglink.org/helpdesk-enquiry • calling 0300 111 1113 • texting 07526 123 255 • emailing [email protected]

Hearing Link on social media @hearinglink facebook.com/hearinglink And remember – there’s lots of useful information, including shared experiences and videos, on the Hearing Link website at hearinglink.org

BT Your online starting point for all of BT’s services is bt.com If you’re a BT customer getting in touch about your account, you’ll need to quote your BT account number, which you’ll find on your BT bill. To manage your own BT services, including seeing and downloading your bills, tracking your orders and getting the latest offers and help, go to My BT at bt.com/mybt or, even simpler, download the My BT app (available for both iOS and Android). You can also find out how to get help and contact BT at bt.com/includingyou/help-support-contact.html If you prefer to contact BT by phone, here’s how: 0800 800 150 – for BT sales and service 0800 800 288 – for the BT Welsh language helpdesk 0800 800 151 – for faults If you’re using the NGT service, remember to dial 18001 before these numbers. To contact BT using BSL, go to bt.com/bsl 44

Getting in touch

Live chat

If you find speaking difficult and have a question or need some help using BT’s products and services, you can use text to chat to them online. Just go to bt.com/includingyou, choose Help & Support > Contact us from the main menu. Then choose Chat online and type your question. This service is open from 8am to 9pm, Monday to Friday. Twitter If you use Twitter, you can contact BT via @BTCare and they’ll tweet you back with help or suggestions. A lot of people find this a quick and easy way to get in touch. Facebook BT is also on Facebook at facebook.com/BTUK

Organisations that can help Hearing Link

Tinnitus Support Facebook group

hearinglink.org 0300 111 1113

facebook.com/tinnitussupport

Ménière’s Society menieres.org.uk 01306 876883

Action on Hearing Loss

actiononhearingloss.org.uk 0808 808 0123

National Association of Deafened People nadp.org.uk 0845 055 9663

facebook.com/groups/36055758523

Communication support professionals Signature and NRCPD hold registers of communication support professionals:

SENSE

For people with both hearing loss and sight loss sense.org.uk 020 7520 0972

The National Deaf Children’s Society ndcs.org.uk 0808 800 8880

Ménière’s Disease UK Facebook group

Signature www.signature.org.uk 0191 383 1155 NRCPD www.nrcpd.org.uk 0191 383 1155

British Tinnitus Association tinnitus.org.uk 0800 018 0527

Get in touch with BT on 0800 800 150 or go to bt.com/includingyou

45

Available in other formats including braille, large print or audio CD. Please go to BT.com or call 0800 800 150

Offices worldwide © British Telecommunications plc 2015 Registered Office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 The services we’ve described in this publication may not always be available and we may change them. And nothing we’ve written here is contractual. When we supply services and equipment, our terms and conditions apply. BT is not responsible for content of third party websites. Written and designed by The Art & Design Partnership and Muse Publishing. Printed in the UK by DST Output Ltd. PHME 76382 Printed on Amadeus 50% Silk, made from 50% post-consumer recycled waste and 50% virgin fibre from well-managed forests independently certified by the Forestry Stewardship Council (FSC). All pulps used are Elemental Chlorine Free and the paper is made at a mill which is certified with the ISO14001 environmental standard and the EMAS eco-label.

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Communication choices: your hearing, your life - BT Plc

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