care & usage of hearing instruments in a skilled nursing facility
TRANSCRIPT
Care & Usage of Hearing Instruments in
a Skilled Nursing Facility
Statistical Information
• As many as 70-80% of nursing home residents may have some degree of hearing loss.
• In residents with hearing aids, approximately 50% will have hearing aids that are malfunctioning or are in need of repair.
Role of the CNA• As the caregiver who has the most
frequent contact with the resident, it is important that the CNA:– recognize the symptoms of hearing loss– understand how a hearing aid works– know how to keep hearing aids working – learn how to troubleshoot hearing aid
problems– know how to effectively and
appropriately communicate with the hearing impaired resident
Lesson Instructions
• Use the Table of Contents on the next two slides to hyperlink to the various components of this lesson. Click on the icon next to each topic.
• When you have completed the lesson, see your instructor in order to complete the practical demonstration and the written test.
Table of Contents
Table of Contents(continued)
Anatomy of the Ear
Three parts of the human ear:
• Outer ear• Middle ear • Inner ear
Anatomy of the EarOuter Ear Middle Ear Inner Ear
Outer Ear
• Auricle or pinna • External auditory canal
Auricle (pinna)
External auditory canal
Outer Ear
Middle Ear
• Tympanic membrane (ear drum)• Three bones:
– Malleus– Incus– Stapes
Middle Ear3 Ossicles (malleus, stapes, incus)
Tympanic membrane
Inner Ear
• Semicircular canals• Cochlea• Auditory nerve• Round window• Eustachian tube
Inner Ear
Semicircular canals
Auditory nerve
Cochlea
Round window
Eustachian tube
Anatomy of the Ear
Auricle (pinna)
External auditory canalCochlea
Tympanic membrane
3 Ossicles (malleus, stapes, incus)
Semicircular canals
Auditory nerve
Eustachian tube
Round window
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Types & Causes of Hearing Loss
Hearing loss can occur in any or all parts
of the ear.
Types of Hearing Loss
• Conductive– problem with conduction, or the transfer of
sound, through outer or middle ear
• Sensori-neural– dysfunction of inner ear; involves problem
with nerve and/or sound interpretation
• Mixed– combination of conductive and sensori-
neural hearing loss
Some Causes of Conductive Hearing Loss
• Debris blocking ear canal (example: wax or other foreign objects)
• Fluid build-up behind ear drum (example: otitis media)
• Perforated ear drum
Some causes of Sensori-neural Hearing
Loss• Dysfunction of inner ear related to:
– aging process (presbycsis)– chronic noise exposure– toxic medications– viral infections (mumps; meningitis)
Example of Mixed Hearing Loss
• Hearing loss related to aging, plus hearing loss related to infection and fluid behind the ear drum.
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Symptoms of Hearing Loss
• High volume on TV, radio• Talking loudly• Frequently asking to have things
repeated• Complaints of not understanding
what has been said• Intently watching face of speaker
More Signs of Hearing Loss
• Cupping the ear • Lack of response to questions• Frequent inappropriate or incorrect
answers to questions• Frustration; anger• Confusion• Withdrawal
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Types of Hearing Aids
• Completely-in-the-canal (CIC)• In-the-canal (ITC) (half shell)• In-the-ear (ITE) (full shell)• Behind-the-ear (BTE)
Behind the ear
In the ear
(full shell)
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(half shell)
How a Hearing Aid Works• Power source = battery• Microphone - receives sound wave and
converts it into an electrical signal• Amplifier - increases intensity of
incoming sound• Receiver - converts electrical signal
back into audible sound wave that can be heard
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Identifying Parts of the Hearing Aid
Volume control
Battery door
Ear mold (body)
Tubing
OTM switch
Canal portionBehind-the-ear
ear-piece
Identifying Hearing Aid Parts
• O-T-M switch -- turns hearing aid on and off, and adjusts for use on telephone.
O=Off T=Telephone M= (microphone) On
• Volume Control - permits the user to increase or decrease loudness of sound
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Care of Hearing Aids
• Cleaning– Clean regularly– Wipe off
accumulated debris from ear mold with kleenex
– Use wax pick , toothpick or small brush to remove ear wax
• Store in a labeled container, away from moisture/heat
• Remove battery when not in use for extended period of time
• DO NOT DROP
Care of Hearing Aids
• Test hearing aid battery at least every 2 weeks.
• Battery should register 1.4 on the tester.
• Replace battery as needed.
• A “listening check” of hearing aid should be done regularly.
To reduce risk of choking, swallowing, KEEP BATTERIES OUT OF RESIDENT’S REACH
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Troubleshooting Hearing Aid Problems
Potential Problems• No amplification or
sound• Weak/reduced sound• Whistling• Buzzing• Static
• Turn OTM switch to “M”
• Adjust volume• Check battery
position• Test battery• Replace battery, if
needed
• Clean / Remove wax
• Check hearing aid for damaged/broken parts
• Notify your supervisor
Troubleshooting Hearing Aid Problems
Return to Table of Contents
Communicating with theHearing Impaired
• Speak at slightly greater intensity. DO NOT YELL.
• Speak at normal pace -- not too rapidly.
• Speak from a distance not greater than 6 feet; but, preferably, not less than 3 feet.
• Make sure you are visible to resident when speaking so that your facial expressions and gestures can be seen.
• Try to reduce environmental noise.
• NEVER speak directly into person ‘s ear. (Clarity may be lost as loudness is increased; and resident can’t make use of visual cues.)
• Do not over-articulate. This distorts sound as well as facial expressions.
• Rephrase, rather than just repeat, your statement or question when it appears that a resident doesn’t understand.
• Treat all residents with courtesy and respect.
Communicating with theHearing Impaired
End of Presentation
• You have now completed the Lesson on Care & Usage of Hearing Instruments in a Skilled Nursing Facility.
• See your instructor for a practical demonstration on hearing aids, and to complete the written test.