Caring For Older People With Hearing Loss v7

Caring for older
people with
hearing loss
For staff, carers and volunteers working in residential, nursing

homes and sheltered housing for older people
The In Touch project, funded by the Big Lottery Fund

provides a befriending service across Northern Ireland to
older people in residential care who are deaf or have a
hearing loss, in order to reduce isolation, loneliness and
risk. The project offers:
O
ne-to-One befriending: where a volunteer is matched
with a resident
G
roup befriending: where a volunteer-led small and
friendly group meets when there is more than one
resident with hearing loss
I nformation talk to all residents explaining hearing loss
and Action on Hearing Loss services
H
earing Health training to staff in residential homes,
detailing communication tips, awareness and
equipment available
When people dont have the right support to manage
their hearing loss effectively, it can have a significant
impact on their life. This information aims to make it
easier for you to support residents who have hearing
loss, so they can manage their condition, maintain their
independence and play an active part in their community.
Contents
The need for action
About hearing loss
How to identify hearing loss
How to improve communication
11
About hearing aids
17
Equipment to help with everyday living
26
How to assess your home
29
Where can I get further support?
33
For further information, contact the In Touch team by

telephone 028 90239619.
Our report A World of Silence: The case for
tackling hearing loss in care homes informs the key
recommendations in this booklet. To read the report,
visit www.actiononhearingloss.org.uk/aworldofsilence
actiononhearingloss.org.uk
The need for action
1 Intervene earlier in hearing loss.
Hearing loss is a major public health issue affecting more than

300,000 people in the Northern Ireland thats one in six of the
population. By 2031, the number of people experiencing hearing
loss is expected to reach 404,000.
2 Meet communication needs.
The most common type of hearing loss is called presbyacusis or

age-related hearing loss. It develops gradually with age. Around
70% of people aged over 70, and more than 90% of people aged
over 80, are living with hearing loss.
3 Improve hearing aid use and management.

This booklet explains how you can take action in these key areas,
and others, to support your residents to enjoy a good quality of life.
About hearing loss

Hearing loss is usually described in terms of severity: mild,
moderate, severe or profound.
If someone has a mild hearing loss, they will have some difficulty
following speech, especially in noisy environments. They may
wear hearing aids if their hearing loss has been diagnosed
and find lipreading useful. They will nearly always use speech
to communicate.
Someone with a moderate hearing loss will find it difficult to follow
speech, especially in noisy environments. They will probably wear
hearing aids and/or lipread (see page 6).
This means that a large proportion of people living in sheltered

housing and residential and nursing homes for older people will
have hearing loss, whether or not they have recognised it or
sought help. It is vital that these people are supported to manage
their hearing loss effectively, to minimise the impact on their
quality of life.
As a result of our research into how hearing loss is managed in
care homes, we have identified three key recommendations for
everyone involved, directly or indirectly, in providing care and
support to residents:
Caring for older people with hearing loss
A person with a severe hearing loss may have difficulty following

speech, even with hearing aids. They may lipread and/or use
British Sign Language (BSL) or Irish Sign Language (ISL) and
communication support (see page 7).
Someone with a profound hearing loss may use BSL or ISL as their
first or preferred language, or lipread. People who use sign language
often consider themselves to be part of the Deaf community.
There are around 23,000 people in the UK who are deafblind
that is, they have a combined hearing and sight loss. Many people
who are deafblind have some hearing and vision. Others will be
totally deaf and/or totally blind.
Age-related hearing loss
depression
The most common type of hearing loss is linked to the ageing

process. To understand it better, it is useful to know what happens
in the normal hearing process.
stress and anxiety.
The ear is made up of three parts: the outer, middle and inner ear.
The outer part of the ear directs sound into the ear canal towards
the eardrum, making it vibrate. These vibrations are passed to
three small linked bones (the ossicles) in the middle ear. These
bones in turn send the vibrations into the cochlea (the hearing
organ in the inner ear) and the fluid within it. Movement in this
fluid bends the tiny hair-like cells within the cochlea, and this
generates electric signals in the auditory nerve (hearing nerve).
These signals travel along the nerve to the brain, where they are
interpreted as sound. Deafness can be caused by problems in any
part of this system.
Everyone loses hair cells in the cochlea as they get older, and,
gradually, their hearing deteriorates and becomes less sharp.
People with age-related hearing loss find that others seem to
mumble. They often find it difficult to understand what people
say, especially in noisy places, or when the TV or radio is on in
the background.
The impact of hearing loss
Some people with age-related hearing loss feel that its a normal
part of ageing that they just have to put up with. They quietly
resign themselves, completely unnecessarily, to a life without active
participation, perhaps believing that theres nothing that can be
done about it, or because they dont want to make a fuss. Others
may want to seek help but may be unsure of what they can do.
Recent research has also shown that there is a link between
hearing loss and dementia. People with mild hearing loss have
nearly twice the chance of going on to develop dementia as people
without any hearing loss. The risk increases to threefold for those
with moderate, and fivefold for those with severe, hearing loss.
Hearing and sight loss

As people get older, their sight, as well as their hearing, begins
to worsen. People with a combined hearing and sight loss will
find communicating effectively especially challenging. They may
have problems reading, getting around and carrying out simple
tasks without help. Sometimes, they may not answer questions
appropriately, which could be misinterpreted as an early sign
of dementia.
communication difficulties
Older people with hearing and sight loss may easily become
withdrawn and depressed. Their isolation may also have a negative
effect on their relationships with family and friends, especially if
they dont visit very often.
social isolation
See page 11 to find out how you can communicate more effectively.
If people are not supported to manage their hearing loss

effectively, it can lead to:
anger and frustration

low confidence, especially in social settings
6
Tinnitus
Tinnitus is a medical term to describe noise that can be heard in
one or both ears, or inside the head, which has no external source.
It can be continuous or it may come and go.
The type and volume of sound can vary greatly; some people
experience a ringing, others compare it to the sound of a train or
a short piece of music. The impact that tinnitus has on someones
life can also vary greatly and is often underestimated. For some
people, tinnitus can lead to depression, anxiety, stress and sleep
problems. And, unfortunately, stress and anxiety can make it seem
worse. There are several ways that someone with tinnitus can try
to minimise the impact that it has on their life. The following may
be used alone or in combination:
T
herapies, including counselling, tinnitus retraining therapy,
cognitive behavioural therapy, clinical psychology and/or
complementary therapies.
S
pecialist tinnitus products, which generate soothing sounds to
distract people from focusing on their tinnitus.
H
earing aids these may help people who also have hearing
loss, as hearing better may distract them from their tinnitus.
How to identify hearing loss
Age-related hearing loss can often go unnoticed for some time,

as its signs can be misunderstood. For example, if a resident is
unresponsive or confused, this may be identified as a sign of
dementia or a mental health condition, rather than hearing loss.
A delayed diagnosis of hearing loss has significant and sad
consequences; many people miss out on getting hearing aids who
could benefit from them hugely.
How to recognise the signs

People with age-related hearing loss often:
complain about others mumbling
need to have things repeated several times
complain that they cannot hear as well as they used to
dont react to you
struggle to hear on the telephone
have the TV or radio on very loud
fail to follow conversation in noisy places.
You might also notice a change in behaviour in residents. They
could be more withdrawn or stop taking part in conversation and
activities. This might be because of hearing loss.
Research shows that, currently, hearing loss diagnosis is

opportunistic and ad hoc on average, there is a 10-year delay
between people identifying that they may have a hearing loss and
seeking help.
The Action on Hearing Loss Hearing Check

As a first step, our Hearing Check can help you to identify
people who have hearing loss and encourage them to take
action. Its a quick and simple test that can be taken over the
phone or online. Its not a full hearing test, but it can indicate
whether someone has a hearing loss and whether they should
go to their GP for further tests.
To use the Hearing Check, call 0844 800 3838 (calls from a BT
landline cost up to 5p per minute. Other providers charges may
vary, a connection charge may apply) or visit
www.actiononhearingloss.org.uk/hearingcheck
What to do if a residents behaviour suggests they may

have a hearing loss
If you notice a resident struggling to hear, it is best to discuss this
with them. It could be that they havent recognised it themselves,
or they may be unaware of the easy steps to take to get a hearing
loss diagnosed and treated.
Diagnosis and treatment

If a resident thinks they have, or shows the signs of, hearing loss
or tinnitus, you should arrange an appointment with their GP,
who will check for any underlying cause for hearing loss, such as
infections or wax, which may be treated easily.
Good-quality digital hearing aids are free as standard on the NHS
and can also be bought privately. If the resident wishes to see an
audiologist on the NHS, they will need a referral from their GP.
They do not need a referral to see a private audiologist, but they
will have to pay for hearing aids.
We recommend that the resident visits their GP first, even if they
10 Caring for older people with hearing loss
are considering seeing an audiologist privately, to ensure that

there is no underlying cause of their hearing loss. The resident and
their family need also to be aware of the options available when it
comes to hearing aids.
Whether the resident sees an audiologist on the NHS or privately,
they will be asked a series of questions about their hearing loss,
and the impact that it is having on their life, and routine hearing
tests will be carried out. These tests will provide the audiologist
with vital information about whether there is hearing loss and, if
so, what type. From this, they can establish what management is
needed for example, hearing aids (see page 17).
For some types of hearing loss, surgery may be an option. Some
people will need to see other specialists, such as an ear, nose
and throat doctor, for further investigation into the cause of their
hearing loss, tinnitus or balance disorder.
How to improve communication

Hearing loss can have a big impact on a persons ability to
communicate and, therefore, their quality of life. There are simple
things you can do to aid effective communication:
Make lipreading easier

When we communicate face to face, facial expressions, lip shapes
and body language are important. Its likely that people with
hearing loss will rely on these visual clues even more to help them
follow what someone is saying, even if they dont realise it. Your
residents with hearing loss may benefit from attending a local
lipreading class, so you could see whats available.
When someone is lipreading you:
Find a suitable environment with good lighting, away from noise
11
and distractions.
Sit or stand at the same level and 3-6ft away from the lipreader.
Face the light, or your face will be in shadow.
Make sure the lipreader is looking at you before you speak.
Introduce the topic of conversation.
Speak clearly at a moderate pace, without raising your voice.
Use natural body language.
Keep your face visible.
Check that the lipreader is following you.
Be patient and take time to communicate.
Place the object in the persons hand so they can feel or smell it.
This is often a good method for communicating with deafblind
people, or people with learning disabilities or dementia. For
instance, you could place a tea cup in their hand for Would you
like some tea?
Use the fingerspelling alphabet

All letters of the English alphabet can be spelled on your hands
this is known as the manual alphabet or fingerspelling. Its used by
people who use sign language to spell out the names of people or
BSL fingerspelling alphabet
See our leaflet Learning to lipread for more information.
Write down key words
If you cant make yourself understood, write down key words
(not everything) and then continue the conversation.
If the person has sight problems, use a thicker pen or a different
colour pen or paper, and make your writing bigger. Work
together to find out what will help the most.
A
void using CAPITAL LETTERS. Its the written equivalent of
shouting and doesnt actually make things clearer.
Use body language to convey meaning

Point to objects, pictures or people that you are talking about.
Use facial expressions to show how you feel.
Use objects to represent specific people, things or activities.
12
13
ISL fingerspelling alphabet
instead. Its therefore vital that you understand the individuals

communication, or other, needs.
places that dont have sign names and words for other signs that
arent known.
If a resident uses BSL or ISL, they will already know the
corresponding fingerspelling alphabet. If they dont use sign
language, you can introduce them to fingerspelling using our free
fingerspelling cards. Contact our Information team for more details.
14
During an appointment, you may need to write some things down

if its clear that the resident didnt hear or understand something.
Notes are also useful for family members who cant attend.
The resident may receive written information from their healthcare
professional before and after an appointment. They can also ask
to be copied into any letters between healthcare professionals,
so that they are aware of what was discussed during their
appointment and any onward referrals that have been made.
Language service professionals for medical appointments can
be booked and paid for by the NHS; however, there may be limited
availability for some types (see below). The GP should make it
clear in new referral letters that someone requires this support,
so it can be booked in advance. However, its a good idea to
call the department or service ahead of the residents
appointment, to check that they are aware of the individuals
communication needs.
Language service professionals include sign language interpreters,
lipspeakers, notetakers and speech-to-text reporters.
Create a comfortable environment

The physical environment has a considerable impact on how
easy it is for someone with a hearing loss to communicate.
There are many simple things you can do to improve the
listening environment.
Help with communication support
Decoration
If a residents family member is unable to accompany them to a

medical appointment to lend support, you may need to go along
Consider replacing wooden flooring with carpet, as this helps to

absorb noise.
15
U
se soft furnishings, as these reduce sound reverberation
and echo.
About hearing aids
A
void busy/bold patterns on walls and curtains, as they can
be distracting.
Many people with hearing loss find hearing aids very helpful but it
can take some time for people to adjust to their hearing aids and
its important that they get the support to make the most of them.
Make sure there is good lighting in all areas, without any glare
or shadows.
Dining room
Digital hearing aids are free on the NHS and they can also be
bought privately. Digital means that the audiologist can fine-tune
them to match a persons hearing loss and needs.
Use padded tablecloths to reduce the clatter of cutlery

and crockery.
Different types of hearing aid
Introduce round dining tables, so everyone can see each other.

Communication
Reduce background noise whenever possible. For example, turn
off the TV if no-one is watching, or turn on the subtitles.
When using notice boards, type notices using lower-case letters
and large print.
There are several different types of digital hearing aids available.

The audiologist will advise which type is best according to the
individuals hearing loss and lifestyle.
Behind-the-ear (BTE) hearing aids
These rest behind the ear and send sound into the ear in one of
three different ways:
a) Through a piece of clear, flexible tubing
connected to an earmould, which fits inside the
ear. Most people who get NHS hearing aids have
this type (see picture 1).
If there are communal lounges, make sure there are quiet
areas so that people can talk without the distraction of
background noise.
Contact Action on Hearing Loss to see what deaf awareness
training we can offer.
b) Through very thin, clear tubing connected to

a small, soft earpiece at the tip of the tubing,
which sits inside the ear canal (see picture 2).
This type is called an open ear fitting and can
C
onsider any additional needs of your residents and consult
specialist organisations or charities for advice.
Ask residents for feedback on the changes.
2
16
17
be less noticeable than an earmould. It can give a very natural

sound but is only suitable for people with mild to moderate
hearing loss.
c) Through a clear tube with a wire inside, which

runs from the hearing aid to a tiny loudspeaker
held in the ear by a soft earpiece (see picture 3).
These are most commonly known as receiver
in the ear or loudspeaker in the ear hearing
aids and they are now available from some NHS
audiology services.
Hearing aid settings

Many digital hearing aids have settings for different listening
conditions. Some adjust automatically in response to different sound
environments; others will have to be activated manually (by hand).
If a resident is going through the process of getting hearing aids,
tell the audiologist about any particular difficulties that they may
have been experiencing or activities they regularly take part in. A
choice of listening programmes may be of benefit to them in these
situations. The audiologist will discuss how to use the hearing aids
and any particular settings that may be of benefit.
The hearing loop setting (formerly the T setting)
In-the-ear (ITE) and in-the-canal (ITC) aids
These have their working parts in the earmould

so the whole aid fits into the ear (see picture 4).
They tend to need repairing more often than BTE
aids and can be fiddly.
Body-worn hearing aids
18
These have a small box that clips to clothes or

can be put in a pocket (see picture 5).
This is connected by a lead to an earphone and
earmould.
Body-worn hearing aids are very powerful and
may be more suitable for people who have sight
problems and/or problems using their hands.
Most hearing aids have a hearing loop setting. This lets them pick
up sound from listening equipment, such as hearing loop systems,
which can be found in public places such as cinemas, theatres and
banks, and can help people to hear more clearly over background
noise. You can also get loops for home use (see What is a hearing
loop?, page 12). Ask the residents audiologist about the hearing
loop setting.
Fitting a BTE hearing aid with an earmould

The earmould is the part of the hearing aid that goes inside the
ear. The hearing aid tube then hooks around the top of the ear,
sitting snugly behind the ear. If a person has a hearing aid for each
ear, there will usually be some marker so you can tell which aid is
for each ear for example, a red mark on the aid for the right ear.
If in doubt, check with the person who fitted the hearing aids.
actiononhearingloss.org.uk 19
Fitting a BTE hearing aid with an open ear fitting

When someone has their hearing aids fitted, they should be given
written instructions about how to look after them. If you are not
sure about any of the information, or do not have access to it, ask
the residents audiologist for advice.
Cleaning is different depending on whether someone has an
earmould, open fitting or receiver-in-the-canal hearing aid.
1 Hold the earmould at the back
with your finger and thumb.
Pull it back past the ear.
2 Put the part that goes down

the ear canal
into position.
3 Then put in place the bit that

goes into the crease at the top
of the ear.
4 Use your other hand to pull

down the earlobe. Push the
earmould firmly into position.
5 Correctly fitted hearing aid.
6 Incorrectly fitted hearing aid

the top part of the earmould
is not properly tucked into the
crease at the top of the ear.
Cleaning BTE hearing aids

Tips for cleaning BTE hearing aids with an earmould
1 Hold the hearing aid behind
the ear with the soft tip facing
towards the head.
2 Place the soft tip in the ear with the

tail facing backwards. Push the tip in
as far as it will comfortably go.
3 Fold the tail backwards into the bowl of

the ear. Sometimes, when its new, the tail does
not stay in place, but after a few days it should
mould itself to the shape of the ear.
4 Correctly fitted hearing aid.
Ask the audiologist if you want to find out
about fitting other types of hearing aid.
21
Clean the main part of the hearing aid by wiping it with a soft,
dry cloth or tissue. Take care not to get it wet.
The way you take off the tubing for cleaning

is a bit different from one model to another.
So, before you start, youll have to check the
instructions you have been given.
Wipe the earmould with a soft, dry cloth or tissue every night.
Dont use any chemicals as they could damage it. Use a pin or
similar item to remove any wax or debris that has got into the
channel that goes through the earmould.
For information about cleaning receiver-in-theear hearing aids, and other types, see
our leaflet Life with hearing aids.
A
bout once a week, you should separate the earmould from the
hearing aid and wash it. However, you should check this with the
audiologist first.
Follow the instructions below for washing the earmould:
1G
ently pull the soft tubing off the hooked part of the hearing aid
by holding onto the tubing with one hand and the hook of the
aid with the other and tugging gently. Dont pull the tubing out
of the earmould as you wont get it back in.
2 Wash the earmould (with its tubing still in place) in warm, soapy
water. Use a nailbrush or a vent cleaner (or both) to remove any
wax. Rinse it well, blow down the tubing to get the water out
and leave it to dry overnight. Then push the tubing back onto
the hearing aid.
3 Make sure the curve of the earmould goes the same way as the
curve of the hearing aid, as shown in the picture on the right.
How to replace hearing aid batteries

Hearing aid batteries need to be changed regularly. Its unlikely
that they will last much longer than a week to 10 days if someone
wears them continuously. Someone with NHS hearing aids can get
free batteries from any hospital audiology or ENT department that
has a battery service. Some local health centres supply batteries,
and pharmacies also sell them. You can also order batteries from
local health centres and audiology departments by post.
1
Cleaning BTE hearing aids with an open ear fitting

The step-by-step guide below shows you how to
clean the tubing of an open-ear-fitting hearing aid.
You will need a very thin cleaning tube to help you
clean the dome and tube this should be issued by
the audiologist.
You will usually need to

take the residents hearing
aid record book to the
hospital department to
pick up the batteries, or
include the record book
in the envelope if you are requesting batteries by post. The record

book will help staff at the audiology department find the right
type of battery for the hearing aid.
To save the batteries, make sure that hearing aids are turned off at
night and turned on again in the morning. Most hearing aids will
be set to beep when their batteries are about to run out, but this
will only be heard by the person wearing the hearing aids.
If you care for several people who wear hearing aids, have a set
time each week to help them change their batteries (if necessary)
and to check their aids for wear and tear. This could be particularly
useful if they have sight problems and/or problems with their
hands, and find cleaning their hearing aids difficult.
Need a little extra help?

The Action on Hearing Loss Hear to Help hearing aid support
service helps people to manage and maintain their NHS hearing
aids through home visits and drop-in services. It is run by Hear
to Help officers and volunteers, who can:
replace hearing aid tubing
make minor repairs
show you how to clean earmoulds and tubes
show you how to replace your hearing aid battery
provide basic training and tips on how to get the most from
hearing aids
When supporting people with hearing aids...
provide information on other equipment and services.
Check and record every day that your residents hearing aids are
working and that they are wearing them correctly.
Call our Information team (see last page for contact details) to
find out if there is a Hear to Help service in your area.
Know how to use the hearing loop setting and different controls
on the hearing aids, how to change the batteries and how to
clean the hearing aids.
Make sure that there are adequate arrangements for hearing aid
re-tubing, repairs and battery replacement.
Make sure that there are adequate arrangements to minimise the
number of lost hearing aids, and to make sure that lost hearing
aids are replaced quickly.
On the medication checklist, put a reminder to change hearing
aid batteries weekly and make sure care plans have information
on each residents hearing aid needs.
Understand that other long-term conditions may have an impact

on hearing aid use; for instance, people with dementia may
forget that they have hearing aids.
If someone is having problems with their hearing aid, check that
all the parts are fitted correctly, that there arent any obvious
signs of damage (for example, split tubing), and that its on the
right setting. If youre not sure how to fix the problem, contact
the audiologist.
Know who to consult (for example, a GP or nurse) to examine
ears for wax and to arrange ear syringing, where appropriate.
For materials to help you support residents with hearing aids,

including a care plan that you can use to ensure battery changes
are done regularly and logged, and a troubleshooting guide, visit
our website at www.actiononhearingloss.org.uk/ helpingyoucare
Equipment to help with everyday living

There are three main categories of equipment designed for
people with hearing loss:
alerting equipment
listening equipment
telephones
Alerting equipment
This includes alarm clocks, smoke alarms, doorbells and other
devices. They make a louder noise, flash and/or vibrate to alert
a person with a hearing loss. In a residential home, they can help
people to maintain their independence and privacy.
Listening equipment
This amplifies sound (makes it louder) and reduces background
noise. Most listening equipment can be used to listen to speech
and can also be connected to a TV, radio or music system (with
cables or through wireless technology). People who do not wear
hearing aids can use the equipment with headphones. Those with
hearing aids will need to wear either a neckloop or ear hooks and
set their aids to the loop setting to listen.
What is a hearing loop?

Loop systems usually consist of an amplifier and a wire cable
(loop) that goes around the listening area and plugs back into the
amplifier. The amplifier then plugs into audio equipment, such as
a microphone or TV. The electric current in the loop produces a
magnetic field that sends sound directly to peoples hearing aids
when theyre on the loop setting, helping them to hear more clearly.
People who dont wear hearing aids can benefit from loop
systems by using a loop listener, a portable device that has
earphones or headphones.
We recommend you install hearing loop systems in the TV rooms,
communal rooms and reception areas of your home, to let your
residents with hearing loss join in social activities.
Telephone equipment
If turning up the volume of the ringer on your existing telephone,
or changing its pitch, doesnt make it easier for people with hearing
loss to hear, and use, the phone, you could try a telephone amplifier
(this only works on phones that have the dialling pad on the base
unit). Or, you could add an extension bell or flashing light in one or
more rooms. You can also buy phones that have a built-in amplifier
and/or flashing light, and some phones have a built-in hearing loop,
so they can be used with hearing aids set to the loop setting.
A textphone has a keyboard and a display screen. Instead of
speaking into a telephone mouthpiece, the person types what
they want to say using the keyboard. Someone who uses a
textphone can use Next Generation Text (NGT), a service that
relays conversations between people who use textphones and
those who use voice telephones. Visit www.ngt.org.uk to find out
more about the service.
How to get equipment

Social services is responsible for assessing the home equipment
needs of people with a disability. Sensory support staff are trained
to understand the needs of people with hearing loss and will be
able to tell you what support is available, so do get in touch with
your local social services department.
Equipment is supplied on a loan basis and eligibility is based on
hearing loss rather than being means tested. Equipment is also
available for people with a sight loss.
Try before you buy
If you think that someone in your care could benefit from
equipment, you can also buy products privately. But make sure
you try them out first. Many audiology clinics, hearing therapists,
hearing resource centres and social services departments have
equipment for people to try out. Normally, you have to make an
appointment to do this. Contact our Information Line (see last
page) to find the resource centre nearest to you.
Specialist suppliers
There are a number of suppliers that sell equipment for people
with hearing loss. Action on Hearing Loss is the only UK charity
with a full range of products for people with hearing loss and/
or tinnitus, so we are full of impartial advice. Contact us for our
catalogue, Solutions, or shop online at www.actiononhearingloss.
org.uk/shop
When buying equipment, look out for:
a 21-day or 28-day money-back guarantee so you can return
goods if they are not helpful.
without having to pay VAT. The certificate is a simple form saying

that the person has a hearing loss and is claiming exemption.
How to assess your care setting

Please use this checklist to assess how well your home supports
residents who have hearing loss and to work out what action you
need to take.
Deaf awareness
H
ave all of the staff and volunteers who work in your home had
deaf awareness training?
H
as there been any staff turnover since your last deaf awareness
training session?
H
ave you ever invited Action on Hearing Loss to give a talk to
your staff?
Communication
A
re staff members aware of communication techniques for
people with hearing loss and do they use them?
Do staff members communicate clearly?
D
o staff members take steps to stimulate conversation among
people in your home?
D
o you know which of your residents have hearing difficulties or
have ever been issued with a hearing aid?
Have you ever referred anyone for a hearing test?
Do staff members know about the language service professional,
a
VAT exemption certificate some products can be bought
such as a sign language interpreter, available to residents who

would benefit from it?
noise; for instance, are table cloths used to dampen the sound of
cutlery at meal times?
Do staff members understand how people can use listening

equipment, such as hearing loops, in order to manage their
hearing loss?
a notice board in a good position?
Have staff members been trained to look after hearing aids,

including cleaning?
Information
Do you have procedures to alert everyone to a possible fire in

the night?
The living environment

Does your home have:
telephones that are fitted with a hearing loop or are specially
designed for people with hearing loss?
textphones (if residents cant use amplified telephones)?
a hearing loop or infrared system in TV rooms, communal rooms
and reception areas?
a seating arrangement that is helpful for communication?
D
o you ensure that residents are able to access audiology
departments, when appropriate?
A
re staff members aware of services available, such as our
Hear to Help hearing aid support sessions (see box, page 25),
and do they facilitate residents use of these services, where
appropriate?
D
o you know how to contact Action on Hearing Loss for
information about hearing aids, etc for residents and their
families?
D
o you include relevant information in your prospectus for
potential residents with hearing loss and their families?
clear procedures for checking that all hearing loop or infrared

systems are checked and maintained regularly?
flashing smoke alarms?
accessible entry systems, or alternative procedures?
accessible lifts with visual indicators?
good lighting in all areas?
TVs with digital subtitles?
reserved quiet areas, without TVs, where residents can go to chat?
procedures in place to minimise the amount of background
31
Action on Hearing Loss
GET INVOLVED
We want there to be no limits to what people with

hearing loss can achieve. Whatever your skills, you
can really make a difference to people whose lives
are affected by deafness, hearing loss and tinnitus.
Where can I get further support?

Action on Hearing Loss
Volunteer
Our volunteers help us transform the lives of

the people we support making new friends
and learning new skills along the way.
Fundraise
Weve got plenty of tips to get you started:

are you a champion cake baker, or a
persuasive tin shaker? Or perhaps you want
to take part in one of our challenges or
events (ever fancied skydiving?!)
Campaign
We are the charity working for a world where hearing loss doesnt
limit or label people, where tinnitus is silenced and where people
value and look after their hearing.
Campaign with us to make life fairer for

people who are deaf or have a hearing loss,
and help encourage others to value their
hearing enough to look after it.
In Northern Ireland, we:
Theres something for everyone so what

are you waiting for?
offer In Touch befriending for residents with hearing loss

give information and support
p
rovide services to improve the lives of people with hearing loss
and/or tinnitus
r un campaigns to understand and change peoples attitudes to
hearing loss.
Action on Hearing Loss Information

Our Information team is a great place to start if you want more
information on hearing loss or tinnitus, or about the work we do.
Harvester House, 4-8 Adelaide Street, Belfast, BT2 8GA
Telephone 02890239619
Textphone 02890249462
Email information.nireland@hearingloss.org.uk
Twitter @hearinglossNI
Facebook Action on Hearing Loss Northern Ireland
Action on Hearing Loss Membership

Action on Hearing Loss website
Visit our website www.actiononhearingloss. org.uk for
information about hearing loss and tinnitus, the latest news
stories, details of our services, campaigns, research, website
forums and much more.
Action on Hearing Loss Products
We sell equipment that can improve the everyday lives of people
with hearing loss.
Visit our online shop to see our full range of products for people
with tinnitus and/or hearing loss at www.actiononhearingloss.
org.uk/shop. Or you can request a copy of our Products catalogue
by contacting our Customer Services team directly, between
8.30am and 5pm, Monday to Friday:
Telephone 03330 144 525
STAY INFORMED
Become a member today to receive
regular, up-to-date information on
hearing loss, deafness and tinnitus.
From as little as 12.50 a year,

youll receive:
Our quarterly magazine packed with expert tips, product
reviews, inspiring real life stories and research news.
A comprehensive guide to deafness and tinnitus.
10% introductory discount* on products to help with
hearing loss.
The opportunity to influence our future direction by
voting in Trustee elections.
Textphone 03330 144 530

Text Relay 18001 03330 144 525
Fax 03330 405 657
Email solutions@hearingloss.org.uk
Join today:
Call 020 7296 8264 (telephone) or 020 7296 8246 (textphone).
Join online at www.actiononhearingloss.org.uk/join
* Applies to products from our catalogue and online shop. Minimum spend is 40
excluding postage and packaging and VAT. Action on Hearing Loss reserves the
right to change the promotion at any time.
35
Were Action on Hearing Loss, the charity

working for a world where hearing loss
doesnt limit or label people, where tinnitus
is silenced and where people value and
look after their hearing. We cant do this
without your help.
To find out more about what we do
and how you can support us, go to
www.actiononhearingloss.org.uk
Action on Hearing Loss Northern Ireland
Harvester House
4-8 Adelaide Street
Belfast
BT2 8GA
Telephone 0289 0239619
Textphone 0289 0249462
Email information.nireland@hearingloss.org.uk
Twitter @hearinglossNI
Facebook Action on Hearing Loss Northern Ireland
Action on Hearing Loss is the trading name of

The Royal National Institute for Deaf People.
A registered charity in England and Wales
(207720) and Scotland (SC038926) A0968/0115

Caring For Older People With Hearing Loss v7

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Caring For Older People With Hearing Loss v7

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Caring for older

For staff, carers and volunteers working in residential, nursing

The In Touch project, funded by the Big Lottery Fund

The need for action

About hearing loss

How to identify hearing loss

How to improve communication

About hearing aids

Equipment to help with everyday living

How to assess your home

Where can I get further support?

For further information, contact the In Touch team by

The need for action

1 Intervene earlier in hearing loss.

Hearing loss is a major public health issue affecting more than

2 Meet communication needs.

The most common type of hearing loss is called presbyacusis or

3 Improve hearing aid use and management.

About hearing loss

This means that a large proportion of people living in sheltered