Category: CaptionCall

Family is where it all begins. Those are the people who shape us and our worldview. They’re our first and most important relationships. They teach us to communicate. When hearing loss or deafness adds complexity to our family, we don’t give up on connection: we make it work.

We’re going to explore how a variety of families connect across different hearing statuses and the information and resources to support mixed hearing communication:

• Categories of hearing loss
• Communication in hard-of-hearing/hearing families
• Communication in Deaf/hearing families
• What is a Coda
• Everyday Deaf and hard-of-hearing communication solutions

What are the different categories of hearing loss?

According to the National Library of Medicine: ¹

A hearing loss of up to 20 decibels below the hearing threshold is still considered to be normal hearing. More severe hearing loss can be described according to severity, as follows:

• Mild hearing loss: Hearing loss of 20 to 40 decibels.
• Moderate hearing loss: Hearing loss of 41 to 60 decibels.
• Severe hearing loss: Hearing loss of 61 to 80 decibels.
• Profound hearing loss or deafness: Hearing loss of more than 81 decibels.

Hard-of-hearing is a loss between mild to moderate on this scale,² where there may be enough residual hearing that an auditory device, such as a hearing aid, benefits the individual.³ These people may struggle with a quiet or typical conversation.

The profound hearing loss that qualifies as medical deafness equates to very little or no functional hearing.³

For perspective, these are the decibel levels of some common sounds

• Quiet conversation: 40 dB
• Normal conversation: 60 dB
• Traffic: 80 dB
• Industrial noise: 100 dB
• Very loud music, for example at a rock concert or a nightclub: 120 dB
• Nearby thunder: 120 dB
• Jet engine: 140 dB

The only way to accurately measure a hearing loss of specific decibels is a hearing loss test. An audiologist can perform a variety of hearing loss tests and can recommend treatment or technology that may make everyday life and communication easier.

Communication in hard-of-hearing and hearing families

More than 37 million Americans say they have some trouble hearing, and it’s more common with advancing age.

There are a lot of people out there who don’t have perfect hearing, especially in older generations. The greatest amount of hearing loss is in the 60-69 age group⁴. Many of them are used to being able to hear and speak normally for most of their lives and start experiencing hearing loss at some point. Young and middle-aged adults are developing hearing loss at a higher rate than previous generations, largely due to noise exposure, including listening to media at a high volume through ear buds or headphones.⁵

People new to hearing loss often are embarrassed, apologetic, or in denial. These feelings may present additional challenges in communicating even with the people closest to them. But many families include someone with hearing loss, and they adjust to get through to each other:

• Speaking slowly and clearly, facing the person when possible if it helps them to read lips.
• Sitting/standing on someone’s “good side” in cases where someone has more hearing in one ear than the other, if they desire.
• Limiting background noise while talking.
• Practicing patience to give clarification when necessary.
• Using technology, including hearing aids, call captioning services, closed captioning, and apps.

Irene

On the other end of the spectrum is Irene, who was relieved at her recent diagnosis of “hidden hearing loss”/Central Auditory Processing Disorder (CAPD) after 47 years of not “knowing that what I was inadvertently struggling with could be managed with hearing aids.” She says for decades her hearing loss affected how she interacted with her family. “More than anything it’s been incredibly annoying. I was diagnosed … about 6 weeks ago. I ‘heard’ just fine but didn’t always understand.”

“I did not realize that I had any hearing issues until I kept using CC (closed captions) while watching TV. I was struggling to parse out different instruments while listening to music, and I had trouble hearing/understanding others while in conversation. I currently use hearing aids and keep the CC on. The hearing aids are Bluetooth, which is pretty cool and easy to manage.”

Irene is part of a growing trend of young and middle-aged people who use hearing aids to improve their quality of life and communication.⁶ They’re defying years of stigma attached to hearing loss and generating mainstream demand for assistive technology. “Oddly enough,” Irene adds, “now that I know what makes it harder for me to understand, I have zero shame in telling others. If I can help others in a similar situation, I will do it!”

She says figuring out her hearing situation has eased the frustration of trying to connect with people she cares about and enhanced her daily life. “Please, please get your hearing checked, and not just the standard test. Ask about CAPD and ask that you get tested for it. Now that I can hear and understand so much better, my burden is so much lighter. I had no idea how much mental energy I was using on a day-to-day, existing basis. I had no idea that music is so much more vast and colorful!”

Communication in Deaf and hearing families

There can be wide variations in communication methods in Deaf/hearing families to fit the preferences of Deaf people who are oral (speaking with their own voice and listening with the assistance of devices such as hearing aids or simply lipreading) or use signed languages as well as the language skills and hearing ability of their loved ones.

More than 90% of Deaf children have hearing parents⁴ — and, likewise more than 90% of Deaf parents have hearing children⁷ — so Deaf, hearing, and hard-of-hearing people learn to connect across hearing status with their own family members.

Yuliya

Yuliya is Deaf and is the only person with hearing loss in her birth family. Her husband is Deaf but they accommodate her hearing family. “None of my family members sign. My kids sign, but the adult members of my family don’t. I speak with them. I am used to it — I grew up oral. I was not really exposed to Deaf culture while growing up. When I went to college, I was exposed more to Deaf culture, the history, the language, etc., and I loved it.”

Yuliya’s children are Codas and she sees the mixture of cultures and languages in them. “My children are mostly in the Deaf culture right now because they are still pretty young and are just with my husband and me. They communicate with us through sign language. But when they see the hearing members of my family, they will use their voice, so we’ll see how things change (which culture they feel most part of) as they get older.”

What is a Coda?

With the success of the 2022 movie, CODA, this term has been in the media more. Coda (sometimes “CODA” or “coda”) stands for Child of Deaf adults. A Coda may have one Deaf parent or both, or a legal guardian raising them who is Deaf.⁸

90% of Codas are hearing. These people frequently navigate between Deaf and hearing culture as they grow up in much the same way as a child born to immigrants navigates between the culture of the country in which they live and the culture of their parents’ countries of origin. Codas frequently feel they are a part of Deaf culture even though they are not Deaf themselves.

Gregg

Gregg is a Coda — he has Deaf parents and a Deaf Aunt, uncle, cousin, and niece. He signs with his Deaf family members. He occasionally will use his voice with his mom, who has some hearing, just to get her attention and then he will sign after that. He both talks and signs with his niece, who has some hearing and wears Cochlear Implants, a version of hearing aids. He adds, “Because I can sign, I tend not to use Video Relay Services. I will text or use apps where I can sign.”

“Culturally I feel half and half. I feel the connection with my family, friends, people I grew up with. But I am also part of the hearing culture.”

Rosa

Rosa is also a Coda. On her dad’s side, he is the only one that has a hearing loss. On her mom’s side, there are many Deaf relatives — grandparents, aunts, uncles, and cousins — mixed in with the hearing relatives. “My parents are both Deaf,” Rosa said, “so it was just part of our life growing up. We’d go to events at the Deaf school such as football games and basketball games. We’d also go to other community events like Deaf bowling nights. And of course, we’d go to our parents’ friends’ or they’d come to our place.”

She said, “Our family only signs. My mom can’t hear at all so she was pretty strict about us signing instead of speaking when we were growing up, and it’s just normal now.” She keeps up easily with her family via text and FaceTime.

Britnee

Britnee is hard-of-hearing and has a Deaf mother and hearing father. Her brother is Deaf and her grandparents on both sides are Deaf. She says her communication methods depends on who she is talking to and what the situation is. Her hearing is good enough with hearing aids that she can talk verbally with hearing family members who don’t sign well. She signs with the other Deaf people in her family. If she is talking with a hearing family member who does not sign well and a Deaf member enters the room, she will start signing.

Britnee says mixed influences growing up have shaped how she identifies and communicates with the people around her. She attended a mainstream elementary school and junior high with hearing peers. Then in high school, she went to a school for the Deaf. She uses a hearing aid when she is around hearing people out in the community or with hearing family members but when she is at home, she generally takes them off.

“For the longest time I identified mostly as hard-of-hearing because I can hear pretty good and can speak and that is what others see me as. But lately I have started to identify more as Deaf since I started working at my current job. Really, I decide if I am Deaf or hard-of-hearing depending on the perception I want to create, how I want to communicate my specific words, and sometimes just my mood.”

Everyday Deaf and hard-of-hearing communication solutions

Communication is not only face-to-face, and families rely on phone and internet services to connect when they’re apart. For decades, that presented additional challenges for families who use sign language, read lips, and have difficulty hearing over the phone. But now, there are many services available to the Deaf and hard-of-hearing for communication and accessibility:

Video Relay Service

Video Relay Service (VRS) is a no-cost service Deaf or hearing people can call where the hearing person in the middle is a qualified ASL interpreter who signs with the Deaf person and speaks with the hearing person.

Videophones

A videophone is a standalone device that connects to the internet and streams both video and audio. It’s one of the devices Deaf individuals can use to make video relay calls to hearing people. The first videophones had basic dialing/ringing/answering functions and a contact list to save phone numbers. Nowadays videophones designed for the Deaf — such as the latest videophone from Sorenson, the Lumina — are more sophisticated. Some of the newest features are the ability to leave a video message (similar to voicemail), change the UI to Spanish, linking multiple devices to one VRS phone number, and customizable light-ring settings (similar to ringtones).

Computers with webcams

While videoconferencing apps such as Zoom and Microsoft Teams existed before COVID, the COVID-19 pandemic prompted an explosion in their popularity. Many businesses used these apps to continue operating. They also found widespread usage in families and friends who wanted a way to see each other when they were not able to visit in person. The arrival of Sorenson VRS for Zoom in Spring 2023 offered a new level of functionality for Deaf and hearing conversation, allowing an interpreter to join the meeting as a participant for fluid interpreter communication with everyone on the same screen.

Smartphones with cameras and videoconferencing capabilities

There are many smartphone apps that offer accessibility benefits for the Deaf and hard-of-hearing allowing users to pick and choose what’s helpful to them. For Deaf smartphone users, front-facing cameras introduced a wave of videoconferencing apps. Those apps include mobile VRS applications, like ntouch, so Deaf users can make and receive calls anywhere they take their phone.

Captioned phone calls

Phone call captioning (IP-CTS) is a no-cost service for hard-of-hearing people who need captions to use the phone. It provides real-time captions of their phone conversations on a specialized caption phone or a smartphone app.

CaptionCall by Sorenson and CaptionCall Mobile are both no-cost call captioning products. With CaptionCall, eligible users can sign up even without home internet service.

Hearing aids

Hearing aids were the first “technology” to improve communication for people with hearing loss, and they have transformed over the years. Some hearing aids are now so small they’re practically invisible in your ears.

About two percent of adults aged 45-54 have disabling hearing loss, meaning they could benefit from hearing aids. That number trends upward with age: 8.5 percent of adults aged 55 – 64, 25 percent of adults aged 65 – 74, and 50 percent of adults aged 75+ have a disabling hearing loss that hearing aids may help with.⁴

The vast majority of people who could benefit from hearing aids do not use them. Only 30% of adults 70+ in that category has ever used them and only 16% of qualifying adults 20 – 69 have ever used hearing aids.⁴

Many recent hearing aid models now have Bluetooth technology which allows users to pair them with other technology such as their smartphones or captioning phones.

Effort is the biggest factor in hard-of-hearing, hearing, and Deaf communication

Communication is critical to understanding. When the desire and effort is there, a shared language is not a necessary starting place. The effort you put into trying to communicate leads to greater understanding and a broader knowledge of other people. Personal stories suggest most of us aspire to connect beyond words.

We see the same adaptability in communication across hearing abilities in immigrant communities. When families span geography for various reasons — moving for a better life, escaping a bad situation, or uniting people from different backgrounds — and have children, those children typically are quick to learn new languages through exposure at school or friends. They can be a great example to the rest of us of how doing ones best to communicate can benefit all of us.

Putting forth the effort to communicate with people who may not hear or communicate the same way you do is a statement of value. Work together to make those connections. There are many apps available to communicate. There’s always good old paper and pen. And, if all else fails, gestures can be useful. Many are universal concepts: eat, drink, sleep, cry, laugh, love.

This concept is the one that matters with communication — if we care enough about each other, we’ll figure it out. Every family with Deaf, hearing, and hard-of-hearing people has proven that if you’re caring, patient, and willing to try, there are no insurmountable obstacles to connection across language and hearing ability.

Sources

1. Quick Statistics About Hearing, Balance, & Dizziness
2. Understanding the degrees of hearing loss
3. Child of deaf adult
4. NAD — Community and Culture – Frequently Asked Questions
5. Questions: How are the terms deaf, deafened, hard of hearing, and hearing impaired typically used?
6. The experiences of cypriot hearing adults with deaf parents in family, school, and society
7. Telecommunications device for the deaf
8. There’s an Increased Risk of Hearing Loss in Young People
9. Hearing Aids Are Changing. Their Users Are, Too.

 
The most common service-connected disabilities for American Veterans are hearing loss and tinnitus, which is a ringing or buzzing in the ears. An estimated 3.6 million Veterans receive compensation for hearing loss or tinnitus.¹ And this impacts Veterans from every war from World War II through the Korean, Vietnam, and Gulf Wars, as well as those who served during peace time.

Compared to the general male population, 11% fewer male Veterans have good to excellent hearing while 10% more have at least moderate trouble hearing.²

Both hearing problems and tinnitus can impact quality of life and communication. Both also contribute to isolation, frustration, and even depression without intervention.

We sat down with audiologist Stephen DeMari, who is also Sorenson’s director of business development and education, to talk about Veterans and hearing loss due to military service.

Why talk to Stephen about hearing loss in Veterans?

Stephen has more than 30 years of experience in the audiology and hearing aid industries. He earned his master’s degree in audiology from Syracuse University. He then completed a clinical and research audiologist fellowship at the Department of Veterans Affairs Medical Center in Long Beach, California. He’s a member of both the American Academy of Audiology and the American Speech-Language-Hearing Association.

Q: Do Veterans have different types of hearing loss than the general population? 

A: No. There are different types of hearing loss. Conductive hearing loss occurs in the outer and/or middle ear. It can be caused by debris, excess ear wax, disease, or trauma.

Sensorineural hearing loss (SNHL), results from noise exposure, age, disease, or a combination of these. It involves the inner-ear and/or auditory nerve. It’s usually the result of damage to the hair cells in the inner ear. Severity of SNHL can be mild to profound.

SNHL is the most common type of hearing loss for Veterans and non-Veterans. Veterans most commonly suffer from high-frequency SNHL, which means they struggle to hear high-pitched sounds.

Q: What are some of the causes of hearing loss for Veterans? 

A: Hearing is a complex mix of three parts of our ears. Sound waves vibrate tiny bones in our ears and those vibrations create waves that interact with hair cells in our ear and create an electric signal that the brain interprets as sound.

That’s a very basic and abbreviated description. The complexity of it creates a number of opportunities for aging, noise exposure, disease, and heredity to affect hearing. Still, the most common cause of hearing loss is loud noise.

Hearing loss for service members results from gunfire, aircraft, tanks, bombs, and trauma from blast explosions. With noise-induced hearing loss (NIHL), the longer the exposure and the more intense sound, the greater the damage that occurs.

A lawn mower has a decibel level of about 95, while military guns range in the 150 decibels. Grenades and louder explosives can exceed 170 decibels.  Anti-tank fire can approach 190 decibels. A single grenade or tank blast can cause immediate and permanent hearing loss. Anything over 140 decibels instantly damages nerves. Exposure to 130 decibels can cause permanent damage with as little as 30 minutes of exposure.
Q: What are some of the symptoms a veteran may experience with hearing loss or damage? 

A: Symptoms depend on the severity of impact. Tinnitus isn’t hearing loss but a sensation of ringing, buzzing, clicking, or even roaring in one or both ears. It can seem like an engine or appliance is always running nearby. For some people, it’s loud and persistent enough to be debilitating.

A feeling of fullness in the ears can be a symptom of hearing loss. It can feel something like needing to pop your ears when you go up in elevation. Other symptoms of general hearing loss include:

• Asking people to repeat themselves or misunderstanding what they say
• Needing the television volume louder than normal
• Difficulty understanding speech, especially in the presence of background noise
• Fatigue after conversation, which results from struggling to listen
• Missing the phone or doorbell ringing

With high-frequency SNHL, Veterans might struggle to hear consonants. Speech will sound like mumbling.

Often, it’s the people a veteran interacts with who first notice a change in a veteran’s hearing.

Q: Does hearing loss only affect older Veterans? 

A: Hearing loss can affect Veterans of any age. It can also affect them while still actively serving. As I mentioned, exposure to a loud enough sound, such as tank fire, can damage hearing immediately and permanently. And as we grow older, our cognitive ability to understand speech naturally declines, as does our hearing sensitivity.

If exposed to sustained, unprotected noise levels during combat or training, a service member can experience hearing loss and/or tinnitus. High-frequency SNHL is the most common form among Veterans, old and young.

Q: Are there things Veterans and active-duty service members can do to prevent hearing loss? 

A: The only preventative methods are avoiding the noise and wearing hearing protection when possible. Ear plugs offer 30 to 40 decibels of attenuation (sound reduction). The military does buy and provide a lot of ear plugs. Earmuffs — like the headphones you see naval servicemen wearing — are another option. Some helmets also have built in hearing protection. Over time though, even with hearing protection, loud noise can damage hearing.

These devices help during active duty, but a veteran exposed to loud noises who didn’t have these options has likely already suffered damage. And even though they may not yet have symptoms of NIHL, their hearing may have been damaged. Options there include Veterans Health Administration (VHA) programs that offer further NIHL prevention and aural rehabilitation services to optimize remaining hearing.

Definitely, any inactive veteran should take the same precautions to protect their hearing as everyone should by avoiding loud noise and wearing hearing protection when using power equipment.

There are a variety of things anyone can do to naturally protect their hearing.
Q: What can vets do if they’re experiencing symptoms of hearing loss and/or tinnitus? 

A: It’s important to see an audiologist. A vet can do that through their local Veterans Affairs Medical Center (informally called the VA). The U.S. Department of Veterans Affairs website is a great place to start if you don’t know your local VA yet.

In some cases, the effects of tinnitus can be alleviated by a hearing aid or tinnitus program.

Q: Can a vet just see their non-VA doctor or audiologist?

A: Vets can see any doctor they choose. If they qualify for the Veteran’s Choice Program, their care for a covered non-VA doctor is covered under their VA benefits. The potential advantage of using a VA medical facility is that those practitioners specialize in helping Veterans with issues, including hearing loss, due to military service.

Q: Are VA audiologists licensed professionals? 

A: Yes. Each of the over 1,000 audiologists employed by the VA must hold a state license and participate in continuing education according to state regulations. And the Veteran’s Health Administration (VHA) operates the nation’s largest audiology program with audiologists at 400 locations.  So, whether a vet chooses their own provider or a VHA provider, they have access to excellent care.
Q: How do Veterans get a hearing test with the VA? 

A: Once enrolled for medical services at a VA facility, they can arrange for an audiometric test. If they’re deemed eligible for hearing aids, they’ll be scheduled for a fitting as well.

Many hearing aids can be adjusted remotely through the VA’s live video conferencing service, VA Video Connect. Veterans can contact their nearest VA audiology clinic to see if telehealth visits are available in their area.

Q: Do VA benefits cover hearing tests, hearing aids, and cochlear implants?

A: They do if the hearing loss is related to military service. Vets can get their hearing aids, hearing aid batteries, and related appointments covered under their VA benefits.

The VA also covers cochlear implants, which are devices that are surgically placed in the skin and used with an external device to transmit sound directly to the auditory nerve. Cochlear implants are sometimes the only option when hearing loss is significant enough or beyond the scope of hearing aids.

If a vet’s hearing loss is deemed to not be service-connected, Medicare may pay for hearing aids for older vets.

Q: Does the VA provide the latest hearing aids and cochlear implants? 

A: Yes. For eligible vets, the VA dispenses hearing aids from the top six manufacturers, GN Resound, Oticon, Phonak, Siemens (Signia), Starkey, and Widex. The devices provided by the VA are actual premium devices that sale for the highest prices in the non-veteran sector.

They also offer cochlear implants from three FDA-approved cochlear implant manufacturers, Cochlear Corporation, Advanced Bionics, and MedEl.

Q: Does the VA offer other hearing solutions for vets?

A: Yes. The VA also offers FM systems, which are frequency modulated (FM) systems. With such a system, someone speaking wears a small microphone that is transmitted to a receiver worn by the person with hearing loss. The transmitter can even be attached to a hearing aid.

Vets also have access to TV amplifiers and transmitters, remote microphones, and internet protocol (IP) captioned telephone service through the VA and other programs and based on their needs.

A TV amplifier works like an FM system but with a TV.

Q: What else can Vets do about hearing loss?

A: There are a variety of tools available to anyone with hearing loss. There are smartphone apps designed to assist with hearing loss, including captioning apps. [*Some no-cost apps have user eligibility standards].

Captioning apps are available. And captioned telephone service uses either a specially designed phone or a smartphone to turn spoken phone conversations into readable captions. Captions on a TV or show can also help. Studies have shown that captions can help with comprehension, even when someone wears hearing aids.

There are also aural rehabilitation programs, including some offered by the VA, designed to help reduce or compensate for hearing loss.

Support groups and organizations are also available to help Veterans with hearing loss, including HLAA Veterans Across America Virtual Chapter (VAAVC).

Whether a vet has symptoms of hearing loss, practicing good hearing hygiene is always a good idea as well.

Q: How can Veterans get captioned telephone service for hearing loss? 

A: Sorenson and other providers offer captioned telephone service to vets and others with hearing loss that requires they have captions to use the phone effectively.

Sorenson offers both CaptionCall and CaptionCall Mobile app by Sorenson to help vets with hearing loss stay connected. CaptionCall transcribes phone conversations using a specially designed phone with a screen for captions. CaptionCall Mobile is a smartphone app that captions calls on a mobile phone.

Vets can ask their audiologist about this no-cost service or visit Sorenson — Global Communications Solutions for People, Businesses, and Enterprises to learn more.

Request CaptionCall by Sorenson for your home

Download the CaptionCall Mobile app

Q: How do Veterans qualify for captioned telephone service? 

A: Captioned telephone service is available at no-cost to anyone with hearing loss that necessitates the use of captioned telephone service to use the phone effectively. Vets who meet this eligibility requirement can access the service through their audiologist by self-certifying they need it when they enroll.

Q: Do Veterans need to have internet access to use CaptionCall or CaptionCall Mobile service? 

A: No. Anyone who qualifies, including Veterans, can get captioned telephone service without internet access on select phones. And all that’s needed to use the CaptionCall Mobile app is a Wi-Fi connection or mobile (cellular) data connection.

by Rupa Balachandran, PhD, CCA-A

The key principles of patient-centered care for hearing health require understanding the emotional and physical needs of the patient while developing a solution that addresses their daily lifestyle. Best practices for patient-centered care go beyond excellence in diagnostic services. Understanding the attitudes, concerns, health literacy needs, and priorities of individuals with hearing loss are key to determining the right treatment options.

What is patient-centered care?

The Institute of Medicine (IOM) defines patient-centered care as “providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient’s values guide all clinical decisions,” (IOM, 2001). The Picker Institute further divided the principles of patient care into eight categories.

These principles, when applied to hearing health care, provide valuable insights into the areas where hearing health providers can develop and enhance our current practices. Applying these principles to hearing health care improves accountability and helps gather information on how well we’re serving the needs of  patients.

In this article, I dig deeper into these eight person-centered principles of health care as they apply to hearing health.

1. Respect for the patient’s values, preferences, and expressed needs

Patients value health care providers who create a positive and supportive environment. Acceptance and adjustment to a diagnosis of hearing loss only happens in an environment where a patient receives information in an empathetic manner.

Interviews with patients about the adoption and use of hearing aids indicated that patients were more likely to pursue the use of hearing aids and overcome challenges in adapting to hearing aids when they perceived consideration, warmth, and empathy from their health care provider (Blazer et al., 2016).

A review of first-time consultations with audiologists in Australia found that patients perceived a lack of empathy and a gap between their needs and the goals of the audiologists’. For example, when the audiologists delivered the diagnosis, two-thirds of them directly transitioned into a recommendation for hearing aids, without allowing the patient time to react or ask questions about the diagnosis and without discussing other available treatment options. For example, hearing assistive technologies, communication programs, and support groups (Ekberg et al., 2014).

When the encounter with the professional creates a negative perception, the individual often delays taking action, resulting in putting off opportunities to improve quality of life and well-being (Clements, 2015).

A patient-centered care model involves going beyond understanding the needs of the patients; it includes measuring if those needs were met. Requesting feedback from patients about whether they were treated respectfully, felt their values were taken into consideration, and whether they felt their needs were met during their encounter with the provider, provides information that can be used to improve on existing clinical services.

Patient satisfaction surveys sent to a patient after an appointment can help a practice hone its patient-centered care efforts. These surveys can be easily administered electronically with web-based survey tools.

2. Information and education

The first consultation with an audiologist or other hearing health care professional can have a long-term impact on decision-making and outcomes (Clements, 2015). In the hearing health care space, discussion of different treatment options and opportunities for social and emotional support lead to a comprehensive solution for patients.

In addition to a  recommendation for hearing aids, written information about the following resources can  help people with hearing loss.

Assistive-listening devices

Other options for treating hearing loss  include assistive listening devices and technologies that give situation-specific help to people with hearing loss. Technologies such as captioned phones, amplified phones, amplified wireless headsets for television, and other audio streaming can be part of an amplification strategy.

Smart phone applications also provide options for amplification and captioning speech in real-time.

Community support

Providers should include information on community-based education programs, such as speech-reading classes and aural rehab groups.

Patient-centered care can also include providing information on support groups for people with hearing loss, such as the Hearing Loss Association of America and hearing-impaired professionals groups that are available both locally and online. These groups not only provide additional support, they help people with hearing loss develop a sense of acceptance and shared community.

Ongoing device support

Health care providers need to offer patients regular updates on the use, operation, and maintenance of hearing aids and hearing assistive technologies after the initial fit. Links to videos and tutorials on care and maintenance of devices, along with a newsletter on what devices can do are a helpful reminder of how people with hearing loss can benefit from different technologies available in their devices.

These additional avenues of support help create an environment where individuals with hearing loss can understand and accept their hearing abilities and achieve positive outcomes with amplification. This in turn strengthens the provider-patient relationship.

3. Access to care

Improving access to care involves providing easy access to the hearing health care provider and addressing the national shortage of hearing health care providers.

With the expected increase in the aging population and market factors keeping the supply of audiologists fairly low, there’s an expectation that new avenues need exploring to improve access to hearing health care (Marquardt et al., 2017). Clinicians today have access to multiple technologies that reduce the need for in-person visits.

Online technologies and patient management portals

Web-based technologies make requesting appointments easy for clinicians and patients. The ability for patients to select the day and time of their appointment themselves; timely appointments; short waiting time in the office; and timely response to emails and telephone calls can be accomplished with the use of a customized patient management portal.

Tele-audiology

The global pandemic  forced practices to transition quickly to tele-audiology, which enables remote appointments that increase efficiency and productivity for the patient and provider. Remote appointments also increase access for patients who can’t get to — or from — the office without transportation assistance. Every provider has had instances where a patient waited in the clinic long after their appointment for a transport to pick them up.

Hearing health care doesn’t reach everyone who needs it. Residents of rural and low-income urban areas are at a particular disadvantage in accessing care.

Tele-audiology holds the key to increasing access for patients who also live several hundred miles away from their provider. Increasing the infrastructure to support a variety of tele-audiology appointments goes a long way toward alleviating the lack of providers in remote areas.

4. Emotional support to relieve fear and anxiety

Despite technological advances, the psychosocial concerns of adults with hearing loss continue to have impact on the decision to seek help for their hearing loss and rehabilitation. Patient attitudes towards amplification are critical influential factors driving consultations for hearing device adoption (Meyer, 2014). Patients experience a variety of emotions when adjusting to a diagnosis of a hearing loss. These include sadness, disappointment, fear, and worry.

Clinician response to patients during this time is an important aspect of patient-centered care. For a lot of patients, the recommendation of a hearing aid triggers an unpleasant association. They may equate hearing aids with old age and lack of independence (Claesen & Pryce, 2012).

When a patient raises these issues with the provider, it’s important that they feel their concerns are heard. A clinician’s interpersonal skills, along with active and empathetic listening, can facilitate more positive associations with hearing aids and foster a strong therapeutic relationship (Grennes et. al 2015). Setting aside time within the appointment to listen to the patient’s concerns and validate them is a critical step towards a strong patient-centered hearing health care model.

5. Involvement of family and caregivers

The National Quality Forum’s National Priorities Partnership characterizes patient-centered care as health care that “honors each individual patient and family, offering voice, control, choice, skills in self-care, and total transparency, and that can and does adapt readily to individual and family circumstances, and to differing cultures, languages, and social backgrounds” (NPP, 2010). For family, friends,  and other caregivers of adults with hearing loss, their contributions fall into two categories:

1. Functional assessment: Family and caregivers can add their perspective on how the hearing loss affects the everyday activities for the person with hearing loss, including their ability to communicate with those around them.
2. Treatment efficacy: They can weigh in on the benefits or challenges associated with the different treatment options for the patient. This information helps the provider make the most suitable recommendation for managing the hearing loss.

Patient-centered care is more than just agreeing to whatever the patient wants. It involves identifying issues that are meaningful in the patient’s life and tailoring a solution that works with the patient’s values. It involves respect for their feelings and emotions along with buy-in from their family, caregivers, and loved ones.

This provision of patient-centered care is complex and time-consuming, and requires broad involvement of the patient, the family, and the care team to consider all  issues that affect the patient’s care.

6. Continuity and secure transition between healthcare settings and coordination of care

Often hearing health professionals are required to share information with other key healthcare providers and work as a part of a team to provide appropriate care for their patient. Timely sharing of health information, appropriate referral to specialists, and keeping the primary care physician informed of the care plan are all key components of patient-centered hearing healthcare.

Working with a HIPAA-compliant electronic health record alongside secure transmission channels of health records is essential. Creating workflows within the administrative office that give patients easy access to their test results and nimble coordination between different providers and insurance go a long way toward building patient confidence and trust in the healthcare provider.

7. Physical comfort

In a hearing health care environment, care must be taken to ensure that the person is in a physical space that feels safe and secure and promotes participation. Ways create a safe and secure environment include:

• Room lighting that reduces glare
• Increasing visual contrast in walkways and doorways
• Having furniture that’s solid and not prone to shifting when the person sits down or stands up
• Signage that’s clear and easily understood
• Providing marketing materials that reflect and respect the patient’s cultural beliefs
• Making pocket talkers and amplifiers available for patients to use during appointments

These techniques help create an office where the patients feel that their values are respected and that the care they receive is comprehensive, competent, and delivered by professionals who care about their well-being.

8. Support for HCP in patient-centered care environments

A comprehensive discussion of patient-centered care needs to include support for those who provide the care. For most practices, patient-centered care requires a significant investment of time and resources.

Many providers are overwhelmed by decreasing reimbursements and encroaching threats to their scope of practice. With a healthcare industry undergoing significant transformations, there’s a need to identify mechanisms that support the provider in reaching the goals of patient-centered care.

Best practices in patient centered care are those that also take into account sustainability from a practice standpoint. Conversations around patient-centered care must include adequate reimbursement for the provider through appropriate billing codes and consideration of fee-for-service models.

Conclusion

Implementation of patient-centered care has very clear benefits for both the patient and the provider — better treatment outcomes, better health outcomes, stronger therapeutic relationships, and improved financial outcomes for the practice.

About the Author

Rupa Balachandran, PhD, CCA-A

Martinez VA Medical Center
150 Muir Road
Audiology Section 126
Martinez, CA 94553-4668

Email: [email protected]
LinkedIn: linkedin.com/in/rupa-balachandran

Sources

1. Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Audiologists, on the Internet at Audiologists
2. Claesen, E., & Pryce, H. (2012). An exploration of the perspectives of help-seekers prescribed hearing aids. Primary Health Care Research & Development, 13, 279–284. doi:10.1017/ S1463423611000570
3. Clements, C. (2015). Why do older adults delay in seeking help for hearing loss. Journal of Otolaryngology-ENT Research, 3(4), 00070.
4. Ekberg, Katie, Caitlin Grenness, and Louise Hickson. “Addressing patients’ psychosocial concerns regarding hearing aids within audiology appointments for older adults.” American Journal of Audiology 23.3 (2014): 337-350.
5. Gerteis, M. (1993). Through the patient’s eyes: understanding and promoting patient-centered care.
6. Blazer DG, Domnitz S, Liverman CT, editors. Hearing Health Care for Adults: Priorities for Improving Access and Affordability. Committee on Accessible and Affordable Hearing Health Care for Adults; Board on Health Sciences Policy; Health and Medicine Division; National Academies of Sciences, Engineering, and Medicine; Washington (DC): National Academies Press (US); 2016 Sep 6. 3, Hearing Health Care Services: Improving Access and Quality. Available from: NCBI - WWW Error Blocked Diagnostic
7. Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015). The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. Journal of the American Academy of Audiology, 26(1), 36-50
8. Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015). Communication patterns in audiologic rehabilitation history-taking: Audiologists, patients, and their companions. Ear and Hearing, 36(2), 191-204.
9. Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US).
10. Marquardt et al 2017. Supply and Demand of Audiologists in the US | Hearing Health & Technology Matters . Meyer, C., Hickson, L., Lovelock, K., Lampert, M., & Khan, A. (2014). An investigation of factors that influence help-seeking for hearing impairment in older adults. International Journal of Audiology, 53, S3–S17. doi:10.3109/14992027.2013.83
11. NPP (National Priorities Partnership). Patient and family engagement. 2010. .
12. Picker Institute: Principles of patient-centered care.

Some 30 million Americans over age 12 have hearing loss in both ears.¹ And 37.5 million Americans over 18 say they have trouble hearing.¹ Like many things, hearing loss often gets worse with age. It can be inconvenient, isolating, and downright dangerous if not adapted to. But as with most things, there’s an app for that — an app for living your best life with hearing loss, that is.

Here, I dive into 12 of the best apps for hearing loss. Many are great for Deaf individuals too.

Included here:

CaptionCall Mobile  |  Live Transcribe  |  Live Transcribe and Notification  | Talk to Deaf  |  Sound Amplifier (iPhone)  |  Hear Boost, Sound Amplifier  |  Sound Amplifier (Android)  |  SoundPrint  |  Subtitle Viewer (Android)  |  Subtitles Viewer! (iPhone)  |  AudioCardio Hearing & Tinnitus  |  Shazam: Music Discovery

1. CaptionCall Mobile call-captioning app

Cost: $0 if you self-certify that you have hearing loss and need captioned calls to effectively use the phone, the cost of captioning is covered by federal funds. The service is unavailable otherwise.

If you have hearing loss and talking on the phone doesn’t work well, you have two options to make effective phones calls. One is a call captioning service using a specially made home phone with a screen that shows captions. The other is a mobile app that captions calls on your cell phone. Either service is available at no cost and requires you to self-certify that you have hearing loss and need captions to effectively use the phone.

Captioned calls work like closed captions on your TV. A captioning service converts spoken words into captions or text that  display on your phone’s screen.

CaptionCall Mobile is a mobile app that captions calls using speech-recognition technology. It displays the captions on your mobile phone screen instantly. This is different than using the built-in captioning on your phone. It gives you faster, more accurate captions.

Of the available mobile captioning apps, CaptionCall Mobile is our favorite, not because it’s a Sorenson product, but because it works in real-time. There’s no lag or delay between what your caller says and your seeing it on your phone screen

Rating and reviews from Google Play

“CaptionCall Mobile is amazing. Haven’t been able to use the phone for almost 4 years now. Have tried other similar apps without success-missed calls, unintelligible transcripts, etc. etc. After a week of use, CaptionCall Mobile has performed almost flawlessly for both outbound and inbound calls. Very very nice. Can’t seem to get it to add directly to contacts, but that is a small matter to me.” 

— P Sweeney, 5 stars 

Rating and reviews from Apple App Store

“As I was tapping out a reply to the chat help person, I received my first CaptionCall Mobile call and the captioning and speed was ah-may-zing. Perfect. Both speed and accuracy. I even asked the caller if he could give me his impression of the delay in conversation while the speech-to-text was occurring and he said ‘there wasn’t any delay, I wouldn’t have even known….’” 

— Mistanik, 5 stars  

Get CaptionCall Mobile for your mobile phone

2. Live Transcribe for captioning everyday speech to text on iPhones 

Cost: Free 

Live Transcribe from Mighty Fine Apps is one of the best apps available for Deaf and hard-of-hearing individuals. Once tapped, it transcribes voice-to-text for any speech in range of your phone’s microphone. You can even set it to start transcribing the moment you open the app.  

One advantage compared to a standard transcription app is that it lets you make the text as big as you want. You can even have the text fill the entire screen. It also offers captions in up to 50 languages. 

You can also save transcripts of conversations to a messaging app or note taking app on your phone.  

A small disadvantage of Live Transcribe is that it’s only available for iOS.  

Rating and reviews from Apple App Store

“I lost 50% of my hearing last year due to a reaction from strong medicine. I was at a loss as to how to communicate with my wife. A friend recommended Live Transcribe. I now have one Live Transcribe loaded on an old iPad we weren’t using, and have placed it permanently on a table between where she sits and me. I also find the iPhone version indispensable for doctor visits and other one on one conversations. Maybe this will work for you, too!” 

— Hearing Champ, 5 stars  

Download from the App Store

3. Live Transcribe and Notification for speech to text captions on Android phones

Cost: Free 

Live Transcribe and Notification from Research at Google give you both live transcriptions of spoken conversation and sound notifications.  

Live Transcribe turns spoken conversation into fairly accurate written captions in real-time and supports 80 languages.  

Unique features include the ability to add your own frequently used words, such as names and household items. You can also use it to set your smartphone to vibrate when someone says your name.  

Unlike Live Transcribe above, Google’s version restricts you to manually saving transcripts. Saving them isn’t automatic. It will also only save them for three days. To keep them longer, you have to copy and paste them into another program.  

The notifications part of Live Transcribe and Notifications lets you choose custom sounds, flashing lights, or vibration mode to alert you to stove timers, smoke alarms, baby monitors, sirens, and more.  

Rating and reviews from Google Play

“I can almost hear again, this app is the best at typing speech. I’ve tried lots of voice to text apps and this one is far and away the best. I keep one other voice to text on my phone to use if there is no wifi or 4gl available. Just love it. With update you don’t need wifi or cell connection to work and it works better if you tell it to use off line. Awesome.” 

— Doug, 5 stars  

Install from Google Play 

4. Talk to deaf for Android

Cost: $6.99 annually 

If you don’t want or need notifications, Talk to Deaf from Kickdata is an option. It does come at a cost of $6.99 a year but has a solid 4.0 rating.  

Talk to Deaf quickly translates spoken language into text that displays on your phone screen. It lets you customize the font for easier reading. And you can choose to delete or save conversation history. 

A disadvantage of this app — or maybe a benefit depending on your needs — is that you have to press the microphone button to capture speech.  

Rating and reviews from Google Play 

“I work with a Deaf coworker and this app has been extremely helpful in talking with them. I like that it doesn’t have ads and that it has Pro features, I just wish it was a little cheaper.” 

— Umbra, 4 stars 

“This app has helped me a lot with my husband and my mother-in-law who are both hard of hearing. both of them have hearing aids and many times they still do not understand what we are trying to say to them and using this app has helped quite a bit. highly recommend!” 

— Irene, 5 stars 

Install from Google Play

5. Sound Amplifier for sound amplification on iPhones

Cost: Free 

Sound Amplifier from Max Volume Booster Hearing Aid “turns your phone into a hearing aid.”  

Use the app and your phone with headphones to increase the volume of sounds up to 100x while also minimizing background noise and taking advantage of its voice isolation feature. 

Also use it easily and intuitively amplify conversations, TV shows, movies, lectures, and more. And you can use it without fear of damaging your hearing further. A built in Loudness Protect feature prevents the volume getting dangerously high.  

One disadvantage: this Sound Amplifier app is available only for iOS.  

Rating and reviews from Apple App Store 

“I can’t always hear the TV and don’t like subtitles, so this is wonderful.” 

— Jeff, 5 stars 

“My cat has such a quiet purr but now I can easily hear him!!” 

— Tanresa, 5 stars 

Download from the App Store 

6. Hearing Remote: Hear Boost EAR

Cost: Free basic app, premium subscription available for $5.99 to $120 

Hearing Remote: Hear Boost EAR from Health, Fitness, Wellness, Medical – IT Solutions is a highly rated sound amplifier for Android phones. And it includes a built-in hearing test.  

The app works with a wired headset to amplify sounds around you. You can customize the sound to the environment you’re in. The built-in hearing test automatically assesses your hearing needs and adjusts the app for maximum hearing improvement in each of your ears.  

The app works for in-person conversations and for phone calls. It supports captioned phone calls. And it even saves amplified calls for you.  

The basic app is free, or you can pay for a premium subscription  

This app is only available for Android phones. 

Rating and reviews from Google Play 

“Great app! I’ve used a few different sound amplifiers and this is by far one of the best. There is a free and paid version of the app. Paid gives you more options and adjustment features, but it really isn’t all that expensive. You also get a 3 day free trial to try it out. You can’t go wrong.” 

— Zoey 

Install from Google Play 

7. Sound Amplifier for sounds amplification on Android 

Cost: Free 

Sound Amplifier by Google LLC amplifies nearby sounds. When you use Sound Amplifier with your phone and a pair of headphones, the app filters, augments, and amplifies what you hear through your headphones. 

It helps you cut through distracting background noises and hear better. And it works for conversations, movies, TV, lectures, plays — anything you want.  

If you have a Pixel 3 or later device, Conversation mode puts the focus on a speaker’s voice to help you hear what they’re saying even better. 

Sound Amplifier is only available for phones running Android 8.1 or later.  

Rating and reviews from Google Play 

“If you need to filter out background noise this is the best free app. I have Sensory Processing issues, and this is a great tool for me to understand speech better in noisy environments. Best paired with noise canceling headphones. Makes a perfect hearing aid for those who need basic assistance. Low med and high noise cancellation and adjustable boost. Works as advertised. Works in the background too so you can watch videos and still hear people.” 

 — Sebastian, 5 stars 

Install from Google Play

8. SoundPrint: Find Quiet Places

Cost: Free 

SoundPrint from Soundprint LLC lets you find quiet places to meet with friends and family or have a business meeting. The app crowd-sources locations from user submissions much like a Google or Yelp review, so you have confidence in their accuracy.  

This app may be great for those who already have hearing loss as well as those who want to avoid future hearing damage.  

The app let you find local quiet locations. And you can submit the decibel level of locations you visit to help others find quieter venues too. And you can encourage friends and family to submit locations as well.  

Rating and reviews from Google Play 

“This is a very unique and essential app that assists us to find venues that offer a quiet environment so we can actually hear and engage in meaningful conversations! The app is simple and easy to use and helps us to avoid those places where we can’t hear our thoughts!” 

— Google user, 5 stars  

Rating and reviews from the App Store 

“I have mild hearing loss in addition to Auditory Processing Disorder, meaning it can be incredibly difficult for me to comprehend speech in noisy environments. SoundPrint has been an awesome resource for scoping out quieter restaurants and venues for activities that I know will involve a lot of chatting! I also love that it’s user-sourced, as I feel I can actively contribute to help others in my community who may deal with the same challenges. I’ve gotten two of my hearing friends to download it and contribute as well, and I hope others will spread it as well! The more the merrier.’” 

— ssaxon, 5 stars  

Get Subtitle Viewer

9. Subtitles Viewer for Android

Cost: $1 

Subtitle Viewer from Benjamin Bisinger lets you look up and see subtitles in your language for movies, whether in the theater or at home, and TV in real-time. Simply synch your phone with the movie to see the subtitles on your phone.  

It keeps pace with the show you’re watching even if you scroll back to an earlier spot. And you can customize the font and brightness to suit your own needs and the environment.  

This app supports several languages. It’s ideal for watching movies away from home when you can’t access subtitles directly on-screen.  

A nice add on for this app: its developer, Benjamin Bisinger, is responsive to feedback and user input. 

Rating and reviews from Google Play 

“This app has saved the day so many times at movies recently. Captioning devices provided at movie theaters are not 100% reliable. Saw the New Avatar movie and was so excited to see you had it available on the app when I was given yet another faulty captioning device. I pulled up this app, found the movie and my daughter helped me connect! Viola! Happy camper! 

— Bobbie, 5 stars 

Install from Google Play 

10. Subtitles Viewer! for iPhone

Cost: 3 free subtitles, more than 3 requires credits acquired through in-app purchases 

Subtitles Viewer! by Craig Grummitt offers the capabilities of Subtitle Viewer for iPhones users. 

It syncs subtitles available from a large database to your favorite TV shows or movies whether at home or in the theater and supports multiple languages.  

Rating and reviews from the App Store 

“So far, I’m incredibly impressed with the accuracy and ease of use of this app. We’ve watched a few obscure titles and had no difficulty finding subs. It allows for those who need subs to have them while not ruining the immersive experience for those who do not need them. It is also helpful for situations when subs are needed but not provided. The customization features are nice and it’s easy to adjust the timing and size of font when needed. Great app so far!” 

— JayceeFW, 5 stars

Download from App Store

11. AudioCardio Hearing & Tinnitus 

Cost: Free trial, $9.99 a month for basic plan, $12.99 a month, $64.99 every 6 months, or $99.99 annually for the pro plan. 

AudioCardio Hearing & Tinnitus from AudioCardio is one of the apps we mention in our post on improving hearing loss naturally. We include it here because it may help improve hearing for some people.   

The app has you take a hearing test. Based on your results, it gives you one-hour sound therapy sessions personalized to your hearing needs in each ear. You can do your sessions each day to potentially protect and improve your hearing.  

According to the app’s description, its technology is clinically proven by researchers — including Stanford University — have clinically proven the technology. 

Rating and reviews from Google Play

“This is crazy! Went in skeptical but might as well give it a try. 2 weeks was all it took to convince me to sign up. Tinnitus has backed off after more a year of 24/7 roaring. And I’m hearing sounds in my left ear again!!! My tinnitus/hearing loss was exacerbated by a Meniere’s/vestibular migraine diagnosis. This app, combined with PT has given me back parts of my life I thought I’d have to accept were gone for good. Can’t wait to see what the next few months bring!” 

— Joey, 5 stars

Rating and reviews from the App Store

“I started using the app back in November 2022 after I got my hearing tested. My high frequencies were not great at all. Too be honest, didn’t see much changes at first but around January I was making 5 decibel changes in certain frequencies and started to take it seriously by doing it daily. And then weirdly enough I started to hear and notice the most minute sounds like water droplets, leaves rustling, and random sounds in daily life which you kind of forget about at my age. It’s truly miraculous that I’m hearing all these little sounds again that you take for granted and although my hearing isn’t perfect, it’s just nice to feel that I’m making progress :)”

— Andrew, 5 stars

Download from Google Play Store

Download from the App Store

12. Shazam: Find Music & Concerts

Cost: Free 

Shazam: Music Discovery is from Apple. And if hearing loss makes it hard to understand the lyrics of the music you love, this app displays the lyrics of all your favorite songs while you listen. You’ll never miss out on the joy of music — or singing along — again.  

In addition to showing songs’ lyrics, Shazam lets you find songs, listen to them on your phone, and watch videos from Apple Music or YouTube. It even works offline and when the app is closed. 

If also finds the names of songs when you can’t remember them.  

Rating and reviews from the Google Play 

“I’ve been using this app for a while now and I am safe to say I am very surprised on how well this works. Every time I hear a song, I like I Shazam it and it tells me all the info about it, the lyrics (if it has any), the music video, and info that I didn’t even know about. It also keeps all the songs you shazamed in a Library which is super convenient; and there’s barely ANY ads, close to no ads at all. 10/10” 

— Jada, 5 stars 

Rating and reviews from the App Store 

“Since day one, Shazam has been that reliable friend. Shazam, you have helped me be mom o’ the year and always know the song. You didn’t stop there either — you went further by letting me sing along! It doesn’t get better than this app. Thanks, Shazam, we are super cool together!”

— Anonymous

Download from Google Play Store

Download from the App Store

Sources

1. 1. Quick Statistics About Hearing, Balance, & Dizziness

Say what? If you find yourself asking, maybe you’re having trouble hearing. And you’re not alone — nearly 15% of people in the U.S. over 12 years old have hearing loss in both ears. If you’re among them and are wondering how to improve hearing loss naturally, there are things you can do.¹

In this post, we break down common types of hearing loss and natural remedies you can use to help protect and improve your hearing.  

Before we dive in, let’s talk about the basics of hearing loss. 

Types of hearing loss 

There are three main types of hearing loss that each affect different parts of the ear. 

Conductive hearing loss comes from an obstruction in, or damage to, the middle or outer ear. The damage or obstruction prevents sound from reaching the auditory nerve. Conductive hearing loss can be temporary or permanent. 

The most common type of hearing loss is sensorineural hearing loss. We hear when sound waves move the hair cells (cilia) in our inner ear, and that movement creates electrical impulses that travel to the auditory nerve in our brains. Damage to our auditory nerve or cilia results in sensorineural hearing loss. 

Mixed hearing loss is a combination of sensorineural and conductive hearing loss. It happens when a blockage or damage in your middle or outer ear makes your sensorineural hearing loss worse. 

Causes of hearing loss 

Several things cause hearing loss.  

While age itself doesn’t cause hearing loss, 33% of people over 65 have hearing loss.² Age-related hearing loss, known as presbycusis, is a slow loss of hearing in both ears that results from changes in the inner ear as we age. 

A variety of factors can cause hearing loss, including:

• Genetics: age-related hearing loss tends to run in families 
• Exposure to loud noises:
  • Noises above 85 decibels (dB), the sound of a gas lawnmower, can damage your ears and hearing in a few hours³
  • Noises above 120 dB can immediately damage your ears and hearing³
• Smoking: smokers are more prone to hearing loss than nonsmokers 
• Medical conditions, including diabetes 
• Some medications, including chemotherapy drugs for cancer treatment 

Knowing what type of hearing loss you have can help you determine if it’s possible to improve it at home, or if you need the help of a doctor or hearing specialist.    

Whether you have hearing loss now or want to avoid it in the future, there are things you can do to protect and improve hearing loss naturally.  

How to improve hearing naturally 

If you’re experiencing hearing loss, there are things you can try to improve it, including natural remedies for hearing loss.  

The best thing is to prevent hearing loss in the first place. And many of the ideas here can help. 

Note that the methods here are not intended as medical advice. Before trying anything at home, talk to your doctor. And if your hearing gets worse, we advise you to see a doctor about it. Know that some hearing loss is permanent and may require assistive devices. 

Clean out the wax 

Built-up earwax is one of the leading causes of conductive hearing loss. It prevents sound waves from reaching your inner ear.  

The good news is that you can safely remove earwax. If you do it regularly, you can help maintain hearing.  

When you clean your ears, keep in mind that they’re delicate. Don’t put cotton swabs, earwax candles, or sharp instruments in your ears. Instead, follow this home remedy for cleaning your ear canal naturally:

1. Soften the wax: Put a few drops of baby oil, mineral oil, glycerin, or diluted hydrogen peroxide in the ear canal. 
2. Flush with warm water: Once the wax softens (usually after a day or two), gently squirt warm water into your ear canal. The warm water should flush out the softened wax and clear the blockage. Tip: Tilt your head to the side, so the water drains out of your ear. 
3. Dry your ear: After removing the wax, gently dry your outer ear with a soft, clean towel. 

Your doctor can also remove excess earwax for you or recommend an over-the-counter ear drop or removal kit. 

Exercise your brain 

A study by the Perelman School of Medicine found a possible connection between hearing loss and grey matter atrophy. Grey matter is the part of the brain that handles sensory perception (including hearing).  

While the study suggested a link between hearing loss to grey matter loss, it may also work the other way: grey matter atrophy may also lead to hearing loss.   

Exercising your brain — and body — can protect your grey matter. Solving puzzles is a great mental workout to get the blood flowing in your brain and improve brain and hearing health. 

Consider the following games to keep your brain and hearing sharp:

• Crossword puzzles 
• Word searches 
• Sudoku 
• Jigsaw puzzles 
• Card games 

Exercise your body 

Cardio exercise, like jogging, biking, hiking, and walking, can help improve your overall health, your brain health, and your hearing.⁴  

Just as working out your brain increases blood flow to it, working out your body increases blood flow to your brain and ears. And like the rest of your body, the tiny hairs in your ears responsible for most of your hearing are more likely to stay healthy and fully functional with good blood flow.

Do yoga 

Yoga won’t get your heart pumping as much as jogging, but it improves blood flow. Some studies show that it may improve sensorineural hearing loss too.⁵

Nix the nicotine

A study in 2013 found that smokers have a higher risk for hearing loss, particularly sensioneural hearing loss.⁶ It also found that the more someone smokes, the higher their risk.⁶ That holds for the number of cigarettes smoked a day and the number of years someone smokes. The older a smoker gets, the greater the chance of hearing loss.⁶  

Smoking can also cause tinnitus.⁸ Tinnitus isn’t hearing loss. It’s a noise or ringing in your ear. And it’s a problem for 90% of people with hearing loss and a nuisance for anyone dealing with it.⁸ 

Bottom line: If you smoke, cut back, or quit altogether to protect and improve your hearing. 

Turn down the volume already 

Listening to loud sounds, such as music or power equipment, can damage your hearing. The longer you listen, the higher the risk of noise-induced hearing loss.   

Everyday noises, even at lower volumes, can lead to some form of hearing loss over time. 

To protect your hearing and prevent further damage, avoid loud, prolonged noises. And if you can’t avoid the noise, use hearing protection. 

Hearing protection devices won’t reverse existing damage but can protect and preserve the hearing you have left. 

Earplugs 

Loud noises contribute to roughly 15% of hearing loss cases.⁹ Using earplugs can reduce the volume of loud noise. Earplugs decrease the number of sound waves entering your ear canal.  

When using earplugs to preserve your hearing:

• Find a pair that fits snugly in your outer ear canal. 
• Consider custom-fit earplugs if you work in a job with regular exposure to loud noises.

Also, turn down the volume when using headphones to listen to music or the TV. 

Earmuffs 

Earmuffs function like earplugs, but protect the entire ear, not just the outer ear canal. You want earmuffs that form an airtight seal around your ear for the best results. You can also use earmuffs with earplugs for up to 15 dBs of added hearing protection. 

Feed your nutritional needs with vitamins and minerals 

Studies aren’t conclusive, but vitamins and minerals may help hearing health.¹⁰,¹¹ They have other benefits too. 

Always talk to your doctor before adding any supplement to your diet. 

Folate 

Folate, or Folic acid, is one of the B vitamins. One study found that men over 60 who take more folate have a lower risk of hearing loss.¹² Other studies have also found correlations between low folate intake and hearing loss.¹³

Foods high in folate include:

• Peanuts 
• Beans 
• Sunflower seeds
• Dark green leafy vegetables 
• Liver 
• Seafood  

Many common foods are also fortified with folic acid, such as bread, flour, pasta, rice, and cereal. 

Potassium 

Potassium may help balance the natural fluid in the inner ear and in the part of the brain that translates noise into recognizable sounds. Research suggest higher potassium intake might lower the risk of hearing loss.¹⁴

The best way to add potassium to your diet is though foods. Potassium-rich foods include:

• Potatoes 
• Spinach
• Lima beans
• Tomatoes 
• Raisins 
• Bananas 
• Oranges 
• Yogurt 
• Milk  

Remember to check with your doctor before taking supplements. Also follow their instructions if they’ve told you to restrict your potassium intake. 

Omega 3 

Omega 3s are known for their anti-inflammatory and anti-aging properties. They may also promote brain function and communication between the brain and the ear, which might improve your hearing.¹⁵ Studies have shown Omega 3s may reduce the risk of age-related hearing loss.¹⁶

Omega 3-rich foods include:

• Mackerel 
• Salmon 
• Cod liver oil 
• Herring 
• Oysters 
• Flaxseed 
• Chia seeds 

Investigate herbal remedies 

Some herbal remedies show promise for treating hearing loss naturally. Traditional Oriental Medicine (TOM) has used herbs to treat hearing loss for centuries.  

Again, ask your doctor before adding any supplement to your diet. 

Promising herbal options as natural remedies for hearing loss 

One study found that 25 herbs and 40 compounds used in TOM might help with sensorineural hearing loss and tinnitus caused by noise, aging, ototoxic drugs, and diabetes.¹⁷ Ginkgo biloba, Panax ginseng, and Astragalus propinquus showed particular promise to improve hearing in patients with sensorineural hearing loss and to reduce symptoms of tinnitus.¹⁸ 

A year-long study found that 10 mg of Vinpocetine (VPC) three  times a day might improve acquired sensorineural hearing loss.¹⁹ Study participants reported their hearing loss not only stopped progressing but reversed. 

Another study found that Coenzyme Q10 (CoQ10) holds promise for treating sudden-onset sensorineural hearing loss.²⁰

There’s an app for your ears 

Technology isn’t necessarily natural, but it does offer helpful, do-it-yourself ways to improve hearing. Playing these apps and programs for just a few minutes a day might maintain or improve your hearing health. 

AudioCardio hearing & tinnitus 

AudioCardio is an app for hearing and sound therapy. After an initial test, the app creates a therapy session for each ear. You can complete daily sessions while you do other things. 

The app is clinically proven to “maintain, protect, and strengthen hearing.” Find AudioCardio in the app store. 

LACE (Listening & Communication Enhancement) auditory training and aural rehabilitation 

LACE is designed to train your hearing to keep up with conversations in noisy environments. The online trainings use artificial intelligence to adapt to your hearing level and keep you on track for improved comprehension.   

While LACE can’t improve your hearing as far as how your ears function, it may improve your brain’s ability to comprehend what you do hear. Find LACE online. 

Offline hearing exercises 

If you don’t want to use apps or computer programs, you can train your hearing at home, offline, with auditory training exercises. 

Start by enlisting a friend or family member to:

• Have a conversation in a noisy environment (turn up the TV or radio) and focus on the conversation to train your brain to cut through the noise. 
• Have someone move around you while your eyes are closed so you can practice identifying the direction and distance of the sound. 

When alone (or not), sing. One study found that singing helps people with age-related hearing loss better perceive speech in noisy environments.²¹

Don’t shun assistive devices 

If you find you still don’t hear as well as you’d like, talk to a doctor. Your doctor may suggest an assistive device, such as a hearing aid or a cochlear implant. You can also try captions on your TV or captioned calls on your own. 

Using assistive captioning improves perception, memory, and comprehension, which helps you and your brain.  

You may qualify for captioned calls at no cost if you have hearing loss that requires call captioning to effectively use the phone. Sorenson offers call captioning on a specially designed phone with a captioning screen and through the CaptionCall Mobile app for your cell phone.

Sources 

1. Quick Statistics About Hearing, Balance, & Dizziness
2. Age-Related Hearing Loss (Presbycusis)
3. About Noise-Induced Hearing Loss
4. Cardiorespiratory Fitness and Brain Volumes
5. Improving Hearing Performance through Yoga
6. The Effect of Smoking on the Hearing Status–A Hospital Based Study
7. The Link Between Smoking and Hearing Loss
8. Tinnitus — Symptoms and causes
9. Noise-Induced Hearing Loss
10. Interplay between Nutrition and Hearing Loss: State of Art
11. A prospective study of vitamin intake and the risk of hearing loss in men
12. A prospective study of vitamin intake and the risk of hearing loss in men
13. Folic Acid for Hearing Loss
14. Association between a High-Potassium Diet and Hearing Thresholds in the Korean Adult Population
15. Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss
16. Fish and fatty acid consumption and the risk of hearing loss in women
17. Traditional oriental medicine for sensorineural hearing loss: Can ethnopharmacology contribute to potential drug discovery?
18. Traditional oriental medicine for sensorineural hearing loss: Can ethnopharmacology contribute to potential drug discovery?
19. Evaluation of vinpocetine as a therapy in patients with sensorineural hearing loss: A phase II, open-label, single-center study
20. Coenzyme Q10 in combination with steroid therapy for treatment of sudden sensorineural hearing loss: a controlled prospective study
21. Short-Term Choir Singing Supports Speech-in-Noise Perception and Neural Pitch Strength in Older Adults With Age-Related Hearing Loss  

More than 63% of the world’s population uses the internet every day. It’s the go-to tool for everything from banking and shopping to filling prescriptions and connecting with friends and family. Most captioning services and phones also use it. But you can get closed captioned telephone service without having home internet access. 

A captioned telephone uses the internet and Internet Protocol Captioned Telephone Service (IP CTS) instead of the traditional phone network to provide call captioning over the phone. IP CTS is a type of telecommunications relay service (TRS). But you don’t necessarily need home internet service to use call captioning. 

Before we dig into having call captioning with no home internet service, let’s review what call captioning is and when you want it. 

What is call captioning? 

Call captioning transcribes one or both sides of a phone conversation into easy-to-read captions. The transcription is virtually real-time and uses a live captioning agent and/or automated speech recognition (ASR) or another voice recognition technology.  

If you have a captioning app on a smartphone, you see captions on your phone’s screen. You can also use a captioning service at home with a specially designed captioning phone with a built-in screen. 

You can get call captioning service and a home phone with a captioning screen at no cost if you have hearing loss and need the service to effectively use the phone.  

Captioned calls over IP CTS are a critical tool if you’re hard of hearing. Its dependence on the internet can be a challenge, but newer phones and cellular data can help keep you connected. 

"It’s a marvelous invention. One of the best things that could happen to people with hearing loss."

— Lou

Not everyone has internet access

For people on a fixed income or living in a rural area, access to internet service with at least 25 Mbps download and 3 Mbps upload speeds continues to improve, but still falls behind access for other groups. In its last Annual Broadband Report, the FCC reports that 14.5 million Americans lack reliable high-speed internet access.  

Pew Research Center reported in 2021 that 43% of households with incomes below $30,000 annually lacked home broadband service.  

In another 2021 survey, the  Pew Research Center found that 7% of the general U.S. adult population doesn’t use the internet, but of the population over 65, 25% doesn’t use it. 

Even for people who have internet service, outages can knock out service for minutes, hours, or days. And Wi-Fi requires a power connection. So, if the power goes out, so does your internet. 

You don’t want to be in a situation where you need to make a call, especially during an emergency, and find that you can’t.  

Why a closed caption phone without internet is important

If you have hearing loss, call captioning empowers you to effectively use the phone. It’s a convenience and even a lifesaver. Especially when you’re in an isolated area or can’t reach out via online communication tools, a captioned phone or mobile phone with a captioning app keeps you connected.  

How to get captioned telephone service without internet access

Select call captioning phone services can give you closed caption phone access without an internet connection. Some use an analog-only connection, and some include a built-in access point, giving the phone the ability to create its own internet connection without the need for home internet service.

You can also get caption telephone service on your mobile phone. All you need is a captioning app and a smartphone with Wi-Fi or a cellular mobile data connection. 

Note that Wi-Fi connections depend on having internet service, especially at home. Some merchants, public libraries, and government offices do offer free public Wi-Fi access.  

Almost all cell phones offer a mobile data connection. Just be aware that you might have a limited data plan that caps the amount you can use each month. If you go over your cap, you may pay extra. Ask your mobile phone provider for details about your plan or how to get a plan with unlimited data. 

A mobile data connection also uses the internet over a cellular connection. If you’re in “dead zone,” you won’t be able to make a call. But 95% of the world’s population now has mobile broadband access. Chances are, you won’t hit dead zones too often. 

Whether your use a mobile phone or a landline home phone, you don’t need home internet service to make captioned calls.  

Here’s how to get a closed caption phone without internet 

Whether you have Internet service or not, you can get a closed caption phone at no charge to you, a family member, or friend.  

If the phone user has hearing loss that makes captions a necessity, they qualify for service and a phone from CaptionCall by Sorenson, the CaptionCall Mobile app, or similar products from other providers. As long as they qualify, there’s no cost for either service or the caption phone.  

Call captions without internet with CaptionCall by Sorenson 

If you, your family member, or friend live in a rural area, on a fixed income, or don’t have internet service, a CaptionCall captioning phone includes technology to create its own internet access point (that only the CaptionCall device can use) so you can connect without home internet service.    

Call 1 (833) 691-1600 to find out about no-internet call captioning solutions, or visit the CaptionCall page on the Sorenson website to learn more and sign up for an account.

Captioned calls without internet on your cell phone with CaptionCall Mobile  

You, your family member, or friend can also get captioned calls on a cell phone anywhere you have Wi-Fi or a mobile data connection. CaptionCall Mobile is a call captioning app available for phones with Android or IOS operating systems. 

Call +1 (800) 359-3186 or visit the web page to learn more about CaptionCall Mobile or download the app. 

Roughly 25% of Americans aged 65 to 74 have age-related hearing loss. After the age of 75 that number increases to 50%.¹ Age is the strongest predictor of hearing loss in adults, and age-related hearing loss affects quality of life more than most people realize.² One of the effects of hearing loss is that when people with hearing loss struggle try to hear, their ability to comprehend and remember speech decreases. The increased effort to understand is a hidden effect of hearing loss — one that’s critically important in understanding the challenges that anyone with hearing loss deals with.³ One way to help people with hearing loss is with assistive captioning.

What is assistive captioning and how does it help?

Assistive captioning, or closed captioning, is an assistive technology that transcribes speech or speech and sound into written text. Captioning includes:

• Subtitles that translate spoken words to written content. Subtitles are common for translating one language into another.
• Closed captions that translate spoken words and contextual sounds and actions into written content. Closed captions are ideal for viewers who have very limited hearing or are Deaf.
• Call captioning that translates what a speaker says on a phone call into written content. Call captioning requires a phone designed to show captions on a screen or an app that can add captions to a call on a smart phone

Captioning benefits people with hearing loss by:

• Improving perception, comprehension, and memory, even when there’s background noise.
• Helping them interpret sounds and speech more clearly and quickly.
• Helping them understand sounds and speech, sometimes even better than with the use of hearing aids.³

Qualify for CaptionCall by Sorenson today!

Studies have looked into how captions benefit adults with age-related hearing loss. Four of these studies showed how captions give adults with age-related hearing loss a way to overcome the challenges caused by struggling to hear.

Captions and comprehension

In the one study, researchers asked participants to listen to a list of numbers. The first half of the list was presented without distracting background sounds. The second half was presented with background noise. After participants listened to both halves of the list, they were asked to repeat the entire list of numbers.

Researchers found that listeners tried so hard to hear the numbers said with background noise that most forgot the beginning of the list.⁴

This study showed that adults with age-related hearing loss can have a harder time understanding sounds with background noise. The conclusion was that background noise interferes with comprehension and memory. The findings present a strong argument for ensuring aging adults with hearing loss have access to tools, such as assistive captioning, to help them struggle less and better understand sound and speech.

Discover CaptionCall Mobile for mobile captioning

Seeing and hearing are key

Researchers in the second study had participants listen to sentences that varied in complexity. They found that older adults with hearing impairments struggled with comprehension and recall of sentences when spoken quickly, even though they accurately perceived what was said.⁵

The study shows that perception, comprehension, and memory of speech improve for adults with age-related hearing loss when they can see and hear what’s said.

Other studies show that even just a one decibel (dB) improvement in signal-to-noise ratio corresponds to a 10% increase comprehension and memory.³

The improvement in this second study equaled a speech-to-noise ratio improvement of as much as 15 dB, which led to a significant increase in comprehension and memory.

Words and sounds work together

In a third study, researchers showed participants two videos with captions and sounds. In the first video, the captions and sounds matched. In the second video, the captions and sounds didn’t.

The results of the study determined that sounds and words (such as captions in a conversation) complement each other to help listeners understand sounds better and to hear sounds more clearly and quickly.⁶

The benefits of captions versus hearing aids

In the last study, researchers determined that real-time closed captioning of speech in television improves comprehension for adults with hearing loss. The study also showed that the benefits of captions outweigh the benefits of hearing aids. In fact, hearing aids provided no benefit to recognizing words when captioning was available.⁷ This study shows just how important captions are for hearing loss.

Assistive captioning for phone conversations

Call captioning, like CaptionCall, transcribes phone calls in real time so users can read the conversation. Call captioning, such as that provided by CaptionCall, provides advanced call captioning for phone calls. Assistive captioning for phone calls lets anyone with hearing loss necessitating call captioning better comprehend, remember, and actively participate in conversations, even when there’s background noise. Call captioning is also available at no cost.

Learn more about how CaptionCall by Sorenson and CaptionCall Mobile can help anyone with hearing loss, including adults with age-related hearing loss.

Sources

1. Quick Statistics About Hearing, Balance, & Dizziness
2. Declining Prevalence of Hearing Loss in US Adults
3. Text Captioning Buffers Against the Effects of Background Noise and Hearing Loss on Memory for Speech
4. Rabbitt, P. M. (1968). Channel-capacity, intelligibility and immediate memory. Q J Exp Psychol, 20, 241–248.
5. Wingfield, A., McCoy, S. L., Peelle, J. E., Tun, P. A., Cox, L. C. (2006). Effects of adult aging and hearing loss on comprehension of rapid speech varying in syntactic complexity. J Am Acad Audiol, 17, 487–497.
6. Frost, R., & Katz, L. (1989). Orthographic depth and the interaction of visual and auditory processing in word recognition. Mem Cognit, 17,302–310.
7. Gordon-Salant, S., & Callahan, J. S. (2009). The benefits of hearing aids and closed captioning for television viewing by older adults with hearing loss. Ear Hear, 30, 458–465.