Sound

I remember the day that I sat where you are sitting now; gazing unseeingly at a hearing loss brochure and thinking "this does not, cannot, apply to me!"

I am not an audiologist, an ear, nose and throat specialist or a hearing aid dispenser. My experience is much more personal. I am one of the thousands (yes, thousands) of Nova Scotians who live with hearing loss! I was born fully hearing and first encountered hearing loss at the age of 27. My hearing loss was degenerative. Within 3 years of being diagnosed as needing hearing aids, I was profoundly deaf. I struggled through the maze of information and communication options, and eventually made the decision to have a cochlear implant operation. So, I speak to you as one who has been through the whole spectrum of hearing, to deafness, to hearing again via technology. I was a successful entrepreneur, completed my graduate studies and re-entered the work force during this time.

Hi! My name is Caitlin and, on behalf of the Deafness Advocacy Association Nova Scotia, I am hoping to make this an easier process for you than it was for me. I will be your guide on one of your first trips through the maze of information on hearing loss, hearing aids, communication techniques, and a wealth of other information which will hopefully provide you with the knowledge you need to keep your life rich, enjoyable, and full of promise and possibility.

We will start with some of the most frequently asked questions, then explore some answers. After that we'll look at some of the common myths of hearing loss, the emotional well-being of you and your family, communication tips and strategies, technological options, and questions you may have specific to your situation. Throughout this brochure, you will see the names of service and support organizations which can provide you with additional information. They are all listed in Service and Support Organizations at the end.

Hearing Loss - Most Frequently Asked Questions

1. How prevalent is hearing loss?

2. What are some of the signs of hearing loss?

3. What are some of the signs of hearing loss specific to children?

4. What should I do if I suspect I have a hearing problem?

5. What are some of my options for coping with hearing loss?

6. Why do some people choose to not correct their hearing loss?

7. Why should I correct my hearing loss?

8. Where can I get information on hearing loss and hearing options?

9. Will my children become or be born deaf?

10. What are the major technological advances for coping with hearing loss?

1. How prevalent is hearing loss?

Major research studies indicate that the number of people with a hearing loss in North America is between 25 and 28 million - or about one in every five people. Two of those studies (Statistics Canada & MarkeTrak) indicate that slightly more than one million of this number are school age children. In Nova Scotia alone, Health and Welfare Canada estimates the number of people with hearing loss at over 55,000; about double the national average.

2. What are some of the signs of hearing loss?

a. Shouting in conversation

b. Turning TV or radio up too loud for other family members

c. Continually asking people to repeat themselves

d. Withdrawing from social contact

e. Straining to hear

f. Misunderstanding conversations

g. Favouring one ear

h. Ringing or buzzing in your ear(s)

3. What are some of the signs of hearing loss specific to children?

a. Not responding to someone talking if that person is out of view.

b. Using "what?" or "huh?" frequently

c. Intently watching the faces of speakers

d. Sitting close to TV with volume high or turning up volume on stereo.

e. Switching ears frequently on the phone

f. Not being startled by intense sounds

g. In infants; not turning head toward sounds (such as rattle)

h. Speech does not appear to be developing normally (e.g. a child should have some recognizable words by twelve months of age)

4. What should I do if I suspect I have a hearing problem?

The first thing you should do is consult with your doctor and have your hearing tested by a hearing care professional. For a complete list of hearing care professionals in your neighborhood ask your doctor, or contact the Nova Scotia Hearing and Speech Clinic, or check the yellow pages under hearing aids. Hearing tests done by the Nova Scotia Hearing and Speech Clinic are covered by MSI. Hearing tests conducted by other hearing aid specialists are sometimes subject to a small fee.

5. What are some of my options for coping with hearing loss?

About 9O‑95% of people with a hearing loss have a loss that may be corrected to varying degrees. Of these, 5‑1O% can be helped medically, including cochlear implant surgery. The remaining 9O‑95% can significantly improve their ability to hear with hearing aids. Neither hearing aids nor cochlear implants can totally restore hearing. You still will not hear everything and the sounds you do hear may be distorted. It will require some time for you to become accustomed to hearing aids. However, hearing aids can make a big difference in improving your quality of life. Other options include speech/lip reading or sign language training, support groups and contact with service organizations.

6. Why do some people choose to not correct their hearing loss?

The major reason people do not correct hearing loss is three-fold: denial, misinformation and cost. Many people are not aware, or deny, that they have a hearing loss until it is repeatedly pointed out to them by family or friends, because it often comes on slowly. Frequently family members and the individual have learned to adapt to the hearing loss, not even realizing that they are doing this. Some people believe others will think they are getting old or will view them as less competent or less attractive if they admit to being hard of hearing or have to wear a hearing aid.

Many people have received misinformation about hearing loss and the extent to which hearing can be helped from well-meaning family physicians or friends. However, they are not hearing specialists. In fact, most physicians have received very little training on hearing loss and hearing aids, and the technology is changing too rapidly for a lay person to keep on top of. If you have been told you cannot be helped, we recommend that you get a second opinion from a person who specializes in treating hearing loss. This would be an Ear, Nose and Throat Specialist, an Audiologist or a Hearing Aid Specialist.

Probably the most common and unfortunate reason people do not correct their hearing is cost. Hearing aids are expensive and unless you have medical benefits there is little funding available to assist. The additional cost of other assistive devices that will help in your everyday life can run into several thousand dollars. However, places such as the Nova Scotia Hearing and Speech Clinic, the Society of Deaf and Hard of Hearing Nova Scotians and the Deafness Advocacy Association Nova Scotia have access to some funding information that may be of benefit to you.

7. Why should I correct my hearing loss?

Each person will have their own reasons for wanting to augment their hearing or communication ability as much as possible. For me, the need to communicate with my children, husband, parents and relatives as well as the need to continue my work was paramount. I did not want to become isolated, anxious or depressed because I was being left out of conversations, like so many others who ignore hearing loss. I did not want to lose my job or potential promotions because I could not hear. I took classes in speech reading, I learned sign language and I was found appropriate for cochlear implant surgery. For me, the only thing worse than losing my hearing, was the realization that I was losing touch with the world around me - and for me, that was unacceptable.

8. Where can I get information on hearing loss and hearing options?

The best places to obtain professional information can be found in the Service and Support Organizations and Websites sections.

9. Will my children become or be born deaf?

This is a question for your hearing specialist, as the causes of deafness are unique to each individual. If the reason for your hearing loss is congenital, meaning it was something that was passed to you through the family genes, then there is a possibility that your child may inherit that gene. If your hearing loss is due to illness or injury, there is usually no reason to believe your child will be affected.

10. What are the major technological advances for coping with hearing loss?

The wide spectrum of organizations, services, supports and technological aids available today make it possible for persons with hearing loss to not only pursue further education and employment options, but to excel in their personal and professional lives. Losing hearing does not mean that you have to quit your job or give up your dreams. Listed below are some things that can help you in your work, school and every day environments. They include:

< workplace assessments

< hearing aids

< cochlear implants

< text telephones or phone amplifiers (even for cell phones)

< alarm clocks/watches (vibrating or flashing light)

< environmental alert systems/room monitors

< fax or e-mail

< sign language and/or speech/lip reading courses

< oral and sign language interpreters

< vehicle alerting devices

< computerized note taker

This list is growing daily. You can find a description of these devices and many more in the section on Enhancing Your Environment.

The Myths of Hearing Loss

There are so many myths associated with hearing loss that it would be impossible to list them all here. The following is a "short-list" of the most common myths, but if you have any questions at all, please contact one of the Service and Support Organizations in this brochure.

a) My hearing cannot be helped.

People with hearing loss in one ear, with a high frequency hearing loss, and with nerve damage are often told by a doctor that they cannot be helped. This might have been true 25 years ago, but with modern advances in technology nearly 95% of people with a hearing loss can be helped to varying degrees, the majority of them with hearing aids.

b) Hearing loss affects only old people and is a sign of aging.

In reality, less than 40% of people with a hearing loss are older than age 64. There are close to 8 million people in North America between the ages of 18 and 44 with a hearing loss and more than a million school aged children.

c) If I had a hearing loss my family doctor would have told me.

Not true. Only 16% of physicians routinely screen for hearing loss during a physical exam according to several major studies. As physical exams occur in very quiet examining rooms, it is virtually impossible for the doctor to recognize your hearing loss. You will probably Ahear@ about it from your family first.......or not!

d) The consequences of hiding hearing loss is better than wearing hearing aids.

"At what price vanity?" If you miss a punch line in a joke or respond inappropriately in conversation, people may think you are inattentive or lacking in mental abilities. How many business deals are lost because important parts of conversations were missed? How many elderly have been inappropriately diagnosed as Alosing their mental agility@ , when they simply could not hear? Quite frankly, the consequence of vanity is missing out on life. With new advances in technology and the smaller hearing aids of today, many hearing losses can be corrected and still be virtually invisible. If you still do not want people to know you are wearing a hearing aid, speak to your hairdresser. He/she will know some fashionable ways to keep your ears hidden.

e) Hearing aids do not work.

Hearing aid technology has improved dramatically over the last 25 years, as have testing techniques and diagnosic procedures. Hearing losses which may have been difficult to suppliment years ago are now being assisted. Bearing in mind that neither hearing aids nor surgery will ever return your hearing to a 'normal' level, if a hearing aid does not correct your hearing loss to your satisfaction, most hearing aid dispensers allow 30 days to return the hearing aid for a refund (less testing costs at some places). However, the vast majority of people indicate significant satisfaction in one to one and small group conversations, including on the telephone. As signal processing improves in hearing aids, we will see the number of large group situations in which hearing aids can be used effectively increase.

f) All Deaf or hard of hearing people use sign language.

Sign language is one communication option that is available to you regardless of your age. It is the primary language of those who are culturally Deaf or become deafened early in life. Many people who become deafened later in life rely on speech reading/lip reading or other methods for communication while still others prefer to sign. The choice is yours.

g) All Deaf or Hard of Hearing People lip/speech read.

Being Deaf or hard of hearing does not mean that you automatically lip/speech read, or that you are good at it! Lip/speech reading training is available to help you learn should you choose this communication strategy. It is not hearing. The English language is very complex and many sounds are not produced on the lips, therefore cannot be Alip read@. Many sounds look the same on the lips and are mis-read. Even with practice and training, lip/speech reading alone will only provide between 25-30% understanding. The remainder of the conversation must be understood from context and other visual cues. Problems may be encountered when trying to lip/speech read people with accents, speech impediments, or moustaches, or when trying to find the speaker in a group setting.

h) Deaf or hard of hearing people cannot speak or are hard to understand.

Hearing loss does not mean that a person cannot speak. Many profoundly Deaf children have learned to speak proficiently. Most people lose their hearing after learning to speak and that speech is retained. There may, however, be changes in your speech pattern. You may talk louder or softer, drop word endings or lose some articulation. Practice speech with your family and ask them to let you know when this happens. Many families develop signals that, for example, alert the person with the hearing loss to make changes in vocal intonation thereby avoiding embarrassment in social settings when the noise level in the room becomes louder or more quiet.

i) Deaf or hard of hearing people are less intelligent.

Deafness or hearing loss is not connected to mental ability. Some Deaf or hard of hearing people take longer to answer a question or offer an opinion in conversation because it takes longer to understand what is being discussed. Helping your family, friends and co-workers become familiar with the Communication Tips will keep you involved and aware.

j) You should shout when speaking to a person with a hearing loss.

Shouting or exaggerating lip movement does not improve understanding. Speaking more slowly and clearly does. Rephrasing a sentence when asked to repeat something also helps. Shouting can cause hearing aids to vibrate...a very unpleasant feeling!

Grieving and Anger over Your Loss - Normal Emotions?

In our society, we are taught that it is natural to feel anger and grief over the loss of a loved one, the loss of a relationship, even the loss of a good job. Rarely do we hear these words in relation to hearing loss. Instead, we are immediately confronted with Acoping@ strategies: how to find or keep a job, communicating with loved ones, functioning in the work or school environment. We are continually faced with the philosophy that we should "pick up and carry on". With all this technology and help we needn=t feel sorry for ourselves! Indeed, the world (and Nova Scotia) is full of admirable Deaf and hard of hearing people who are role models to others - they succeed in their careers and in their family situations.

So, before we go any further, I want to confirm that it is okay for you to feel anger, grief, sadness and yes, even despair. Before you can move on and embrace the possibilities that lie ahead for you, it is important that you acknowledge these feelings. They are perfectly natural. You are losing something important.

Where are you situated emotionally, right now?

Are you starting to think or have you thought that others are talking about you, or that they are deliberately speaking softly or mumbling to prevent you from hearing? Many people experience this anxiety as their hearing diminishes.

Do you find yourself dominating the conversation? This is a coping mechanism that we may not be consciously aware of...keeping the conversation centered on a topic of our choosing allows us a better chance of understanding what is being said, and decreases the chance that we will be embarrassed by an inappropriate statement or response.

Do you find yourself withdrawing socially? When you cannot follow a conversation, or cannot hear what is being said in a social setting, it is no longer an enjoyable activity. Straining to hear, frustrated and embarrassed by a failure to understand - it is easy to see why we withdraw from family gatherings and social events with friends.

Do you find yourself filling in the blanks? We, who are hard of hearing, can often pick up part of the words we hear. We tend to try to "fill in the blanks" with what we think we missed. When we respond inappropriately, family and friends may think we are not paying attention, becoming forgetful, confused or even rude.

We all enjoy moments of silence now and then, but if forced to endure it all the time it can result in a lonely, frightening, frustrating and boring life. We may feel left out, sorry for ourselves, misunderstood, or neglected. We may fear situations that present communication challenges and cause feelings of inadequacy. Lack of awareness by others can cause communication gaps and misunderstandings that result in further isolation. Inappropriate statements may leave you feeling foolish and reluctant to participate in group settings.

The best weapon you have against these feelings is awareness and acceptance. Be willing to let others know that you have hearing loss and tell them what they can do to help you understand and participate more fully in conversations. When you access the technology, services, supports and strategies that are available to suit your unique situation, you will feel increased self-confidence.

As you confront your hearing loss, consider how it affects just about every aspect of your life. It is entirely possible that you may have friends or family members who have difficulty adjusting to your new circumstances. It definitely affects your relationships and how you deal with others. Just because you have hearing loss does not mean that you will be unemployed, but some job opportunities may no longer be feasible. School and/or work will require adjustments. Music will not sound the same even with hearing aids or a cochlear implant. Telephone conversations may become more strenuous or you may need to start using a text telephone. You may find that you must now concentrate fully to understand what people are saying to you rather than doing two tasks at once. Simple conversation will require effort and may become exhausting.

These are not small changes to be brushed off as minor adjustments. They are major life changes. Your whole style of doing things, including your approach to tasks and people, is going to change. But, before you can accept or embrace these changes, it is important to acknowledge your hearing loss, the changes which affect you and how you feel about them. It is important to mourn your loss or even be angry over your loss...these are the first steps towards acceptance. If you feel the need to cry in sadness, scream in anger or stamp your feet in frustration, that=s okay. Only once you have done this can you begin to explore the options, services and supports that are available to help you.

Many people try to explain these feelings to friends, family or even their doctor or therapist. While others may want, and try, to understand what you are experiencing, they are not the ones losing their hearing. They can only imagine what this is like for you. There are several support groups and associations of people who are going through this very same thing. Sometimes talking and sharing personal experiences of hearing loss with others who have had the same experiences helps us to learn more about our new situation. Many, many people have experienced success in all areas of their lives, in spite of their hearing loss. In fact, some people have even experienced success in their lives because of their hearing loss. As they became more deeply involved in helping others face the same situation, new opportunities and challenges arose for them. There is a list of support groups in the Halifax area under Service and Support Organizations. I strongly advise you to give them a call.

Dealing with your Family=s Sense of Loss

Obviously, you are the one most affected by your hearing loss but your family may also feel anger, grief and frustration as much, in their own way, as you. They may feel this for you and for the changes it means for them; how it is going to affect their lives. They may feel guilty for feeling this way but the reality is that the lifestyle changes discussed above will also affect them. They will have to make more of an effort to communicate by speaking more slowly and more clearly. They will have to learn to repeat without become frustrated. They may fear your social lives will change, that you cannot enjoy theatre, movies or music together anymore. They may fear a loss of intimacy. These are valid concerns and fears which need to be discussed.

The essential thing for you to understand and remember when family members express frustration is that these feelings are not directed at you but rather at this new situation. New situations can cause discomfort, frustration and stress as all members of the family work together to find new ways to communicate and interact. Involving your family in discussions and support groups, and teaching them how best to communicate with you, can ease frustration. For example, make it a family policy to always go into the same room to speak to each other.

Here are some additional tried and true communication tips for you and your family. Pass them out freely to friends, co-workers and anyone else with whom you are speaking.

Communication Tips ... for family, friends and co-workers

< Remember to stand close to me before you begin to speak. Do not shout to me from another room.

< Remember to gain my attention before you speak by a tap on the shoulder, a wave, a stomp on the floor or a gentle bang on the table.

< Face me directly when speaking even when speaking to someone else, and make sure your mouth is empty and clearly visible (no gum, food, or untrimmed mustaches please).

< Let me know the topic of conversation through a gesture, pointing, a written word, etc, as this will help me infer some words from the context.

< Do not stand with a light source behind you as this will put your face in a shadow.

< Speak clearly but not too quickly. Do not shout or exaggerate your lip movements. Do not just mouth the words.

< Repeat and rephrase when necessary. Be patient. Remember that listening to other people takes a lot of effort.

< Talk in places where it is easier to hear; for example, places with less background noise (running water, music, TV), less movement (fewer people) and less visual distractions (blowing curtains, vibrant colours).

< Avoid moving around while speaking.

< Have a pen and paper handy in case something is not understood. Remember that the message is more important than the medium.

< If there is more than one speaker in the room, be my guide. Turn to face the next speaker so I can tell who is speaking. Repeat or rephrase conversation, if the speaker is not clearly visible to me.

< Remember that I am in the room so do not talk through me to another person. I can still carry my own end of the conversation.

Communication Strategies

Choosing the way in which you will conduct your primary communications with others is an ongoing process. Depending on the cause and progression of your hearing loss, the age of onset and your lifestyle, you will probably experiment with a combination of several options before finally choosing the ones that are right for you. There are thousands of people who live full and satisfactory lives without any hearing, while thousands of others choose to augment whatever residual hearing they may have with hearing aids or surgery. Most people will eventually chose a combination of technological aids and other communication strategies including verbal/auditory rehabilitation, computer notetaking, sign language and interpreters.

Let's start by examining the range of options:

Hearing Aids

Hearing aids can be worn behind the ear (BTE) or in the ear canal (ITC). Younger children may require a system that is strapped to their body, but youth and adults have a wide range of choices. Hearing aid technology has come a long way from simple amplification. It now includes everything from telecoils that allow telephone and audio loop signals to be transmitted to the hearing aid, to programmable digital aids that can automatically adjust for environmental noise. The decision about which may be the right one for you is between you and your audiologist, but too often the choice is limited by cost. Your work benefits or private insurance may cover the cost, however if you do not have insurance, discuss your options with your audiologist or contact the Deafness Advocacy Association Nova Scotia or the Society of Deaf and Hard of Hearing Nova Scotians for information on funding assistance.

Cochlear Implants

A cochlear implant does not rely on simple amplification. It is an electronic device that is designed to provide electronic hearing to those with profound hearing loss. Part of the device is surgically implanted into the inner ear and part is worn externally. A cochlear implant does not restore hearing to normal. As a prosthetic device, the cochlear implant stimulates the auditory nerve directly, bypassing the damaged part of the cochlea. Many viable nerve fibers remain in the hearing nerve, even in cases of profound deafness. The cochlear implant can restore activity to this nerve and the hearing pathway. Many individuals with post-lingual (after learning to speak) deafness are capable of excellent speech and sound recognition with their implant. At this time, cochlear implant surgery is not done in Nova Scotia, however MSI will pay for the surgery to be done elsewhere. To find out more information, or to see if you are suitable for this surgery, contact the Cochlear Implant Centre at the IWK/Grace.

While both of these technologies allow people to communicate more effectively, neither one provides Anormal@ hearing. Hearing aid users often complain of distortion and increased background noise because hearing aids boost all sounds, not just the ones we want to hear. Cochlear implant recipients may find that sound is rather electronic, it may be difficult to differentiate voices, or voices may sound Acartoonish@. For this reason many hearing aid users and implant recipients augment communication with other methods.

Verbal/Auditory Rehabilitation

Verbal/auditory rehabilitation refers to process of relearning many aspects of oral communication. This includes learning to lip/speech read as well as a number of strategies that train you to use your residual hearing to distinguish, in particular, speech sounds. Your audiologist, the Nova Scotia Hearing and Speech Clinic or the School of Human Communication Disorders at Dalhousie University should all be able to provide you with information on workshops, seminars or classes offered in your area. The Society of Deaf and Hard of Hearing Nova Scotians and the Deafness Advocacy Association Nova Scotia can provide you with the names of qualified instructors who offer private lip/speech reading classes.

Lip/speech reading becomes increasingly difficult as hearing diminishes. Even the best trained lip/speech reader will only ever understand about 30% of the spoken word. Therefore, most people find that hearing aids and cochlear implants boost their ability to lip/speech read, especially in one to one or small group settings.

Sign Language

When hearing diminishes to the point where hearing aids do not help, and when lip/speech reading becomes, or is, too difficult, many people choose to learn sign language. Signed languages are not 'verbal languages spoken with hands'. They are separate and distinct languages, rich with expression, each with their own unique syntax and grammar. In Nova Scotia, there are three distinct signed languages used - Maritime Sign Language (MSL), Langue des Signes du Québec (LSQ) in the French communities and American Sign Language (ASL) which is the most popular and is widely used across North America.

There are many sign language courses offered and interpreters available to assist you should you choose this option. At the very least, an introductory course will provide you with information on sharpening your non verbal skills. Information on courses can be obtained from the Deafness Advocacy Association Nova Scotia, the Society of Deaf and Hard of Hearing Nova Scotians, the Nova Scotia Community College, and the School of Social Work at Dalhousie University. You may also find courses in your local Continuing Education brochures.

Computer Notetaking

Some people choose to augment both technology and oral or sign communications with the written word by using computer notetakers in classrooms, seminars, business meetings and workshops. When you are seated at a distance from the speaker or where multiple speakers are present, a trained computer notetaker may be invaluable. The notetaker sits beside you and uses a laptop computer to relay the information to you, as it occurs. When several hard of hearing people are present, the information may be projected onto an overhead screen.

Most hard of hearing support groups provide computer notetakers for meetings. An increasing number of work places and publicly offered seminars and trade shows provide computer notetakers upon request. So, the next time you want to attend a training session, ask for notetaking services. Chances are, you will not be the only one using the service.

Interpreter Services

An interpreter is a fully trained, screened and qualified professional who facilitates communication between two or more people who speak different languages, or between those who have difficulty understanding each other for any number of reasons. They are bound by a professional code of ethics and adhere to strict rules around confidentiality. There are approximately 60 active interpreters across Nova Scotia who provide sign and/or oral interpreting services in public schools, post secondary colleges and universities, training or re-training programs, in the workplace and to the general public in every imaginable situation including church services, doctors appointments, counseling sessions and court, to name but a few.

If you become a proficient lip/speech reader, you may prefer to augment your communication with an oral interpreter. If you choose sign language as your preferred means of communication, a sign language interpreter will be required in many situations. Using an interpreter can be a little unnerving the first time, but I can assure you that you will quickly forget they are present as you realize how much more easily you can communicate.

The Dalhousie Advisor to Students with Disabilities, the Nova Scotia Community College and the Atlantic Centre for Disabled Students all provide interpreter and notetaking services to students at a post secondary level. The Atlantic Provinces Special Education Authority provides interpreters for students in public and secondary schools. The Nova Scotia Department of Education and Culture provides interpreter and notetaking services for training or retraining related to employment. The Society of Deaf and Hard of Hearing Nova Scotians provides interpreting and computer notetaking services for government services and to the general public. Most, but not all, interpreting situations are fully funded.

Enhancing Your Environment

Are you concerned that you will not hear your child cry? Are you upset that you can no longer hear the telephone or watch television? Are you missing people at the door or not hearing your alarm clock in the morning? Do you stay home instead of going to your usual religious services? Why?? There is a wide range of wild and wonderful electronic gadgets and gizmos known as technical devices that are available to assist you to maintain your independence. The most common are listed below, however if you have a unique need or would like more information, contact the Society of Deaf and Hard of Hearing Nova Scotians, the Deafness Advocacy Association Nova Scotia or the Canadian Hearing Society.

< FM Systems consist of a transmitter, receiver and microphone. The microphone and transmitter are worn by the speaker and the receiver connects directly to your hearing aid or cochlear implant. The result is that the speaker's voice is transmitted directly to your hearing aid or implant, and much of the environmental or background noise is eliminated. This is commonly used by teachers and students, but can also be valuable for lecture style presentations.

< Audio Loops are similar to FM Systems, however, rather than having a single transmitter and microphone, several such devices are placed strategically around a room. Many churches, theathers, board rooms, and large public auditoriums already have them permanently installed. All you have to do is ask for a receiver.

< Telephone amplifiers are volume control devices that increase the volume found on standard telephones. Most public telephones, many newer phones and some cellular phones have them already built in. If you have an older style desk or wall mount phone, MT&T Special Needs may be able to provide you with an amplified headset. Portable units that are samll enough to carry around in your purse or pocket may be purchased from a variety of sources.

< Text telephones or TTY's are small, portable typewriters that allow you to use the telephone by typing and reading messages. It either plugs directly into the phone jack or it can be used in combination with your voice phone. You may contact another TTY user by dialing directly or you may call voice phone users by dialing 711 first to access Relay Service. Relay Service Operators read your message then relay it by voice to the other person. The operator then listens for the response and types the message back to you. Relay service is available 24 hours a day, 365 days a year without cost. Long distance discounts are available for registered TTY users through the Special Needs department of MT&T. The technology found in tty's is becoming so sophisticated that you can even purchase pocket size ones which will attach to cellular phones. In addition, there are about 50 tty payphones located across Nova Scotia in strategic places such as airports, train stations, malls, hospitals, schools and even one truck stop/restaurant.

< Phone/Door/Alarm Flashers: There are a number of devices on the market that connect to your telephone, door and special fire alarms. When your phone or doorbell rings, or the fire alarm goes off, a light will flash. Depending on the model, you can get flashers that connect directly to a lamp in your home or to a separate light that will flash solely for this purpose. These systems are good but limiting in that they are only seen if you are in the room with the flasher.

< Alarm Clocks are also available to connect to a bedside lamp and will flash when the alarm clock goes off. There are also vibrating models that can be placed under a pillow or mattress to shake you awake when the alarm goes off.

< Environmental Alerting Systems are the ultimate in personal environmental alarms. The monitor is the size of a pager and is worn on your belt when you are at home. The main unit remains plugged into an outlet in one room, usually the bedroom. The pager vibrates when there is a noise in your environment and a flashing light on the pager will indicate whether it is the phone, doorbell, a loud room noise, a crying child or the fire alarm. Included in the system is a vibrating alarm clock and a light flasher which many people set up while they are in the bathtub.

< Close caption decoders are standard on all televisions built in the U.S. after 1994 and display what is being said in written text at the bottom of the screen. The decoding option can be accessed on your remote control under the options or language menu. If your television does not have one, you can purchase a separate decoder which can be connected to your television. Most television shows and all news broadcasts are captioned.

< Alphanumeric pagers are frequently used by people with hearing loss, and their family members. An alphanumeric pager will allow the caller to leave a brief voice or tty message for you, both of which will appear as written text on your pager. You will be alerted to your message by vibration as opposed to a beep.

< Vibrating wrist watches are handy little items that vibrate instead of beeping to alert you to an important time.

< Emergency vehicle alerting devices are fairly new items available for free on new or newly leased vehicles from GM, Ford, Chrysler and Saturn when any member of the family has a hearing loss. They can also be purchased separately for older or other models of vehicles. It is a small device that sits on the dashboard and will alert you to a siren from an emergency vehicle up to 500 feet away. Although not required by law, many deafened people feel more secure driving with this device.

Special Age Considerations

Each phase of our life presents us with different issues, challenges and obstacles to learn from and overcome. Our concerns in midlife are different than the concerns we once had in our adolescence and will be different again from those we will have in our later years. In this section, we'll look at some of the individual questions you may have at this exact stage of life. Remember too that support groups are available for people of all ages and people there may have answers to your questions.

Youth Concerns

You=re young, you=re hip, you=re cool, (or whatever the current lingo is for young people today) and you=re losing your hearing. Probably, the only person you can think of as being deaf or hard of hearing is an elderly relative or the Atypical@ hard of hearing person you see on television who is also usually an elderly person. How can this be? You=re not old. As stated previously, age and hearing loss are not necessarily related. Despite what you may have seen on television or what your experience has been so far, there are lots of young people who have hearing loss. You are not alone.

There are many services available to students attending school. The Atlantic Provinces Special Education Authority, Atlantic Centre for Disabled Students, and the Department of Education and Culture are a few of the places that provide support for students with disabilities. In the case of hearing loss or deafness, there are funded programs available to help provide assistive listening devices, interpreters and notetakers.

Outlined in Communication Tips are some ideas that will make communication easier for you in social and in family situations. Also, technical devices listed under Enhancing Your Environment may provide you with some solutions. Many movie theaters will make sure an FM receiver is available for you if you call them in advance. Some even offer open caption nights so you can go to the movies with your friends. Almost all rented movies are captioned and so are most video games.

With very few restrictions, apart from those that may be medically indicated, there isn't really anything you cannot do or achieve in life. Across Canada there are Deaf lawyers, doctors, teachers, postal workers, truck drivers and computer technologists. Right here in Nova Scotia there are Deaf and hard of hearing people in every job imaginable, including some rather key positions in both business and government. Going to interviews and dealing with potential employers can be approached in the same way as your schooling with the help of interpreters, notetakers and technical devices. There are specific organizations such as Teamwork, The Department of Education and Culture and Human Resources Development Canada that can provide assistance with employment supports.

There are even special programs for summer student jobs, only for students with disabilities, to help you gain valuable work experience. Included in funding for employers are special grants that will make the workplace more accessible for you so discuss your needs with your potential employer.

The most important thing to remember is to believe in yourself. Your hearing loss does not make you less of a person. You have all the special, unique qualities and talents that you had before you started to lose your hearing. Your task is to make sure that teachers, friends and employers see these qualities, first and foremost. My own experience has been that if you demonstrate your abilities, your disabilities will cease to matter.

Adult Concerns

Many of the concerns working adults have are similar to those of youth, so please read those as well. More importantly at this stage of life, you are probably wondering if you will be able to keep your job, how you will be able to afford the technical devices, whether you will be able to drive safely, raise your family, or continue to run your own business. I have heard the saddest stories from people who have quit their jobs or sold their businesses as they began to lose their hearing because they thought they did not have any other option.

Do not quit your job! Human Rights protects people from being dismissed because of a disability. More importantly, there are specific agencies within the government that provides funding assistance to help people who are in danger of losing their job because of a disability, to adapt the work place. Employment Support Services, a branch of the Department of Community Services and a program within Teamwork can be valuable financial resources. There may also be some financial assistance through your current workplace benefits plan. You may think that because you work with hearing people, you will not be able to function in your current job. I was teaching a college computer course when I became totally deaf. With assistance from these programs and a little patience from my students, my classroom was converted to allow me to continue teaching without problem. If you do decide that you need retraining, Teamwork and the Department of Education and Culture can provide support.

With the technology listed in Enhancing Your Environment you will be able to continue to raise your family, run your household and participate in your usual activities with little difficulty. Many local service clubs will provide you with some funding assistance if needed, to help you pay for your technical devices. Revenue Canada offers special tax deductions for persons with disabilities and for the purchase of anything related to disabilities, so please contact them for more details.

You can continue to drive your car, truck and recreational vehicle. Some Canadian car manufacturers offer emergency vehicle alerting devices for people with a hearing loss for free when you purchase or lease new vehicles. Ask your car dealer, or contact the Deafness Advocacy Association Nova Scotia or Society of Deaf and Hard of Hearing Nova Scotians for more details.

Senior Citizen Concerns

Many of the concerns that senior citizens may have are similar to adults. Seniors may also worry about getting help in emergency situations (fire, break-ins, medical emergency), contacting friends and family, and the choices around a visual environment for apartments and nursing homes.

In all emergencies, it is important to remember that 911 will respond to your call even if you cannot hear or talk to them on the phone. If you dial 911 and leave the phone off the hook, a police officer will respond immediately. If you have a specific medical condition, you can contact the Special Needs department of MT&T, and they will inform 911 call takers. By doing this, you can have your medical condition posted permanently on the 911 screen for your phone number so if, for example, you have recurring problems with your heart and need to get to a hospital, 911 will know this and dispatch an ambulance even if you do not say anything on the phone.

Strategically placed, inexpensive motion sensors will flash lights if someone is in your yard and can even be placed within your house to alert you to intruders. Setting up regular schedules for visitors will keep you in touch with family and friends, and establishing an emergency contact routine will alert family to any special needs you might have.

Pets can be very helpful to deafened seniors. Trained hearing-ear dogs are available and can provide invaluable assistance. Even without special training, many breeds of dogs and even cats are particularly sensitive to their owner's special needs and often, with little prompting, can learn to alert you to telephones, visitors and other events in your environment such as water taps left running or kettles boiling.

When choosing a retirement home or a senior's apartment building, always remember to ask questions about their ability to meet your specific needs. Many senior's buildings have secure entries, but are they secured by a buzzer entry or do they have a video camera so you can see who is at the door on your television screen? Are pets allowed? Does the retirement home have closed captioned television? Do the telephones have volume controls?

Again, technical devices are wonderful gadgets even when you are not technically inclined, and should be considered to enhance your living environment.

Service and Support Organizations - General

Canadian Hearing Association/Canadian Hard of Hearing Association

1-800-465-4327

Information on services and programs available across Canada, technical devices sales and service, access to provincial Hard of Hearing Association representative.

Cochlear Implant Centre

428-8363 (v/tty)

Information about cochlear implant surgery, surgical follow-up and support services

Dalhousie School of Communication Disorders

494-7052

Education, community/public workshops, technical support, general and medical information on hearing loss

Deafness Advocacy Association Nova Scotia

425-0240 (v), 425-0119 (tty), 429-9312 (fax)

Advocacy, support, referral, community education, assistance with Human Rights issues, and information on: technical devices, funding sources, support groups, speech/lip reading and sign language courses

Nova Scotia Hearing and Speech Clinic

423-7357 (v), 423-7354 (tty)

Provincially funded with regional offices and regular community clinics across Nova Scotia, hearing tests, hearing aids, rehabilitation, medical and technical information, funding sources

Other hearing aid specialists can be located in the yellow pages under Hearing Aids. They too have access to a wide range of information and funding sources.

Nova Scotia Human Rights Commission

424-4111 (v), 424-4129 (tty)

Advocacy and information on discrimination or other violations of human rights due to disability

Society of Deaf and Hard of Hearing Nova Scotians

422-7130 (v/tty) - main

429-5752 (v/tty) - Provincial Interpreter Services

Interpreter services, notetaking services, educational programs and services, community counselor, resource library, family literacy program and information on: technical devices, funding sources, support groups, speech/lip reading and sign language courses

Service and Support Organizations - Employment

Centre for Entrepreneurship Education and Development

424-5263

Drop in centre with very low cost seminars and weekend workshops for new entrepreneurs, very accommodating for persons with disabilities

Network of Entrepreneurs with Disabilities

426-0561 (v/tty), 1-800-797-4188

Education, excellent information, services and supports for disabled entrepreneurs or those who would like to be self-employed

Job Brokerage Centre

420-0800 (v), 420-0862 (tty)

Employment agency for persons with disabilities, job readiness assistance, job placement, employment support services, access to funding information for job accommodation

Teamwork Cooperative Ltd

422-8900 (v), 422-8943 (tty)

Assist job seekers with disabilities to prepare for, find and keep employment, career and return to work action planning, employment counseling and goal setting, case management and support; funding for some employment related technical equipment may be available

Department of Community Services:

Employment Support Services

call 424-1995 for referral to your local employment support service office

Funded services, supports and technical equipment required to help people with disabilities get back to work or remain in the workforce

Service and Support Organizations - Educational

Atlantic Provinces Special Education Authority

424-8500

Funded educational support services for Deaf and hard of hearing students from Grades Primary to 12, educational resource library, parent support group, parent newsletter, itinerant teachers

Atlantic Centre for Disabled Students

420-5452 (v), 425-1257 (tty)

Information and services to students with disabilities for all Nova Scotia Colleges and Universities, loan of educationally related technical equipment, coordination of interpreter and notetaking services

Dalhousie Advisor to Students with Disabilities

494-2836 (v), 494-7091 (tty)

Information on supports, services and funding for students with disabilities, advocacy and student support services for Dalhousie University, some educationally related technical equipment on site

Department of Community Services:

Student Intake Services

424-1967

Intake service for all post secondary disabled student programs, career counseling, education counseling. Medical assessment required to qualify.

Department of Education and Culture:

Employability Assistance for Persons with Disabilities

424-6737 (v), 424-7893 (tty)

Access to a wide range of funded services and supports for students with disabilities of any age who are registered and accepted to attend or return to a post secondary education program or course at a College or University level that will lead to employment. Students must be referred to this program by the Department of Community and Social Services (424-1967). Programs include but are not limited to: Literacy Services, Rehabilitation Training, Skills Training, Student Aid/Student Services, Interpreter and Notetaking Services, and funding for some educationally required technical equipment.

Access to Special Opportunity Grants Federal funding assistance for students with permanent disabilities who qualify for Canada Student Loans. Approved students can receive up to $5,000 for goods and services needed by the student to compensate for a disability.

Religious Organizations

Atlantic (Inter-Denominational) Ministry of the Deaf

454-5366

Weekly inter-denominational religious services conducted in sign language, weekly signed bible study groups, home visiting and shut-in visiting volunteers, quarterly newsletter for Deaf, hard of hearing and Deafblind Nova Scotians published together with the Deafness Advocacy Association Nova Scotia and the Society of Deaf and Hard of Hearing Nova Scotians

Information on signed services for specific faiths as well as information on churches equipped with audio loops and other technical devices can be accessed through the Atlantic Ministry of the Deaf.

Social Organizations

The following social support organizations or individuals can be accessed by contacting the Deafness Advocacy Association Nova Scotia, the Society of Deaf and Hard of Hearing Nova Scotians and/or the Nova Scotia Hearing and Speech Clinic:

Acoustic Neuroma and Late Deafened Adult Support Group

Tinnitus Support Group

Meuniere=s Support Group of Nova Scotia

Halifax Association of the Deaf

Deaf Sports Nova Scotia

Deaf Association of Youth

Eastern Canadian Association of the Deaf

provincial representative of the Canadian Hard of Hearing Association

Hard of Hearing Support Groups

Web Sites

These are just a few of the sites that you may find helpful. If you are on-line I strongly suggest using your search engine to research hearing loss, deafness - or whatever interests you! It=s a great source of information and it changes frequently. If you are not on-line at home, your local library probably has one or two computers dedicated to Internet use.

dww.deafworldweb.org

International web publication of the Deaf with access to an amazing number of very useful sites, Deaf and hard of hearing chat rooms for persons of all ages, resource library, on-line sign language dictionary and much, much more

www3.ns.sympatico.ca/sdhhns/

Society of Deaf and Hard of Hearing Nova Scotians

www.chs.ca

Canadian Hearing Society

www.apsea.ca

Atlantic Provinces Special Education Authority

www.daans.ca

Deafness Advocacy Association Nova Scotia

Last thoughts

1. If you pay for any technical device, technical aids or services related to your hearing loss from your own pocket, keep your receipts. They are all tax deductible under medical expenses. This even includes the cost of lip/speech reading or sign language classes for both you and your family members, as well as transportation (mileage or gas) and babysitting costs to attend classes, clinics or medical appointments related to your hearing loss. Contact Revenue Canada for a complete list of all deductible expenses.

2. If you choose to use a TTY text telephone, register with the Special Needs department of MT&T for special long distance discount rates.

3. If you are in hospital and require a TTY text telephone or a phone amplifier, you may request one free of charge from the MT&T representative assigned to that hospital. Ask your nurse for details.

4. 911 Emergency Services are accessible by TTY directly. Call takers have TTY capability. If you are at a payphone and need to call 911, just leave the phone off the hook. Police respond to all 'no voice' calls.

The Deafness Advocacy Association Nova Scotia would like to express a sincere thank you to the area audiologists and hard of hearing individuals who provided invaluable information and feedback during the writing and re-writing of this brochure. Many of you have requested this information over the years, so we are pleased to be able to provide it to you in a brochure format. To our writers, Caitlin Commanda and Linda Lelièvre, thank you for your expertise and patience with the numerous additions and amendments. To our committee members Dave Spencer, Nancy O'Halloran, Frank O'Sullivan and Cindy Boutlier, thank you for your time and for sharing your personal experiences. And, to the Community Health Promotions Program, thank you for continuing to fund life and health enhancing programs in our community.

Robert Tupper

Chair

1999