Category Archives: Uncategorized

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Social isolation, loneliness, and hearing loss during COVID-19

With the South African government implementing quarantines and physical distancing due to the COVID-19 pandemic, people with hearing loss may be at risk of heightened social isolation and loneliness.

In a recent systematic review, the authors concluded that “hearing loss was associated with a higher risk of loneliness and social isolation,” adding to the body of research connecting untreated hearing loss with increased risk of depression, dementia, and falls.

“It was not surprising to learn that numerous studies show a significant connection between hearing loss, loneliness, and social isolation,” said study co-author, Jonathan J. Suen, AuD, of the Johns Hopkins School of Nursing and the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health. “Even anecdotal assumptions about a link make sense because we know that hearing loss affects our communication patterns, which therefore can impact our relationships with others.”

Physical distancing and loneliness

One concern during quarantine is that the increased reliance on remote communication technologies may be difficult for people with hearing loss.

Individuals with hearing loss lose the ability to ‘put a voice with a face,’ and the sound distortion that occurs with e-conferencing technology makes it difficult to distinguish who is talking and what they are saying.

As a result, individuals with hearing loss risk (1) being disruptive if they ask for clarification, (2) being misinformed if they misinterpret speech content, and/or (3) being disengaged if they cope by avoiding active participation in these communication forums.

Closure of audiology offices without alternatives for device repairs and adjustments puts patients at risk of abruptly abandoning the use of their hearing aids or significantly decreasing their wearing time. This could create communication, safety, and health issues more akin to acute hearing loss.

As concerns of seclusion build as physical distancing mandates are fortified, social isolation does not necessarily lead to loneliness. It’s well established that loneliness and social isolation are distinct. A recently published National Academies consensus report reinforced this concept. While the report identified sensory impairments such as hearing loss as a risk factor for loneliness and social isolation among older adults, it also asserts that someone who is socially isolated may not necessarily feel lonely.

Indeed, the current public health mandates for quarantining and physical distancing impact everyone on varying levels, but , while we also know that older adults with an acquired hearing loss already have increased risks for experiencing loneliness and social isolation, we cannot say for sure how these measures may acutely affect these risks right now.

Still, patients with hearing loss do face unique concerns. This is especially true when it comes to the facial coverings, or masks, which have been recommended to help avoid transmitting the novel coronavirus to others, as they may also affect speech reading.

Speakers and listeners also need to practice effective communication strategies, such as repeating, rephrasing, and summarizing what was heard.

When someone with hearing loss does use facial coverings, it is important to be mindful about their ear-level devices. There’s always the risk of inadvertently knocking them loose and off of one’s ear(s) when removing facial coverings.

Recommendations for Audiologists

As the pandemic continues to demand physical distancing measures, how can audiology professionals help address increased loneliness among people with hearing loss?

While remote strategies will never completely replace face-to-face professional services, hearing providers can continue to safely meet many patients’ needs. The quality of relationships is often key and not necessarily just the quantity.

Hearing providers can proactively reach out to patients by using the most basic remote technology: the telephone. Consider calling patients to simply ask, ‘How are you? Is there anything I can do to help you?’ Let them know that you are available. In addition to addressing their hearing aid device issues, your phone call may help the social isolation and loneliness that people with hearing loss are disproportionately experiencing.

Audiologists can support clients and their families through thinking creatively about how they can generate and appropriately reinforce a quality professional relationship in their own circumstances and practice settings. Some approaches for showing that you’re a professional whom your clients can count on may involve a video/phone call or even just a note sent through the post sharing that you recognize the gravity of the current public health situation and that you are available to support their communication needs in a way that is aligned with safety precautions.”

Providing extra care for hearing aids and amplification devices is vital, particularly for patients who rely on these technologies to communicate and stay connected with their support system.

The ongoing pandemic has raised our consciousness around proper handwashing and overall infection control. In line with this increased concern for proper hygiene, audiologists can encourage patients to develop helpful habits such as wiping down hearing aids or other amplification devices daily. They can encourage patients to check their user manuals for specific instructions on appropriate cleaning methods. Patients must be reminded to avoid alcohol-based disinfectants since they can dry out the silicone piece that’s inserted into the ear canal and make them brittle over time.

Audiologists can also share tips with caretakers of patients with hearing loss, such as:

  • Keep yourself well through health and sanitation precautions.
  • Teach and encourage patients to better use video chatting technology.
  • For homebound elders, keep them involved in household projects and activities.
  • Plan with the elder on how to manage interruptions in their routines and the possibility of getting sick.

And lastly, simply just catching up with patients can go a long way.

Going back to basics, simply contacting clients and their families to share that they’re on your mind because you care about their well-being can be a powerful display of social solidarity and have a profoundly positive impact. In a collective sense, we could all benefit from a little bit of that solidarity right now. We’re hear for you!


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Face masks are a challenge for people with hearing difficulties

The use of face masks by the public is a controversial topic and not supported by the World Health Organization. Evidence suggests that while face coverings and surgical masks can prevent large particles spreading from an infected person wearing a mask to someone else, they don’t trap tiny particles such as coronavirus.

A mask may also increase a person’s risk of contracting COVID-19 by encouraging them to touch their face as they fit and adjust it. Exhaled air can irritate the eyes, which might also tempt the wearer to wipe them.

On the other hand, wearing a mask may stop people with coronavirus spreading it to others (although the evidence for this is currently weak). As governments search for a surefooted transition to whatever the new norm will be, there is a danger that a policy of encouraging the public to wear face masks may precede the evidence.

Unintended consequences

It’s important to consider some of the unintended consequences. Wearing a face mask may impair the ability for some people to communicate with ease because it prevents lip reading and it can reduce the level of speech transmitted from the mouth.

At the very least, removing visual cues can make communication more taxing because of the mental exertion required to listen, especially when there is background noise. As a result, even if a person can follow what is said, they have fewer mental resources left to think about and recall what they heard.

Research has shown there are beneficial effects of wearing surgical masks made from a transparent material that allows the mouth to be seen, but these aren’t widely available. And there have been calls for the public to use transparent face shields, rather than masks, which may offer a solution. But the public has yet to adopt this solution.

The increased effort needed to listen and communicate is exacerbated in people who have a hearing loss. According to the WHO, there are 1.33 billion people globally with hearing loss.

Hearing loss leads to communication difficulties between family members, colleagues and friends. It is associated with negative factors such as poor social interactions, isolation, depression and anxiety, increased risk of dementia and reduced quality of life. In fact, there are probably many people with hearing loss who were able to manage but would struggle with the widespread use of masks.

Mask misery

An unintended consequence of wearing a face mask might be that social distancing is replaced with social isolation and poor mental wellbeing in older adults with hearing loss. A huge section of society could be subjected to mask misery.

It is also not clear whether wearing a face mask provides a false reassurance about risk reduction (encouraging people to relax behaviours that are known to interrupt transmission, such as keeping at least two metres apart), or if it acts as a reminder to steer clear of people.

Coronavirus tends to take a more severe form in older people, many of whom are likely to suffer from hearing loss. This means that those admitted to a hospital are especially vulnerable.

The N95 and FFP3 respirator masks for frontline health and care workers can filter 95% of tiny particles, but they are much more likely to distort and reduce the level of speech. This makes communication particularly difficult at a time of heightened anxiety and when the content of conversations is novel and unpredictable. Imagine the apprehension of being greeted by someone in full PPE wearing a fitted mask and muffled speech competing with the hiss of oxygen from a breathing mask or nasal cannula.

Practical advice for the hard of hearing

So what can you do to improve communication if you have a hearing loss and are confronted by someone wearing a face mask?

  1. Ask them to reduce the background noise as much as possible or move to a quieter location.
  2. Ask them to talk slowly and not shout.
  3. If you have a hearing aid, make sure to wear it.
  4. Some hospitals provide portable hearing amplifiers to help with communication if you have lost your hearing aid or it has stopped working.
  5. If you don’t have a hearing aid but need one, you can always download a hearing aid app to your mobile phone that can provide amplification to improve speech understanding. Or you can find an app that translates speech into text in real-time.

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9 Ways to Boost Your Body’s Natural Defenses

While the whole world is in lock down facing this COVID-19 pandemic, there is very little mention in the media about how you can boost your immune system to help your body fight this virus, should you come into contact with it. Masks and gloves and social distancing may not be enough. There are several dietary and lifestyle changes you can make that may help to strengthen your body’s natural defenses and help you fight harmful pathogens, or disease-causing organisms. Here are 9 tips to strengthen your immunity naturally.


1. Get enough sleep

Sleep and immunity are closely tied.

In fact, inadequate or poor quality sleep is linked to a higher susceptibility to sickness.

In a study in 164 healthy adults, those who slept fewer than 6 hours each night were more likely to catch a cold than those who slept 6 hours or more each night.

Getting adequate rest may strengthen your natural immunity. Also, you may sleep more when sick to allow your immune system to better fight the illness.

Adults should aim to get 7 or more hours of sleep each night, while teens need 8–10 hours and younger children and infants up to 14 hours.

If you’re having trouble sleeping, try limiting screen time for an hour before bed, as the blue light emitted from your phone, TV, and computer may disrupt your circadian rhythm, or your body’s natural wake-sleep cycle.

Other sleep hygiene tips include sleeping in a completely dark room or using a sleep mask, going to bed at the same time every night, and exercising regularly.

SUMMARY: Inadequate sleep may increase your risk of getting sick. Most adults should get at least 7 hours of sleep per night.


2. Eat more whole plant foods

Whole plant foods like fruits, vegetables, nuts, seeds, and legumes are rich in nutrients and antioxidants that may give you an upper hand against harmful pathogens.

The antioxidants in these foods help decrease inflammation by combatting unstable compounds called free radicals, which can cause inflammation when they build up in your body in high levels.

Chronic inflammation is linked to numerous health conditions, including heart disease, Alzheimer’s, and certain cancers.

Meanwhile, the fiber in plant foods feeds your gut microbiome, or the community of healthy bacteria in your gut. A robust gut microbiome can improve your immunity and help keep harmful pathogens from entering your body via your digestive tract.

Furthermore, fruits and vegetables are rich in nutrients like vitamin C, which may reduce the duration of the common cold.

SUMMARY: Several whole plant foods contain antioxidants, fiber, and vitamin C, all of which may lower your susceptibility to illness.


3. Eat more healthy fats

Healthy fats, like those found in olive oil and salmon, may boost your body’s immune response to pathogens by decreasing inflammation.

Although low-level inflammation is a normal response to stress or injury, chronic inflammation can suppress your immune system.

Olive oil, which is highly anti-inflammatory, is linked to a decreased risk of chronic diseases like heart disease and type 2 diabetes. Plus, its anti-inflammatory properties may help your body fight off harmful disease-causing bacteria and viruses.

Omega-3 fatty acids, such as those in salmon and chia seeds, fight inflammation as well.

SUMMARY: Healthy fats like olive oil and omega-3s are highly anti-inflammatory. Since chronic inflammation can suppress your immune system, these fats may naturally combat illnesses.


4. Eat more fermented foods or take a probiotic supplement

Fermented foods are rich in beneficial bacteria called probiotics, which populate your digestive tract.

These foods include yogurt, sauerkraut, kimchi, kefir, and natto.

Research suggests that a flourishing network of gut bacteria can help your immune cells differentiate between normal, healthy cells and harmful invader organisms.

In a 3-month study in 126 children, those who drank just 2.4 ounces (70ml) of fermented milk daily had about 20% fewer childhood infectious diseases, compared with a control group.

If you don’t regularly eat fermented foods, probiotic supplements are another option.

In a 28-day study in 152 people infected with rhinovirus, those who supplemented with probiotic Bifidobacterium animalis had a stronger immune response and lower levels of the virus in their nasal mucus than a control group.

SUMMARY: Gut health and immunity are deeply interconnected. Fermented foods and probiotics may bolster your immune system by helping it identify and target harmful pathogens.


5. Limit added sugars

Emerging research suggests that added sugars and refined carbs may contribute disproportionately to overweight and obesity.

Obesity may likewise increase your risk of getting sick.

According to an observational study in around 1,000 people, people with obesity who were administered the flu vaccine were twice as likely to still get the flu than individuals without obesity who received the vaccine.

Curbing your sugar intake can decrease inflammation and aid weight loss, thus reducing your risk of chronic health conditions like type 2 diabetes and heart disease.

Given that obesity, type 2 diabetes, and heart disease can all weaken your immune system, limiting added sugars is an important part of an immune-boosting diet.

You should strive to limit your sugar intake to less than 5% of your daily calories. This equals about 2 tablespoons (25 grams) of sugar for someone on a 2,000-calorie diet.

SUMMARY: Added sugars contribute significantly to obesity, type 2 diabetes, and heart disease, all of which can suppress your immune system. Lowering your sugar intake may decrease inflammation and your risk of these conditions.


6. Engage in moderate exercise

Although prolonged intense exercise can suppress your immune system, moderate exercise can give it a boost.

Studies indicate that even a single session of moderate exercise can boost the effectiveness of vaccines in people with compromised immune systems.

What’s more, regular, moderate exercise may reduce inflammation and help your immune cells regenerate regularly.

Examples of moderate exercise include brisk walking, steady bicycling, jogging, swimming, and light hiking. Most people should aim for at least 150 minutes of moderate exercise per week.

SUMMARY: Moderate exercise can reduce inflammation and promote the healthy turnover of immune cells. Jogging, biking, walking, swimming, and hiking are great options.


7. Stay hydrated

Hydration doesn’t necessarily protect you from germs and viruses, but preventing dehydration is important to your overall health.

Dehydration can cause headaches and hinder your physical performance, focus, mood, digestion, and heart and kidney function. These complications can increase your susceptibility to illness.

To prevent dehydration, you should drink enough fluid daily to make your urine pale yellow. Water is recommended because it’s free of calories, additives, and sugar.

While tea and juice are also hydrating, it’s best to limit your intake of fruit juice and sweetened tea because of their high sugar contents.

As a general guideline, you should drink when you’re thirsty and stop when you’re no longer thirsty. You may need more fluids if you exercise intensely, work outside, or live in a hot climate.

It’s important to note that older adults begin to lose the urge to drink, as their bodies do not signal thirst adequately. Older adults need to drink regularly even if they do not feel thirsty.

SUMMARY: Given that dehydration can make you more susceptible to illness, be sure you’re drinking plenty of water each day.


8. Manage your stress levels

Relieving stress and anxiety is key to immune health.

Long-term stress promotes inflammation, as well as imbalances in immune cell function.

In particular, prolonged psychological stress can suppress the immune response in children.

Activities that may help you manage your stress include meditation, exercise, journaling, yoga, and other mindfulness practices. You may also benefit from seeing a licensed counselor or therapist, whether virtually or in person.

SUMMARY: Lowering your stress levels through meditation, yoga, exercise, and other practices can help keep your immune system functioning properly.


9. Supplement wisely

The following supplements may help to strengthen your body’s general immune response:

  • Vitamin C. According to a review in over 11,000 people, taking 1,000–2,000 mg of vitamin C per day reduced the duration of colds by 8% in adults and 14% in children. Yet, supplementing did not prevent the cold to begin with.
  • Vitamin D. Vitamin D deficiency may increase your chances of getting sick, so supplementing may counteract this effect. Nonetheless, taking vitamin D when you already have adequate levels doesn’t seem to provide extra benefits.
  • Zinc. In a review in 575 people with the common cold, supplementing with more than 75 mg of zinc per day reduced the duration of the cold by 33%.
  • Elderberry. One small review found that elderberry could reduce the symptoms of viral upper respiratory infections, but more research is needed.
  • Echinacea. A study in over 700 people found that those who took echinacea recovered from colds slightly more quickly than those who received a placebo or no treatment, but the difference was insignificant.
  • Garlic. A high quality, 12-week study in 146 people found that supplementing with garlic reduced the incidence of the common cold by about 30%. However, more research is needed.

The bottom line

You can make several lifestyle and dietary changes today to strengthen your immune system. These include reducing your sugar intake, staying hydrated, working out regularly, getting adequate sleep, and managing your stress levels. Although none of these suggestions can prevent COVID-19, they may reinforce your body’s defenses against harmful pathogens.


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How to talk to someone about their hearing loss

Hearing loss makes it harder to connect with those we love, harder to function in the workplace and tougher to take part in everyday life. It can be stressful and tiring for everyone. Every day we see clients who have suffered in silence through years of hearing loss when the solution is free – a hearing check with an audiologist.

Refusing to acknowledge a hearing loss is a common occurrence. In fact, we probably all know someone who should be doing something about their hearing. They nod and smile when you ask them a question, they mishear what you’re asking, they turn the TV up and may even tell you you’re mumbling!

Living in denial

We all want our senses to work perfectly, and it can be hard to accept that they aren’t. Because hearing problems can happen slowly, people with hearing loss are often able to cope, sometimes for years, without taking action. They lose the sounds they love gradually, so the changes are almost unnoticeable.

Often, it takes someone who cares about them to help them understand just how much they’re missing and to help them take the next step. If that’s you, we’re here to help.


Here’s how you can start talking to someone about their hearing loss:

  • Reassure them hearing loss is common and the solution is as simple as getting reading glasses.
  • If you’ve noticed specific signs of their hearing loss you can ask them how they find that situation: e.g. ‘Do you find it frustrating when…?’
  • Hearing loss often creates an unnecessary strain on your relationship. You may want to share how you feel and what you’re doing to help them cope with the sounds they’re missing. It’s possible they don’t know the impact it’s having
  • You may notice that they are missing out at work or that other people are starting to avoid chatting with them. Sharing examples of these times may help them understand that it’s time to take the next step
  • The next step is easy, and there’s no obligation. Ask them to book a free hearing check with an Advanced Hearing Audiologist.

The common signs of hearing loss

Are they turning the volume up on the TV or radio?

Are soft, high pitched voices are harder to hear?

Do they have trouble following conversations?

Are they struggling to hear in noisy environments?

Do others are comment on their hearing?


Is it time someone you know sought help?

Talk to Advanced Hearing today. Our hearing checks are free and we welcome loved ones to come to the appointment to support those struggling with hearing loss and ask any questions you may have.


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5 Things to consider before you get hearing aids

We’ve come a long way since the giant banana boat hearing aids that we associate with the 80’s and 90’s. Technology has changed, and so have our expectations. If you’re thinking about getting hearing aids or know someone who is thinking about getting them, there are a few things to consider.

1. They’re unique from person to person

Hearing aids are not a simple one-size-fits-all amplifier. Just like glasses, hearing aids are unique to the wearer and you must be tested by an audiologist to discover your own personal audiogram.

Some people experience low frequency hearing loss, while others have high frequency hearing loss, and both types affect people to varying degrees. This means that if two people switched devices, they probably wouldn’t do much good.

2. The brain needs to adjust to new input

When you get a new pair of hearing aids, your mind must go through an adjustment period. Some sounds may seem completely changed from the normal ‘unaided’ sound you were used to.  

Also, experiencing a large amount of sound that you’re not used to is overwhelming, and this can overstimulate the brain as it tries to organise the new sensory input.

The brain needs consistent stimuli to organise the signals to create words, sentences, and meaning. The brain won’t get the full benefit of the hearing aids if it is only getting sporadic exposure to sound.

Audiologists tell their patients that it is very important to wear their hearing aids consistently because in order to get the most out of hearing aids, practice makes perfect.

Those who use hearing aids every single day often report that their hearing aids become a natural extension of their hearing, because over time their brain has learned to interpret the new signals so that they sound natural.

3. Deciding to wear hearing aids is a personal choice

Some people choose to wear hearing aids, while others decide that they would rather not wear them because the negatives do not outweigh the positives, or their hearing loss is severe enough that it doesn’t allow them to benefit.  It’s always important to respect that this is a personal choice.

4. Modern hearing aids come with all kinds of assistive features

Hearing aids have made giant leaps in technological advancement – back in the 90’s many people would complain that their hearing aids sounded robotic and artificial, but these days audiologists have advanced their methods to allow a much more authentic experience of sound.

Modern hearing aids are often extremely small, and some models have the entire hearing aid hidden in the canal, so nobody would ever know you are wearing them without closer inspection.

Top-of-the-line hearing aids allow you to connect through Bluetooth to your phone or television, to allow the sound to travel directly into your hearing aids instead of losing precious detail due to it having to travel a further distance.

More environmentally friendly features have also been added in recent years. Rechargeable hearing aids are now available on the market, which removes the need to purchase expensive single-use batteries. 

5. It’s okay if getting earing aids feels like a big step

While it can be a scary decision to begin to wear hearing aids, they can make a huge difference.  

The older you get without wearing your hearing aids, the worse that your mental health will get, your anxiety creeps up, you realise you can’t hear things in social situations and you’re missing things. You need to wear your hearing aids… but you don’t want to accept that responsibility. Sound familiar?

It’s not an easy step, and you will definitely go through a lot of emotions, but it will absolutely worth it and you will never look back.

If you think you may have a hearing loss and could benefit from hearing aids, we recommend that you contact a local audiologist.

Advanced Hearing offers initial hearing screenings for free. Booking a free hearing check is a great first step to learn more about your hearing, and an opportunity to discuss which hearing aids would be best for you.  


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