Personal Communication Systems the Next Evolutional Step

By Jay Thurman; B.Sc., BC-HIS

My wife and I were out shopping the other day and stopped to get a bite to eat at a nice restaurant.  There was music playing in the background and the restaurant was very busy as it was the lunch hour.  While we were sitting at our table talking I noticed an older couple being seated at the table across from us. They must have been in their mid-seventies and I also noticed that he was wearing binaural digital ITE hearing aids with directional microphones. Halfway through our meal my wife made the comment that it seemed so sad that the older couple were just starring off into space while they were eating and never saying a word to each other. I started to observe them through the balance of our meal and came to the same conclusion that my wife had. They never spoke to each other. They would look at each other at times but then just start looking at the ceiling. This brought back memories of a patient I had worked with and his spouse who, when I was explaining the advantages of using a Personal Communication System (PCS) and how it could be used in a restaurant she had broken down in tears. When I asked her what the reason for crying was she said “I’m so tired of going out to eat and eating alone.” I realized that was what we had just witnessed, two people going out to eat together, but eating alone, and it left me feeling sad. I was also sad, and just a little angry, because someone who had taken on the responsibility of helping that person improve both his listening ability and his quality of life had only done half their job. One of the things I would like to help accomplish is to never have to see couples going out to eat together and ending up alone when we have the technology to allow them to enjoy each other’s company while dining out.

Defining the Problem

Today’s modern hearing aids are both sophisticated and extremely adjustable. The hearing aid can be fit to compensate for a person’s hearing loss plus meet their personal needs for sound quality to what they hear, which is a very personal perception. Good hearing aids coupled with good fitting should allow our patients, with moderate to moderately severe hearing losses, to listen to speech in a quiet environment at between twelve to fifteen feet from the source. This distance will shrink as the patient’s loss increases and/or their word recognition decreases. In a moderately noisy environment, with the patient wearing good hearing aids equipped with digital directional microphones that are fit correctly, we can reasonably expect our patient to hear at a range of five to six feet. This is because we make the assumption that the sound source our patient wants to hear is within six feet and everything beyond six feet is sound clutter in the environment. Also physics and the inverse square law start to come into play generally beginning at about six feet in a mildly sound cluttered environment. The effect of this law is to reduce the sound source we want to listen to closer to the ambient environmental noise threshold causing a loss of speech recognition. It also must be kept in mind that ambient noise environments that our patients believe to be quiet are in reality mild to moderately noisy environments. This means that most home environments are not quiet even if the hearing aids are acting like it is. These environmental noise levels reduce both the range at which our patient can listen to conversation and the clarity of speech.

How many times have we heard our patients or their spouses complain about not hearing or being heard in the home and the distances involved are between six to twenty-four feet. How many times have we heard our patients could not hear their friends or family members when they came over to the house and the distance between our patient’s chair and the couch was ten to fifteen feet and the distance at the dinner table was five to ten feet. Plus, we have the complaint “my wife expect me to hear her when I’m watching the news (it’s always the news, never sports) and she is talking to me from the bedroom or the kitchen (generally working at the sink with water running). And they always ask us “why don’t these new, fancy, and extremely expensive digital hearing aids improve my ability to hear my spouse better then my old aids?” The answer we need to give them involves a physics lesson in sound propagation followed with the problem’s solution. Or maybe the correct answer should be a physics lesson with a complete solution before we sell them that NEW, FANCY, and EXTREMELY EXPENSIVE DIGITAL HEARING AID. Maybe we need to incorporate both that expensive new hearing aid plus an integrated package of on-board and/or out-board devices designed to overcome or bypass the inverse square law and/or the acoustical physics of sound propagation that’s the problem.

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