The meeting was not audio recorded. This edited version of the transcript is provided on the basis that it is not a 100 per cent verbatim record and may contain errors.
Geraldine O’Loughlin accepts no liability for any event or action resulting from this transcript.
The attendees of this meeting contributed freely to the discussion in the knowledge that this material is not intended for publication other than to assist the people who wish to keep a record of discussions for meeting purposes. Please take this into consideration when reading their contributions.
BARRY MacKINNON: Good morning, ladies and gentlemen, and welcome to our Hearing Awareness Week little event. To start with today I would like to make an acknowledgement of course; that is, we wish to acknowledge the traditional custodians of the land on which we are meeting and we wish to respect their traditional and ongoing culture and the contribution they have made to the life of this city, which is significant, and the region. Can I also make a special welcome, to our guest, the Minister for Aged Care, Ken Wyatt. Thanks again for coming, Ken, out of your busy day; to Aileen Stewart from Santos. Stand up, Aileen, so people can see you. Santos are the people who support us for the youth scholarship that we run every year. And Australian Hearing has the hearing bus. We had a little bit of a hiccough with the shopping centre. The bus is not now out to your left; it is up the stairs outside the library. If anyone wants a hearing check, the hearing bus is outside upstairs. Finally, if I can say thank you to Lotterywest. Lotterywest has been very generous all we have done over the years in terms of Hearing Awareness Week. Can I say as a political comment to some extent that we are very, very lucky in Western Australia to have two political parties that oppose poker machines, who don’t want pokeys in this state. We don’t have them; we have Lotterywest. It makes a huge contribution to this society and without them we would be the poorer‑‑and we’d be the poorer with the pokies in my opinion. That is my political sermon for the day out of the day, out of the way.
The purpose of this event is to focus on hearing loss, particularly for elderly Australian, or seniors. Most Australians, me included, will lose our hearing to a degree over our life and some of them, of course, more significantly than others. And when people lose their hearing, a lot of the time, they become very isolated. We want to try to ensure that modern technology and the services to that a whole raft of people is provided can help people overcome that isolation.
We are going to start with Ken having the opening and talking about the hearing roadmap that the government of Australia is developing to try to chart out the future of hearing loss in this country. We will then have presentations from a range of people the range of services available. We will have a presentation of our awards and then a Q&A discussion at the end of the day, hosted by Geof Parry. All those people will be introduced as we go through the morning.
To introduce the minister, I would like to welcome Mark Fitzpatrick. Many of you would have met Mark. He is the CEO now of the Telethon Speech and Hearing Centre‑ has been since 2017. Prior to that, he was the CEO of Saint Vincent De Paul, vice president of WACCOS and a board member of First Voice. He has two children and tragically for me‑‑I can’t understand‑‑he’s a Carlton supporter! I’m sorry about that, Mark. They have had golden years but not in recent years. Please welcome Mark Fitzpatrick.
MARK FITZPATRICK: Thanks, Barry and thanks for revealing my not so secret passion for the Blues. I often get asked why I barrack for the Blues. The truth of the story is that I am one of before four boys and when we were growing up we weren’t allowed to barrack for the same team before the AFL came in. You stick with your team, and at that stage in the early 80s, they were winning and Mark Fitzpatrick was their captain. That is the link.
I would also like to acknowledge the Noongar people in terms of the land we stand on today and pay my respect to elders past and present. It gives me pleasure to welcome Hon Ken Wyatt, AM, the member for Hasluck, the Minister for Indigenous health and the Minister for seniors and aged care. I asked Barry whether there was a bio and we got it yesterday afternoon, but I did my homework on the weekend. He was born in 1952 at Roelands Mission farm, near Bunbury, to Don and Mona. After school, he went to what has now become Edith Cowan University, obtaining a Bachelor of Education, a Dip Ed, teacher’s certificate, plus many more. From there Ken has had a successful career in education, Aboriginal education and Aboriginal health, including as district director Swan education district and director of Aboriginal health in New South Wales, and after, holding that, the director of Aboriginal health in Western Australia. Not only has Ken had an extensive career in health and education, he has also made an enormous contribution in the wider community in training and mentoring young people. This was recognised in 1996, when Ken was awarded the Order of Australia in the Queen’s Birthday honours list, and later in 2000, Ken was awarded the Centenary of Federation Medal for efforts in improving the quality for life for Aboriginal and Torres Strait Islander people and mainstream Australian society in education and health. In 2008, Ken was awarded the Indigenous Education Warrior Award at the World Indigenous Peoples Conference. Ken was then elected in 2010 as the federal member for Hasluck, making history as the first Indigenous member in the House of Representatives. In December 2013, Ken then became the first member for Hasluck re‑elected for a second term. And in 2015, Ken made history, becoming the first Indigenous member for the federal executive after being sworn in as the Minister for Health.
Ken brings his knowledge in health and education in his role as Minister for Seniors and Aged Care and the Minister for Indigenous Health, as well as a lifetime of experiences in raising a family and being part of the local Perth community. Most recently and importantly for us, Minister Wyatt has facilitated the important work on the roadmap for hearing health. Please join me in welcoming Hon Ken Wyatt.
KEN WYATT: Barry, I’m joining you with old joints! In Noongar language, I say “kaya wanju”. Hello and welcome. I acknowledge the traditional owners of the land on which we meet today, the Wadjuk people of the Noongar nation, their elders past, present and future. I want to acknowledge Barry McKinnon, the President of the Deafness Council WA and other council members. Barry and I have known each other for a long time and I know of his passion working in this area, and we have had some good conversations over the years. We know that one in six Australians experience some form of hearing loss, often resulting in significant long‑term impact to their health and wellbeing, with more than 90 per cent of those age over 50. Due to our ageing population, by 2050 the number of people affected is expected to rise to one in four. We know the social, mental and economic impact of deafness is profound. Staying connected through hearing is also vital to our emotional wellbeing with international research now indicating that deafness and the failure to use hearing aids can increase the risk of dementia by more than 20 per cent and in men markedly raise the risk of depression. The cost of hearing loss to our community is significant, with a report estimating that the annual direct economic impact of poor hearing in Australia is around $15.9 billion. Hearing loss becomes more common as we get older, but over 1.3 million Australians are living with a hearing condition that could have been prevented. While avoiding hearing damage is best, modern hearing assistance can do wonders, so it’s important to have regular hearing checks and to seek help early. Our government’s hearing services program provides free or subsidised hearing services and devices to more than 7 500 eligible Australians.
Hearing Awareness Week is also an important reminder of the particular challenges of hearing loss for some Aboriginal and Torres Strait Islander children. Diseases such as otitis media can have a long‑term impact on education, employment and wellbeing, so working with Indigenous communities and families to improve ear health is one of my highest priorities. I have had two mining companies tell me that they would have liked to have employed young Indigenous men and women, but couldn’t employ them because their hearing had been impaired and they would have been at risk on a mining site of not hearing reversing vehicles or important sounds for which they can take the measure of placing themselves in a safe position. That is not particular, either, just to the Indigenous people. The commonwealth’s Australian hearing specialist program for Indigenous Australians provides diagnose, professional ear health training, equipment and surgeries for people with more than 200 Aboriginal and Torres Strait Islander communities each year. In addition, the Morrison government is supporting dedicated Indigenous ear health activities, allocating more than $76.4 million over 10 years. Various inquiries and reviews have highlight the fragmented nature of action to improving hearing health, even when there is significant effort such as that targeted to Indigenous Australians. That is why I established the Hearing Health Sector Committee in 2018, and tasked it to develop a roadmap for hearing, in consultation with the sector but also with consumers. The committee is made up of 16 representatives of consumer and community groups, suppliers and providers, manufacturers, professionals and academics, and it is independently chaired by Mr David Chew, AO, PFM. The committee met four times between July 2018 and January 2019 and hosted two stakeholder forums in September 2018 and 2019. The resulting road map provides the basis for the sector, consumers and governments to move forward with collective understanding of the issues and actions that will lead to improvements in hearing health for all Australians. Developed and owned by the hearing sector, the roadmap sets out the short, medium and long‑term actions across six themes, or domains. A similar roadmap approach is being successfully developed for the senior sector.
Reflecting the importance of hearing, this issue was discussed at the COAG health council meeting on 2 August 2018, and I will take the roadmap to the council’s next meeting on 8 March 2019. The purpose of the roadmap is to encourage the commonwealth and state and territories governments to work together to look at the solutions needed both within the immediate term, but then to plan for the short‑term gains that we can make to improve access to hearing, and then, ultimately, what is the long‑term outcome. As we use a roadmap as we travel, say, from Perth to Hyden, we know the points that we need to pull in at on the way to Hyden. Once we’re at that end point, we know we have achieved our objective. The roadmap is designed in the same way, so that the sector committee, and state and territory governments use that roadmap as the direction they need to take in order to achieve the outcomes that we need. The challenging parts was with the Auslan group, who felt that there should be a separate domain. But when I talked to them about the need to have it included in a couple of the key areas because it was critical, they’ve accepted that and now the roadmap will go to the next health council meeting of all the Australian health ministers to adopt. That means that states and territories will need to respond to it, including the commonwealth. The roadmap is a step forward in representing a whole‑of‑sector view. It presents potential actions for the commonwealth and states and territories as well as for other stakeholders.
The roadmap has not been informed by questions of cost or relative benefits, and contains over 100 actions. Nonetheless, the roadmap is a step forward from the 2017 “Still waiting to be heard” parliamentary inquiry report, and its preceding inquiries and reviews, particularly in terms of the increasing collaboration and capacity within the sector. State and territory health ministers may express concern that they were not consulted in the development of the roadmap and are being asked to develop the implementation plan with two potential implications, including initiatives that reach beyond their responsibilities, into disability services, education, employment, criminal justice, communications, infrastructure, and social inclusion. The Department of Health is yet to consider how it will implement actions directly within our minister’s remit. While the hearing sector will welcome publication of the roadmap and continued attention, some will review of the roadmap as further evidence of inactivity by governments. Some may critique the roadmap as rushed. The Independent Audiologist Association has been publicly critical, arguing that it has been unfairly excluded from the committee. What is important, though, is that there have been numerous reports from which there has been no action. I have Australians who approach me, because I have responsibility along with Michael Keenan, for Australian Hearing Services‑‑Michael has one part and I have the other. Every time I meet with people who have hearing challenges, they express to me their frustration that there is not a unified approach across the nation that includes all the key sectors in ensuring that something is done in the future. The most challenging group I met with were young people, who talked to me about their social isolation within their formative school years, high school years and tertiary years, and having the levels of support that were critical and important to them to acquire the knowledge for the disciplines they were studying. That was probably the most significant and profound group that I talked to, because we also talked about social exclusion in sport‑‑that they could play football, they could play netball, but an umpire didn’t understand that they couldn’t hear so they were penalised, and they had to explain that they didn’t hear a whistle. So once they had those conversations with referees and umpires in those games, they were able to influence the thinking of people. There are other areas that they also talked about the social exclusion from.
In the Joint Standing Committee on the National Disability Insurance Scheme’s report, provision of hearing services under the NDIS was also to be considered. The Hearing Care Industry Association report, “The Social and Economic Cost of Hearing Loss in Australia” was included in their deliberations. The PricewaterhouseCoopers’ report, “Review of Services and Technology Supply in the Hearing Services program”, and the Siggins Miller “Examination of Australian Government Indigenous Ear and Hearing Initiatives” report were also considered. Most of the recommendations arising from the reports either require potentially significant funding, areas where government is also providing significant support. There are areas which are the responsibility of state and territory governments, while areas that need further work to settle a position. The reviews and reports do not indicate the relative priority, efficacy or cost‑effectiveness of the recommendations made. The Hearing Health Sector Committee provides the opportunity to commence working with the hearing sector to improve the hearing health of all Australians in a considered and coordinated way. Some stakeholders, particularly the Hearing Care Industry Association have highlighted concerns with any potential changes to the hearing services program. The roadmap has some distinct areas. It has a set of guiding principles. It identifies the priorities that have been agreed to by those who attended the forums and on the planning committee that produced the roadmap. The first was enhancing awareness and inclusion. They are all structured with a background, the desired outcome, key actions‑‑short term, that’s up to two years; medium, three to five; and long term, five to seven years. The second priority was closing the gap for Aboriginal and Torres Strait Islander ear and hearing health. The third, preventing hearing loss. The fourth, identifying hearing loss. The fifth, providing support‑‑and that’s where Auslan features significantly in its own right‑‑and in enhancing the sector’s workforce which focuses on what is needed for the future. The roadmap, whilst it is not the definitive document, it nevertheless points to a direction that we as a nation have to take if we are to address an area that is not visibly seen by Australians who walk past somebody who has a hearing problem or a hearing challenge, unless they have a distinct hearing aid. I was excited, working in New South Wales in Aboriginal health, when I met the inventor of the cochlear ear. We had a great conversation. I caught up with him recently. I thought he would not remember the discussion we had. But he came across and we rekindled our discussion and discussed the need for a concerted national direction and we could use as the foundation for the reforms that were needed. Once the roadmap has been ticked off by the Australian health ministers, it will be released for public discussion. It is an important step forward. Whatever the outcome of the federal election, I would hope that my counterpart will continue with the roadmap and by establishing the hearing sector committee. I know that they will be the drivers of the work that they have brought together.
I wish you well in your deliberations. It would have been good to stay, but I have to jump on one of those silver things that fly through the sky to be in Adelaide by six o’clock tonight for some major announcements tomorrow. It’s a privilege being here with you all and I thank you, each and every one of you, for the work you do. Santos for the scholarship that you provide and to the young lady from Australian Hearing who is having your third anniversary tonight, who is having a meal with her husband tonight, and I hope you have a pleasurable meal. Thank you all.
BARRY MacKINNON: Thank you, Ken. Can I just say before the minister goes that whilst he’s there, thanks very much, minister, for your contribution. He hit some very interesting points in that talk about the hearing health roadmap. One, of course, of which is a perennial problem in this country, and that is cooperation between state and territory and federal governments to ensure services are appropriately delivered. I hope the roadmap can spell that out. Secondly, the importance of early intervention and identification of hearing loss so that we can provide support for young Australians so they can play their positive and proper role in the future of our country. Thanks again. Can I ask you to put your hands together again and thank the Minister Ken.
We now come to the section where we’re going to have a talk from a whole group of people about issues and how we can address hearing loss. The first person to talk to us today is David Gibson. David is on my left. You will see what a good‑looking colt he is. David was a graduate of the Royal Military College in Duntroon; he was an army officer for eight and half years. He then was a state member of Parliament in Queensland, and the Minister for Police and Community Safety. He then woke up to himself and came back to Western Australia, instead of living in Queensland. He’s the oldest child of deaf parents, so he has a clear understanding of the issues facing deaf and hearing impaired people. He’s currently, of course, the CEO of Access Plus WA Deaf.
You all have 10 minutes and I will give you a yell at nine minutes.
DAVID GIBSON: I feel the need to include my AFL allegiance at this point, which is the Dockers. I am born and bred in Fremantle so I am a long‑suffering Docker supporter for many good reasons. When you hear your bio being spoken by people, it’s an opportunity to reflect on your own life and on organisations. I have a great opportunity at the moment to act as the CEO of Access Plus WA Deaf. We have been around since 1921 servicing the deaf and hard of hearing community in Western Australia. We started off with just 12 people who gathered together on Railway Parade, and wanted and identified there was a need to support the deaf and hard of hearing here in Western Australia back then. It’s moved through. It was originally established as a Western Australian Deaf and Dumb Adult Deaf Society. It then moved on to be the Western Australian Deaf Society, and just last year we rebranded as the Access Plus WA Deaf.
Our purpose today is to facilitate a community of communication without limits. You will notice in that purpose there isn’t anything about the word about “deaf” or “hearing”. It deliberately focuses on communication and without limits. I think that ties in nicely to today’s topic. Our mantra, however, is slightly different. Our mantra is putting the deaf and hard of hearing at the centre of everything we do, and that we feel is important for all the services we provide. I will touch on those in a moment. Our values, as identified by our community, are exactly, firstly, community, access, inclusion, and progress. The organisation today does not reflect the same approach that the organisation had in 1921. There is a very good reason for that; society today is very different from what it was in 1921. In 1921 women were not expected to work. In 1921 the Indigenous did not have the vote. Our society has moved on in many areas, as it has in the disability space as well. Access Plus WA Deaf takes a bi‑modal, bilingual approach to communication. We do that based on the evidence. We’ve currently been working with those who have cochlears who identify that the cochlear itself, whilst a great tool, does not provide full communication, and they need additional support with Auslan. We work with those who choose to only have Auslan and later in life then identify that a cochlear brings that additional support, and those wishing to have the cochlear installed at a later point in their life. We are currently assisting a gentleman in his 40s, being profoundly deaf for most of his life who now feels that a cochlear will provide him assistance and probably will for his choices moving forward.
The services we provide are across four main areas and these are been shaped with the needs of our community and government funding. The NDIS causes us to have to adjust our business model for those areas. The four service areas we have are: Access Interpreting that focuses mainly on Auslan interpreting across a whole lot of areas, as per the interpreter standing here right now. We also have Access My Life, which is our community services area. This is where we provide community support workers for those who have NDIS packages, WA NDIS packages, or metro packages for community support work. This can be across a whole range of areas. It can vary from community support workers, communication guides, support in the home, support in sporting environments as was alluded to by the minister with regards to individuals needing support to go through. We look at a broad range of those areas. We also have a service called Access My NDIS. A large part of that service right now is ensuring that deaf and hard of hearing people get the right NDIS plan, and the problem we’re seeing there is that the NDIS is, whilst it is a life‑changing and a generational shift, it is yet has a lot to improve on. We are seeing peoples’ plans lacking key areas and a view that if you don’t, ask you don’t get, whilst is great for the commonwealth, is not necessarily good for individuals. So Access My NDIS is about support for people going to their plans, understanding what their plan means, and then in appeals and reviews afterwards.
We also then have Access My Training. This is focused on delivering a whole range of education and training resources around Auslan that involves community education, deafness awareness training, our language early acquisition program‑‑LEAP‑‑along with other specialised courses we may deliver for employers or individuals or such as families in the home where a deaf individual may want to ensure that their family have Auslan skills, so the feelings of isolation that may occur at a BBQ may not occur when other family members have the language themselves.
Our approach has been to engage and work with the community. It is the way we have been doing it since 2021 and we continually adapt and move forward. Just recently we have identified that for those who are deaf and hard of hearing and also identify as LGBT face an additional barrier within not only the disability but also prejudice towards sexual orientation. So we’re beginning to work on a program in that space.
We’ve also been supported for entrepreneurship to assist the deaf and hard of hearing with gaining employment within the “gig” economy. For those who are not familiar with what the term the gig economy‑that is, when you order Uber eats or you get Airbnb or any of those online‑type businesses that are not becoming not only micro businesses but challenging the way our economy operates. We see a great opportunity there for the deaf and hard of hearing. I have had the great fortune on three occasions on the east coast to order an Uber and to be told by Uber that my driver is deaf. We don’t have any deaf drivers of Uber in WA yet, but we’re keen to support this program that will roll out over the next month or so to embrace the gig economy.
Technology is changing the way we live‑‑for the deaf, the hearing and for everybody. For those of us who are able and seeing this technology and embracing it, we are there to support them. We also recognise that section of community who are of an age who do not necessarily feel comfortable with the technology. There are people, believe it or not, still writing cheques and going into the post office to pay phone bills. That’s okay. That is absolutely okay! We support people in those areas as well. That support tends to be more in translation; in explaining what the written documents are and assisting them to unpack them in an easy English version. If you have ever had to deal with the foreign affairs department with a visa application, you will know that it quotes chapter and verse on legislation and at the end of the day, it’s just asking you to provide information. We translate not just for the deaf and hard of hearing but sometimes for the hearing where English is a second language.
Access Plus WA Deaf is an organisation that I am incredibly proud to be leading. It has great support across the whole community in WA, and one in which we see a great future as we work in partnership with all the other providers in the hearing sector. I thank Barry and the Deafness Council for today because I think it shows that commitment we have across the whole sectors in working together. Thank you.
BARRY MacKINNON: Thank you, David. He has pointed out a raft of issues, probably finishing on one that really impacts on us all, which is new technology. When you think about technology‑‑I have witnessed it certainly with our son who is deaf and has a cochlear. The impact of the new technology, particularly mobile phones and texting has opened up a whole new world for deaf and hard of hearing people. Before that my son was isolated in communication with his peers. Not anymore. He’s the most active bloody bloke on Facebook that you have seen. People keep telling me what he’s up to, that I don’t know half the time. It’s fantastic technology and it’s good to see that Access Plus has recognised that and is working hard to ensure that its community is getting the benefits of that technology. Thanks, David.
As David talked about cochlears‑‑and there’s a whole raft of technologies to assist people. CICADA is an organisation that has been going for some time. It is an organisation that supports people with a cochlear implant. We have Lynette Fleming here today. Come on down. Lynette is a long‑term supporter of the Deafness Council and CICADA. Her husband Ross has had a cochlear since 1996, so she’s well aware of the challenges that face any person with a cochlear. She’s an active CICADA member. Please, welcome Lynette Fleming.
LYNETTE FLEMING: Thank you very much, Barry. Good morning. As Barry has said, I have hearing; my husband, Ross, after many years of hearing and ear problems has been a cochlear implantee since 1996. We have been associated with CICADA since its his implantation. CICADA‑‑Cochlear Implant Club and Advisory Association‑‑has branches throughout Australia. We are a non‑profit, self‑help support group of volunteers. CICADA is mainly for adult implantees, anyone thinking about having a cochlear implant and their family members. The type of support offered can vary from person to person. The support offered by our group is fairly casual, discussing and comparing stages of rehabilitation, and each person’s way of dealing with stages of hearing again. Most people seem to relax and find it easier to discuss problems of ways around problems or even great leaps forward with a cuppa in hand. Prior to, or after implantation, we encourage family members and friends to come along with the implantee, as sometimes people may have unclear ideas of what an implantee can expect, and with time, and experience, the amazing result that may be achieved. People with hearing impairment seem to avoid social gatherings, so included in our support we arrange social outings and encourage anyone who in the past may have avoided such venues to join us in an area that could be outside their comfort zone with companions who have dealt with similar uncertainties. If required, we offer a more personal support. An implantee may live alone or have difficulty finding a family member or friend to help with certain areas of rehabilitation. CICADA members will try to fill the gap. We try to keep members up to date with items of interest to the hearing impaired. We do a limited amount of fundraising and any money we make is donated to areas to assist the hearing impaired.
CICADA is simply, with our meetings, quiet chats, fundraising and outings, implantees, offering encouragement and support to implantees. Thank you. [Applause]
BARRY MacKINNON: It’s amazing. When I asked Lynette to talk today, she said, “I wouldn’t know what to say.” But that was fantastic. You hit the nail on the button. She made a very important point: that is, hearing loss is an individual thing. It will affect every person differently. From whomever it is, from a person who is Auslan user or a person who doesn’t use a hearing aid, or a person like John Byrne who communicates manually by writing‑‑there is a raft of individual differences and I think CICADA fills a gap there for people. Thanks for what you have told us. Lynette hit the nail on the head when the theme of today is “communication, not isolation”. That is what CICADA is all about‑‑trying to assist that communication. The next speaker is Kirsten White; she is the wonderful woman who the minister talked about who is having her third anniversary today. Give her a big clap. I don’t know whether you read the paper on the weekend‑‑being a young people don’t read papers these day; I do. There was an article in the paper about Jack Bendat, who you probably don’t know. Jack Bendat is a very wealthy Western Australian, and he owns the Wildcats. He was talking about his personal life. His wife died last year, but he’d been married for 73 years, so you’ve only have 70 to go! [Laughter]
In Kirsten’s case, she was born in Western Australia and then went to New Zealand, to live in Christchurch. She came back to Australia when she was 19 to find a good‑looking, young Australian man to marry so she married a New Zealander! She’s been working now at Australian Hearing for nine years. She’s the manager of the specialist centre and Outreach program for over 2 000 people in Western Australia. Was a keen surfer, but these days is scared of sharks. I don’t know why! So she goes snowboarding because there are no sharks on the mountains. Welcome.
KIRSTEN WHITE: Hi, everyone. I’m pleased that the minister and Barry have acknowledged my third wedding anniversary today. I woke up this morning, my husband forgot, so we’re off to a rolling start!
I’m from Australian Hearing and many people probably know who Australian Hearing is, in the room today. But for people, to give you history about Australian Hearing. We were first established in 1947, so we’ve been around for 72 years. Not far off that marriage, actually, that Barry just referred to. It’s a long time. We became a statutory authority under the Australian Hearing Services Act in 1991. We’re part of the Department of Human Services. We offer the most advanced technology and devices and accessories to assist all our clients with their hearing and communication difficulties. We have over 500 000 clients‑‑it’s half a million clients in Australia‑‑and we have more than 490 locations throughout Australia. You may have also heard of our research arm NAL‑‑National Acoustics Laboratory. We are also the only provider funded to deliver services to children and eligible adults with their complex needs, and we hold the funding for the Aboriginal and Torres Strait Islander remote communities. We have over 450 audiologists, and we fit more than 130 000 state‑of‑the‑art hearing aids each year.
There are two strands to our program, mainly referred to as the “voucher” and then the “community service obligation”. The hearing services program funds that for us. We are talking about offering clients’ free hearing tests, fully subsidised hearing aids, repairs and batteries on maintenance, and ongoing rehabilitation and advice.
Some interesting facts that I think the minister also touched on:
One in Six Australians, that’s 3.6 million Australians, have some form of hearing loss and this will rise to one in five by 2060. Between 9 to 12 children per 10 000 live births are born with a moderate or gross hearing loss in both ears. A further 23 children per 10 000 will require hearing aids by the age of 18 due to accident, illness or other causes. Seven in 10 Indigenous Australians have a hearing loss and almost half of childhood hearing loss is preventable. Over a third of adult hearing is also preventable‑‑37 per cent.
Again, the financial costs that the minister touched on is estimated in 2017, at $15.9 billion and the value lost is $17.4 billion. It’s a huge cost to our country.
Australian Hearing fits approximately 2 000 children every year with their first hearing device. We look after children from infancy through to the age of 26, when they are developing into young adults. More than 500 000 Australians wear a hearing aid and 1.4 million could benefit from wearing a hearing aid. It takes an average in Australia seven years for a person to first notice they might have a hearing loss until they take action, and only 16 per cent of adults who could benefit from a hearing aid actually wear one.
Some of the effects on untreated hearing loss include fatigue, tension, stress and depression, social withdrawal and isolation, diabetes, reduced alertness and increased risk to personal safety. There’s potential to reduce opportunity in the workplace, and safety, cognitive decline and reduced quality of life with a moderate to worse hearing loss.
So what can Australians do to help Australians who are facing issues with hearing and communication? We want to support communication, not isolation. There are a number of services that Australian Hearing offers. These include for our adults, hearing assessments and hearing aid fittings, first and foremost. We give access to the latest hearing device technology. We also run a home visiting service for clients who can’t come into the appointments. We do repair to supplies and batteries. We do evaluations of hearing aid benefits as we go and we give ongoing follow-up and care to our clients. We run rehabilitation programs to effectively manage the hearing loss. We give strategies in the home and other environments. We give tips for family and friends and other support people; specialist support and communication training to adults with severe to profound hearing loss as well.
So to give you an idea of some communication training and rehabilitation programs, I have just popped a few things down. We do tactics and strategies that include positioning when we talk to clients, use of visual clues, contextual clue, writing down message, speech reading and questioning techniques as well. We provide assistant listening devices and we also provide assertive listening strategies for our clients. We have a range of handouts available for clients on our website, and audiologist can also hand these out during appointments. We go over telephone and telecommunication management‑‑the use of a Telecoil, benefits of an amplified phone, specialised telephone products that are out there. We talk about the use of TTY and relay service and we the use of faxes and email.
At Australian Hearing we also use interpreters and translators. And our website actually has a translator so that people accessing our website for the first time can change it into their primary language and print anything from the website to provide information. We give information for family and friends in the way of handouts. We can encourage a client to bring a family member or loved one along to an appointment and also run through tactics of positioning for best communication effectiveness. Some of the professional development we do out in the community includes accredited “GP Plan, Do, Study, Act” for GPs, which we promote. We run GP information sessions. We do training for staff at nursing homes, and this training would include tops of the signs of hearing loss, management of the hearing devices in nursing homes, which is important for elderly clients who can’t manage devices themselves, and general support for hearing, for people who have a hearing loss.
So hearing aids and assistive technology can help. Hearing aids are associated with improvements in the socio‑emotional, psychological and physical wellbeing of all people with a hearing loss. Different levels of technology will suit different levels of communication. Some big advancement of hearing aids in the last few years, that have taken place‑‑most people with a hearing loss even a mild one, can get some benefit from a well‑fitted hearing aid, and success depends on how well the auditory nerves can pass the message from the ear to the brain. The modern hearing aids sound better. They are smarter and more adjustable. They are smaller. They can also be set to fully automatic and offer a huge range of amazing features, but they will never restore normal hearing.
Some of the factors that affect hearing aid success would be the type and degree of hearing loss, speech discrimination, motivation of the person wearing the device and also their expectations. That is really what the Australian Hearing audiologists work with clients to achieve. For mainly our older clients, there’s also a bit of manual skill and dexterity that comes into it. Support for other people is really important, perseverance and practice, and length of any auditory deprivation will have an effect on how successful the wearer is. The question comes up sometimes with new clients: One versus, two? So 80 per cent of our clients have two hearing aids for a good reason‑‑that’s because we have two ears. Two aids are better than one and they give you a more natural and balanced sound and help you work out where the sound is coming from.
Most of you would be familiar with the behind‑the‑ear hearing aid. These can be used with moulds or light clips, and suit all types of hearing loss right the way from mild to profound. This style is easy to keep clean as well. Then we also have the in‑the‑ear and completely in the canal. This style is more suitable for a mild to moderate hearing loss. It has a customised fit and they’re small in size but they can make it difficult sometimes with management.
Just to give an example of some of the features, or one of the most common features, is the noise reduction in background noise. The microphones are used over directionality, and we go hand in hand with practising with our clients about positioning to get the most out of a hearing aid in a busy room. For the higher level hearing aid level, the more focus on the individual and the length it requires just to hear. We counsel clients and family also on environmental factors, expectations and limitations of hearing devices.
Some of the more recent technology includes Bluetooth hearing aids, direct streaming, streamline TV, and streamline mics. We have a new range where you don’t need to change the battery‑‑if anyone is interested in that, see me at the back‑‑Lithium‑ion rechargeable batteries and rechargeable case as well. Technology is certainly advancing.
I will go right to the end because I’m getting kicked off the stage! I don’t take it personally! [Laughs]
In summary, there are a range of things that Australian Hearing can do. Largely it is devices, but we are here to support all our clients, friends and family as well, on how to get the best out of using hearing devices. We certainly do a lot of communication training, particularly with our very complex adults who have profound hearing losses, severe to profound, and need support. Australian Hearing can support communication, not isolation, by best offering clients the latest possible hearing aid technology and advice. Thank you.
BARRY MacKINNON: Thank you, Kirsten. Again, a reminder, if you want a free hearing check outside‑‑up the stairs and outside of the library. Again, focusing as Kirsten did, as most people have, on the theme “Communication, not Isolation”, which is what Australian Hearing are all about. In fact, I was sitting there listening to Kirsten and I remembered clearly when our son was first diagnosed, going to Australian Hearing and going to that little sound booth and going through all those tests. It was quite confronting as a dad when you find out that your little boy who is 11 months old has a hearing loss. But you meet those challenges as you go forward. Thank you to Australian Hearing for the support they gave our family.
Dr Barnard Clarkson, from Better Hearing Australia, is next. Barnie’s hearing all of a sudden started deteriorating in his 30s‑‑only looks 35 now so it was not very long ago! He’s been advocating hearing solutions ever since. As an academic and researcher, he tries to master the useful facts to bring forward for discussion. He is the Vice Chairman of Better Hearing Western Australia. He will talk about its approach to ageing and hearing loss.
BARNARD CLARKSON: Gee, this is a tough ask. I should ask you all to stand up do a bit of stretching and relax. Are we ready for five minutes of stories about Better Hearing, and my last couple of minutes I’m handing over to those handsome young men in black T‑shirts to talk about SENSORIUM, which is one of our projects, at the end.
Is that better? My apologies. I was using mute because I didn’t want any of those stories being shared publicly when we were talking earlier.
Better Hearing is one of Australia’s largest independent, consumer‑based not for profits, supporting adults with hearing loss. We provide advocacy, advice and education. We he have a couple of projects I plan to talk about, particularly WADA, the public loop, the idea of lip reading, Auslan and SENSORIUM.
I have been involved with Better Hearing for a while and it’s been a lovely journey. It is fabulous to feel we are part of progress. But as we have discovered recently, and you all probably already know, it’s not about hearing aids, it’s about what’s behind the hearing aids. We know better than worrying only about hearing aids; it’s actually about the brain. So when I talk to you about our activities, you will remember, of course, that all of them are related to the fact that there is a brain and we need to keep it stimulated as we age. In fact, looking after our hearing is better done by looking after our brain, and if we’re not doing a better job, then we’re not looking after our hearing either. So we have some key projects. There roughly is the list of them, but to remind you, the brain is what we’re talking about. The brain is the engine behind everything we do and we need to make certain we continue to look after our brain. We know that we’re about adult hearing loss, it’s an invisible problem. It’s more than just the ears. It’s associated with isolation and dementia, and estimates vary from $12 billion to $16 billion a year‑‑can I say that again, $12 billion to $16 billion a year is the cost of hearing loss in Australia. We are a large health issue, and it is only recently‑‑Ken Wyatt as he was leaving was showing me the report he is about to deliver tomorrow that he’s working his way through, and it looks very impressive. It’s lovely to think that hearing might at last be a major issue with the federal government.
But we also know three and four adults over the age of 70 are going to have some form of hearing loss and yet we were told earlier that something like one in six Australians on average have a hearing loss and one in six of those wear hearing aids. So we have got a long way to go, haven’t we? We also know it’s best treated early, not as a disease, but as part of ageing and that we can exercise age away. There is evidence, increasingly good evidence, that good exercise can help the brain and the bodied. Recent research I heard on the ABC last week‑‑put someone in bed for three weeks and don’t let them move, they were aged 20 to 30, and measure their hearts at the end, and the damage is apparently quite significant. They were promised “We will give you an exercise program that repairs your heart if you suffered any damage from that three weeks in bed.” Guess what? It took three months of an active exercise program to get their hearts back to normal. A researcher was reading this research that happened when he was 10 and he wanted to follow them through. They found them all‑‑78 of them. They said, “Look, you were willing to participate in research on the heart 30 or 40 years ago, would you do it again today? We want to find out what condition your heart is in?” Guess what? They varied from some who were terribly active to people doing nothing at all. But the people in the middle who were doing a small amount of exercise, reasonable amount of exercise, keeping active, the damage to their hearts after 35 years was less than the damage that had happened when they were told to stay still for three weeks. That tells me ageing is something that we’re in charge of. If we keep fit, we’re putting off the ageing problem and, of course, it has consequences for our hearing.
So let me talk briefly about our projects and then we will introduce the SENSORIUM boys. First of all, we want to know about loops. Loops are being used here today. There aren’t really enough public loops out there. The latest technology is a tiny one‑to‑one loop. It’s slightly bigger than my hand. You can put it on a counter, an office somewhere, and it has a microphone on the back of it and rechargeable battery. No wires. Anyone with a T‑switch in their hearing aids, can walk up to the loop, talk to the loop and the person behind the loop, who’s voice is picked up by a microphone and amplified to a small area in front of it. This is the sort of technology we need to be pushing.
WADA‑‑Julie is going to introduce WADA when they perform for us later. But it is a creative output and opportunity for those with hearing loss. We of course do classes, teach Auslan and lip reading, and we provide advice and advocacy. And finally there is the SENSORIUM activities that we strongly recommend you think about supporting, because we are encouraging not just those with hearing loss but all people to come along to a sensory‑rich activity, a nightclub experience, which is going to be talked to you‑‑you’ll find details from Isaac and Rory. Would you welcome them.
ISAAC EDMONDS: As Western Australians, we all enjoy a night out whether it with families or friends and often it can be accompanied by music. So‑‑hold on. Sorry.
RORY SMITH: With SENSORIUM we aim to close the gap between the hearing and hearing impaired with a nightclub‑style experience. It will cater for anyone from young adults, families or anyone in between, irrespective of their level of hearing. The night will be tailored for the needs of the deaf but it is not to be confused with a deaf rave, which can isolate the deaf community. We are looking to bring the deaf and hearing together, but not in a way that excludes either.
ISAAC EDMONDS: The idea for SENSORIUM was formed from a 2003 initiative Sencity project in the Netherlands. It provided a nightclub for the deaf and has since launched in London, South Africa and even in Sydney. We, through Skype sessions, we have gained information and knowledge that has helped us to get a better insight into bringing our own adaptation of the project to Western Australia. Today we have heard about technology that can improve the lives of deaf community. Take, for example, the screen to my left with the live captioning, or we talked about the instant messaging that has brought kids closer to their peers.
RORY SMITH: We believe that the technology scene in nightclubs today can be tweaked in a manner that will better cater for the deaf community while still remaining a joyful experience for those attending.
ISAAC EDMONDS: SENSORIUM looks to excite all the senses. The sense of sight with the lighting and audio visual effects that will synchronise with the music; the sense of touch, with vibrations pulsating through the dance floor; and the sense of smell with aroma jockeys circling the room spraying different aromas to elicit different emotions.
RORY SMITH: SENSORIUM will have you seeing, hearing and even smelling the music. It will be a night to cater for all. We look to break down the perceived barriers between the deaf and hearing. SENSORIUM will deliver an experience‑‑an experience that delves you deeper into the music.
ISAAC EDMONDS: Our vision for 2019 is to carry out an official launch of the project with the aim of holding future events. We hope to work with WA Deaf Arts and we look for other youths, hearing or deaf, who may be interested in joining our project. Thank you for listening.
BARRY MacKINNON: We’ve talked a lot about technology this morning in progress, and that’s another lot. I don’t think I’ll be going to SENSORIUM, but you might be, David; you’re young enough perhaps. But it sounds fantastic. Thanks, Barney. You talked about the importance of the brain, the importance of age, which is right from the beginning to best way to treat hearing loss is early, and the range of services that Better Hearing provides and SENSORIUM sounds like an exciting thing in the future.
Lize Coettzee is now our second last speaker. She’s from Ear Science Institute. Lize is married, has been for four years. She was born in Upington, South Africa, somewhere near Durban. She arrived in Australia in 2001. She then went to University of WA and did a masters of clinical audiology and has spent nine years at Ear Science Institute.
LIZE COETZEE: Thank you so much for having me today. My name is Lize. I’m a passionate audiologist in clinical services at Ear Science Institute Australia. My journey with hearing started very many years ago when my brother was diagnosed with a hearing loss. As a young girl I attended every hearing test, I attended the discussion about what our options were, I attended the hearing aid fitting and the rehabilitation. So I have been acutely aware for really my whole life about the importance of a good audiologist, accurate and reliable testing, and good technology. But, more importantly, I have been aware and I know how important it is the care that is provided through that whole process, and the importance of that process taking into consideration our individual needs‑‑our families’ needs and what we needed. That is the approach I take every single day when making decisions in the clinics: is this good enough for my brother? I truly believe that every service, every appointment should take that individual client’s needs into account. So everybody will here have individual needs and individual views on how your hearing loss should be managed. So I would like to stress that whilst I have been asked today to talk our services and the technology available, and the amplification solutions available at Ear Science Institute Australia, we understand and respect all modes of communication.
So a little about Ear Science Institute Australia. We are a not‑for‑profit research institute, with a vision as a centre of excellence enhancing the lives of people with hearing and ear disorders. We do that through multiple activities. Firstly, education, where we educate GPs, nurses, medical students, care staff, audiologists‑‑we really have a focus to make sure people are aware of hearing. Our community, again, has really a focus on increasing awareness of hearing loss in the general community. Our research is where we focus every day on how we can improve the quality of services that people receive every day, and how can we change peoples’ lives with ear and hearing disorders. Then we have a clinical division where our purpose is to improve people’s quality of life through improved communication, and we do that through two separate divisions of clinical services. We have a Lions Hearing clinics and Ear Science clinics.
We’ve heard about the statistics already today, but 466 million people have disabling hearing loss. This is a statistic brought out by the World Health Organization‑‑328 million of those are adults; a third of people over 65 have hearing loss, and one in six Australians, which is going to increase to one in four when we go to 2050. It’s something we need to address because it is increasing‑‑the prevalence will increase. This is not limited to old age. Hearing loss is not just there as we get older. There are many risk factors and conditions linked to hearing loss, cardio vascular disease and diabetes just to mention a few.
When we have hearing loss and that hearing loss affects our communication, it can lead to multiple disadvantages in our life. It can really negatively affect your life‑‑embarrassment, attention, fatigue, social embarrassment, so you don’t go out and become socially isolated. When we look at the research, we need to say what is healthy ageing? What do we need to do, when we get older, to do that well? We heard about that in the previous talk. We need that social connection. We need to feel connected to those people who are important to us. We have to have quality and we have to have quantity of social interactions. So can I propose that if we address hearing, if we improve the communication, that we can improve that connection with people, we can lead to people feeling socially connected, not feeling socially isolated and that can positively impact you as you get older. But yet, it still takes people, on average, seven years to do something about their hearing loss‑‑despite the benefits that we have already heard about today, it is still taking people a long time.
So I really want to just break this down into three really easy steps. Why is this and what can we do? Firstly, we need to identify that hearing loss. We need to identify it’s there. We need to understand and navigate the services available, and we need to take action, because sometimes we can know everything but we don’t make that final step of taking action. I will guide you through this. Check your hearing. That is the message from the World Health Organization for World Hearing Day: Check your hearing. Hearing‑‑and the reason I still call it a simple statement, but our hearing in many cases deteriorates slowly over time. We can develop compensations, so we don’t realise that the difficulties that we’re actually experiencing is because of our hearing loss; the reason we don’t want to go out anymore and socialise with our friends, maybe because “I don’t like doing that any more”, but we don’t realise it’s because of our hearing loss that we’re not doing that anymore. So check your hearing. Make it as routine as we get our eyes checked or as we go to the dentist. Let’s make it a routine that every year we check it. This is not in old age; this is from when we’re young. We don’t wait for it to become a problem.
I’ll go through our services, the services available at the institute. I can tell you about every service we have and about every technology, but what I really want to more go over is our approach‑‑the way we approach the services that we offer, the solutions that we have available, and the locations where you can find these services.
We have got two different, or two separate units within Ear Science Institute Australia. We have Lions Hearing Clinic which offers the adult hearing services, concentrating more on hearing aids and assistive listening devices. Within Lions Hearing Clinic, we also offer tinnitus services and hearing testing for children. So this is not children with long‑standing or diagnosed hearing loss; this is just those who might have an ear infection so we can test them and get them some help for the teachers if there is just a hearing loss for a short period of time. In our Ear Science Clinic, this is where we concentrate on hearing implantable solutions‑‑so cochlear implants are obviously a very big part of this, but we offer balance services, so for people who struggle with balance they can have the testing and rehabilitation.
Our approach within the hearing journey is we do a hearing test. We then discuss the solutions that are available for you based on all your hearing results. We do the fitting. We ensure that you have adequate follow‑up. If you need anything in between, we provide those services and encourage a yearly annual review to ensure you continue to get that benefit.
What makes us different is our approach in how we do that. We make sure that it is individualised, that it’s based on your needs, because two people are not the same. We can’t do the same for every person. We need to guide you through that journey differently. We include your family, because hearing loss affects your communication. Your communication affects your family and friends. We want to include them and see how we can really improve the communication. You are the guide through this process. We are there to support you, but we put you in the driving seat of making that decision of what’s best for you. There are no commissions in what the audiologist would receive in making that recommendation. We really can make a recommendation based on your individual needs. The appointments are unlimited. We want to make sure that we empower you, that you don’t have to come back to the clinic all the time because we know that is a stress. We all have to work, but those appointments are available. The technology is making that easier now as well, with there being the availability of having remote follow‑ups and adjustments on hearing devices.
Medical approach‑‑ o we always include the doctors where possible or where needed and there’s a full range of hearing services or solutions available, and that results in quality outcomes.
So we have heard a little bit about the solutions available for hearing and at the Ear Science Institute with Lions Hearing Clinic and Ear Science Clinic we offer the full range. So it could be as simple as communication strategies for pose people whose hearing loss is not as severe enough to warrant amplification, but just strategies on how you can benefit or improve your communication with those people important to you. Assistive listening device‑‑the there might be one situation where you have difficulty, like the TV where the headphones for the TV will work perfectly fine in situation. A full range of hearing aids from multiple manufacturers so we can get the features that match you. Cochlear implant, bone conduction implants and whatever meets your hearing needs.
There are extensive funding options available for the hearing services program. We have the Department of Veteran Affairs; there’s Medicare funding, NDIS and also privately‑funded solutions. There are many locations across WA‑‑north is Joondalup and south is Bunbury and lots of locations in between. So I’d like to encourage all of you to take action today. Book in that hearing test. The Lions Hearing Clinics are offering the free hearing screening for the month of March in support of Hearing Awareness Week and of the WHO message of check your hearing. Thank you so much for listening.
BARRY MacKINNON: Thanks, Lize, very much. We’ve had a broad range of speeches this morning and the final is Emma Chaffey. Before I do that, Lize has highlighted the point that has been made throughout this morning. There are individual needs; individuals will be dealt with differently. But in Lize’s case, she said make sure you identify the type of hearing loss you have‑‑there are a range of services available from Ear Science‑‑and then take action to address it.
Our final presentation is from Emma Chaffey. She is from the Chair of the WA chapter of Audiology Australia. She has a Bachelor of Science and honours in audiology and psychology at UWA. She’s has been employed at Australian Hearing and is in working in the area of complex adult and paediatric rehabilitation. I thought it was important to have someone like Emma to give us an idea that if you go to Ear Science or wherever you go, what are the things you should be looking from an audiologist. Thank you over to you.
EMMA CHAFFEY: It is fantastic for Audiology Australia as a professional body to be included in an event like this, yet so much of what has already been said is in my presentation. Hopefully I don’t repeat too much however it is fantastic that so much of what we are trying to get across is reinforced in the community. I’m chairing the WA chapter of Audiology Australia. Our primary role is to strengthen the profession with training, advocacy in the community for audiology and for better hearing health. I must just‑‑I have called this audiology awareness for Hearing Awareness Week.
I wanted to start with what our mission station is and how audiologists view themselves. Our primary role is to work with clients to preserve, to manage and to improve their hearing and their ability to process sounds. Audiologists can help a whole range of ages, from infants to older adults, and also people with quite complex needs, to communicate and interact in all situations. I wanted to make a distinction that the audiologists in Australia should have a Masters of Clinical Audiology, or an equivalent qualification in another country as well as having done exams. They are a highly‑trained professional, different from an audiometrist or a hearing screener you might see in the community. I also wanted to highlight a couple of things‑‑I don’t think the slides have worked so I haven’t highlighted the things I wanted. But I wanted to highlight: Who are our clients? What do we mean by preserve manage and improve? What do we mean by complex needs? What do we mean by communicate and interact?
I think these stats have been spoken about quite a lot. This gives a visual representation on just how significant the portion of people with hearing loss are as older adults. You can see a majority of people by the time they turn 70 will have a hearing loss in the better ear. So the consumers of audiology services in Australia are primarily older Australians. The skills that audiologists have fall in two main distinctions: A diagnostic skill, so being able to test hearing, doing advanced physiological testing, testing auditory function of processing and also testing our balance; and the other important one is oral rehabilitation. When I say “rehabilitation”, I mean any intervention that seeks to minimise the impact hearing loss has. That doesn’t necessarily need to be just devices; it can be training and it can also be counselling, information counselling, support for the individual on understanding why things are the way they are, what can be done about it and then partnering with them to minimise that impact. I have also mentioned tinnitus assessment and management, because that’s also a major part of the hearing loss or the hearing health industry.
Going on to talk about preserving, managing improving. By preservation we mostly mean education‑‑trying to minimise the preventable causes of hearing loss, and I really want to emphasise hearing protection. That’s at any age‑‑it’s never too late to start with hearing protection. Noise is such a major cause of hearing loss around the world, so solutions for hearing protection we really want to drum into the community, I think. Possibly some wax removal, if that’s appropriate and connecting you with other referral pathways if needed.
We move on to management. This is more about the rehabilitation program. So how we manage and minimise the impacts of hearing loss. How are we getting you to communicate effectively and in an easy way with the people who are important to you? That could also be how do we help in the workplace as well. Then improving‑‑we mean training, so that’s communication training, but also training to use devices that have been prescribed. Devices are getting ever more complicated and they are ever more diverse, so training to use those devices effectively.
Connecting with other support services like we have heard of today, then making sure that you have that appropriate referrals if medical intervention is needed.
Where might you see an audiologist? You see them in a hospital. That could be diagnostic audiology or hearing testing that helps with the medical management of other medical conditions. That could be through surgery through implanted devices. It could be monitoring your ear health. It could be a balance assessment or rehabilitation as well. The other part you might see is in the clinic. This is probably where a majority of audiologists in Australia work and the majority of services that are available. We have diagnostic audiology. That is primarily for the intention of prescribing devices or matching a rehabilitation program for the individual. Also, it can be about tinnitus and noise consultations as well. In terms of funding, which is often a bit unsure, if you have not taken the step to meet with an audiologist and query funding. Primarily the hospitals are mostly publicly funded but there are some private fees that would need to be paid for audiology services within a hospital context. You would primarily need to be referred into the hospital system. There is a mixture of private and government‑sponsored, or government‑supported, services in the clinics. By “government‑supported”, I mean the voucher program which is available for people over 65 on a pension or other full pension. That would allow you to have subsidised services and devices through certain clinics. There is also a significant private fee‑paying option in those clinics as well.
I’ve put this shop on the end as well. It might be an interesting one to touch on‑this kind of over‑the‑counter retail option with hearing devices. I mean off‑the shelf devices, where you’ve had no formal assessment done and possibly haven’t got a great deal of interaction with the person you’re buying these products from. I have put a question mark here because audiologists as a profession don’t interact with these services often. They can be convenient and they are well marketed in some areas of the community. But as audiologists, we haven’t had a lot to do with them because they don’t often meet our standard of clinical care. However, I think as the industry diversifies and the technology available diversifies, you may be seeing audiologists more in this retail aspect of audiology. It is a private space. There is no government funding for these off‑the‑shelf devices, so using your discretion when you interact with these devices is really important.
Then talking about what to expect when you see an audiologist. It is quite difficult for me from the professional body to give you an exact sense of how you might interact with each individual company, but I certainly wanted to give you an idea of the standard of care that you should expect. This patient‑centred care model, which is about individual tailored rehabilitation program, making sure that your needs are met in partnership with your audiologist, not the audiologist taking you down a path that you don’t understand and that you don’t want and that doesn’t meet your needs. So care is personalised, care is coordinated with other services and care is enabling, making sure that dignity and compassion and respect are utmost throughout the rehabilitation program. I think if you’re not finding that within your audiology service or your individual audiologist, seek to find someone who can you trust, making sure that you do try to make them understand you as an individual. Give them your personal goals, who are important to you, and what outcomes you want to see, hoping that they are going to be able to meet that challenge and then maybe that there is another individual that would better suit your need.
I think with this one‑‑seeing the audiologist early, making sure that your needs are addressed before they have become really significant and complex. Hearing loss is like a chronic illness. It may affect you for many, many years, so starting early and forming that partnership with the audiologist is very important.
I have this little cartoon here. This is obviously the patient at the centre but not patient‑centred care. An audiologist wants to strengthen our profession by improving the services they provide and holding them to account for the services they provide.
Finally, what you might see in the future of audiology. I wanted to put this graph. It talks about the market penetration of hearing aids within a hearing loss population. You can see in that mild hearing loss, it’s only 10 per cent of people using devices. Audiologists are really focusing on what is it about the services and technology that are not meeting the needs of the other 90 per cent or the other 50 per cent of moderate and 30 per cent of profound hearing loss … what is it about those services and technology that are not meeting the needs and how can we change things so that they are. This could be for a range of ways. Maybe online services‑‑I know more businesses are developing online or remote consultations or remote adjustments for their devices. I think that will have a big impact on people. It could be self‑fitting devices, things you can do in the comfort of your home, or fully implanted devices. The diversification, I think, is really what we’re talking about, so diversification of what is available and what assistive technologies might be available.
Then I wanted to touch very quickly on changes to the fee structure. I think there is a push to de‑couple the services and the fees that you have away from just focusing on devices, maybe de‑coupling them to what services that audiologists are providing as well. I know that fees and funding‑‑it’s always tight in the health industry, and so I strongly encourage, if you wanted to speak during the morning tea break, about those changes and what may occur later down the track. Please come and talk to me.
When I said we want to hold audiologists to account, please get in contact with the professional body if you have concerns. There is an independent complaints process, and if you’ve got tips or some advice or questions for the profession, please get in touch. Please take our details if you would like to and we encourage you to be engaged with the profession. Thanks.
BARRY MacKINNON: Thanks we’ll break for morning tea. But a couple of points that Emma touched on that haven’t been touched on earlier. One, I think, is that in this whole hearing loss area, tinnitus is a key issue. Of course, you might not have a hearing problem, but you may have tinnitus. There are a range of services available in that area she just highlighted. Also the question of hearing protection. We should protect the hearing we have. That needs to be emphasised over and again. It’s been an interesting morning. The point that has been made over and over is that hearing loss is an individual thing. It will affect everybody in a different way. There are a range of services to address that. The point that Lynnette made is also very important. We found as a family, when our son was diagnosed, some of the best information you get is, with all due respect to professionals, talking to other people about the range of services and what happens to you. Please discuss it and make sure you share your thoughts with other people and find out what’s appropriate for you.
Please join us for morning tea and we’ll have a presentation from the Deaf Arts and our Q&A session. Thank you very much.
[Morning tea break]
BARRY MacKINNON: Can I have your attention, please. Can you please take your seats?
Please take your seats, ladies and gentlemen.
Julie Edmonds, can you please come down? Julie is going to introduce the Deaf Arts people. Julie, as you probably know, has been very active in supporting in supporting the Deafness Council for a long time. She is president of Better Hearing WA. Julie is involved also in the Transplant Australia. Julie told me this some time ago now, she donated her kidney 39 years ago.
She’s a kindred spirit with my wife. I don’t know why my wife’s kidney was in better shape than mine. I am at a loss as to how that happened, but it did! Julie is going to introduce WA Deaf Arts.
JULIE EDMONDS: I haven’t got a microphone. As Barry told you, I’m Julie Edmonds. I’m about to introduce Western Australian Deaf Arts. WA Deaf Arts was a concept started in 2010. They’ve been going for quite some time. It’s a wonderful group of people. There are many more than who are here today. The ones here today are a just small snippet of who we have; we have children and many people who work and can’t come along. The journey over the last nine years has been interesting to say the least, but I’m so proud of no matter what has gone on that rollercoaster ride, they have kept on going and they’re here today to perform for you. I would like them to come up. While they’re doing that, they have done performances, they did a cabaret performance. They did a performance for young children several years ago. They were also asked to perform at the Concert Hall, which they did and they were fantastic. Verity James from the ABC said it was the most moving act she has ever seen. I was very proud of them too. They’re going to help the Sensorium boys with the SENSORIUM. Good thing to know is one of the boys helped WA Deaf Arts when they did their performances. More recently they’ve been invited to Denmark to join the Denmark Festival of Voice. They’re going to visit the children learning Auslan, work with them and do performances. I would like to introduce Kerry Brock, and Rae Gibson. They are both co‑director of WA Deaf Arts, along the front we have Christine Lee, Anne, Rae, who I just introduced, Janelle, along the back we have Scott Warner. Scott is always good for a laugh. Jeffery Scott, we have Susan and Julian MacDonald. I will get Kerry to give you all a quick snippet of the songs we’re about to perform.
KERRY: Hi, everyone. We chose three songs today. The first one is by an Australian artist Mama Kin. It’s call “Beat and holler”. It’s a nice simple song, just to get you in the mood. It’s basically “We’re not going to sit here and let you sit back and watch, you’ve got to play with us, you’ve got to have fun.” The second song I would love you to get in the groove with us. I’ll introduce that quickly next time. And the third song I would like you to join in the chorus. Next year we’ll have you all up on stage. Shall we do it?
# (drum beat)
# I’m gonna beat at your window, and holler at your door
# I won’t rest now while you play small
# I’m gonna beat at your window, and holler at your door
# I won’t stand down till you stand tall
# I’m not frightened, I’m not afraid
# I don’t want my life in shackles of shame.
# I’ve been standing here day and night till you’re brave enough to be who you might.
# I’m gonna beat at your window, and holler at your door
# I won’t rest now while you play small
# I’m gonna beat at your window, and holler at your door
# I won’t stand down till you stand tall
# You can turn away, yeah, you can shield your eyes
# But, boy, you’re in for a big surprise
# You think I’m your enemy and I’m no fun
# But once you let me in your house will shine full of sun
# I’m gonna beat at your window, and holler at your door
# I won’t rest now while you play small
# I’m gonna beat at your window, and holler at your door
# I won’t stand down till you stand tall
# ’cause what you hide from is what you seek
# You can’t live the life from the comfort of your seat
# So open up this window, open up this door
# The wind of change is gonna carry you home
# I’m gonna beat at your window, and holler at your door
# I won’t rest now while you play small
# I’m gonna beat at your window, and holler at your door
# I won’t stand down till you stand tall
# I’m gonna beat at your window, and holler at your door
# I’m gonna beat at your window, and holler at your door
# I’m gonna beat at your window, and holler at your door
# I’m gonna beat at your window, and holler at your door
KERRY: Who hasn’t heard of “Lean on me”? Lean on me! Fair go! Yeah. So we’re going to use the Club Nouveau version‑‑they’re 1986 I believe. Came out in 1987. They won an award for this, a Grammy I believe. Best rhythm and blues. It is a real groove song. It’s really hard!
# (Piano plays)
# Woo, woo woo woo woo, woo woo woo woo, woo woo woo woo
# (Syncopating beat)
# Some times in our lives, we all have pain
# We all have sorrow, but if we are wise
# We know that there’s always tomorrow
# Lean on me, when you’re not strong
# And I’ll be your friend
# I’ll help you carry on
# For it won’t be long
# Till I’m gonna need somebody to lean on
# Please swallow your pride
# If I have things you need to borrow
# For no one can fill those of your needs
# That you don’t let show
# Lean on me, when you’re no the strong
# And I’ll be your friend
# I’ll help you carry on
# For it won’t be long till I’m going to need somebody to lean on
# Just call on me, brother, when you need a hand
# We all need somebody to lean on
# I just might have a problem that you’d understand
# We all need somebody to lean on
# Lean on me when you’re not strong
# And I will be your friend, I’ll help you carry on
# For it won’t be long till I’m gonna need somebody to lean on
# If there is a load you have to bear
# That you can’t carry
# I’m right up the road
# I’ll share your load
# If you just call me
# Lean on me when you’re not strong
# And I’ll be your friend
# I’ll help you carry on
# For it won’t be long till I’m gonna need somebody to lean on
# Just call on me, brother, when you need a hand,
# We all need somebody to lean on
# I just might have a problem that you’d understand
# We all need somebody to lean on
# Lean on me when you’re not strong
# And I’ll be your friend
# I’ll help you carry on
# For it won’t be long
# Till I’m gonna need
# Somebody to lean on
# We be jammin’, we be jammin’
# We be jammin’
# We be jammin’, we be jammin’
# We be jammin’
# (Syncopating beat)
KERRY: Thanks. Thanks, Rae.
Did she take your phone? Great!
Okay. Don’t know what you’re doing!
Our last song is another one that you’ve probably heard of it’s called “I am Australian”. It’s actually a really nice song. I didn’t know it before. I really enjoyed learning it. I hope you’re all in tears at the end. Oh, can you join in the chorus with us? It’s really hard. You don’t have to do all the bits, “We are young”‑ I can’t even remember it now. But it goes “I am, you are, we are, Australian”. Everyone knows Australian‑‑pick up the convicts. Yeah? Okay. “I am, you are, we are, Australian”. I’d love you to join in and then auditions start at about 1 o’clock! Okay? Right.
# I came from the dreamtime
# From the dusty red‑soil plains
# I am the ancient heart
# The keeper of the flame
# I stood upon the rocky shores
# I watched the tall ships come
# For 40 000 years I’ve been
# The first Australian
# (Guitar plays)
# I came upon the prison ship, bowed down by iron chains
# I bought the land, endured the lash, and waited for the rains
# I’m a settler, I’m a farmer’s wife on a dry and barren run
# A convict, then a free man, I became Australian
# I’m the daughter of a digger who sought the mother lode
# The girl became a woman on long and dusty road
# I’m a child of the depression
# I saw the good times come
# I’m a bushy, I’m a battler, I am Australian
# We are one, but we are many
# And from all on the lands on earth we come.
# We’ll share a dream and sing with one voice
# I am, you are, we are Australian
# I’m a teller of stories, I’m a singer of songs
# I am Albert Namatjira, and I paint the ghostly gums
# I’m Clancy on his horse, I’m Ned Kelly on the run
# I’m the one who waltzed Matilda, I am Australian.
# I’m the hot wind from the desert
# I’m the black soil of the plains
# I’m the mountains and the valleys
# I’m the drought and flooding rains,
# I am the rock, I am the sky, the rivers when they run
# The spirit of this this great land, I am Australian.
# We are one, but we are many
# And from all the lands on earth we come
# We’ll share a dream, and sing with one voice
# I am, you are, we are Australian
# we are one, but we are many
# and from all the lands on earth we come
# we’ll share a dream, and sing with one voice
# I am, you are, we are Australian
# I am,
# You are
# We are Australian.
KERRY: Thank you very much. Let’s have another big round of applause.
BARRY MacKINNON: Thank you very much. That was fantastic. One of my favourite songs, that. David Gibson is going to handle the next session. I have introduced David. You’ve heard about him. Lots to like about him and dislike, but the best thing is he’s a Docker. Good on you, David.
DAVID GIBSON: Hopefully my mic will come on. Hopefully there’s more to like about me than dislike. Can I take this opportunity as we prepare to present the Dr Harry Blackmore Award, by welcoming Reece Whitby, MLA. I thank for making time for this today. He was elected as the member for Baldivis on March 11th, 2017. He is the Parliamentary Secretary to the Treasurer; Minster for Finance; Energy; Aboriginal Affairs; and to the Minister for Environment and Disability. Where he finds time for anything else, I am at a loss. He’s married to Natalie and has four children. A former journalist, having worked in regional Western Australia as well as the ABC. He’s also worked in television as a reporter at Channel Nine and spent most of his time as senior reporter and news reader at Channel Seven. We are grateful you are able to be here. Can I welcome you to the stage.
REECE WHITBY: What an introduction. It’s really good to be here today. Can I say to the WADA performers: Wow! That was fantastic! Like Barry, that’s a very emotional song, and as someone who only recently discovered they have a convict heritage, there’s a line in there which brought something home to me. Thank you to the WADA performers. Thank you very much.
Rae, I think Collingwood might have found their new mascot. I’m not sure if you’re a Collingwood supporter. If you’re not, I apologise. But I’m a Dockers fan, so we could use you as well if you want to put purple on.
It’s a pleasure to be here today. I would also like to acknowledge the traditional owners, the Noongar and Wadjuk people. I would also like to acknowledge David and my old friend Barry. He and I go back a few years in journalism and I was probably on the other side of a microphone to Barry on more than one occasion. I did spend about 25 years at the ABC and Channel Seven working with a bloke called Geof Parry. I thought going into politics I could get away from him, but here he is today. Geof, good to see you, mate. You’re looking brilliant and good to see that you got that thing off your face that was growing there for a while.
It’s a real pleasure to be here to represent the Minister for Disability Services, Stephen Dawson, and to in a moment to award the Quadrant Energy and Deafness Council scholarship and the Dr Harry Blackmore Award. The Deafness Council has a rich history in Western Australia, going back to 1974. That’s 45 years this year; you are coming up on a very important milestone anniversary in a few years’ time. The McGowan government is proud to support the Deafness Council of WA and we notice that this year it’s realigning the launch with the Hearing Awareness Week.
The hearing care industry association estimates that one in seven Australians suffer from a hearing condition. The projections by this same team are that by 2060 that number will double. So at the moment, about 3.6 million Australians are dealing with some form of hearing loss. By 2061 it will be about 7.8 million. The most common forms of hearing loss are noise induced but a lot of it comes by from the ageing process. A significant proportion of Australians and Western Australians are getting older. We’re an ageing population. It’s estimated that 73 per cent of Australians aged over 70 have some form of hearing loss, which is why we are focusing on the senior community this year and the impact that hearing loss has on older Australians. This year marks the first time that Hearing Awareness Week has been made to fit in with World Hearing Day on 3rd March. We are seeing improvements, we really are, and there is constant consultation and engagement. We are seeing the introduction of new technology, which is making a big impact on people’s lives. The technology in terms of hearing and connectivity‑‑things we never saw a couple of years ago. These are improving the lives of those with a hearing challenge and, indeed, all older Australians. We’re committed to advocating for Western Australians with a hearing loss to ensure the safety and wellbeing of, indeed, all seniors. We are at the moment in the process of developing a 10‑year plan to build and inclusive community which is part of the state disability plan. We’re going through the process at a moment to review the state disability plan. We are in consultation and getting feedback to define what the values of the plan should be, and it will be central to helping provide initiatives that empower people to live full lives.
I’m thrilled to be presenting the Dr Harry Blackmore and the Quadrant Energy Deafness Council awards today. They go to some of the most deserving people in our state who make a contribution in this area. It’s my pleasure to meet this year’s recipients and to welcome you all here today. Thank you very much.
DAVID GIBSON: We’ll commence with the Dr Harry Blackmore Award. Since 1988 Deafness Council has presented an award during Hearing Awareness Week. The first being Kevin Campbell from Channel Seven for his involvement in the introduction of live captions for the Channel Seven News. The award is named after Dr Harry Blackmore, a life member of the Deafness Council of WA, in recognition of his work over many years in advancing the interests of deaf and hard of hearing people. The award is given in recognition of the contribution made by an individual or an organisation that has enhanced the quality of life of people who are deaf or hard of hearing, or have raised the level of awareness in the broader community of issues that affect deaf and hard of hearing people.
This year’s recipient of the Dr Harry Blackmore Award goes to Mr Geoffrey Reader, Deputy Principal at Telethon Speech and Hearing.
Geoff has had an astonishing work history for creating outcomes for children who are deaf or hard of hearing and their families for over 35 years. Working as a tutor, notetaker and teacher of the deaf, and now deputy principal, Geoff continues to optimise innovation and dedication in serving the Western Australian community to create better outcomes for the deaf and hard of hearing. Through Geoff’s leadership, and as a champion for children and their families, he has led the involvement of teaching practice for children in Western Australia. As a teacher, a leader, a thought‑provoker and as a champion for others, Geoff’s efforts and dedication of ensuring every deaf and hard of hearing child is offered the best education and opportunity to establish a good foundation for later success in life later on is the reason he has been awarded this honour.
GEOFFF READER: Thank you very much for those kind words. I didn’t know I had done all those things, but thank you. I started at the centre in the early ’80s when I came to do volunteer work. I’m still trying to work my out, but haven’t managed it so far! One of my first experiences at the centre was to represent us on the Deafness Council, and I had the pleasure of working alongside Dr Harry Blackmore. He was an awesome leader and advocate for the deaf community and did remarkable work, so this is indeed a fantastic honour. It’s been a real honour for me to work at the centre for so many years. I’ve worked with amazing people. It’s all about people. We have done remarkable work for a long time and the programs that we have developed have been fantastic. I coordinate what we call our Outpost program now and that provides services into schools for our deaf and hard of hearing children. We aim to get all our kids as far along their journey as they can possibly get. They really do get to reach their potential and have really successful lives. It’s always been a pleasure to work for the centre. It’s an amazing organisation. I think I’ll be there for another one or two years. But who knows? Thank you very much. [Applause]
DAVID GIBSON: I would now like to announce the recipient of this year’s Santos Deafness Council Scholarship. Santos is a proudly Australian company and a leader in the supply of domestic gas in WA. Santos has enjoyed a long association with the Deafness Council of WA, extending over 10 years, and this is entirely appreciated, so thank you. It recognises and commends the work of the Deafness Council in supporting hearing, hard of hearing people and the deaf and their families across this state. The award recipient for this year’s scholarship goes to Spartacus Devereux.
SPARTACUS DEVEREUX: I just want to say thank you to Leanne Potter the principal of Shenton College Deaf Education Centre; my amazing teacher, Rae Walker; and, most importantly, my mum who has been supporting me ever since I was a child when I was deaf since one‑‑profoundly deaf. Thank you to those special three women. Without them I wouldn’t be who I am today.
DAVID GIBSON: Thank you very much, Spartacus, and thank you Reece for your time. Over to you, Barry.
BARRY MacKINNON: Thanks for that. We’ll just take a couple of seconds to set up the chairs on the stage for when Geof and the others come up. Spartacus is going to use his funding, he’s going to be attending university, and he wants to become a teacher of the deaf. Good luck to you, Spartacus, in your career and I hope you’re very successful and you can pass your wisdom and knowledge onto young people in the future and they can be just as good as you. Well done.
BARRY MacKINNON: Thank you, Reece Whitby, for coming along. I’m well aware of how busy your job is and we do appreciate your support. Thank you very much. Give us a couple of seconds and we’ll set up the stage to introduce Geof and the team.
BARRY MacKINNON: Thanks, ladies and gentlemen. We are ready to go. Geof, will do the introductions of the panel. Let me introduce firstly Geof Parry. Geof has been a journalist for more than 40 years. You wouldn’t know it. I would have it was 50 or 60‑‑32 were with Channel Seven. He first began with the Collie Mail. He then spent eight years in Canberra. He’s reported on unrest in South Africa during the Apartheid era. He reported on conflicts in Somalia and the Balkans and in East Timor. I was really interested in his CV which said the highlight of his career was‑‑I would have thought it was an interview with me some time ago ‑‑‑
GEOF PARRY: It was close!
BARRY MacKINNON: I was trumped by Nelson Mandela, believe it or not! He was the first Australian journalist to interview Nelson Mandela on his release from prison. He’s been married to Marlene‑for how many years?
GEOF PARRY: Forty this year, and counting.
BARRY MacKINNON: She deserves a couple of gold medals for that. He has three children and one of his children is Caitlin who is 32 who has a profound hearing loss who developed that after contracted meningitis. This is the third Q&A he has done for us. We really appreciate his support.
GEOF PARRY: Thank you for that. Reece! Hello, Reece. I’m trying to decide whether you’re a better politician than a journalist‑‑split decision at the moment. Reece was my boss for a long time. I also congratulate Geoff Reader, who was Caitlin’s tutor for a number of years when we moved back to Perth after she lost her hearing, and a better choice for that award, I can’t think of. Thank you, Geoff. I need glasses.
It’s my third Hearing Awareness Week function, as Barry said, as a moderator of the panel. Again, we have another panel that are smarter and more knowledgeable than I am. The first one was 2017. The subject was the NDIS. That was very interesting. Then last year we had a fascinating one down at Fremantle. That was about cochlear implants. There was some vigorous discussion there. This year, we’re doing hearing loss in older Australians, which is closer to my heart, at least something that affects me. My wife was diagnosed with a hearing loss not that long ago and she should be fitted with hearing aids but she refuses to pay thousands of dollars for them. I would pay for them because she’s driving me nuts! She was talking to someone in Melbourne who bought a pair from Costco for about 600 buck. I know you get what your pay for but these are the sorts of things that going on with older Australians. Of course we don’t have Costco here, but I have checked the fixtures and West Coast are playing Collingwood on April 6th. We may go over and look at it, but probably not.
A friend of mine got his hearing aids from a dead person. It sounds creepy, doesn’t it? He had a client, whose wife had recently got a brand new set of hearing aids but then she upped and died and the husband didn’t need them and he got them. Apparently they work quite well. Anyway, our panel today‑‑I would like to introduce them. Dr Peter Friedland, who is sitting here is a surgeon and scientist, clinician, teacher, researcher at Sir Charles Gairdner Hospital, where he is the head of the ENT department. He is also associate professor in health and medical science at UWA and an adjunct professor in the school of medicine at Notre Dame University in Fremantle. As if he’s not busy enough, he is also on the National Panel of Clinical Experts at the Department of Health and Ageing. He participates in outreach ear health programs in the Kimberley and recently started a charitable humanitarian ear mission in Bhutan.
Jody Maitland‑‑hadn’t met Jody till now. She was born with a hereditary hearing loss and has had bilateral hearing aids since the age of 3. Her father was also born deaf and did not get a hearing aid till he started grade 1 in primary school. He needed two hearing aids but his family couldn’t afford it at the time. That is probably something that we hear of a lot as well. In 2007 Jody received a bilateral cochlear implant from Professor Marcus Atlas, and that led to a remarkable improvement in language and hearing recognition, from 10 per cent to 96 per cent in 12 months. She has two sons, both deaf. Hayden was fitted with hearing aids when he was 3 and had a cochlear implant in 2017. And her other son, Blair, is fitted with bilateral hearing aids. Is he expected to get a cochlear as well?
JODY MAITLAND: I think so.
GEOF PARRY: Jennifer Lawrence is the CEO of the Brightwater Group which has been offering care to Western Australians for 100 years. Jennifer hasn’t been there all that time! She only joined in 2003. Several positions in that organisation before moving up, and CEO in 2016; established the Brightwater Centre‑‑and I would be interested to hear about that as we go through because it’s a research centre? She has published professionally, locally and internationally; has a background in private pathology industry here and interstate and a strong focus on innovation and technology. And technology is obviously a thing we’ll talk about in this session.
JENNIFER LAWRENCE: So important.
GEOF PARRY: You’re a graduate of Australian Institute of Company Directors and a member of the Australian College of Health Service Management.
A couple I got here late, Emma Chaffey; she’s sitting here. You completed a Bachelor of Science and Honours in Auditory Physiology at UWA, you’re doing a masters?
EMMA CHAFFEY: It’s already finished.
GEOF PARRY: Well done. How did you go; all right?
EMMA CHAFFEY: Yeah.
GEOF PARRY: You have had graduate positions in the government sector where you deal with adult and paediatric areas. You have been or you still are the chair of the WA chapter of Audiology Australia for the last two years and you run annual conferences and support for audiology in Western Australia.
And Rae, of course, who we’ve met. I have a few notes from Rae’s son, who said you’ve been profoundly deaf since birth, Rae. You attended the Mosman Park School For the Deaf; as we have seen, you are a deaf mime artist, involved in many theatrical projects over the years and passionate about supporting Deaf Arts.
Will you welcome the please welcome the panel.
Can I start, first, with Jennifer. How is the Royal Commission Into Aged Care going?
JENNIFER LAWRENCE: It’s interesting. I think there’s such an opportunity for having a royal commission into any systemic program. I know there’s one into disability soon. Brightwater also has a disability business, so the royal commission is looking at really what the system is all about and then looking at opportunities for how we improve. And I’m going over to Melbourne next week to sit on a panel just talking about how we can improve the lives of people with dementia and the services that we offer. There’s lots of bad news in the press, but there’s a lot of good things we can learn out of this.
GEOF PARRY: We will, of course, invite questions from the audience. I think there is he a roving mic going around. We’ll do that in a minute.
Can I ask Professor Friedland. Peter, what are the advances in technology that are going to help the ageing population, if you like? Of course, we know about cochlear implants; are they becoming more common in aged people and are they worth that sort of expense in carrying out?
PETER FRIEDLAND: First of all, I would like to thank Barry McKinnon for inviting me. I really appreciate the invitation and the wonderful organisation you represent; and Geof for chairing this panel. I acknowledge some of my colleagues that I recognise in the audience: Lize Coettzee and Ronel Chester‑Browne from the Ear Science Institute, who I have worked with for 10 years; and, of course, the audience because all of you are important because you’re here for a specific reason because of your interest and awareness of hearing loss and how it helps people. It’s such an important thing that you’re advocating for that, really, I would like to acknowledge that.
In terms of your question, there is an enormous amount of technology that is now available to help people hear a lot better. Everyone tends to focus on a cochlear implant, but that’s kind of the end of the road. There is a lot that can be done before one gets to a cochlear implant. People tend to think, “Oh, you’ve got severe hearing loss, cochlear implant”. A cochlear implant, I will just start with that‑‑and stop me if I’m going on too long. I don’t mind feeling like I am at home.
A cochlear implant is very sophisticated, and for people who have profound hearing loss, as we have seen, can make an enormous difference. But there are a spectrum of patients who have varying degrees of hearing loss who don’t necessarily need a cochlear implant. They can get hearing amplification with a good hearing aid, and that questions that you raised that we can discuss later in terms of the cost and sophistication of a hearing aid are important. Beyond a hearing aid, we can do other things that people are not aware of. We can do a bone implant, which is much smaller‑‑it doesn’t go into the cochlea. It sits on the bone and vibrates sound directly into the inner ear. That’s an operation that only takes half an hour, or 45 minutes. It can be done under local anaesthetic. It can really restore your hearing, depending on the kind of hearing loss that you have. We also have smaller implants that we can implant into the middle ear onto the little bones of the ear. So there is a whole broad spectrum that can be achieved, but patients really‑‑and elderly, really needed to be guided by responsible people who have their interests at heart.
GEOF PARRY: So there are choices now more than before?
PETER FRIEDLAND: Absolutely, there are lots of choices. There are also choices with devices, with different times of cochlear implants, for example, ones that are Bluetoothed that you can answer your telephone through the implant or have remote hearing through the implant. So there are a whole host of technologies available.
GEOF PARRY: Jody, the implant made a massive difference to your life in terms of your speech and hearing. Do you see that as the future or is that something that you would advocate? One of your sons has had an implant, the other one hasn’t; do you expect the other one will have one?
JODY MAITLAND: Absolutely. As soon as Hayden had his implant his grades improved. I took the younger son straight to test him to have the implant because I could see such an improvement in his brother, and myself and my father.
GEOF PARRY: Your dad had one too?
JODY MAITLAND: My father had his implants, he couldn’t hear in one ear and had limited hearing in the other ear. With the rehabilitation I can now ring my dad and talk to him on the phone, something he has never been able to do. To have that communication with him is amazing.
GEOF PARRY: Hearing Australia dealings with all ages, but in particular with an ageing population‑‑and Australia’s population is ageing. I mean the baby boomers‑‑I am a baby boomer, you’re not. But we are getting to the point that we are going to need those services. Is Australian Hearing concentrating more focus on the elderly?
EMMA CHAFFEY: What Australian Hearing is trying to do with many audiology businesses is to start earlier, so not leaving it until possibly you’re a very elderly person who is really struggling with communication in a fundamental way. Starting earlier, learning to use devices, keeping the stimulation of the auditory system going much earlier than what has maybe been done historically. I think there’s been a delayed uptake of devices and access to hearing services. I know at Australian Hearing we are trying to get the message across, that if you start earlier, understand things earlier and access services earlier, the outcomes regardless of what type of hearing loss you have will be much better.
PETER FRIEDLAND: If I may interject, I absolutely agree and endorse exactly what you’re saying. There is a concept that we all know that if you don’t use it, you lose it. So you’ve broken your leg and it comes out of plaster, all the muscles have kind of weakened and you need physiotherapy for a couple of weeks or months to get that strength back in that leg. Sometimes you can lose it permanently. What happens to all of us, every single one of us in this room, at some stage or another, sooner or later, our hearing undergoes ageing and we start losing our hearing in the higher frequencies. I’m not only talking about those people who are born with a hearing loss, but all of us who are born with normal hearing. When our hearing starts decreasing‑ that’s what Emma is saying, that’s the time we need to realise that we need to keep on stimulating that pathway from the lower centre, the ear, up to the brain. If we don’t, then we lose that sensitivity of that pathway. If we can start stimulating it early on with a hearing aid, we have stimulated that ear. If our hearing deteriorates later, when we put a cochlear implant or another implant, it switches on just like that because it’s ready and it’s been primed and it’s been maintained so to speak; it hasn’t gone to sleep and you need a whole period of months and years of rehabilitation to wake it up. That’s why in children, if they’re profoundly deaf at birth and we provide them with a hearing aid and implant them within six months or a year, they switch on and their uptake is enormous. They’re mainstreamed at a normal school by the time they’re five or six. In some adults it takes a lot longer. We’re not used to wearing devices. We’re happy to wear a pair of spectacles, but we’re not happy with wearing something in our ears. If we get our brains used to, adapt to it, and get over that hurdle, it will make a significant difference.
GEOF PARRY: Rae, can I ask you‑‑ you and I are closer to the ageing population than anyone else on the panel, with great respect to you. What would you like to see or what are you expecting from the services that, say, Jennifer provides or Emma at Australian Hearing provide, as an ageing Australian?
RAE GIBSON: Well, the reason I’m deaf is my parents contracted Rubella, and so I was born one of the Rubella babies. At the time the technology wasn’t there. I didn’t have hearing aids. My parents were at a loss with how to communicate with me, so my dad actually corresponded with John‑‑ hang on let me get the spelling right‑‑ in America‑‑ the JL. He used to correspond with him and my mother and father started to teach me as a very young child to sign. At the time there was the Cottesloe or Mosman Park schools as options. My parents looked at both and decided that the Mosman Park school was better because of the learning of the sign language. Because, you know, they actually had connections to there and I used to do the boarding at the school, at the Mosman Park school. I learnt the language. Then they also did a bit of lip reading and voice training with vibrations. A major part of that was to allow me to learn my love of theatre. I would go watch the ballet, and my mum would finger spell what was going on in the theatre. My dad would play the banjo and I would be feeling the vibrations. That would enable me to get language that way. I would practice finger spelling, voicing and lip reading, and we noticed there was a change over time.
I think the younger kids now days, if they’re deaf‑‑ yes, with the hearing aids, the cochlear implants, it’s giving them a more of an open world than I had, there’s more opportunities for them. The systems that are in change now, I know I didn’t have the same opportunities that kids do nowadays. I am thinking, however, I am still an advocate for giving the children the technologies and include the sign language for when those technologists aren’t being used‑‑ when they take them off. Teach them the sign language and show them the beauty of it and use every opportunity to have that connection with communication. Using the deaf adults would be a great way of teaching the kids, when you use the facial expressions and everything else, to make them understand and how important body language is not just to the deaf community but the community in general. We need to teach the kids to be able to hear the noises with the technology and the wider environment and give them every opportunity.
GEOF PARRY: That’s interesting‑‑ that’s fascinating. But I also ask, had you considered using or would you consider looking at the technology, a Cochlear, yourself?
RAE GIBSON: No. Apologies for my bluntness, but I have been deaf my entire life. I have quite accepted that and I am very happy communicating the way I do. I made adaptations to how I work with the community. You can hear me say how are you right now.
GEOF PARRY: That’s interesting because we had quite a boisterous discussion last year from the Auslan community, who were quite I think protective, or certainly supportive, of their culture and the fact that their language and all that sort of thing. So it’s interesting. I know there’s a political aspect to it but it’s fascinating to hear that. Peter, are there older people, though, who will‑‑ that sort of technology, if they want to uptake‑‑ that is it’s suitable for?
PETER FRIEDLAND: Absolutely. I wanted to bring another point‑‑ I think what Rae has said is amazing and commendable. Certainly when she was born there wasn’t that opportunity. I fully respect the deaf culture and those people who are proud of their deafness and want to maintain sign language and Auslan. What I do want to say, and I think a lot of people aren’t aware of‑‑ and the research we have done at Ear Science centre and the Alzheimer’s Research Foundation and some of the universities‑‑ is that what’s so important with hearing loss among all us is that it affects our brains and our cognition and our later on in life, losing our minds. The question is: we always worry when we get older, “Am I going to lose my mind? Am I going to go demented and get Alzheimer’s?” We know there’s a definite connection between hearing loss, cognitive loss, memory loss and Alzheimer’s. What is that connection? We are not sure if it’s the brain that’s ageing and that affects the ear and signals to the ear, or the fact that the ageing ear affects the brain. You need all the stimulation from the ear to go up from the brain and stimulate the brain. But we do know that when you improve peoples’ hearing, our cognitive tasks, but our working memory, improves. And so there are lots of options and so‑‑ sorry, to answer your question‑‑ it’s very important for adults to start rehabilitating their hearing early for their minds.
GEOF PARRY: I want to ask for questions from the floor in a minute. But first I have questions for Jennifer and one for Jody and Emma. Firstly, Jennifer, in the aged‑care industry, you run aged‑care homes and that sort of thing and I lot of us‑‑ we don’t want to end up in aged‑care homes clearly, but we do. Some of us do; some of us don’t make it that far. But, in an aged care you have lots of different challenges with people with different challenges like deafness. In this respect, how do your staff cope with people who are suffering from deafness? It’s quite an isolating condition.
JENNIFER LAWRENCE: It’s a really good question, Geoff. I suppose there are a couple of points I would like to make and only a small percentage of people who are ageing end up in residential aged care. A lot of people don’t know that. They think it’s the only option. But most people stay at home; most people live wonderful lives, stay at home and die at home.
GEOF PARRY: Brightwater facilitates that as well, doesn’t it?
JENNIFER LAWRENCE: Certainly; we have services for people in the community. The most important thing for us is that when somebody comes to us and they need support, is getting to know that individual. It’s getting to know‑‑like all of us here, we are all really diverse, we have diverse skills and wants and beliefs, and it’s important that we get to know that person coming into our facility, and we need to know whether they have some hearing issues or they might have visual issues or they might have issues around their sexuality, for instance. And we’re currently going through accreditation for LGBTI people.
GEOF PARRY: Another challenge.
JENNIFER LAWRENCE: Yeah, another challenge, because we are all different. That’s the first point. So finding out if somebody has a hearing problem when they come to us is really important. As I think we’ve spoken about today, age‑related hearing issues are really, really common. If we can identify that upfront and take steps so that people are engaged as possible when they live with us, that reduces the incidence of their dementia progressing. As Peter said, there are studies now that say that aged‑related hearing loss is a preventable risk factor that leads to dementia. The more we can do to bring people to identify that hearing loss, to engage with people, to get them to live really good lives, means that they will continue to harness the power of that brain and actually contribute to society. We do all sorts of things with the environment. The environment is really critical. Having an environment‑‑but this is not a good example‑‑that has small rooms, that has soft furnishings, that enables people who have hearing loss to hear better. We train our staff to be quiet and calm because none of us like‑‑I certainly don’t like lots of noise, and being able to hear. If you’ve got hearing deficit when there’s lots of background noise, is not good. We use things like on the buildings we use carpet on half of the walls so that dampens some of the noise from the facility. We also use sound bars with TV. We use technology in terms of earphones, if people can’t hear. That environment is critical, but actually knowing that someone has a problem is the most critical.
GEOF PARRY: Is that what the Brightwater Research Centre does‑‑it looks at all these problems, not just hearing, but in this case hearing?
JENNIFER LAWRENCE: We have two main arms to our research centre which we started a few years ago, because it is a passion of mine because I’m a scientist by background. We started that so the people who put themselves and trust us with their care, we’re making evidence‑based decisions and we’re making the right decisions for that particular person. So there are two areas that we do a lot of research in and the first is in brain injury rehabilitation, which is not dissimilar to what Peter was talking about which is engaging with the neuroplasticity of the brain which has amazing potential. Neurological conditions is one speciality and dementia falls into that category and supporting people with dementia. They are the two areas we look at.
GEOF PARRY: Emma, with the ageing population, how does Australian Hearing see the next decade?
EMMA CHAFFEY: I guess our client base is growing. The services that we need to provide those people need to be more flexible to meet a really changing‑‑a way that older Australians interact with health care. It’s much more personalised. I spoke before about, it’s about tailoring individual programs for individual needs. It is no longer this formal, clinician‑patient interaction; including families; making sure that each individual daily activity is taken into account as well. I think as people age, possibly as aged care grows as well, I know Australian Hearing is out in age‑care facilities or in retirement villages trying to bring the audiology to them.
GEOF PARRY: Are you more like mortgage brokers now, you go out trying to sell the product? I know it was a cheeky question?
EMMA CHAFFEY: I would hate to be compared to the mortgage broker, but I think there is a bit of a mismatch in that age‑care facilities don’t have audiology in‑house. It’s not one of the rehabilitation services offered in their standard package of care, so audiologists, or families and individuals, have to seek out audiologists to bring those services to them. So I think a growth in that area as well, rather than kind of bringing the patients to us.
GEOF PARRY: Is that through aged care homes like Brightwater and people in their homes?
EMMA CHAFFEY: Certainly. That home visit service that Kirsten was talking about, I think there is a growing demand for that. It’s a highly expensive service to be sending people around to different places, so I think striking the right balance of making services accessible for those people and doing it in a way that doesn’t drain the funding that is available for those people.
GEOF PARRY: I have one more question for Jody and then we’ll call for questions from the floor. Jody, you are a daughter and mother. Are you encouraged by what you hear, and for the future of your kids, but your dad particularly as he gets older?
JODY MAITLAND: I am encouraged. I’m excited, especially for my dad who dropped out of school at a young age because his family couldn’t afford a hearing aid.
GEOF PARRY: That’s fascinating. He could only have one hearing aid because the family couldn’t afford it.
JODY MAITLAND: Back in that day you had to pay for the hearing aid. Parents could afford to only buy one. I am excited that the government is getting on board and supporting with technology and funding not only young kids but also the older people as well.
GEOF PARRY: I was going to jump in‑‑funding can you address that?
PETER FRIEDLAND: The government has been very good for funding for adults. We didn’t have a lot of funding in the beginning. There was a lot of funding for children at PMH. And slowly over the years at Sir Charles Gairdner Hospital we have been able to increase the funding from three implants a year to 36 a year. That is for adults. So if there are adults who have Medicare, there is no charge to them. We do have a waitlist and they need to be appropriate for a cochlear implant and have a complex hearing assessment and rehabilitation. There’s funding there. There’s funding the Fiona Stanley for adult cochlear implants. In fact, Western Australia is funded far better, publicly, for cochlear implants and middle ear implants and bone conduction implants than the other states on the east coast.
GEOF PARRY: Why is that?
PETER FRIEDLAND: Because we have advocated for it. We’ve done audits and shown the cost benefits for it and we’ve been very, very vocal and we’ve shown our results are very good. The government realised it. It’s part of the Health Department’s criteria. They recognise that profound sensorineural hearing loss can be treated with these devices and they’re available.
GEOF PARRY: Let’s go to the floor. Does anyone have a question? We have a microphone?
JOHN: I am John Byrne. Like Rae, I have been profoundly deaf since I was a child. Like Rae, I am in my 70s; And, like Rae, no use for a cochlear implant even though I’m not a member of the Auslan, as you can see I can talk. Basically, I was in my 30s and 40 when it became available, but I was as an adult working in a professional field, why would I need to hear? The basic principle: if it ain’t broke, don’t fix it. There is nothing wrong with my life. It didn’t need to be fixed. It would be different if I had some residual hearing and a cochlear implant enhanced it. Rae and I will die out, we’ll solve that problem in time. The second point I would make is … the connection with hearing loss with older people. Not people who are always deaf, it’s really change as they age that causes that development. It was a comment not a question.
GEOF PARRY: As I understand it, you were raising the point about people losing their hearing later in life, the older people, and that’s a big issue, isn’t it? No, if one of you wants to answer.
EMMA CHAFFEY: I guess the evidence for the links with dementia or that cognitive decline is related with hearing loss in older adults. I think that’s where the studies have been.
PETER FRIEDLAND: It’s related to older adults who have always heard. When you take a gentleman here‑ he’s absolutely correct and so is Rae correct. They’re not going to develop cognitive loss because they have lost their hearing. They lost their hearing at an early age. Their brain was stimulated by other stimuli, with Auslan, which works well for them. But for us who have been stimulated with language and with sound and deciphering that sound and stimulating our brain, the less we get of it, the less stimulation of the brain. That’s the problem. That’s the key. The biggest problem. You asked a question: What is the challenge for us as ageing Australians going forward? There are two in my opinion: the one is awareness that we will all lose our hearing. By the age of 50 or 55, 60 per cent of us have a hearing loss; by the age of 70, 75 per cent of us have a significant hearing loss. But the biggest problem is it’s a silent epidemic. No‑one can see. You can walk around, no‑one knows you have a hearing loss. If you needed your glasses, you could walk but you would stumble. The problem is we deny it. It takes the average Australian man six to 10 years before he does something about his hearing loss when it’s been pointed out to him. That takes a long time. We’re saying: get your hearing tested. That’s what the World Health Organization, having a hearing down on 3rd March, is saying to everybody. Get your hearing tested. Know what your baseline is and do something about it.
GEOF PARRY: How do organisations like Brightwater and the other care homes respond to stimulating people, clients, who have a hearing loss? I know you spoke earlier, Jennifer, about carpet and trying to make the conditions better, but how do you stimulate them and their lives so they don’t become isolated?
JENNIFER LAWRENCE: It’s a really good point. The other point that is important is that most of the people who live with us have some level of dementia. So engaging with people who have dementia is a little bit more difficult than engaging with people who don’t. So people with dementia are not as likely to wear hearing aids. It’s really difficult for us to get them to wear them all the time; you can’t make people do things. So it’s a multifactorial solution or problem and we don’t always get it right. So it’s about, I suppose, having nonverbal queues for people. It’s about having‑‑we use a lot of music therapy. Music therapy using headphones is really important for people because it actually brings memory back and it’s great for calming and relaxing and reducing depression. They are just a couple of things.
GEOF PARRY: One more from the floor.
>> If there’s interaction between hearing and the brain and the stimulus of that, isn’t it simply, instead of getting a hearing aid, is it possible just to turn the volume up if you’re listening to a radio, listening to something? I have no problem at all hearing all of you speak. Is that just as good a stimulus as anything else.
PETER FRIEDLAND: I’ll give it a go, and our expert will answer. What I would like to say‑‑I’m just a wax doctor‑‑you are absolutely right, you can just increase the volume. If it’s simply a question of volume, you can increase the volume and you will hear. Thirty years ago we had analogue hearing aids and all they did was increased the volume. So when you wanted to test your hearing aid‑‑when I was in Bhutan, these poor 110 children had analogue hearing aids from 40 years ago, they’d clap their hands. Hearing is more far more sophisticated than increasing the volume. We have such a sophisticated inner area and cochlea that goes from low to half frequencies, that when that gets damaged as a result of hearing loss, we lose various frequencies. When the instrument itself is damaged and doesn’t respond to various frequencies, when you raise the whole volume, you create a lot of sensitivity in the ear, people don’t like the noise, it’s uncomfortable and they don’t get clarity of the noise. You obviously don’t have a significant hearing loss that just by increasing the whole volume it helps. What the modern hearing aids do, if they can program various frequencies, low frequencies and in half frequencies, and program them out and in certain circumstances block out background noise, you will hear from patients “I can hear you perfectly in this room. You are speaking clearly.” But as soon as there is a background noise, I can’t hear you”. So screeching noise is he a problem. The problem with those kind of hearing aids and those are the cheaper hearing aids that you can buy when you go to Melbourne and that you can buy across the counter, is they kind of blast you with sound and you think you can hear, but most people want to understand speech and listen to music. Of course, you want to hear the radio, the doorbell, and a hooter, but you want to communicate. That’s where you need more sophisticated input from trained audiologists, from good equipment, and not just an over the counter‑‑I know my script, I’m 0.25 and I’ll get glasses over the counter.
GEOF PARRY: I think that is right. My wife’s hearing loss is at the frequencies I speak at! [Laughter]
PETER FRIEDLAND: So her selective hearing is perfect.
GEOF PARRY: That is right! Emma, why are hearing aids so expensive?
EMMA CHAFFEY: Hearing technology replacing the complex physiological system that is our ears, you know, there’s so much research and development that has had to go into these pieces of technology and then to make it fit into an aesthetically pleasing device is highly complex. Historically, also the people who manufacture these devices, they have fit into that higher end prosthetic market. Although hearing aids are expensive, I think that turns so many people off from starting the process at all. And I think when you put it down to how often you might be wearing a device, what type of impact it could have on your life, considering how much money we spend on other forms of technology‑‑a new phone every two years, bits for the car and caravan‑‑I think there is a real mismatch in the cost benefit that people see with hearing devices. If fitted properly, if used properly and if the correct training and information is given at the time of fitting, I think they are really worth the expensive prices that people can pay, much more than a simple amplifier that may not be suitable but appears cheaper and more cost effective but is not really going to help in the modern listening situation in the diverse situations we have in our lives. I think those types of devices aren’t going to meet the need.
Certainly making sound louder, if we can make sound loud enough for things to be audible, we’re stimulating our auditory system, and that just doesn’t have enough impact or meet the needs of so many people. I have patients who come through‑‑clients that I see, who have the option of turning their TV up really loud, and they’ve got a nice sound bar, and they can enjoy the program without the need for any other device. Yet there are other people who maybe still don’t hear all of the words. They lose the enjoyment of that program or simply can’t turn it up because it will disturb others in the home. Simply turning external noises up louder is not going to meet the need for people and that’s why we need a greater diversity of devices and making sure people are aware of the different devices available, knowing that one device may not correct in all situations.
GEOF PARRY: I’m going to come you to in a second, Rae. Jody, I ask you, because you’re a consumer and it is your pocket that gets hit all the time. Is it difficult‑‑do you find it expensive? Do you wonder sometimes what you’re having to contribute?
JODY MAITLAND: Yes, in the early days. We have only been on the NDIS‑‑my younger son has been on his first plan now. In the early days, yes, speech therapy, OT, all that stuff, is expensive. You just do‑‑you do it because you have to do but the good old credit card get as I thrashing. But now we’re lucky that we have the NDIS, so that makes a huge difference. But definitely financially ‑‑
GEOF PARRY: This is an expense that’s going to be with you for the rest of your life‑‑for yourself and the boys.
JODY MAITLAND: Yes, especially when it comes to speech therapy. People say but you speak okay but my son speaks okay, but he doesn’t understand a lot of the stuff. Hayden has been going to speech therapy for two years now and he’s just learning about understanding what he’s hearing, and he can speak okay. So, yeah, when it comes to speech therapy it’s not just learning how to speak.
GEOF PARRY: My daughter will hate me talking about her. But she has had speech therapy, a lot of speech therapy through speech and hearing and private as well, and she is now 32. My wife and I believe she probably needs to get more speech therapy but she’s reluctant, but it is something that needs to be maintained.
JODY MAITLAND: I think so, and you can never stop learning. There’s always something out there, whether it be the speech therapist can help you through technology, even different language. I don’t understand my kids with their techno language and stuff like that sometimes. The speech therapist is something that you could continue, yes.
GEOF PARRY: I’m going to take another one from the floor, but firstly from Rae, if I can ask Rae. Rae, what will you be looking for as an older Australian? What are you looking for as you get older and the sorts of services that you need?
RAE GIBSON: Well, as a deaf older person, I need services that are more focused on caring for a deaf person that has people with Auslan skills. I mean I need to focus on staff who are open to deafness awareness training. Because I’m not the only deaf older, senior here. I have friends in nursing homes and they are so isolated. All they do is sit in the corner and have people wave at them. They aren’t able to ask for help. They are the loneliness people on the planet and soon after they go into the nursing home, they pass away. From my perspective even if you have a hearing loss or profoundly deaf, once you’re in a nursing home, deafness awareness training‑‑and the basics, even keyword signs. Gestures‑‑you can gesture things. You can gesture house. You can gesture shower. Just some deafness awareness training in those settings will open that door slightly to communicating. For me, I want a service where they are training the staff and doctors that awareness.
GEOF PARRY: Is Rae, Rae, do you have obviously hesitation, I mean that you might go into a home and suffer that same consequence, with the isolation?
RAE GIBSON: Yeah, that’s a big question. I’ve got no idea.
GEOF PARRY: Where do you go? What do you do? How do you tackle that?
RAE GIBSON: To be honest, for me, I feel there’s no chance I’m going into a nursing home. That’s not an option for me. I know as soon as I do, I will be leaving this planet very soon, purely because I don’t have that communication. I would like, personally, to be home. At the moment I’m being supported by Ananda Living. They come to my house. They support me well. Keep me living in my home. And they do some‑ they have students from TAFE who are learning the language, to come into volunteer with me so I can talk to the staff. I find that very pleasing. I have com guides as well who also sign. Most of my support staff either sign or they have access to someone who signs. Yeah, now you’re talking about nursing homes, you’ve created a fear in me. There’s no way I want to go to one.
GEOF PARRY: You might have to talk to Jennifer.
RAE GIBSON: No, no, no‑‑can’t stress it enough.
GEOF PARRY: Anyone on the floor. Susan?
>> Hi, my name is Susan. I’m finding all this so interesting. For me I’ve never heard such views. I had no idea about the connection between the hearing and the brain and the physical body. I was born profoundly deaf. I mean, for me, you know, I also lost out on family connections. I didn’t have a sense of identity as well. I had no idea who my family was and there was no communication as we were growing up. I didn’t hear anything. I was confused a lot of my time. However, we used to play games and communicate that way. I remember asking my grandmother how she knew I was deaf. She told me that I actually showed her. There was a clock and the alarm went off and I did respond to it. So that’s was when they found out I was deaf and my parents were very stressed at that time. Sorry, I just got off track. The question I wanted to ask you. I wanted to direct this more to the medical side. With regard to the cochlea and everything else, how much can you actually fix of the ear itself if there is damage? Like, you know, with the drum, the bones, everything. How much work can you do technology wise to fix the hearing?
GEOF PARRY: You were in surgery this morning doing exactly that, weren’t you, Peter?
PETER FRIEDLAND: Yes. Thank you so much for your comments. I really appreciate them. I really see that it’s been such a hard journey for you and you’re amazingly courageous to have undergone all that and shared that with us because it’s an important insight into not being able to hear and being stimulated. For a long period of time, we can repair eardrums and replace the little bones in the middle ear. If those little bones are missing, we can put in a middle ear implant or a bone conduction implant, and if there is a problem with a cochlea we can put in a cochlear implant. That is where we are at. In fact, there’s more than that.
>> I believe the hairs in my cochlea are down.
PETER FRIEDLAND: Okay, if the cochlea are down, we would use a cochlear implant. If the cochlea is not there, sometimes we’ve started doing brain implants where we put a little hearing device in the brain, in the auditory centre of the brain, that stimulates the hearing. It’s not as successful as a cochlear implant. But the biggest issue is that it’s very hard to stimulate the cochlea after so many years of it not being stimulated by sound. So when it’s been 20, 30 or 40 years, then it’s very hard. We can do the operation, but we can’t guarantee what the outcome will be like in terms of that. Would you agree with that? Yeah.
GEOF PARRY: Another from the floor. There was a gentleman over here who wanted to ask a question.
>> Geoff, this meeting to me today has been truly remarkable because it’s the first meeting I’ve been to in a long time where I have heard and understood every word that’s been said. Everybody has spoken very clearly, and as one who has worn a hearing aid for about 15 years‑‑this is the third set‑‑as I say, it’s been very remarkable to me. I was at a public meeting only yesterday. There was 150 of us in the hall and in comparison to today, it was absolutely terrible because I think I heard about one word in 10 and understood even less.
What I would like to ask the panel is, for people in my sort of situation, with two hearing aids‑I’ve got a fair bit of experience with him; they’re I think probably the best that can be supplied these days‑‑if I am in a public place like this, and I mean, like 150 in a hall or even sitting around the table with half a dozen guys having a cup of coffee or in a restaurant, what measures can I take to improve what I can hear because that’s really where the hearing aids which I have really fail dismally? Thank you.
EMMA CHAFFEY: I think conversations with multiple speakers or hearing a speaker over a distance are the biggest challenges that face traditional hearing aids. I don’t believe that all the sound processing and microphones within a hearing aid have been able to replace normal hearing in those specific situations. So having additional changes in behaviour and additional devices for those situations make a big difference. In this specific event, we’ve got really good sound systems, we’ve got the live captioning and we have the Loop system. So those three things go a long way to making the speaker more audible. It could be that a personal listening device, like a wireless communication device, a personal remote microphone that I would wear that communicates directly to your devices, would be the next step to take. Children with hearing impairment who use hearing devices are often quite familiar with this technology because they’ve been using it in the classrooms for a long time. But the technology that’s really only become popular in the maybe the last 10 years or as the technology has improved, and I think older Australians could use that same technology a lot more than they currently are. I know Barney talked about personal Loop systems or Loop systems for more public places. I think that could also be highly valuable and needs to increase the places that those systems are available. I think they went out of favour a while ago in terms of the technology faults‑‑they were poorly maintained. The technology is improving and there is a push to have that implemented in public places. When I talked about changes in behaviour, I think the other part of group communication for people who have hearing loss is that it often does need to change. I don’t think that we can have conversations easily with the behaviours that we’ve developed over many years as the hearing decreases. So making sure that people are aware of your hearing loss, knowing that maybe many of your peers also have hearing loss that they have that hasn’t been addressed, making sure that the lighting is good, that everyone is able to see each other’s faces, and also using a lot of the non‑verbal communications as well, I think that needs be to part of it.
GEOF PARRY: Jennifer, I know it’s a broader question, is that in your organisation, and the industry in general, the age‑care industry in general, something that you’re aware of, and when it comes to things like clients, residents who have hearing aids and hearing needs, is that left to the relatives to look after, or does the home itself, the residents themselves, play an active part?
JENNIFER LAWRENCE: Yes and no.
GEOF PARRY: It’s not as good as it could be?
JENNIFER LAWRENCE: Nowhere near as good as it could be. We could always improve. The current system does not fund audiology services for residential aged care. We have to rely on friends and family. If we pick up there’s an issue, we rely on friends and family to take the person to an appointment. It’s the same with dental and various other allied health professions. The industry could do a lot better but we’re not funded to provide that.
GEOF PARRY: Because it’s all about money. I know it’s not all about money, but you have to have things funded, don’t you? There’s a cost somewhere and someone has to meet it.
JENNIFER LAWRENCE: You do, but I think the most important thing‑‑and I hark back to this‑‑is recognising each person as an individual and recognising what they need. If someone has an issue with their hearing, what can we do to help them lead a good life with that hearing deficit. It may be getting onto the family. We support people to go to‑‑if we really have to, we support people to go and go to appointments. We’ll fund that; we’re a not for profit and it’s really important so if they haven’t got family, we’ll help them. But just recognising there is an issue is the biggest part of the problem, because often you forget because it’s not something you see. If people are blind, you know; if they’ve got a physical disability, if they’ve got a leg missing, but you don’t see if they’ve got a hearing deficit.
GEOF PARRY: I know we’re running out of time, Barry, so call me when you need to. But another question from up the back, from Ron, and another from the gentleman in the green tie.
>> A couple of questions. Firstly, you have two royal commissions coming up‑‑aged care and disability. Who is providing some sort of submission to these regarding hearing, regarding hearing loss, regarding all the things you have talked about? That’s my first question.
EMMA CHAFFEY: I can quickly make an interjection there. Audiologist Australia has put in a number of submissions for both royal commissions, and also the government investigations, I think it was, that started in 2017 where the findings have not been released, that Ken Wyatt spoke on. Audiology Australia, as the professional body representing the audiologists and their clients, has put a number of submissions into those and advocating strongly for the improvement in services and funding.
>> The second question was regarding private health insurance. Never been raised here. Surely if you have private health insurance and you’re going to buy $5 000 or $6 000 hearing aids, you can get more than $800 for one aid. That’s the present situation. The private health insurance really doesn’t want to hear more about that. You try to raise it with them, that is it. So I think there’s a real need for a militant approach to private health insurance.
Lastly, what Peter said is so true. I am 80 now, into my 80s. I got hearing aids, 10 years ago. I made a point of listening to music and music is so important. I now play music all day long and I notice a difference. It was raised here before about hearing aids, what difference they make. If you listen to classical music, I listen to jazz, blues, African music, Indian music and classical music. I take it all very seriously. I know that when you hear a hearing aid it gives the quality of the music a greater depth and you hear more and you can analyse more. A string quartet is a good example. You can hear them if you’re not wearing hearing aids. But once you put on your hearing aids you can hear all the different elements of it. It’s so important. Also I would have to say the personal health and activities. I go to the gym fairly often now. I have lost about 15 to 20 kilos about five or six years ago. You feel totally different. When you’re active, it definitely helps. If you’re active, your hearing becomes better.
PETER FRIEDLAND: Can I make a comment. Can I thank you for your comments.
You’re absolutely right and I endorse everything you have said. Certainly when it comes to keeping your mind active. The Lancet commission on dementia said it’s not only hearing; it’s exercise, alcohol, cardiovascular health, cholesterol, activity and music therapy. Two points I want to raise. I think it is a travesty that the health care funds do not fund hearing aids. It’s interesting that those same health care funds will fund a cochlear implant for $25 000, or a bone conduction implant, but when you need a hearing aid they won’t fund.
GEOF PARRY: Why?
PETER FRIEDLAND: Because they know people need hearing aids and economically it’s going to cost them too much money. And they know the uptake on cochlear implants is far less so it’s going to cost less. If they recognise that people need cochlear implants, for heaven’s sake, how much more so do people need hearing aids. That needs to come out. I get a little bit uptight and upset so don’t start me on that. The second thing is‑‑this comes to the quality of your hearing aid‑‑when you are buying your across the counter ‑‑
GEOF PARRY: Costco.
PETER FRIEDLAND: With respect ‑‑
GEOF PARRY: I will speak to my wife, Peter. I don’t want to miss …
PETER FRIEDLAND: When you buy a pair of spectacles from the same people, you know your prescription, the biggest question is what kind of frame am I going to get. You select your frame, but the glasses you put your glasses on and your vision is perfect. It doesn’t happen like that with an ear. It’s more sophisticated. The hearing aid is the first part of the journey. When you put it on, it’s difficult. It’s not what it’s meant to sound like. You need a lot of adjustment. That hearing professional, the audiologist, spends a lot of time, and their expertise and insight to sit with you a couple of times, to let’s say, let’s reprogram it, let’s spend time with that person, or that elderly person because it’s not so straightforward. It’s not just one program fits all. That’s what I think also‑‑the cost that goes into it. It’s not the just the device, it is the time and experience that that experienced individual puts into it.
GEOF PARRY: I know we’re running out of time now so let’s wrap this up. This is out of left‑field. Let’s run down the panel for a brief final statement from each of our guests, on where they think, if they’re encouraged, if they think there is a bright outcome for ageing people in terms of hearing, people who are hearing affected. Jennifer, I’ll start with you.
JENNIFER LAWRENCE: I knew he was going to ask me first! [Laughter] I think with the changes to aged care, that we haven’t spoken about today, that focuses on the individual and the individual’s needs and wants, that can only benefit who have hearing loss. I think that is a really good thing. I think we can do a lot more, and certainly what I’ve heard today gives me all sorts of ideas for what I can do back in my organisation. [Applause]
GEOF PARRY: Jody? What are your thoughts.
JODY MAITLAND: I’m excited about the future for young and old be it‑‑the technology is getting better each day. The hearing aids that I had when I was growing up I couldn’t listen to music or do anything of that stuff, now whereas my son can listen to the music. The technology is improving every day. I think it’s quite exciting.
RAE GIBSON: For me, I mean, I have learnt so much today. I mean, even just thinking about the brain and its development with the sound. I know for me even though I may not hear it, I still have to keep active. I still have to engage my brain and not look for that‑‑I mean Alzheimer’s is not for me, and I don’t think it’s for anyone. [Laughter]. We all together have to be connected to our universe our community. Be active and get involved. We need to do all that whether you’re young or old. The thing for the seniors that I would like is intergenerational connection. I want something where we can still have that connection between older and younger and that will be the success to our community. [Applause]
EMMA CHAFFEY: I couldn’t be luckier to be in my early career as an audiologist. There is so much more that will happen in this field, and meeting people today and hearing that maybe the skills that I have, or the skills the profession has, can help people, that maybe people still don’t know a lot about hearing and hearing health care means that there’s so much more that I can do. Older Australians are more connected, more tech savvy, and can advocate for themselves so much more than they ever have before, and I think there will be a huge push to meet the needs of those people that it has not perhaps in the past.
PETER FRIEDLAND: Thank you very much for having me on this panel. I have learnt an enormous amount from all of you and from the audience’s participation. This is an incredible country Australia. It’s incredibly lucky and blessed. I come from overseas. There is a fantastic future. Already at the moment what’s provided here for hearing and ageing people compared to other countries is enormous and I think it will only continue. I think the royal commissions that expose sunlight to a lot of these issues as it has in the banking royal commission will make an enormous difference to all of us who are ageing. So thank you very much.
GEOF PARRY: Could I just say ‑‑
>> Could we give this lady an opportunity to have a voice?
>> Thank you for your services in the past.
GEOF PARRY: Ah, a former patient. I have done this‑‑this is my third as I said before, and we’ve had some very stimulating discussions in the last three years. I think this was‑‑I learnt so much today. I didn’t realise the connections between hearing loss and ageing and dementia. They are things I didn’t know. If we have learnt something today, that’s wonderful. I think the panel has been a stellar panel. Would you put your hands together and thank them for us.
BARRY MacKINNON: Can I wrap it up by saying, thank you very much to a whole lot people but particularly to the panel. As Geoff said, we’ve had three of these and every single time it’s been stimulating for lots of different reasons because we’ve had quality people on the panel who have been really good in their contribution. We have a thank you for you all, which is a book voucher.
GEOF PARRY: Thank you, I love books. I don’t like that digital stuff. I like to be able to hold the book.
BARRY MacKINNON: Thank you. Can I say, out of all of today, when you’ve listened to that there are a couple of messages come through. The first one I think‑‑I wasn’t going to talk for so long but I will rabbit on a bit. It was just mentioned a little bit. We are so lucky to live in this country. Believe me. If you want to get sick anywhere in this world, get sick in Australia. Think about where we have come from since my son has been alive, since I have been involved in deafness. We have digital hearing aids, bone conduction, cochlear implants‑‑invented in Australia. It’s unbelievable. We have text on the phone. Anybody can do that today. We never had that before. We have captions on telly. This little organisation started that with Kevin Campbell. We never had that 20 years ago. You can go to the movies. The movies‑‑where is John Byrne, standing here. Because of that man, you can now go to movies in Australia and see a late movie captioned, because he took the complaint up to the Human Rights and Equal Opportunity Commission. That bloke there.
We couldn’t do that before. Of course, we now have‑‑when I left politics back in ’93, I said this to many people‑‑I went to every tertiary institution in this state. There was a part-time equity officer at Murdoch University‑‑one, part time. You can go to any institution now in WA and there are an equity officers, you get captions, lecture notes, interpreters. My son’s mate was the first deaf vet in Australia because of that. So how lucky are we? We have a long way to go still, and the royal commissions will show that into the future. That was my rabbiting on.
Out of today, the message is, we’re all individuals, we’re all going to face an individual problem. It’s a matter of finding out that individual person’s problem is, identifying it and treating it. Early intervention is very important, as is the technology provided by the people who have spoken. Thank you to the panel. To Geoff, who does an outstanding job. We couldn’t get a better person to handle that Q&A. Thank you.
To the presenters. The other thing that has been outstanding here today and it’s been mentioned. What’s your name‑‑Warren mentioned it‑‑the captioning and the service provided to enable people to participate and listen has been outstanding. Thank you very much.
To the Auslan interpreters, to the realtime reporter, everybody‑‑it’s been fantastic, because it comes back to the point: It’s an individual’s preference. How do you want to communicate? How do we cater for that. It’s disappointing to hear that you went to a meeting, you meeting you went to yesterday was on franking credits run by a government agency that didn’t have the wherewithal or the presence of mind to cater for people who can’t hear. The franking credit issue, who does it mostly affect? Elderly Australians. Bloody governments! Don’t get me onto that! And two final thanks. The Deaf Arts were fantastic. Thanks very much to Deaf Arts and it’s been made possible by Julie Edmonds. Come down, we have some flowers for you. Thank you very much.
The only final comment, which is probably the most important comment I’m making today, go Dockers!