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24/11/2009 Hearing solutions for Seniors Andi Vonlanthen

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24/11/2009

Hearing solutions for SeniorsAndi Vonlanthen

Page 2Hearing Care for Adults Conference 2009

Who are the seniors?

Page 3Hearing Care for Adults Conference 2009

Products for Seniors has to be big

Page 4Hearing Care for Adults Conference 2009

Population ageing from 1990 to 2010Population of people age 80+ is the fastest growing segment in developed countries

(* http://www.census.gov/ipc/www/idb/worldpopinfo.html Average through all major Phonak Markets, 2007: USA, France, Canada, UK, Germany, Italy)

Demographics

p o p u la t io n a g e in g U S A

0

5 0 0 0 0 0 0

1 0 0 0 0 0 0 0

1 5 0 0 0 0 0 0

2 0 0 0 0 0 0 0

2 5 0 0 0 0 0 0

5 0 - 5 4 5 5 - 5 9 6 0 - 6 4 6 5 - 6 9 7 0 - 7 4 7 5 - 7 9 8 0 +

a g e

popu

latio

n

1 9 9 02 0 1 0

+68%

p o p u la t io n a g e in g G e rm a n y& F r a n c e

0

2 0 0 0 0 0 0

4 0 0 0 0 0 0

6 0 0 0 0 0 0

8 0 0 0 0 0 0

1 0 0 0 0 0 0 0

1 2 0 0 0 0 0 0

5 0 -5 4 5 5 -5 9 6 0 -6 4 6 5 -6 9 7 0 -7 4 7 5 -7 9 8 0 +

a g e

popu

latio

n

1 9 9 02 0 1 0

+46%

Page 5Hearing Care for Adults Conference 2009

A day in the life ……. A little story

Page 6Hearing Care for Adults Conference 2009

A day in the life ……. A little story

On Off

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HISettings

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

Page 7Hearing Care for Adults Conference 2009

A day in the life …….

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

On Off

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-Phone Call with daughter

-Appointment for Lunch-Phone Call for a Taxi

HISettings

Page 8Hearing Care for Adults Conference 2009

A day in the life …….

-Taxi to the doctor

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-Phone Call with daughter

-Appointment for Lunch-Phone Call for a Taxi

HISettings

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

Page 9Hearing Care for Adults Conference 2009

A day in the life …….

-Taxi to the doctor

-Conversation at the doctor

-In the waiting room-With the doctor

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-Phone Call with daughter

-Appointment for Lunch-Phone Call for a Taxi

HISettings

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

Page 10Hearing Care for Adults Conference 2009

A day in the life …….

-Taxi to the doctor

-Conversation at the doctor

-In the waiting room-With the doctor

-On the way to the restaurant (lot of traffic)

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-Phone Call with daughter

-Appointment for Lunch-Phone Call for a Taxi

HISettings

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

Page 11Hearing Care for Adults Conference 2009

A day in the life …….

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

On Off

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HISettings

Page 12Hearing Care for Adults Conference 2009

A day in the life …….

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

-In car with daughter

On Off

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HISettings

Page 13Hearing Care for Adults Conference 2009

A day in the life …….

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

-In car with daughter

-Relaxing-Reading a book-Doing some housework

On Off

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et TV

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HISettings

Page 14Hearing Care for Adults Conference 2009

A day in the life …….

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

-In car with daughter

-Relaxing-Reading a book-Doing some housework

On Off

Traf

fic

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taur

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Traf

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Qui

et

Qui

et TV

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Phon

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21.00Ph

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-Phone Call with friend

HISettings

Page 15Hearing Care for Adults Conference 2009

A day in the life …….

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

-In car with daughter

-Relaxing-Reading a book-Doing some housework

-Watching TV-News (good understanding)-Movie (difficult)

On Off

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Qui

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et TV

6.00 12.00 18.00

Phon

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21.00Ph

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-Phone Call with friend

HISettings

Page 16Hearing Care for Adults Conference 2009

On Off Tr

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HISettings

Better solution in the different situation… but how?

A paradigm that emerged from “barrier-free”or “accessible design” and “assistive technology”.

“A barrier-free design is accessible for impaired but also attractive for non-impaired”

Example: “curb cuts”

There are a lot of different hearing situations during the day ! also for Seniors, not only for people doing business

What are the adequate solution ? …. But not only for Seniors

Page 17Hearing Care for Adults Conference 2009

Majority of seniors 80+ (90%) has problems with manual dexterity

Dexterity

Problems:Inserting ear moldHandling hearing instrumentsCleaningChange of batteryManipulating buttons, remote controls

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

Page 18Hearing Care for Adults Conference 2009

Battery

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

Battery or Rechargeable ?To maintain independent senior with physical and mental limitations profit from reduced handling and maintenance. A accumulator hearing aid could help.

ReasonsNo fiddling around with batteriesNo purchasing of batteriesNo On/Off handing (HI could run as soon as it is taken out of the charging station)Better reliability (sealed?)Consequences

Operation time reduced to 30% (max 2 days) !!!!!!!!!!!!Regular charging required Bigger products due to bigger rechargeable batteries and Senior requirements (easy handling)

So far not yet a good solution for Seniors available

Page 19Hearing Care for Adults Conference 2009

Earmold

No intuitive differentiation between right and left by elderly first-time users

Clear visual cue for right/ left is needed !!!

-Get up-Get on the HI

-Battery test-Switch On the product-Insert the earmold/HI

Possible solution with colored tips of the earmolds

Page 20Hearing Care for Adults Conference 2009

Insert an earmold

Main problems:Confusion of right and leftInsecurities about the required placement of the hearing instrumentInsecurities how to proceedWrong grabbing and orientation of the HI instrumentDexterity problems in handling the small instrument

-> Poster Schimmelpfennig et al.

Page 21Hearing Care for Adults Conference 2009

Insert an earmold

Main problems:Confusion of right and leftInsecurities about the required placement of the hearing instrumentInsecurities how to proceedWrong grabbing and orientation of the HI instrumentDexterity problems in handling the small instrumentInsecurities about the required fit of the earmold

Standard dome Individual half skeleton Individual full skeleton

First impression: The smaller and less complex - the easier. But dissatisfaction regarding comfort of fit in the ear.After tryout: Resentments related to size and form of individual earmolds diminish. Comfort of fit in the ear more important.Focus on criteria that determine fit in the ear!

-> Poster Schimmelpfennig et al.

Page 22Hearing Care for Adults Conference 2009

Phone I

Phone is a big challenge for HI users (not only for Seniors)-Phone Call with daughter

-Appointment for Lunch-Phone Call for a Taxi

Specific Phone Program Changing Listening Program?

Yes Manually

No Yes Automatic

-Remember the program-Knowing how to change - Remember to change backNot suited for Seniors

-Bad quality (hearing performance) via HI microphone except for CIC. Reduced speech intelligibilityNot suited for Seniors

-Recognition of the Phone (magn. Switch)… choosing Phone program-Wireless direct or via Bluetooth

Wireless delivers the best sound quality for speech intel.

Page 23Hearing Care for Adults Conference 2009

Phone II …. Enter the wireless world a challenge…. and an opportunity for Seniors

HiBAN

Wireless Phone via FM

Wireless Phone via Bluetooth

Wireless Phone with binaural Link (Binaural Phone)

Better intelligibility due to binaural signal Only One click to

-Connection-Sound quality-Speech

intelligibility

Page 24Hearing Care for Adults Conference 2009

Traffic

High noise level, Safety, Security

Important issues for seniors in traffic

Still needs to understand

Product should support Seniors in choosing the right program in this situation

No manipulating of the buttons

Fully automatic systemAutomatic directional systemsAutomatic gain adjustment for diff. listening situations, Program manager

-Taxi to the doctor

Automatic adaptation to listening environment will improve quality of audio signal and speech intelligibilityNew and special features such as steering the beam of a directional microphone can improve even very difficult situation

Page 25Hearing Care for Adults Conference 2009

Restaurant … Speech in Noise

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

Best possible solution to improve speech intelligibility for Seniors

Automatic directional systems

Automatic gain adjustment for diff. listening situations, Program manager

Automatic adaptation to listening environment

Manual adaptation to listening environment

In some situation a manual interaction could be needed

Easy access to the button on Remote or Product

Intuitive

Page 26Hearing Care for Adults Conference 2009

Improved manual access

Ony a few buttonMore functionality behind the buttons (Changing Vol/DirMic/NC with one click)

Using wireless functionality to ease handling-Synchronization (only one side has to change)-Vol up on right side -Vol down on Left side

Less but bigger controls

-+

Page 27Hearing Care for Adults Conference 2009

Gatehouse 2006:

‘With benefit of one kind of fitting over another:High-cognitive ability listeners derived greater benefit from a fast-acting, wide- dynamic-range compression fitting than from a slow-acting, automatic- volume-control fitting, but Low-cognitive capacity listeners were the opposite with greater benefit from a slow-acting, automatic-volume-control fitting

Improve speech intelligibility with slower time constants

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

ExcitePatGainModel

Expansion

DSA slow

DSA fast

AVC

Band Couplin g

DSA Expansion

min

ExcitePat

Bspec

Page 28Hearing Care for Adults Conference 2009

Improve speech intelligibility with slower time constants

Study in Mainz:Test acceptance and satisfaction of a new dual-

path signal processing strategy (AD / DP)

• Compare acceptance and satisfaction level generated by two different settings (AD / DP)

• subjective signal quality• subjective loudness perception• Speech intelligibility in quiet and in

noise

-Lunch with daughter-Conversation with waiter-Conversation with daughter-Difficult situation

ExcitePatGainModel

Expansion

DSA slow

DSA fast

AVC

Band Couplin g

DSA Expansion

min

ExcitePat

Bspec

Page 29Hearing Care for Adults Conference 2009

Results

We could see a better performance for half of the group. ☺

But there was no evidence to the age but rather to the hearing loss.

Page 30Hearing Care for Adults Conference 2009

TV

TV is not an easy sound situation

All signal coming out of a small box

Speech intelligibility depends strongly on the TV program

News, speaker is fineMovies can have a very bad signal to noise

TV creates a very fast changing of the acoustic signals (environment). speech in Noise.. and Music…

Difficult situation for an Automatic

Special TV listening program in the HI is recommended, but should engage automatically

-Watching TV-News (good understanding)-Movie (difficult)

Page 31Hearing Care for Adults Conference 2009

Wireless application for TV.. Automatic; easy to use , great quality.

Application for Seniors need to be easy

Wireless technology offers best quality and no hassle for the user.

Modified (low delay) Bluetooth Technology)

Proprietary solution to the HIBluetooth

FM

Don’t forget FM !!!

Page 32Hearing Care for Adults Conference 2009

Summary

New technologies such as the wireless technology improves the situation for seniors

Handling

Hearing performance

Solution for seniors should also work for other user groups (and vice versa)

Seniors does not show a clear preference to a specific signal processing strategy….. Hearing loss is a better parameter to differentiate than age.

Page 33Hearing Care for Adults Conference 2009

Thank you