All Ears: Hearing Loss in the Elderly

Listening And Talking

Have you noticed that your elderly loved one keeps asking you to repeat what others say, turning up the volume of the radio or television, recognizing sounds in the background (such as birds chirping or doorbells), and speaks more loudly than necessary?

If you have, then your loved one may be having hearing loss.

To become hard of hearing is a common problem that can be caused partly by genetics, disease, aging, and the environment. It is said that approximately 1 in 3 people between 65 and 74 years of age have hearing loss, as well as 1 in 2 people over 75 years.

Reluctance to seek consult

The realization that it is becoming difficult to hear is not one that can easily be admitted, even to one’s self. They may mistake other people just speaking more softly than necessary. They may also feel embarrassed about not understanding what is happening, and this can result in social withdrawal, confusion, and becoming uncooperative.

However, hearing problems that are not adequately addressed can get worse. It is important to seek consult so that appropriate treatment can be given. This is especially important to monitor because studies have shown that elderly people who have hearing loss also have a greater risk for developing dementia, with memory and concentration declining faster than those without.

Signs of hearing loss

Aside from what was mentioned, other signs of hearing loss include:

  • Having trouble hearing over the phone
  • Difficulty in following conversations
  • Sounds seem muffled or slurred
  • Some sounds seem loud and annoying
  • Hearing a default background noise (or having a ringing sensation in the ear)
  • Especially finding it difficult to understand high-pitched sounds (from women or children)

Types of hearing loss

Hearing loss can be due to damage to the inner part of the ear or to the nerve that is responsible for hearing (the auditory nerve). Called sensorineural hearing loss, this type of damage is usually permanent.

Meanwhile, conductive hearing loss occurs when sound waves cannot reach the inner ear for processing. Possible causes include buildup of earwax or fluid or a punctured eardrum. For these causes, there is usually treatment available to resolve the issue.

Presbycusis, or age-related hearing loss, usually occurs in both ears and develops gradually so that sometimes, it is hard to detect that it is happening. It is genetically-linked and also is due to changes in the inner ear and auditory nerve over time.

Older people are also more prone to have tinnitus. Although traditionally described as a ringing sound, it can also sound like roaring, clicking, or buzzing. It may be continuous or intermittent, in one ear or both, or loud or soft. While it is one of the earlier signs of hearing loss, tinnitus may also occur due to medications, allergies, or high blood pressure.

Causes of hearing losses

More than genetics, environmental factors also play a role in hearing loss.

One of the more common causes of hearing loss are loud noises. This includes concerts, high volume on the stereo, television, or headphones, as well as airplanes, lawnmowers, and vacuums. These loud noises causes a high amount of vibrations that can damage the inner ear.

Earwax buildup, as mentioned, can also cause hearing loss. Another common cause is a punctured ear drum, usually due to infection, pressure, or the use of cotton-tipped swabs. Vascular diseases, such as diabetes and high-blood pressure, as well as stroke, brain injury, or a tumor, can also affect the auditory nerve and therefore impact hearing. Some medications like antibiotics and those for treating heart disease can also be toxic for the ear.

Preventing (further) hearing loss

Unfortunately, damage to the inner ear is permanent, and some hearing loss can be irreversible. Nevertheless, there are ways to protect your ears from further hearing loss.

  • Wear ear muffs or ear plugs.
  • Avoid loud noises.
  • Do not use cotton-tipped swabs to clean the ears.
  • Seek consult when symptoms of hearing loss are present.

Diagnosing hearing loss

It is advisable to bring your elderly loved one to see a doctor if there are symptoms of hearing loss. A doctor will primarily use the otoscope to look into the ears and examine the ear drum and ear canal for any inflammation, impacted ear wax, or infection. A tuning fork will also be used to determine if there is sensorineural or conductive hearing loss.

A referral to an audiologist may be done for an audiogram. This test involves playing different sounds through headphones, one ear at a time. It is a great screening tool prior to further evaluation.

Devices to help with hearing loss

There are several devices available on the market that may help people with difficulties hearing.

Hearing aids are devices that make sounds louder. They are usually prescription-based, depending on the degree of hearing loss, although over-the-counter ones may soon be available. Hearing aids can be in the ear canal, in the ear, or behind the ear. Some types are more prone to pick up wind or be impeded by earwax buildup, and some have extra features such as variable programming, rechargeable batteries, noise reduction, remote control, and wireless connectivity. Depending on a person’s lifestyle and preference, a specialist will be able to help select which type is best for a situation.

Assistive-listening devices include alert systems that operate with doorbells and alarm clocks that utilize visual signals or vibrations. Finally, cochlear implants are preferable for people with profound hearing loss.

Coping with hearing loss

If you are suffering from hearing loss, do not fret and be discouraged from conversing with people. These are some techniques to follow.

  • Let the other person (or people) know that you have a hearing problem. Try to decrease the distance between you and the other people, to look for quieter places to talk, or to remove physical barriers that may dampen sound.
  • Request them to face you and for them to speak more slowly and enunciate more clearly. Ask them too to speak more loudly, ideally in a lower voice, without shouting.
  • Pay extra attention to gestures and facial expressions.
  • Let them know if you do not understand completely. Do not be shy about asking them to repeat something.

On the flip side, if you are talking to someone with hearing difficulties, here are some advice to follow to encourage him or her to participate.

  • Let them know that they are included in the conversation.
  • Find a quiet place to reduce background noise.
  • It is best to talk somewhere there is adequate light, so they can watch your facial expressions and/or gestures.
  • Face the other person, maintain eye contact, and speak clearly.
  • Speak slowly, a little more loudly, but don’t shout. Do not hide your mouth or chew while speaking.
  • If in a group, try to keep only one person talking at a time.
  • Ask them if they have questions or if they need some words repeated. Try to be patient and relaxed.

We can help

If you or your loved one is struggling with hearing loss, and you need help and support with lifestyle changes, going to doctors’ appointments, and learning to use assistive devices, Likas Nursing and Home Care can help you. We can work with your doctors and the rest of your healthcare team to create an individualized plan for you. If you live in the Lower Mainland in British Columbia, contact us for a free consult today.

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