Hearing Impairment in the Elderly

POH BOON FONG


How common is hearing loss in the elderly?

Hearing loss is a sudden or gradual decrease in how well you can hear. Approximately 1 in 3 individuals over the age of 65 years old have some degree of hearing loss and nearly half of those older than 75 years have difficulty in hearing. Hearing loss is more common among older men than women.

Having trouble hearing can make it hard to understand and follow the doctor's advice, to respond to warnings, and to hear doorbells and alarms. It can also make it hard to enjoy talking with friends and family. All of this can be frustrating, embarrassing, and even dangerous (National Institute on Deafness and Other Communication Disorders, 2014).

Hearing loss occurs when there is obstruction along the auditory pathway resulting in abnormal or reduced hearing sensitivity. “Deafness is worse than blindness. The handicap of the silent world, the difficulty of communicating with the hearing and speaking world makes it so” (Stevenson, 1977).

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Typical emotions of a person with hearing impairment

Effects of hearing loss

"I can hear the words, but I just can't understand them!"

In the majority of elderly with hearing loss, higher frequencies are affected. This is where the consonants lie (/p/ /k/ /th/ /f/ /s/ /sh/). So a lot of older people hear the vowels but not the consonants.

Consonants convey most of the word information; they are much more important to speech intelligibility than vowels. It is usually possible, for example, to figure out a word if you remove the vowels. But if you remove the consonants, you are lost.

In addition, since consonants are spoken more softly, they tend to get drowned out in background noise. No matter how hard they try, they are just not getting it all. The result is fatigue, frustration, and an increasing reluctance to engage in socially frustrating situations.

Early signs of hearing loss

Prevention & care of hearing

How to detect hearing loss?

Various diagnostic tools such as Pure Tone Audiometry, speech test and middle ear analyser are being used to detect hearing problems among the elderly. Pure Tone Audiometry is a 15-30 minutes test to seek the hearing thresholds of an individual.

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Management of hearing impairment among the elderly

To help patient to hear better again, custom-made or fit-to-go hearing aids are available for varies degree of hearing loss as well as the degree of handicap. Hearing aids are recommended when hearing loss affects the patient socially, emotionally, financially or psychologically.

In addition to hearing aids, assistive living devices such as telephone/television adaptor or FM system can be used effectively to improve communication in specific situations. Assistive listening devices transmit acoustic signals by wire, magnetic induction, Bluetooth or radio frequency. Alerting devices, which use lights to signal fire alarms or the telephone or doorbell ringing, can reduce the hazards to safety imposed by the hearing loss.

Auditory training and communication strategies such as maximizing the use of visual cues, reducing background noise as well as the distance of speech source is also recommended to enhance the information received through amplification and to improve patients’ ability to cope with daily life activities.

 

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Benefits of early detection & rehabilitation


POH BOON FUNG 1.jpg MS POH BOON FONG, B. Audiology (Hons.) UKM, MASH (M’sia), AAA (USA), is an audiologist based in LohGuanLye Specialists Centre, Penang. In 2004, she initiated the first “Better Hearing & Speech In May” (BHS) awareness campaign, aimed to provide early diagnosis and intervention to those suffering from speech-language and hearing problems. She is also part of the team that started the Cochlear Implant Programme in the Northern Region in 2005. In 2012, she established the Malaysian Resource Centre for Hearing and Speech-Language (MARCHES) with the aims to raise funds for underprivileged individuals with hearing and/or speech-language impairments as well as to enhance public awareness on the importance of hearing and speech-language in everyday life. She has special interest in cochlear implantation rehabilitation programme, tinnitus management and aural rehabilitation for adults.

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