Hearing impairment is very common for all who survive into old age and a gradual deterioration in hearing with advancing age seems inevitable. With slow progress of hearing loss many never complain and manage remarkably well in conversation or on the telephone.
The age of onset of this deafness is variable; however, it is estimated that at least 30% or more of all people over the age of 65 are deaf enough to require a hearing aid; and about 50% over the age of 80 have significant hearing and communication problems. Deafness is one of the most common disabilities of the elderly.
Type of deafness:
The hearing loss is bilateral and symmetrical affecting high tones making it difficult to hear consonant sounds especially in the presence of background noise. These people are not only hard of hearing, but their sensation of loudness is disturbed resulting in distortion of sounds or ringing in the ears.
Deafness may be aggravated by a common cold, drugs, in particular pain relief medications, quinine or ototoxic diuretics. There may be also a general slowing down of understanding, central processing and a reduced ability to listen.
Effect of deafness:
This hearing difficulty if not recognised can lead to gradual detachment from everyday life. Family conversation, social events become difficult and embarrassing. Such people often become difficult to live with; asking for remarks to be repeated, misunderstanding conversation and turning the radio or television on so loud that causes annoyance for others. These problems can seriously affect their quality of life and ability to live independently.
How to talk to an older person with deafness:
Most normal hearing people are totally unaware what it means to deaf. Communication is a two-way process, involving both the speaker and the listener. Simple measures can help to a significant degree to minimise the difficulties arising from hearing impairment in the elderly, requiring active cooperation of the speaker. Public awareness programmes could emphasise the role of speaker in improving communication with the elderly.
Useful suggestions:
- Be patient and eliminate distractions.
- Talk with a person face to face and make sure your face is in a good light and it is at the listener’s level allowing the person to be able to lip-read effectively.
- Speak clearly and slower than normal with moderately raised voice but do not shout.
- Reduce the speed of your speech.
- Leave longer pauses between sentences.
- Try to re-phrase sentences which are not understood the first time.
- Try to adopt a sympathetic attitude so that the elderly person is not agitated with his/her difficulties.
Listening devices:
Many modern devices can be helpful for hearing impaired elderly people by reducing the impact of background noise. These devices can be used in function and meeting rooms of social events. Telephones compatible with hearing aids and telephones with adjustable volume and tone controls for home use can play an important role in maintaining safety, independence and quality of life of hearing-impaired elderly people.
Environmental design and planning of buildings which can reduce reverberations and background noise can make life easier for the deaf people. Rehabilitation services such as hearing aid advice, auditory training, lip-reading classes and counselling can help a great deal to cope with daily problems.
Hearing aid:
A hearing aid is a miniature sound system with its own microphone, amplifier and speaker. As the name suggests it makes sound louder and makes speech easier to understand in most situations, but it does not restore normal hearing.
Hearing aids are freely available from local hospital departments after a referral by a general practitioner. Hearing aids have been helpful for many hard of hearing people, but most hearing-impaired people are reluctant to acquire a hearing aid and some who have an aid do not use it.
How does a Hearing Aid work?
Sound enters the hearing aid through a tiny opening and is picked up by the microphone. The amplifier makes the sound louder. The amplified sound comes out of the hearing aid through the speaker and is channelled into the ear canal. A tiny battery supplies the electrical power. Volume can be adjusted by turning a small control on the hearing aid. Some hearing aids adjust the volume automatically
Types of Hearing aids:
The NHS can supply hearing aids which can be worn in the ear or behind the ear. A body worn aid with an earphone in the ear and a bone conduction hearing aid for use when an ear mould can not be put in the ear canal. Hearing aids can be built in into spectacles or built into or mounted on a headband. It is important to emphasise that it is the needs of an individual that are paramount in selection and fitting a correct aid and these needs vary enormously from person to person.
Fitting a hearing aid:
At the hearing aid clinic ears are examined for presence of wax or disease and hearing test (audiogram) is performed to assess the suitability for a hearing aid. Selection and fitting a hearing aid to an individual will depend upon many factors which include type and degree of hearing loss, medical, technical, cosmetic and user preference.
Fitting of hearing aids is based on intuition and experience of the dispenser. However, experience cannot provide all the information to be obtained from a meaningful measurements and performance. A hearing aid is of little value unless it fits properly on and in the ear and provides satisfactory amplification for an individual person.
One aid or two aids?
The main advantage of hearing with two ears is ability to detect the direction from which the sound comes. This directional hearing is important not only for knowing where the sound comes from, but also it enables us to hear better against background noise. It is advisable to have hearing aids fitted for both ears.
NHS or Private aid?
NHS hearing aids are manufactured by reputable firms under contract and purchased in bulk for general use. They are as good as commercial hearing aids and are freely available on loan from the hearing aid departments. Modern digital hearing aids are now available from most audiology departments.
Patience and perseverance:
Acquiring a hearing aid is a first step towards adjusting with difficulties in communication. The effect of unrecognised progressive hearing loss can lead to loss of a listening skill making it difficult to adapt use of hearing aid. Learning to listen again to an amplified sound takes time to learn new processing and communication skills. The main barrier to this still appears to be the stigma associated with wearing hearing aids.
Care of Hearing aid:
All patients fitted with hearing aids are instructed in use of the appliance and are also given a hearing aid booklet for reference and use at home.
Practical tips:
- Keep the hearing aids clean and dry.
- Do not drop them on a hard surface.
- Keep spare batteries readily available.
- Make a habit of keeping the aids at the same place at night.
- Let your family members be familiar with your hearing aids.
- Keep your aids away from your pets.
- Have your aid checked every six months or earlier if necessary.
- If possible keep a spare hearing aid for an emergency.
