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 Hearing Loss In Elderly Residents Not Being Adequately Treated, Study Finds

According to a new study, the vast majority of people aged 80 and over have some hearing loss. While this may not be especially surprising, it is notable that many people with this problem are not receiving treatment or using hearing aids or other assistive devices.

The study, published in JAMA Otolaryngology—Head & Neck Surgery, involved 647 subjects, all aged 80 and older who underwent auditory evaluations at an academic medical center. Participants were divided into four groups of those aged 80-84, 85-89, 90-94, and 95-up. Researchers determined that hearing loss was more significant in the older of the four age groups. Interestingly, despite the widespread incidence of hearing loss, only 59 percent of the participants in the study used some type of hearing aid.

“We’re not doing enough to address hearing loss in the elderly,” the study’s lead author Anil Lalwani, MD, tells Provider. Sensory deficits often get overlooked in older patients, who often have a number of comorbid illnesses and conditions, notes Lalwani, who is vice chair for research, otolaryngology—head and neck surgery, chief of the division of otology, neurology, and skull base surgery, and director of the cochlear implantation program at Columbia University Medical Center.

Additionally, in the long term care setting, getting residents out to see a specialist is challenging. Pennsylvania-based medical director Daniel Haimowitz, MD, CMD, agrees.

“There are multiple barriers to addressing hearing loss in our residents.  Audiologists may or not be available, sending residents out for appointments is time-consuming and costly, health care providers may not have time to do proper assessments and treatments, and staff in all likelihood do not have equipment for fairly easy procedures such as ear wax cleaning,” he says.

“The model of how we deliver hearing health care has to change. We have to change how hearing aids are dispensed, and we have to make them affordable,” says Lalwani. He adds that there is a greater role for primary care practitioners to play. For instance, they need to ask about hearing loss during regular exams, and they should work to remove stigmas about wearing hearing aids and help their patients get the assistive devices that are best suited to their needs and lifestyle.

Identifying and addressing hearing loss does more than help a person hear better, Lalwani says. “Imagine being in a loud bar and trying to carry on a conversation. You can’t understand what people are saying, and you have to look directly at the speaker and really pay attention. This is what it is like every day for elders with hearing loss, and this type of active listening is exhausting.”

Lalwani says that elders with hearing loss begin to withdraw and can become isolated and depressed. They become less active, he says, and they are more likely to experience falls and cognitive decline.

He stresses that hearing aids—and hearing aid providers—are not one size fits all. He suggests researching both and working with patients to find the best fit for them. In addition to hearing aids, there is other technology that might be useful for elders with hearing deficits. These include FM systems, phones with special volume controls, telephone TTY devices, and closed captioning for television and video.

Reducing background noise—such as air conditioners or fans—in the resident’s environment also can help make it easier to hear. For those individuals with profound hearing loss that is no longer helped by hearing aids, cochlear implants may be an option.

Lalwani urges practitioners, patients, and family members alike to be proactive about hearing loss in the elderly. He stresses that it is important not to “lump older people together.” He says, “We have to recognize that 65 isn’t the same as 75 or 85 when it comes to hearing loss or other health issues.” By addressing hearing loss early, it not only improves quality of life for elders, it contributes to slower deterioration in hearing and enables them to stay active and alert for as long as possible.

Link to this study at http://archotol.jamanetwork.com/article.aspx?articleid=2552989.

 

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