Hearing Loss in Older Adults: a Quality of Life issue – Part 1
By Laine Waggoner
Editor: “Growing older is not for sissies!” I don’t recall where I first heard that comment, but daily experiences convince me it’s right on the mark. Hearing loss is one more condition that many people have to deal with as they age, and it’s not easy!
Here to discuss these issues is Laine Waggoner, Director of HEAR (Hearing Loss Education and Relationships) in Palm Springs. Laine has earned Masters Degrees in communications and counseling and is a candidate for certification in Gallaudet University’s new Peer Mentoring program. She has worn hearing aids for nearly 50 years, and has been an active hearing loss educator, counselor, and presenter for nearly 15 years. You can reach her at LaineWaggoner@dc.rr.com.
Among seniors in the US, hearing loss is the third most prevalent, but treatable, disabling condition behind arthritis and hypertension.
Hearing loss can be frustrating, embarrassing and even dangerous at any age. Hearing problems can have a dramatic effect on our ability to understand speech and to be aware of environmental sounds. Regrettably, people tend to deny or underestimate the impact hearing loss has on their personal growth, happiness and satisfaction in daily life.
They do not understand the direct relationship between hearing loss and the interpersonal communication problems they frequently have with spouses, family, friends and coworkers; or the negative effect that stress and communication difficulties often have on their bodies, minds and emotions.
Untreated hearing loss in seniors is linked to serious emotional and social consequences, such as depression and isolation. Unfortunately, it is often misinterpreted as rudeness, lack of interest or low intelligence. Aided hearing loss leads to a better quality of life, according to a 1999 study by the National Council on Aging (NCA).
My goal when counseling and educating older adults with hearing loss and their families is to help them feel empowered and hopeful so they will stay involved in life.
Why early diagnosis is important
Many people with hearing loss get by for years through denial and bluffing. Yet, early evaluation and diagnosis are crucial in order to rule out or treat correctable medical problems, such as drug reactions, infections, tumors and allergies. Any of these can temporarily or permanently damage the auditory system.
Hearing loss is one of the most common conditions affecting older Americans. Most problems of hearing are caused by malfunctions in the inner ear or the auditory nerve. Some degree of age-related hearing loss (presbycusis) will be found in nearly 40 percent of people who are 65 to 75, about half of those 75 or older and perhaps 90 percent of institutionalized older adults. Impacted ear wax (cerumen) is implicated in only 25-30 percent of hearing loss.
A November 2004 MarkeTrak survey found that nearly 32 million Americans (10% of the total population) now indicate they have a hearing loss. The greatest increase is among baby boomers due to noise exposure and among those who are age 75 and older, due to aging.
Hard of hearing persons represent 94.8 percent of the total, 3.8 percent are late deafened and 1.4 percent is culturally Deaf. The overwhelming majority of people with hearing loss identifies with the hearing world and wants to stay involved in it, using speech as their main form of communication.
Feedback and timing in the aging brain
I recently learned about research by Robert D. Frisina, Ph.D., an expert on age-related hearing loss, and his team at the International Center for Hearing and Speech Research (ICHSR) in Rochester, NY, funded by the National Institutes of Health (NIH). Dr. Frisina reports on the discovery of two factors: feedback and timing that influence the older person’s ability to distinguish speech sounds.
He explains that, “There are many people with good inner ears who just don’t hear well.” Starting in our 40s and 50s, according to Dr. Frisina, our brains develop problems with filtering, sorting and making sense of the massive amounts of information that flow through our senses daily. This explains something I have noticed in myself and in the older people I counsel.
The brain’s feedback problem explains why so many older adults experience speech discrimination difficulties in noisy situations. This is true, even among those with “normal” hearing.
The timing problem affects our ability to distinguish separate consonants and slight gaps in speech, which makes sentences seem to run together and sounds seem muddy or distorted. That is why asking someone to speak somewhat slower and more clearly can often minimize the problem for a person who is hard of hearing.
Another aspect of this word discrimination problem was uncovered by a recent Brandeis University study that found that older adults with mild-to-moderate hearing loss may develop problems remembering what they hear because of the tremendous effort their brains must expend on hearing accurately. Neuroscience researcher Dr. Arthur Wingfield advises anyone who works with older people to be especially sensitive to how hearing loss affects cognitive function. For this reason, he also urges hearing people to speak more clearly, pausing after clauses and chunks of meaning.