Most of us know somebody that has a hearing loss, especially if we have elderly parents or grandparents with age-related hearing loss. While hearing-impairment affects people of all ages, it is most commonly found among the elderly. The World Health Organisation’s hearing loss statistics show that around one-third of those aged 65 years or older have a disabling hearing loss. Hearing loss among the elderly population tends to get worse over time: 50% of those who are 75 years and up have disabling hearing loss.
How Does Hearing Loss Affect the Elderly?
Hearing is rated as the second most important among the five basic human senses after vision. Especially for the elderly, hearing loss can be difficult to live with if the loss is not treated.
On the most basic level, the impacts of hearing loss in the elderly are a reduced ability to communicate with others and perceive the world.
As a result of the difficulties in communicating, the elderly with hearing loss are at risk of becoming more socially isolated and losing touch with loved ones. They may opt-out of attending social gatherings, or they may be frustrated with their circumstances and take it out on loved ones. Studies have found links between untreated hearing impairment and depression and that the hearing loss can hasten cognitive decline.
Commonly, seniors with hearing loss feel they are a burden to their loved ones, because they need to rely on help from others to handle practical matters in their daily lives, and because they feel that people have to go out of their way to communicate with them.
Untreated hearing loss can also affect the personal safety of the elderly and their ability to detect dangerous situations. Being unable to hear the fire alarm or vehicles when crossing the road puts the elderly with hearing loss at risk.
Other impacts of hearing loss on the elderly include reduced balance and tinnitus, which is more commonly known as ringing in the ears.
Given the potential impacts of hearing loss on personal safety, mental health, and interpersonal relationships of the elderly, caregivers need to understand the symptoms of hearing loss in the elderly and know how to help.
What Are the Symptoms of Age-Related Hearing Loss?
There are numerous signs of possible hearing loss among senior citizens that can be spotted by partners, children, grandchildren and friends.
Sometimes the signs will be rather obvious, for example, if they complain their hearing is not as good as it used to be. Other times, there will be symptoms of possible hearing loss that require interpretation.
Eight less straightforward signs of age-related hearing loss are:
- They watch television with loud volume
- They cannot hear clearly during phone calls
- They complain that other people are mumbling or not speaking clearly
- They answer questions in ways that suggest they did not understand what was being asked
- They have a hard time following and participating in group conversations or conversations in noisy environments like in the car, at a dinner party or a restaurant
- They complain about pain or a ringing sound in the ears
- They are often feeling dizzy
- Their behaviour changes and they become less social
What Helps Hearing Loss in the Elderly?
Unfortunately, there is no cure for permanent hearing loss. Once the inner ear nerves and hair cells are damaged, there is no known way to repair them. Since age-related hearing loss tends to come gradually, people tend to gradually increase the volume of their television, radio or telephone. This can lead to further damage to their hearing.
Through hearing loss treatment, you can protect remaining hearing ability. That is why it is important to help the elderly with hearing loss at an early stage.
The main ways to treat hearing loss are:
- Hearing aids
- Cochlear implants
- Personal sound amplifiers
These devices are the hearing world’s answer to eyeglasses. Glasses don’t cure visual impairment, but when worn, they allow the wearer to see more clearly. Similarly, hearing aids, cochlear implants, and personal sound amplifiers help the wearer hear more clearly.
Before spending money on hearing devices, it is best to seek the assistance of an audiologist or hearing care professional to get a diagnosis and rule out treatable hearing loss causes.
Tip: Sometimes, hearing loss is caused by earwax buildup and blockage and does NOT require the use of hearing devices. A doctor or hearing care professional can check the ear canal for earwax and blockage.
How to Help the Elderly With Hearing Loss?
The process of helping the elderly with hearing loss can be broken down into three steps.
Step 1: Find Out Their Awareness of, and Attitude Towards, the Hearing Loss
One may be eager to help and want to make progress as soon as possible. However, some hearing-impaired, especially those who are younger or only experiencing mild to moderate hearing loss, may either be unaware of their hearing loss or not be willing to entertain the possibility of getting hearing aids.
The first step towards better hearing health is a change in attitude.
Many will change their attitude once the hearing loss level becomes worse and turns into moderate, severe, or even profound hearing loss. Yet, research shows that on average it takes people 7 years to get hearing aids after they develop a hearing loss.
Some people who are hard-of-hearing may think that it is not possible or necessary to do anything about it. They may lean towards trying to cope with it, or they may be worried about the stigma surrounding the use of hearing aids.
Ultimately, hearing impairment does not only affect themselves but also their loved ones. Bringing up how one feels their hearing loss affects others might lead to a change in attitude. If any of the eight signs of hearing loss are present, it may also be appropriate to bring them up to explain why you suspect their hearing is not as good as it used to.
The goal is to convince them to see a hearing care professional for a thorough check without being too pushy.
Step 2: Take Them to See a Hearing Care Professional
It is important to seek the assistance of a hearing care professional to get a diagnosis and rule out treatable causes of hearing loss. If someone had a sudden hearing loss, it is crucial to see a hearing care professional sooner.
The hearing care professional will complete a series of tests and to assess the unique hearing health situation of the patient. If necessary, they will make a referral to a specialist for further checkups.
They can also help evaluate whether a hearing device would be beneficial.
It is important to find a good hearing care professional that follows best practices. Consider: is the hearing consultation thorough? Is it focused on the patient’s well-being, or is it sales-focused?
Step 3: If Necessary, Help Them Get a Hearing Aid, Personal Sound Amplifier or Cochlear Implant
If it appears that hearing devices will be beneficial, the third and final step is to help them through the process.
The hearing aid selection process should take several factors into account, such as:
- The unique hearing profile of the patient;
- Their daily habits;
- Familiarity with digital technologies;
- Style preferences; and
There are many options in the market, but a hearing aid clinic will typically only stock devices from one or a handful of brands, so seek more information before making a purchase.
Some people may refuse to wear hearing aids because of stigma, price or the complicated setup process. Although not intended to compensate for hearing loss, they may instead decide to use smart personal sound amplifiers after learning about how they compare to hearing aids.
Tip: You don’t have to buy a hearing device during the first appointment. A common sales strategy among hearing aid centres is to offer the hearing test free of charge if a hearing device purchase is made on the same day. If necessary, take more time to consider your options.
What Causes Hearing Loss in the Elderly?
There are many types and causes of hearing loss. Age-related hearing loss, also known as presbycusis, is the most commonly observed type among senior citizens. It is usually caused by gradual changes to the inner ear due to repeated exposure to noise throughout our lives.
Since age-related hearing loss comes gradually, the elderly themselves may not be aware of it. That is why it may be necessary for a partner, child, grandchild or friend to bring up the suspected hearing loss.
Typical Age-Related Hearing Loss Audiogram
Usually, when people develop age-related hearing loss, their sensitivity to high-pitch sounds will be affected first. The audiogram below would be typical for an age-related hearing loss.
In this audiogram, there is a severe hearing loss in both ears at the high frequencies (4000 Hz and 8000 Hz). They have also developed a mild-moderate hearing loss at 2000 Hz, while the hearing ability at 250, 500 and 1000 Hz borders between normal hearing and a mild hearing loss.
Hearing Loss Prevalence by Age
As mentioned, age-related hearing loss is something that comes gradually, and it can start early on in our lives.
In fact, an estimated 5.43% of those aged 30-39 years will have at least some degree of hearing loss.
People aged 50-59 years have a 28.69% chance of having hearing loss, although the majority of the cases are mild to moderate. People’s hearing ability deteriorates rapidly after that point, and by the time they are in the age group 70-79 years, two-thirds will already have a hearing loss. Among those aged 80 years and above, 9 in 10 people have hearing loss.
How to Communicate With the Elderly With Hearing Loss?
When a loved one suffers from hearing impairment, they will have difficulties communicating. They may miss out on the entire conversation or not be able to decipher which topic you are discussing.
A hearing aid, personal sound amplifier or cochlear implant might help. However, sometimes those options are not available, and it is up to those around them to know how to communicate with the elderly with untreated hearing loss. This requires patience and effort, and it can take time to get used to.
The top 8 tips for communicating with the elderly with hearing loss are:
- Talk in more quiet environments
- Focus on pronouncing words clearly and avoiding mumbling or lowering your voice
- Use body language while you speak
- Speak at a normal speed (neither too quickly nor too slowly)
- Speak more loudly – but do not shout
- Face them when you are talking to them
- Pay attention to their verbal and visual cues to see if they understand what you are saying
- Be willing to rephrase if they do not understand what you say - certain sounds or words may be especially difficult to hear, depending on the unique characteristics of their hearing loss