3.2: Hearing
- Page ID
- 160211
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Hearing in Geriatrics
Hearing Loss
1. Conductive (Example: Wax in the ear.)
- Hearing impairment due to the failure of sound waves to reach the inner ear
- Outer ear and middle ear may be affected.
- Will cause decrease in loudness only.
- Can fix the problem quickly and easily.
2. Sensorineural (Example: Nerve damage from listening to loud music.)
- Will cause sound to be fuzzy or distorted.
- Occurs most frequently in elderly, hunters or people working around loud machinery without ear protection.
- High frequency sound less likely to be heard, i.e., s, th, f, sh, ch, t, p (high-pitched sounds.)
- Harder for men to hear the high voice of a woman.
3. Mixed
- Combination of conductive hearing loss and sensorineural hearing loss.
- A combination of any of the following: outer ear, middle ear, peripheral
4. Central (Could be born with this problem)
- Hearing loss resulting from central nervous system, as nerve passes through the brain stem, cerebellum, thalamus and cortex.
- Central nervous system or brain and brain stem.
Hearing Aids
- Behind the ear (BTE) – Most common type.
- In the ear (ITE)
- Body aid – Less frequently seen; commonly used in the 1970s for severe hearing loss.
- Cochlear implants – A new surgery and not frequently seen in geriatrics yet.
Check/Maintain Hearing Aid
- Use stethoscope to check sound.
- Check batteries with battery checker or use cupped hand method.
- Never get wet, clean with alcohol swab.
- Never use toothpick, needle, etc. to clean out wax.
Hearing Aid Tips
Be sure resident wears his/her hearing aid every day
Morning Care
- Place battery in hearing aid. (Battery should be replaced every 2-3 weeks)
- Place hearing aid on the resident.
- Turn on the hearing aid.
- Turn up volume to a comfortable level for the resident.
Evening Care
- Remove hearing aid from resident before bedtime.
- Open battery compartment.
- Check ear mold for wax.
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Troubleshooting Hearing Aid Problems |
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Problem |
Cause |
Possible solution |
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Hearing aid has no sound or is weak |
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Instrument whistles |
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Sound is distorted or intermittent |
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Suggestions for Talking With the Hard of Hearing
- Get the attention of the individual. Don’t begin without establishing eye contact whenever possible.
- Place yourself on the side of the bed away from the window in order to let the light shine on your face. Avoid backlighting as this will place your face in the shadows.
- Take distance into consideration when talking to the resident or individual. Two to five feet seems to be the optimum distance for successful lip reading.
- Talk naturally, but not too fast, without shouting or elaborately “mouthing” the words. Words spoken a bit more slowly, and not run together too rapidly, are clearer than those that are shouted or exaggerated.
- Turn down the radio, TV and any other competing noise within the room.
- Avoid using sentences that are too complex or run on too long. Slow down a little, pause between sentences, and wait to make sure that you have been understood before going on.
- Emphasize the key word in the sentence, regardless of the less important words that come before and after it. Try to avoid speaking in monotone.
- If, after repeating a word or phrase, the resident continues to have difficulty understanding you, try to find a different way of saying the same thing.
- Keep your hands, medical chart or clipboard away from your face while talking.
- Eating, chewing gum or smoking while talking will not only distort the sounds of your speech, but will interfere with visual contact.
- If you are giving a specific instruction, such as time or place, be sure that it is repeated back to you. Many numbers and words sound alike.
- Avoid “ah,” “um,” “well,” “er” and coughs, as they are meaningless to the lip reader.
- Remember that some words are physically invisible to the lip reader, such as “hair” or “egg.”
- Try to remember that abrupt changes of subject on your part can be very confusing.
- Remember that lip reading is physically fatiguing. Take this into consideration when you have been talking for any length of time.
- Recognize that nobody, especially the hard of hearing, hears as well and understand as well when tired or ill.