Does this look familiar? Do you know how hearing loss in elderly occurs?
To understand, we need to know how the human ear functions.
The ear starts with the outer ear. Then comes the ear canal, ear drum and middle ear with tiny bones called malleus, incus, and stapes. (the stapes is the smallest bone in human body, BTW found this photo on Quora, it illustrates very well the size of it) and then the inner ear.
When the sound reaches the outer ear, it travels through the ear canal, causing the ear drum to vibrate. These vibrations will be amplified by the three bones in the middle ear and sent to the inner ear, to a snail shaped structure, called cochlea, full of fluid.
There is a flexible membrane inside it with cells, called hair cells, which actually catch the vibrations of this membrane and cause a chemical reaction which causes electrical signals, now sent to the part of brain called auditory cortex. The brain will then recognize these signals as sound.
In addition, the cochlea has the very important role of giving us the sense of balance.
Any dysfunction of these parts can cause a hearing loss at any age. This type of hearing loss is called sensorineural and is mostly permanent.
There’s another type, when the way of the sound waves to the inner ear is blocked by something-too much earwax, fluid or a punctured eardrum. It is called conductive. This type of hearing loss can be treated or restored by surgery. Sometimes the two types are combined, which is simply called mixed.
Age-Related Hearing Loss
What is more common in elderly is age-related hearing loss, called Presbycusis.
It is sort of expectancy in nearly every third man (and slightly less in women) between 50 and 74 and in almost every second man or woman equally, aged 75 or more.
I found this cartoon on Pinterest, might be a bit odd, but describes the situation very well.
Usually, first goes the high frequency, causing difficulties with more complex sounds like music and speech, especially of women and children. The speech with background noise becomes especially difficult to understand. That’s when a person will slowly have to understand he/she has hearing issues. Very often, it will be denied, though, for a long time.
The communication in this condition with others becomes more and more difficult and in time, an elderly person might start avoiding it.
Although any part of the auditory system wear out through years, the especially affected part is cochlea and the nerves leading to the brain. If, the blood supply to the inner ear is reduced it will contribute significantly to the hearing loss. The hearing centers in the brain are also sensitive to the blood supply dropping. Cardiovascular disease is often to blame for such a blood supply shortage.
Diabetes. A US conducted study in 2008 concluded that diabetes, due to high blood sugar levels may damage nerves and blood vessels (including those in the ear), thus contributing to hearing loss. Another, 2013 research established this connection to double the risk in people with diabetes to suffer hearing loss as opposed to people without diabetes.
Symptoms of Hearing Loss
A senior with hearing loss, depending on the level of loss, may not hear
-door bell, clock or other alarms
-the phone ringing and might not hear or understand the person talking on the other end of the line
-or understand speech on TV or radio
-a whisper or any muffled speech
-a conversation in a group of people, as it might be difficult to single out one voice at a time
-others by the same table in a restaurant
-movies in a movie or speech in a theater
-a fast speaking person
-women and children speaking (due to higher frequency of their speech)
-anyone not speaking clearly enough
-or understand anyone they can’t see the face of
-or they misunderstand what they were asked
-the first time, so they ask the speaker to repeat himself
Sudden Sensorineural Hearing Loss – A Medical Emergency
A sudden sensorineural hearing loss may occur, when a person can’t hear at once, which happens within 12 hours or less. Quite often, a person wakes up to the condition. If it happens, an immediate medical attention is needed. If, the treatment by steroid medication is not started in a very short critical time-not more than 48 hours-it might become irreversible.
It may leave the person hearing distorted, blended together and loud, magnified sounds.
Some people can’t balance well with this condition. Tinnitus, another condition described below, in these persons also becomes very loud, starts suddenly and doesn’t stop for a long time at night. All this can affect someone’s life to the very point of not being able to cope with everyday tasks or sleeping at night and may result in isolation and severe depression.
Ghost Sounds-Coming From Nowhere
Tinnitus, which is also very common in seniors is “hearing” sounds that are not coming from the outside source. These can be described as a hiss, whistle, whirr, ring, buzz, humming, pulsating or roaring sound. You can hear a few examples here.
As I explained above, sound gets to the inner ear, where hair cells catch the sound and transform them into electrical signals. When these cells are damaged, tips bended too much or broken, they can’t send signal, but the relevant part of the brain sort of can’t believe it, which stimulates the neurons to an activity of their own, creating the illusion of sound, which science named tinnitus.
According to Hearing Link, a UK charity website, the exact trigger of this condition is unknown, but exposure to loud noise or certain medicines, injuries, ear diseases may have a role and it can accompany any type of hearing loss.
Also, it can be a result of more simple causes, as earwax build up, foreign body in the ear canal, or infection, for example. If any such underlying cause can be found, actually treating it may help improve the condition. If a specific cause can’t be found, treatment will consist of helping the affected person to manage the condition on a daily basis and it will require a long term commitment.
Effects of Hearing Loss on Mental Health
We still are mostly a society that treats older people with hearing loss in one of the two ways: either we are overly sympathetic, treating them as if they were nearly deaf, trying to shout at their ears and overly express with our lips and face what we are saying, or we are impatient, irritated by their inability to understand us, giving up the communication by a wave of hand, leaving the person very much hurt by our behavior.
Both approaches only add up to the probably already shaken psyche of the person. Not being able to hear as others, usually triggers feelings of being ashamed, not fitting in, being stupid, awkward and humiliated.
The phrase “deaf and dumb” is one of the most common pejorative epithets used by people who can hear well in reference to those who can’t, peculiarly if it is an older person.
Often enough, elderly won’t even seek help, assuming this is how it has to be, since the aging inevitably brings it. Instead, they start hiding the condition and avoiding finding themselves in situations where their hearing is challenged, like going out, especially in larger company, taking part in leisure activities.
Withdrawal from social life and resulting depression are not uncommon. Former excellent relationships with co-workers, family and friends may turn into arduous ones. Difficulty to think or concentrate, can seem like inattentiveness, distraction, or even boredom to the other person.
A higher degree of hearing loss may cause problems controlling and monitoring their own speech, which will worsen even further the existing communication problem. Having great difficulties hearing the speaker, a senior may also develop a habit of getting into someone’s personal space in an attempt to compensate for the hearing loss, which is rarely accepted well minded. This will deteriorate their relationships even further, until they completely give up talking with someone, except to perhaps one or two very close family member or friends.
Dangers of Having a Significant Hearing Loss
The physical safety of elderly with significant hearing loss may be endangered, as they:
-may be unaware of alarms, such as smoke alarms, doorbells, sirens and other audio signals
-might not be able to hear an intruder coming in to the property
-not being able to hear smoke, or fire alarms may be led to huge danger, even death
-being out in a busy street without hearing traffic sounds puts them in risk of being hit by a vehicle
-may have difficulties with their balance, therefore falls and injuries are a greater risk for them, than for others.
-might find calling for help a daunting task if they can’t hear whether there was an answer or not to the phone call
Your Response to a Senior With Hearing Loss – How It Should Be
Stay sympathetic, but not overly. It is very frustrating when you have to repeat yourself multiple times and still are not understood, but do not give up. Do not try to shout and do not wave away: “Never mind, forget it”. It is offensive as it clearly shows you don’t think that person is worth of you making the effort.
Be patient: Have you ever experienced a long distance phone conversation of law quality? When you struggle to understand the other part, but only some random vowels come through which you can’t connect to reasonable words, let alone a sentence? That’s how irritating it is for people who suffer from hearing loss. Remember that before you burst with intolerance.
Show understanding: Studies have proved hearing loss in seniors to trigger feelings of irritability, tension, stress, negativity and anger, depression and social isolation.
Don’t let any of these dispirit you, but try to see what they struggle with every day. Then treat them as you would want to be treated if in their shoes.
Stay respectful: Do not assume what his/her response to a question asked by someone else would be and do not answer instead of him/her. Repeat instead the question clearly or simplify it to be easier understandable. Speak a bit louder if needed, but do not raise your voice to the level of yelling. It is offensive, plus it distorts words.
Create a good environment: Eliminate background noise as much as possible, try to position yourself so that your face is visible to the person you are talking to and use facial expressions and hand gestures where appropriate. Speak at normal speed and do not mumble or lower your voice when you come to the end of the sentence. These will help the hearing loss sufferer to understand you better.
Is a Hearing Aid a Good Idea?
The short answer is Yes, mostly, by all means. Now, let’s see it more detailed. First, in order to decide what is best for someone, a visit to a specialist is needed.
There is currently no cure for hearing loss. So, no hearing aid will actually cure or reverse the hearing loss to a normal hearing. BUT, it can help hear better again. Similarly, as glasses will help see better again.
A hearing aid is not the perfect substitution for a human ear, but will significantly contribute to an improved quality of life. However, there still might be situations when, even with the best hearing aids a hearing impaired person will have difficulties to hear well.
It will take some time to adapt to a hearing aid, as, practically, the brain also have to be trained to differentiate sounds, filter out some, and decode others-the same as with a normal hearing. After maybe years of being used to very low sounds, the brain has to get adjusted to amplified ones. You can read more about hearing aids here
Help those you care about get the hearing loss help they need.
For many subtitles for watching a movie, face and lip-reading while having a conversation with someone or learning sign language for those whose hearing loss is on a high level can be helpful. For others aids in a form of hearing aid, or special phones or alarming systems will mean the help they need. But, very often, our loving support for seeking help is what our elderly need the most, even if they say: “My hearing is not that bad!”!
You might have experiences in the field, and if so, please share them with me in the comments below. I’d appreciate it and it will certainly be of help to someone.
And, as always, feel free to reach out should you have any question. I’ll be happy to answer to the best of my knowledge.When you buy something from this website, I may receive an affiliate commission, at no extra cost to you. Full disclosure here