| An estimated 24 million people in the United States - most of
them elderly suffer from some type of speech, language, or hearing
handicap. Aging itself is the major cause of hearing disorders.
Speech and language disorders however are usually caused by acquired
neurological diseases or head/neck cancer and are not significantly
affected by the normal aging process. This section describes various
hearing and speech disorders and offers practical steps on how to
improve communication with impaired older adults.
Presbycusis
Presbycusis is a permanent, irreversible communication disorder
characterized by a progressive breakdown of hearing. It is caused
by physical changes in the inner ear and the degeneration of inner
structures. Presbycusis is a by-product of aging. Thirty percent
(30%) of the population between ages 65 and 75, and 50% over age
75 experience significant hearing loss.
Symptoms: Presbycusis is easily detected, but often goes
untreated. Older adults may be aware of the hearing disorder and
may accuse people of not speaking clearly.
Symptoms include: difficulty distinguishing words that sound similar;
an inability to hear high pitched sounds such as a young child's
voice; difficulty understanding over the telephone; problems in
following conversations in group situations; saying "what?"
frequently; and, turning up the volume on the television.
Effect on Behavior: Presbycusis causes a hearing loss that
impairs the understanding of speech. Hearing loss can lead to behavioral
changes such as withdrawal, frustration, anger and embarrassment.
Some hearing impaired elderly are mistakenly thought to be confused,
paranoid, senile, uncooperative, or unresponsive. To avoid the embarrassment
and frustration of asking people to repeat themselves, those affected
tend to withdraw socially and become depressed by their inability
to interact with others.
Treatment and Rehabilitation: Sudden changes in hearing
should be brought to the immediate attention of your family physician.
More complicated cases might require the expertise of an otolaryngologist,
a physician who specializes in the treatment of ear, nose and throat
disorders. Some physicians may refer patients to audiologists, professionals
who specialize in diagnosing and treating communication disorders
associated with hearing loss.
To assess hearing, the audiologist administers a painless hearing
test with an audiometer, a device that produces sounds of varying
intensity and pitch. The audiologist will conduct a battery of audiological
tests to define the nature and extent of the hearing problem and
its effect on communication.
If indicated, the audiologist will develop a plan of audiologic
rehabilitation which may include use of a hearing aid; use of various
assistive listening devices; counseling with the patient and family
concerning the communication disorder; and/or a program of speech
reading (lip reading) and auditory training to reduce the effect
of the hearing impairment.
Hearing Aids
Many styles and models of hearing aids are currently available
that can help individuals compensate for hearing problems. While
many elderly persons can be helped with hearing aids, some may not
significantly benefit. It is important that an audiologist carefully
evaluate a person's potential for wearing this device. Increased
volume from an improper hearing aid tends to make sounds louder,
but more distorted and thus more difficult to interpret. The hearing
impaired consumer should have a realistic expectation that a hearing
aid will not restore, but rather, compensate normal hearing. The
audiologist may dispense the hearing aid or refer the individual
to a hearing aid dispenser to order and fit the prescribed device.
Caregivers should plan to attend follow-up training sessions that
are provided by the audiologist to better understand the operation,
care, and limitations of the hearing aid. The audiologist will also
stress methods that can be used to alter one's communication style
and enhance successful adjustment to the use of the hearing aid.
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