Hearing loss has many possible causes. If there is interference in the ear itself, the hearing loss is conductive deafness. The other major cause for hearing loss, neural hearing deafness (nerve deafness), is interference with the transmission from the ear to the brain. Both types of hearing loss occur with increased frequency in elderly patients. Presbycusis is the principal cause of the hearing loss of aging. It is a neural form of hearing loss. The occurrence and severity of the hearing loss are highly variable from patient to patient. High blood pressure, heredity, and a history of exposure to noise are all important factors in determining how severe and how progressive the hearing loss will be.
Usually the hearing loss involves higher-pitched sounds, but it is progressive in that it gradually involves sounds of lower pitch. At first, the ability to hear speech is intact, but eventually the loss progresses and some speech sounds can no longer be heard.
Physicians recognize four different causes or types of presbycusis. Treatment varies with each variety. The patient’s physician will use audiometry (a hearing test) to begin the evaluation of the patient’s hearing loss.
Important Points in Treatment
The most important feature in the management of hearing loss is recognizing that the loss has occurred. Most of the management consists of a mix of supplementing the loss with properly selected, properly fitted hearing aids and accommodating for the loss with appropriate environmental adjustments.
A hearing aid can compensate for some kinds of hearing loss. The hearing aid’s performance must be matched with the kind of hearing defect to provide any benefit at all. Even carefully selected and properly fitted hearing aids require a period of training on the part of the wearer to be effective. The patient must learn to use the hearing aid. It is unlikely that the hearing aid will completely restore normal hearing, and it is this new kind of hearing that the patient must learn in order to appreciate its benefit. A hearing aid is not an instant solution for a hearing defect.
Hearing aids require maintenance to function optimally. Changing tiny batteries can be difficult for elderly patients.
Care with communication can supplement the benefits of a hearing aid or compensate when a hearing aid is ineffective.
A few simple rules will make communicating with the hearing-impaired person easier.
- Eliminate as much of the background noise as is reasonably possible.
- The speaker should face the hearing-impaired person. Do not shout from another room or speak to the hearing-impaired person’s back.
- Arrange the positioning and the lighting so the hearing-impaired person can see the face of the speaker. Even without a knowledge of lip reading, a listener gets many clues from watching the speaker speak.
- Ask the speaker to speak distinctly. Slow speech is not particularly helpful. Do not shout.
Notify Our Office If ...
- The patient has a problem understanding conversation. The most important feature in the management of hearing loss is recognizing that the loss has occurred.