Loud and Clear: Strategies to Address the Signs of Hearing Loss for Older Adults
Updated: Dec 21, 2020
Yesterday’s hearing aids were often big, bulky, and immediately conspicuous. Today’s hearing aids can slide inside the ear (ITE) or tuck behind the outer ear (BTE) making them more discreet. Hearing loss, therefore, has become a more invisible condition. Similarly, symptoms of hearing loss are not always completely apparent either. Despite this, a family caregiver or in-home caregiver can easily identify initial or ongoing deafness.
6 Signs of Hearing Loss in Seniors
Does your loved one do any, or all, of the following?
Ask for repetition. Seniors aren’t the only ones who may repeat what they’ve said. Caregivers may need to also restate. Doing so (and perhaps multiple times) can be a frustrating sign of hearing loss.
Misunderstand. A senior experiencing hearing loss may mishear or misinterpret spoken messages. Many English words sound similar, so it is not surprising that seniors may be confused. Hearing aids work to reduce the chances of seniors providing completely unexpected answers to a family caregiver’s statements or questions.
Complain. Does your senior grumble about other’s speaking volumes? Even when a caregiver speaks more loudly and/or clearly, what is said may sound like faint whispers to a senior with hearing loss.
Turn up the volume. A senior may try to compensate for hearing loss by turning up the volume on a television set - possibly loud enough to bother the neighbors. Alternatively, the senior may begin to rely on show captions if this feature is available because they find reading easier than listening.
Miss conversations in busy environments. While restaurants and shopping malls may not be active these days with COVID-19, they are more normally bustling with customers producing more background noise. A family caregiver’s conversation, even from across a dining table, can be easily drowned out by the increased sound. More voices and noise can result in a confusing hum to a senior and can make hearing and focusing on just one discussion even more difficult.
Struggle to hear women and children. Women’s and children’s voices are often softer or quieter. Men’s voices can be louder and more forceful. Therefore, a deaf senior may be better able to hear a man speaking.
8 Tips for Communicating with Seniors Experiencing Age-Related Hearing Loss
There are many far worse physical and mental health problems for seniors than hearing loss. Communication remains possible; however, family caregivers must be more mindful. Try any, or all, of the following tips:
Slow down and enunciate. Remember the story of the tortoise and the hare? The turtle won their race. Going slowly can be a better means of reaching your finish line and achieving your goals. Family caregivers, therefore, should be aware of their speaking pace. Rushed speaking can result in words blending into others or being completely missed.
Project. Projecting your voice may also help. When speaking louder, try increasing your volume gradually to a sufficient level rather than immediately shouting.
Face the senior. Even those with perfect hearing can benefit from this strategy. When facing a senior directly, a caregiver can be better heard. Family caregivers in closer company can also command more attention and continued attention. When a family caregiver is in front of a senior, he/she may also be better able to lip-read spoken words.
Repeat. Saying things over again can become a common practice for caregivers trying to communicate with deaf seniors. A slightly different tactic may be rephrasing what is said. Family caregivers can choose different words. Replace longer and more complex words with shorter and more easily understood words. Remove unnecessary words from sentences and be concise.
Incorporate touch. Asking a senior with hearing loss to join you for a walk may not be enough. Try gently reaching for the senior’s hand to attract attention and provide encouragement.
Write or draw. When a verbal message is not heard, a family caregiver may still use other forms of communication. Writing a sign or drawing a picture may help a senior with hearing loss.
Alternate. When having a conversation with a senior with more than one individual, take turns speaking. Let one person finish a thought or sentence before interrupting. Family caregivers could also state the senior’s name, wave, or lightly tap his/her shoulder to become noticed prior to speaking.
Ensure that the hearing aid is placed and working correctly. When my father was in long-term care, I frequently found that he wasn’t wearing his hearing aids. Staff were often too busy and didn’t prioritize this job. When troubleshooting hearing aids, family caregivers can further check to see if the devices are turned on, require replacement batteries, or need cleaning – excessive wax buildup can muffle or block incoming sound.
Wearing Hearing Aids (Instead of Throwing Them in a Drawer)
“What’s that you said?” People suffering from mild or extreme hearing loss may often ask this question. Hearing aids can help now, but they will only work when properly used.
My sisters and I purchased a pair of hearing aids for our father but these proved to be ineffective. Dad had advancing Alzheimer’s disease and would have never remembered to insert the devices each morning. Being able to use their hearing aids correctly can be a step in the right direction for your loved one to continue maintaining independence when living with Alzheimer's or other forms of dementia. You might expect facility caregiving staff to make this happen; however, they often had other residents with other problems to deal with. In this case, the care staff may have classified hearing aids as low priority.
Undergoing a hearing test and choosing a hearing aid are just the beginning. Whether you have purchased a “Behind the ear” (BTE) or an “Inside the ear” (ITE) model, there is much to know about with regards to proper use, care, and maintenance.
If the hearing aids don't work for the wearer, they will end up unused or lost. Here are strategies to make sure hearing aids are worn after purchase.
Be Sure Wearing the Hearing Aids is Comfortable
In order to be sure that wearing the hearing aids is comfortable, consider these six practical steps.
Effectiveness. Seniors need time to get used to and adapt to new hearing aids. During this acclimatization period, a senior – essentially – relearns how to hear. This requires close work with your audiologist. Follow-up visits to the audiologist will be necessary to make necessary arrangements to volume, background noise filtering, fit and comfort.
Fit. Whether you have chosen a BTE or an ITE hearing aid, this must fit comfortably for best results. You’re looking for a snug fit – not a painful pinch.
Battery. All hearing aids operate with a small battery which needs regular changing. Depending on the severity of hearing loss, you may be replacing the battery once every three to ten days. For best results, your audiologist can show you the procedure of changing batteries. Before leaving the audiologist's office, try changing the batteries for yourself. You will want the procedure to run smoothly. Take note that hearing aid batteries also have a shelf life. Check the “best before” date on the battery package before purchasing. The senior may hear a whistling sound after you have replaced the batteries. If this occurs, chances are that the hearing aids are improperly placed. Try removing and replacing the hearing aids.
Placement. Hearing aids can be very different for each ear. Therefore, ensure that each hearing aid is in the correct ear. Identifying the two hearing aids is quite easy … look for colored spots or letters on each device. The blue spot (or the letter, “L”) means the left ear while the red spot (or the letter, “R”) means the right ear.
Volume. If the hearing aid has an external volume control, try adjusting this. Typically, if you turn the knob towards the user’s nose, you are increasing the volume level.
The wearer's activity level. Does the person still join in any sport/activity? If so, certain types of hearing aids can be better than others. Wet hearing aids are ineffective. Remove these devices before showering/bathing, swimming, or walking out in the rain.
How To Best Care for Hearing Aids?
To best care for the hearing aids, these next three steps can also help.
Storing. Keep your hearing aids secure in the provided storage case when they are not in use. Keep this case in the same spot to help with consistency in remembering.
Cleaning. A BTE hearing aid can be washed out with warm water and mild soap. After washing it clean, allow the BTE hearing aid to dry thoroughly before use. An ITE hearing aid, however, needs more gentle care. Brush off any built-up earwax on your hearing aid. Wax can also build up inside the small tube on many hearing aids. You should find a short wire in your user’s kit. This wire can be gently pushed through the tube to remove this wax. Return your hearing aids to the audiologist every three to six months for a more thorough cleaning.
Troubleshooting. Have the hearing aids ceased to work? Don't just toss them into the trash. Check to see if the senior is wearing them. The senior may also be wearing the aids incorrectly. When worn in the wrong ears, hearing aids can be ineffective. Alternatively, the volume control may be turned down. Has earwax built up to cover the hearing aid’s air hole? Does the battery need to be replaced? More extensive troubleshooting can be done at the audiologist’s office. Expect numerous follow-up visits – the first of these will likely be within a month after your purchase.
Continued hearing loss can be confusing, frustrating, and even dangerous for seniors. The correct hearing aids and proper usage of these aids can improve the ability to hear and boost quality of life – for both the senior and the family caregiver.
Author: Rick Lauber