Hearing healthcare professional toolkit (CUNY - US)
Hearing healthcare toolkit for use in primary and geriatric care
What follows is a more detailed explanation of the relationship between age-related hearing loss, other chronic medical conditions and their impact on the overall health and wellness of individuals. Hearing loss shares many unique characteristics with dementia . Hearing loss is a highly prevalent condition, increasing in prevalence with increased longevity. While high in prevalence, it typically goes unrecognized. Invisible at first, the person with the condition often does not know they are missing important aspects of communication with others. Hearing loss is often invisible to healthcare practitioners, as well. It is insidious, taking about seven to ten years before people realize that the condition is problematic and is interfering with aspects of their lives. The inability to communicate effectively which is a hallmark as the condition progresses, robs the individual from being a productive member of society. Hearing loss has various consequences in the physical, behavioral and social domains. It is indirectly associated with mortality and directly associated with functional disability, social isolation and poor self-reported health and depression. Hearing impairment is a risk factor for cognitive decline, falls and mobility decline. Older adults with hearing loss have the increased burden of medical co-morbidities relating to aging such that more than 50% of older adults have three or more chronic diseases (i.e., multimorbidities) (American Geriatrics Society, 2012). Individuals with hearing loss, vision loss and dual sensory loss have an increased likelihood of presenting with co-morbid conditions ranging from falls and walking difficulty to hypertension to cardiovascular disease. There is a higher prevalence of diabetes in those with hearing impairment, as well. Present in nearly two-thirds of persons 70 years of age and older, hearing loss remains untreated in the majority of persons in this age group (Chien and Lin, 2012). While the prevalence of hearing loss is nearly 80% among persons 80-plus years of age and older, only 14% reported owning hearing aids; among persons 70–79 years of age, with a prevalence of hearing impairment of nearly 50%, approximately 8% reportedly used hearing aids (Chien & Lin, 2012). Older adults are prone to impacted cerumen which can lead to temporary or exaggerated hearing loss and can also obstruct hearing aids interfering with their function. Overall, the majority of persons with hearing loss do not use hearing aids or other sensory aids despite their proven effectiveness in reducing some of its negative consequences. Hearing aids may not be an option for some and the advent of hearing assistive technologies and personal amplifiers as inexpensive alternatives opens the door to numerous options fromwhich to choose. Of course older adults with severe to profound hearing loss who are no longer candidates for hearing aids are increasingly being referred for cochlear implants with excellent outcomes emerging. Hearing loss is independently associated with increased burden of disease, poorer self-reported health, increased odds of hospitalization and healthcare use. Specifically, as compared with normal hearing adults 70 years of age and older, individuals with hearing loss had more hospitalizations and had a positive history of cardiovascular disease. Hearing loss was associated with any hospitalizations and number of hospitalizations (Genther, Frick, Chen, Betz, & Lin, 2013). After hospital discharge, nearly half of hospitalized patients experience at least one adverse event. It has recently been acknowledged that most errors result from a breakdown in communication between parties (e.g., the hospital team and the patient or primary care physician) Specifically, upon discharge, physicians tend to rely on verbal instructions and the entire interaction is typically rushed (Kripalani, Jackson, Schnipper
Nearly 50% of inviduals between the ages of 70 to 79 have hearing loss, yet only 8% use hearing aids.
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