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Dealing with hearing loss

LTC Nursing Assistant Trainer, November 10, 2004

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Roughly 10% of the population has some degree of hearing loss. In people 65 and older, the occurrence of hearing loss is about 25%. Chances are, many of your facility's residents suffer from some type of hearing loss and may wear hearing aids.

The three general categories of hearing loss are conductive, sensorineural, and central. Each type is related to the part of the ear where a problem has occurred:

• Conductive
  Conductive hearing loss is due to either blockage of sound waves through the external ear canal to the bone of the middle ear, a problem with the bone of the middle ear, or a perforated eardrum. Earwax or a foreign object may cause the blockage of the external ear canal.
• Sensorineural
  Sensorineural hearing loss occurs when there is damage to the inner ear, the auditory nerve, or the nerve pathway to the brain.
• Central
  Central hearing loss occurs when there is damage to the area of the brain involved hearing. Brain tumors, strokes, or diseases that affect the blood supply to the inner ear can cause central hearing loss.

Treatment and hearing aids
Treatment of hearing loss depends upon the cause. For instance, removing blockage from the ear canal, treating ear infections, or microsurgery on the inner ear may be helpful. Most often, however, a hearing aid is prescribed.

The effectiveness of a hearing aid depends, to some degree, on the type of hearing loss. Conductive hearing loss responds better to hearing aids than sensorineural hearing loss.

There are two basic types of hearing aids-air conduction and bone conduction.

• Air conduction hearing aids can fit into the ear or fit behind the ear with a tube connected to an earpiece. These hearing aids generally produce better results than bone conduction hearing aids. Body hearing aid-a type of air conduction hearing aids-are usually placed in a pocket on the chest and are connected to the earpiece by a wire. These are used by people with severe hearing loss.
• Bone conduction hearing aids are usually prescribed because of a damaged ear canal or discharge from the ear. Bone conduction hearing aids are placed against the skull behind the ear and conduct sound through the bone of the skull to the inner ear. This type of hearing aid requires more power, causes more distortion, and is not as comfortable as an air conduction model.

Adjusting to a hearing aid may take some time. Often a new user of a hearing aid will have to relearn how to ignore background noise. He or she may feel frustrated and want to give up. People who do not consistently wear their hearing aids will have more trouble adjusting to them than those who do. If you have residents who are new to hearing aids, continue to offer them encouragement and support as they adjust.

We'll continue this lesson next week when we discuss care of hearing aids.

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