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Helping residents with hearing loss

LTC Nursing Assistant Trainer, July 28, 2005

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Hearing loss is one of the most chronic conditions affecting quality of life for residents. There are two broad types: sensorineural loss, also known as nerve deafness, and conductive loss. In many cases, residents may have some degree of both types of loss. Below are some characteristics of each, some of the causes, and some of the things CNAs can do to ease communication troubles.

Sensorineural loss/nerve deafness

This is the most common form of hearing loss. It often develops slowly, and the affected person may not even notice it. Changes in the inner ear and the auditory nerve are the primary causes, and rather than affect the level at which sound is heard, those causes instead make it difficult for a person to clearly understand what is being said. Talking louder or shouting at a person with this type of loss will only further distort the sound and may be painful. The most difficult sounds for a person experiencing nerve deafness to discern are "ch," "sh," "th," "f," "s," "t," and "p."

Conductive loss

Conductive hearing loss occurs when the ear canal and middle ear do not conduct sounds properly, thus reducing the overall loudness of all sounds. The most important thing for CNAs to remember here is that because people with conductive hearing loss cannot hear at normal sound levels, they will not be able to hear sounds of approaching danger.

What are the common causes of hearing loss?

• Infections and ear disease
• Damage to the eardrum
• Tumors
• Head trauma
• Certain medications
• Excessive ear wax and blockage of the ear canal
• Age
• Excessive noise for long periods of time
• A combination of any of the above

Helping residents with hearing loss

Because of difficulty in communicating, many hearing impaired people tend to withdraw from social contact. They want to avoid the embarassment of constantly asking others to repeat themselves, and also the frustration of feeling left out of conversations. They may even become convinced that people are talking about them, and exhibit signs of paranoia.

Many people who are hard of hearing smile and nod a great deal. Smiling and nodding are pleasant ways to respond that also cover the fact that they may not have heard what was said. As a CNA, if you give an important instruction, ask the person to repeat it back to you. That way, you can be certain he or she did hear and does understand.

Hearing aids cannot help everyone who has hearing loss, and they are primarily useful for people with conductive loss. When people first begin wearing a hearing aid, a period of adjustment is usually necessary. Suddenly, the person can hear all the noises around them again, including much of the background noise that people with normal hearing learn to shut out. For residents with new hearing aids, be as encouraging and slow-going as possible. Speak slowly and at a normal volume so residents can adjust to your voice and relearn how to separate sounds they want to hear from the sounds they don't.

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