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Hearing Loss in the Geriatric Population PowerPoint Presentation

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Description : Check out this medical presentation on Audiology, which is titled "Hearing Loss in the Geriatric Population", to know about hearing loss in the geriatric population, brief review of the anatomy and physiology of the hearing and balance systems, and signs and symptoms of hearing loss and balance disorders.

Tags : Audiology, Hearing Loss, Geriatric Population, balance disorders

Published on : Jul 10, 2021 | Views : 2633 | Downloads : 2

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Slide 1-

Hearing Loss in the Geriatric Population Strategies for working with older adults with hearing loss in medical settings Michelle Arnold, AuD, CCC-A February 23, 2018
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Overview Hearing loss in the geriatric population Brief review of the anatomy and physiology of the hearing and balance systems Signs and symptoms of hearing loss and balance disorders Bedside strategies Referrals Questions? 2
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Hearing Loss in the Geriatric Population 3 Hearing loss is highly prevalent in the US Adults: 16%+ (Agrawal, Platz, & Niparko, 2008) Adults 70 years and older: 65% (Lin, Thorpe, Gordon-Salant, & Ferrucci, 2011) Untreated hearing loss is a significant public health concern Significant associations with other chronic conditions Dementia (Lin, 2011; Lin et al., 2013) Falls (Lin & Ferrucci, 2012) Social isolation, depression (Kramer, Kapteyn, Kuik, & Deeg, 2002) Vulnerable populations are at an elevated risk for untreated hearing loss Known disparities in hearing healthcare use (Nieman, Marrone, Szanton, Thorpe, & Lin, 2016) And thus, at an increased risk for comorbid conditions
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Hearing Loss in the Geriatric Population Presbycusis – age-related hearing loss Primarily affects adults age 50+ Manifests as a high-frequency, sensory loss Permanent, damages to the cochlear structures Sometimes neural involvement (“sensorineural”) Results from: Noise exposure Age-related changes in the auditory system Vascular Genetic predisposition 4
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Hearing Loss in the Geriatric Population 5 Lin et al., 2011
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Hearing Loss in the Geriatric Population 6 Lin et al., 2011
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The Inner Ear: Auditory & Vestibular Systems 7
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The Auditory System 8 Hearing process video
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Peripheral to Central… …how the ear has “solved” the problem of transducing mechanical energy into neural impulses. …sound coding to meaning Peripheral auditory system Central auditory pathways
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The Auditory System 10 Peripheral to Central… Central auditory pathways …how the ear has “solved” the problem of transducing mechanical energy into neural impulses. …sound coding to meaning
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The Auditory System The audiogram 11
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The Vestibular System One of the oldest CNS system reflex pathways In humans, has evolved to provide Orientation Equilibrium Responsible for sensing head motion Maintain postural control Stabilize images on the fovea of the retina Transmits information to the central vestibular pathways Control reflexes and perceptions Vestibular system video 12
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Hearing Loss Symptoms Reduced attention to sound Reports of ringing in the ears “Missing” information, despite reporting no problems with hearing Difficulty hearing in diverse settings Noise (restaurants, family gatherings, noisy hospital rooms) Lack of interest in social activities, increased isolation 13
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Vestibular Dysfunction Symptoms Reports of positional dizziness Reports of dizziness that is rapid onset, lasts up to 90 seconds, is recurrent Reports of falls Additional potential symptoms: Migraine Nausea Lightheadedness 14
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Bedside Strategies – Vestibular Dysfunction Ask pertinent questions Most common balance disorder among older adults is BPPV Benign positional paroxysmal vertigo Screening – Dix Hallpike Test Other screeners 15 Mike Valdez, PA-C (2016)
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Bedside Strategies – Hearing Loss Screen patients 65 years and older for hearing loss Use good communication strategies Ensure patients are using corrective devices (hearing aids; cochlear implants) Use assistive devices 16
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Hearing Screening Objective vs. Subjective Objective bedside tests Otoscopy Tuning fork tests Whisper test (objective??) Screening audiometry and distortion product otoacoustic emmissions (at TGH, need to place audiology referral) 17
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Hearing Screening Objective vs. subjective Subjective “Do you think you have a hearing problem?” Yes or no Single item screener found to be accurate in most older adults (Kamil, Genther, & Lin, 2015; Torre, Moyer, & Haro, 2006) Hearing handicap screening for the elderly (HHIE-S) (Ventry & Weinstein, 1983) Brief, 10-item screening tool that assess self-perceived hearing handicap Score of 10 or greater warrants referral for full audiologic exam 18
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Communication Strategies 19
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Ensure Patients are Using Their Hearing Devices For patients who report they have hearing loss, ask if they wear hearing aids or cochlear implant(s) If “yes”, be sure they are wearing them (correctly) before you continue to speak to them! If they do not have their devices, have an amplifier on hand for conversation If they have their devices, ensure the battery is new If battery is dead, replace from patient supply – or contact audiology for replacement battery 20
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Ensure Patients are Using Their Hearing Devices 21 Cochlear Implant Hearing Aids
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Use Assistive Devices If you are working in a geriatric unit, ask the nurses for a pocket amplifier If the unit doesn’t have at least 3 pocket amplifiers for use, request them 22
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Referrals Utmost importance to refer older adults for vestibular assessment if they have history of falls or symptoms of dizziness American Institute of Balance 8200 Bryan Dairy Rd Suite 340, Largo, FL 33777 Office 727-398-5728 Office 800-245-6442 Fax 727-398-4914 University of South Florida Hearing Clinic 4202 E Fowler Ave PCD 1017 Office 813-974-8804 23
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Referrals For patients with hearing loss a variety of options exist Refer to PCP Refer to TGH Audiology as outpatient (located in outpatient rehab center) Refer to TGH Audiology as inpatient Dr. Rebecca Marcadis – contact TGH outpatient rehab center Refer to USF Hearing Clinic (contact information on opposite page) 24
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Questions? ??? My email: mlarnold@usf.edu Thank you! 25
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References Kamil, R. J., Genther, D. J., & Lin, F. R. (2015). Factors associated with the accuracy of subjective assessments of hearing impairment. Ear and Hearing, 36(1), 164-167. doi:10.1097/aud.0000000000000075 Lin, F. R., Thorpe, R., Gordon-Salant, S., & Ferrucci, L. (2011). Hearing loss prevalence and risk factors among older adults in the United States. Journals of Gerontology. Series A: Biological Sciences and Medical Sciences, 66A(5), 582-590. doi:10.1093/gerona/glr002 Nieman, C. L., Marrone, N., Szanton, S. L., Thorpe, R., & Lin, F. R. (2016). Racial/ethnic and socioeconomic disparities in hearing health care among older Americans. Journal of Aging and Health, 28(1), 68-94. doi:10.1177/0898264315585505 Torre, P. T., Moyer, C. J., & Haro, N. R. (2006). The accuracy of self-reported hearing loss in older Latino-American adults. International Journal of Audiology, 45, 559-562. doi:10.1080/14992020600860935 26