Presbycusis: Hearing Loss in the Elderly

Presbycusis: Hearing Loss in the Elderly

Hearing loss develops slowly as people grow older. Changes in hearing become apparent in the third decade of life and worsen with time. The aging process generally affects high pitched sounds including many of the consonant sounds. (Low pitched vowels are the last to be affected.) This means speech becomes difficult to understand and leads many elderly people to say “I can hear you, but I can’t understand you.” As well, aging slows down transmission of speech from the ear to the brain causing difficulty in speech understanding when someone speaks quickly. The loss of hearing sensitivity occurs in both ears to the same degree. This type of hearing loss is called presbycusis, pronounced ‘press-buh-cue-sis’.

Hearing loss results in a communication problem. You cannot respond appropriately to that which you have not heard. It is a frustrating and anxiety provoking experience for all concerned. It taxes the patience of hearing people and can be devastating for the one who is hearing impaired.

Hearing impaired persons may withdraw into isolation and loneliness as their hearing loss becomes more severe. Everyday pleasures such as watching television, going to the theatre, attending church, playing bridge and chatting with friends become difficult or impossible. People need to be aware of this and know they can provide assistance to those with a hearing problem.

The following is a list of helpful communication hints for people who do not have a hearing loss but wish to learn how to improve communications with those who have impaired hearing.

Reduce all background noise to a minimum

Music, television, air conditioners, dishwashers and other people talking in the same room can interfere with a person’s ability to hear clearly. Either turn off the competing background noise or move away from it, so that your voice can more easily be heard by the person with the hearing problem.

Get the persons attention before you begin speaking

It is difficult for the person who has a hearing problem to speech read and to understand you if attention their focussed elsewhere.

Talk at a moderate rate

Slow down your rate of speech and pause after a few words before continuing. This allows the brain to process what is being said. The aging process slows down the transmission of information to the brain.

Always speak as clearly and accurately as possible

Consonants especially, should be articulated with care.

Do not over – articulate

Mouthing words or over – articulating is just as bad as mumbling. Over – articulating distorts sound and also makes speech reading more difficult.

Pronounce every name / subject with care

Make a reference to the name or place for easier understanding (ie.) “Joan, the girl from the office, or The Bay, the big department store”.

Change to a new subject at a slower rate

Make sure that the person follows the change to a new subject. A key word or two at the beginning of a new subject is a good indicator.

Be sure that important items are understood

Ask the person to repeat key pieces of information to be sure they are understood. Don’t just rely on a nod.

Do not attempt to converse with something in your mouth, such as food, cigarettes or chewing gum

Do not cover your mouth with your hand.

Do not shout

Talk in a normal tone of voice. Shouting does not make your voice more distinct, although many people seem to think it does. Shouting distorts speech and therefore makes it more difficult for a hearing impaired person to understand. Shouting is embarrassing and unnecessary. In fact, it can cause discomfort to a hearing aid wearer. It is also almost impossible to look pleasant while shouting.

Address the listener directly

Do not turn away in the middle of a remark or story. Make sure that the listener can see your face easily, with good lighting.

Use longer phrases, which tend to be easier to understand than short ones

For example, ‘Do you need milk from the grocery store?’ is less difficulty than ‘Do you need milk?’ Word choice is important here. Fifteen or fifty cents may be confusing, but a half dollar is clear.

Reword your sentence if the person does not understand

Do not repeat the same words over and over. Some words are easier to hear and speech read than others. Try to use other words that have the same meaning.

Get closer

The nearer you are to the hard of hearing person, the clearer your speech. A good distance is 2 – 4 feet.

Allow seating preference in a group setting

Allow the hearing impaired person to sit as close to the main speaker as possible. Encourage only one speaker at a time and alert the person to a change in topic.

Keep the light on your face when speaking

This helps with lip reading.

Write down your message if you cannot communicate otherwise.

Hearing impairment is a common problem in elderly people. Through understanding and patience we can alleviate some of the frustration and loneliness associated with presbycusis.