Why Should Elderly Go for Hearing Test?

Why Should Elderly Go for Hearing Test?

Hearing is one of our basic senses and is important in terms of communication in which most people fail to realize by the time they begin to lose their hearing.

Some facts below shows how important it is for elderly to go for hearing check-up before any serious losses  occur:

1) According to WHO (2012), it is estimated that there are about 350 million people suffering from hearing loss worldwide.

2) 95% of them are adults, mainly the elderly as they have the highest prevalence of hearing impairment due to the strong correlation between aging and hearing loss.

3) The graph below shows the prevalence of hearing loss in the United States based on age. To summarize, 1 out of 3 elderly above 65 years old suffer from hearing loss.

The impacts of hearing loss in elderly are devastating. Below are the top 5 reasons why an elderly (60 years and above) should go for hearing test:

1) Loss of hearing often goes unnoticed and ignored. It may be too late when one realizes about his/her hearing loss and goes deaf. The person facing hearing problems may be able to recognize sounds but will not be able to distinguish the correct words and sentences.

2) Hearing loss can result in communication breakdown which can lead to other issues. A person with hearing loss may be paranoid and suspicious of another person’s intentions and motives. In addition, they will either be highly alert or careless about their surroundings.

3) A person with hearing problem will also face communication problems with their family and friends. Both speaker and listener will be lead into confusion when communicating and soon their relationship will be affected.

4) Hearing loss can lead to Dementia along with Alzheimer disease indirectly. Without hearing sounds, it can weaken the ear cells and will reduce the input to brain, therefore decreasing the alertness to the surrounding. A study reveals that people with hearing problems often struggle hard to focus on the surrounding which disrupts a section of the brain which is for memory, hence causing Dementia.

5) Hearing loss has proven to increase the risk of fall. According to USNews.com, “People with a 25-decibel hearing loss (classified as mild) were nearly three times more likely to have a history of falling than those with no hearing loss. Lack of sound awareness from the surrounding also increased the chance of car accident for people with moderate hearing loss or more.”

It’s important to get your hearing test done especially when you reach the age of 60 and above.

Download Teleme’s mobile app and consult an audiologist on hearing test.

 

Ms. Alleya Cheng

Ms. Alleya Cheng

Audiologist

 

Causes and Management of Hearing Loss

Causes and Management of Hearing Loss

When an individual has hearing loss, the person would most often be referred to an audiologist for a diagnosis of the type of hearing loss, severity of hearing loss, site of problem and non-medical management.

An audiologist is an allied health professional specializing in hearing and non-medical management of the auditory and balance systems. An audiologist is trained in the prevention, identification and assessment of hearing loss and other related disabilities (like balance disorders) as well treatment and (re)habilitative services.

Some types of hearing loss can be prevented. A good example would be noise induced hearing loss. This is a loss of hearing due to continuous exposure to loud levels of sounds. Traditionally, this type of hearing loss is often seen in factory workers, soldiers and musicians. Nowadays, more of this type of hearing loss is detected due changes in lifestyles such as overexposure to Walkman and MP3 players at very high volume levels. The increasing popularity of loud bands and nightclubs also might contribute to this trend.

listening-to-music

Image source: Pexels

The prevention of these types of hearing loss would include educating and increasing general awareness on hearing loss and their causes, the suggestion to factories on measures to control sound levels and the advocacy of usage of hearing protection devices when exposed to loud levels of sound and noise.

Identification of hearing loss is most often done by screening for hearing loss. This is usually done for population groups with high incidences of hearing loss such as newborns, school going children and the aged due to the simple reason that sometimes hearing loss cannot be detected and early identification would lead to better intervention and outcome. In fact, in many states in the USA and across Europe, Universal Newborn Hearing Screening is mandatory to identify hearing loss in newborns as soon as possible after birth.

Studies show that hearing loss in children if identified and diagnosed early so that intervention could begin before 6 months of age results in speech and language development that is on par with normal hearing children. Currently in Malaysia, newborn hearing screening is done only in a few hospitals.

ear-nose-throat-doctor

Image source: Alamy

The management of hearing loss is most often a team work that involves the individual or parents of a child with hearing loss, audiologist, paediatrician, Ear, Nose & Throat (ENT) Surgeon, Speech Language Pathologist and other specialist based on needs of the individual. For example, after diagnosing the hearing loss, the patient might be referred to an ENT surgeon for problems that can be treated with medications or surgery. In other cases, a referral to the Speech Language Pathologist would be made to address speech and language delay.

 

However, in a lot of cases, the hearing loss might be permanent and cannot be cured. In these cases, the audiologist would recommend and fit amplification devices such as hearing aids or suggest cochlear implants for more severe-profound cases.

What follows would be (re)habilitation process whereby the individual with hearing impairment is trained to listen with their amplification devices. This might be a long and trying process as the sounds from hearing aid might be different than what the individual is used to or the processing of sound by the cochlea is abnormal causing a lot of fine-tuning to be done before the hearing aids or cochlear implant is accepted.

sign-language

Image source: Shutterstock

The notion that a deaf individual cannot hear and a deaf child is also destined to be mute is outdated. Technological advancements and knowledge has given these individuals the key to overcome the handicapping effects of hearing loss. However, the only way that this can be achieved is if each and every one of us knows what hearing loss is and what we have to do in order to help someone with hearing loss to address their problem.

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

 

Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon

 

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

 

Ms. Alleya Cheng

Ms. Alleya Cheng

Audiologist

 

Types of Hearing Loss

Types of Hearing Loss

Hearing loss also takes many forms. To describe every type of hearing loss and their causes would be impossible within the context of this article. Instead, we will focus on the more common types of hearing loss and some common causes. Normally, hearing loss is divided into conductive loss, sensorineural loss and mixed loss. These descriptions are based on where the problem that caused the hearing loss is present.

 

ear-infection

Image source: Getty Images

1. Conductive Hearing Loss

A conductive loss would mean that the cause of the hearing loss is present in the outer ear canal or the middle ear which are considered the conductive pathway for sound into the ears. Some common causes would be wax blockage in the outer ear, middle ear infections and hole on the eardrums.

Please refer to Figure 1 below for anatomy of the ear.

 

noise-induced-hearing

Image source: Earlens

2. Sensorineural Hearing Loss

Sensorineural hearing loss indicates that the cause of the hearing loss is in the cochlear or the auditory nerve that connects the cochlear to the auditory centres of the brain. Some common causes would include damage to the cochlear hair cells due to noise, aging or infection; Meniere’s disease (increase of fluid levels in the cochlear) and acoustic neuroma (cancer on the auditory nerve).

Please refer to Figure 1 below  for anatomy of the ear.

3. Mixed Hearing Loss

A mixed loss is a combination of a conductive loss and sensorineural loss existing together. Some of these causes can be cured especially conductive loss either by medication or surgery. However, some are permanent and need other management.

Figure 1:

anatomy-of-ear

Next up on Teleme’s blog, Causes and Treatment of Hearing Loss.

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

 

Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon

 

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

 

Ms. Alleya Cheng

Ms. Alleya Cheng

Audiologist

 

Can a Deaf Person Hear?

Can a Deaf Person Hear?

Can a deaf person hear? If your answer was a no, then you are among the majority who has the wrong idea about hearing impairment. Being deaf or hard of hearing does not mean that a person can’t hear any sound but merely that they do not hear all levels of sounds or all types of sounds, depending on the severity of their hearing loss.

Hearing loss takes many forms and has varying degree of severity. In fact, it would not be a big stretch of imagination to say that every one of us has faced hearing loss at least once in our life.  Do you laugh at that claim and think it is ridiculous? Well, if you had ever felt a blocked feeling when you were driving up a hill or had some water that went inside your ear canals when swimming, then you had experienced temporary loss of hearing at those moments.

Fortunately, most of these incidences were temporary and rare that you quickly put it off your mind once it has passed. However, for a number of individuals, hearing loss is permanent or lasts much longer than a few minutes that it causes difficulties with communication and bears a significant impact in their lives.

hearing-problem

Image Source: Shutterstock

In fact, a family member or a close friend could have hearing problems and you might not have realized it. Hearing loss is an invisible problem and because of that, it has often been neglected or not taken seriously. However, the impact of hearing loss affects academic performance, social life and career. Helen Keller, a deaf and blind writer and lecturer said “Blindness separates us from things but deafness separates us from people”.

Take a few minutes and think of your family members and close friends. Have any of them seemed to have not been paying attention or very quiet lately? Have any of them seemed lost in a conversation especially in noisy places? Have they asked you to repeat a sentence more than once frequently? If yes, there is a strong possibility that person might be having some hearing impairment.

I am very sure that you have not think very long before you could think of someone with those signs as the incidence of hearing loss is not very rare. Worldwide statistics show that 1 to 5 babies in every 1000 babies born have permanent hearing loss which makes it one of the highest incidences of birth defects. Other researches estimate that more than 40% of those aged above 65 years old have hearing loss.

Image source: Getty Images

In fact, there might be a number of us who have hearing loss without even realizing it. This could be due to the fact that the hearing loss had a gradual onset and the degree of loss is mild or the loss is limited to certain frequencies of sound only. Many of us would only realize that we have a problem when we face difficulties understanding others speech but by the time we realize that we would already have a moderate to severe levels of hearing loss.

To properly understand hearing loss, we have to accept the fact that hearing loss can occur at different levels of severity which is described by the softest intensity of sound we can detect. The accompanying Diagram 1 shows the different levels of hearing loss and the associated difficulties with communication.

Diagram 1

degrees-of-hearing-loss
Degree of hearing loss Communication Problems
Normal
  • No problems in hearing even the softest sounds
  • No communication problems
Mild hearing loss
  • Difficulties hearing soft sounds and sounds that are further away
  • Difficulty in comprehension in noise
  • Children will be developing speech but will have problems with articulation and clarity
Moderate
  • Speech and other sounds will be heard softer and not very clear
  • Dependence on lip reading especially in understanding speech in noise
  • Difficulties understanding speech if signal is from the back
  • Children will have delayed speech and abnormal speech patterns
Severe
  • May hear speech but lots of difficulty in understanding
  • Dependence on lip reading and other adaptive strategies
  • Very difficult in understanding speech in noise
  • Speech and words are not acquired spontaneously in children without the fitting of hearing aids

 

Profound
  • Most natural sounds cannot be heard
  • Speech will not be developed at all unless detected early and amplification as well as habilitation programs are begun early
  • Without early intervention, most children with profound hearing loss will resort to signing and will not speak as they have difficulties monitoring speech

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon

 

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

 

Ms. Alleya Cheng

Ms. Alleya Cheng

Audiologist

 

Hearing Loss in Your Child: Communication and Assistive Listening Devices

Hearing Loss in Your Child: Communication and Assistive Listening Devices

Communication Decision

One of the most difficult decisions that you might have to make for your child would be the method of communication that he/she would use. The choices vary from the Aural-oral which relies totally on normal spoken language to Sign language that is a language that uses visual hand signs only. Other communication methods that are in between these two choices would include Total Communication and Cued Speech.

No single approach would work with all children. Thus, a thorough discussion with your audiologist and speech language pathologist would help you decide the primary communication method your child would use.

Visits to centers where these particular methods are taught before deciding would also help. A good audiologist would never presume to suggest the best option for your child. Instead, he would provide you with all the information you require to decide the best option for your child and your family.

sign-language

Image Source: Stanford University

Communication method chosen would also bear an important impact on your child’s school placement when he is older. A child with hearing impairment with good amplification and acquisition of speech and language can be considered to be placed in normal schools. Others might be placed in integrated schools while those who use signing as their primary communication mode have the choice of attending special school for hearing impaired children.

 

Assistive Listening Devices (ALD)

assistive-listening-device

Image Source: USC News

As your child’s needs changes, hearing aids alone might be insufficient for all situations. Devices that are designed for specific needs of a hearing impaired person are often termed as assistive listening devices.

The most popular ALD would be the FM system. This system which usually couples to your child’s hearing aids is important in situations that are noisy and there is a significant distance between the speaker and the hearing impaired person. Examples would be classrooms, meetings and lecture halls.

Although a hearing aid amplifies speech and modern digital hearing aids are capable to reduce some background noise, the challenges of a noisy classroom is more difficult. Imagine a teacher that is standing at the front of the classroom at a distance that is more than the optimum amplification region for the hearing aids.

 

fm-system

Image Source: Phonak

In addition, background noise that is highly speech noise. When the speech signal from the teacher reaches your child’s hearing aids, the loudness is greatly reduced; it is then further degraded by competing background noise. It would be very hard and tiring for your child to continuously pay attention to understand the teacher.

An FM system which consists of a microphone worn by the teacher and a receiver worn by the hearing impaired child ensures that the speech signal is transmitted directly to the child’s hearing aid, thus ensuring no degradation of signal due to noise. FM systems are routinely recommended to school going children to aid their studies.

Other ALD devices would include vibrator alarms that wake up the child in time for school as he would not hear the normal alarms because he does not wear his hearing aids to sleep. More examples would be blinking lights for fire alarms, teletext phones and many others.

 

hearing-aid-child

Image Source: The Indian Express

Hearing loss is a condition that could be managed by you. The important thing to remember is that your child is just as normal as the next child with the only problem being he does not hear sounds as clearly. In every other aspect he has the same potential to be whatever he wants. It is up to parents and professionals to ensure that the impairment does not become a handicap.

As parents, you face the heavy burden of being your child’s teacher, mentor, friend, therapist, advocate and support system. However, you have the assistance from a whole range of professionals, ever improving technologies for amplification and other communication needs as well as the growing knowledge on hearing impairment and ways of managing it.

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

 

Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon

 

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

 

Hearing Loss in Your Child, What to Do Next?

Hearing Loss in Your Child, What to Do Next?

First series of hearing loss in your child: When parents are told that their child has hearing loss, many a times they are lost about what they should do next. What are the management steps that parents should take to help their child?

 

Knowledge is power

There is nothing more important than finding out every detail of the problem that your child has. Feel free to ask your audiologist or doctor, how they test your child and what is the purpose of each test done. Confirm how reliable were the tests done. Next ask the exact nature of the hearing loss as it would be crucial on deciding what the next step would be.

If it is a conductive hearing loss, whereby the problem is either on the outer ear or the middle ear, the problem might be cured by a medical doctor. If it is a sensorineural hearing loss, determine whether it is a permanent hearing loss or is there a chance of a cure.

The audiologist should be able to advice you on this. Remember, you have the right to have a second opinion. You can ask the audiologist to provide you a copy of all the results, a report for records and also reference if a second opinion is sought.

baby-child

Image Source: Singapore Motherhood

You should also find out the sounds that your child could still hear. Contrary to common perception, it is rare for us to find an individual who does not have any hearing at all. In fact, most children with hearing loss have a degree of residual hearing. Knowing the types of sounds your child can hear as well as the level of loudness is important to help him communicate. Even for temporary hearing loss, it is important to know the communication strategies that you would need in order to help your child through this trying period.

 

Hearing Aids

hearing-aid-child

Image Source: Pinterest

The Malaysian Association of Speech-Language and Hearing (MASH), the professional association for audiologists and speech language pathologists in it’s guideline states that all children with hearing loss of 25dBHL or more should be considered for hearing aid fitting. Various researches worldwide also indicate that a child who receives optimum amplification and rehabilitation early has the potential of developing speech and language that are similar to children with normal hearing levels.

In most cases of permanent hearing loss, your audiologist would recommend that your child should be fitted with hearing aids to help him/her hear. The first thing that we should know about hearing aids are that they help your child to hear by making sounds louder however they will not cure hearing loss. Your child needs to be trained to hear with the hearing aids as amplification alone is not sufficient to help your child understand sounds and language.

Technology in amplification has been improving tremendously. It is important that you know the difference between the various technologies available before deciding on which hearing aids are the best for your child. Most audiologists would recommend digital hearing aids compared to analogue hearing aids for your child. A complete discussion on the differences and benefits of these technologies would require an entire article. Your audiologist would be more than happy to explain to you about them.

 

ear-diagnosis-child

Image Source: Very Well

Another question that you would be asking yourself would be whether one hearing aid is enough or should you get a pair. For children with hearing loss in both ears, the best benefit would be amplification in both ears. This is to maximize their learning potential as well as to ensure that sounds are as natural as they can be. Wearing a single hearing aid when both ears have hearing loss is similar to using a monocle instead of your spectacles. An adult who has acquired speech and language might be able to cope but a child who is learning would struggle with a single hearing aid.

If your child has severe to profound hearing loss and gets insufficient amplification even from the most powerful hearing aids, then a cochlear implant might be beneficial. Again, please remember that a cochlear implant is a device that helps your child to hear and a lot of rehabilitation needs to be carried out before they could listen and understand speech as well as proceed to speak. This is true with both hearing aids and cochlear implants.

Next up on Health Tips by Teleme, the second series on Hearing Loss in Your Child: Communication and Assistive Listening Devices.

 

Source: The Malaysian Association of Speech-Language and Hearing

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist

 

Dr. Shailendra

Dr. Shailendra

Ear, Nose & Throat Surgeon

 

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray

Audiologist

 

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