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Hearing Loss in the Elderly

Degradation of hearing in the elderly is called Presbycusis. “Presby” refers to the “elderly” and “cusis” denotes “hearing.” The process involves degeneration of the inner ear (cochlea). If you live long enough, you too will have some form of Presbycusis.

Hearing function deteriorates from either environmental causes (loud noise such as work areas or too much live band music in the 60’s) or from certain diseases that negatively impact our hearing:

Otosclerosis is a disorder of the middle ear capsule, specifically having the negative effect on the stapes movement  (one of the three tiny bones in the middle ear).
Meniere’s disease has influence on the membranous inner ear and the main symptoms are surdity, dizziness (vertigo), and ringing in the ear (tinnitus).
Drugs utilized to control some disorders are violating the auditory system (ototoxic) and become a cause of hearing loss. Some of the appropriate medications known to be ototoxic are aminoglycoside antibiotics (such as streptomycin, neomycin, kanamycin); salicylates in large quantities (aspirin); loop diuretics (lasix, ethacrynic acid); and drugs used in chemotherapy regimens (cisplatin, carboplatin, nitrogen mustard).
Trauma can also result in hearing loss. Examples are comprised of temporal bone fractures, puncture of the eardrum by foreign objects, and sudden changes in air pressure.
The level of hearing loss can vary from mild to severe. Hearing disorder in the elderly can be a miserable disorder. When we speak at the usual volume we are accustomed to, it is not loud enough for someone with hearing impairment; therefore they miss most of what you saying. While it’s not necessary to shout every time you are communicating with an elder person, it doesn’t hurt to ask them if they hear you okay.

One of the dangers of elderly hearing loss is misdiagnosing the elder resident/patient for dementia. If they are asking them verbal questions and their responses are wrong, incomplete, or the senior has a constant confused look on their face, there is the likelihood that the examiner will contribute the low score results to dementia. This does happen in about 6% of cases.

If your resident or patient is at home or living in a senior community such as a nursing home, assisted living center, or a continuing care center and you notice they have a hard time hearing you, then you should see to it that they are given a through hearing exam. It your job to help them make sure they are getting the most out their life and there are hearing aid devices available that work wonders that are so small they no longer have the stigma once attached to them. It may require a little pushing at first but ultimately the senior will be glad that you helped them along.

Is Aging Becoming a Social Problem?

Aging is not a predictable positive or negative outcome. Most people age gracefully over the years but not everyone is so fortunate; some people succumb to illness and die immediately and unexpectedly or linger on the edge of life until they pass.

Growing older has many attributes. People become wise with age and can be repositories of valuable information both culturally and commercially. In some societies the elderly population are endeared and respected and heralded like national treasures. They become the hub of the family and pillars of the community.

In more modern societies that are accustomed to “measuring and evaluating” a person’s worth and output on a regular basis, the elderly are often seen as burdens or expensive liabilities to society.

Where I grew up, the Amish plowed their fields with mules instead of horses. When a mule became weak with age and infirmities and could no longer plow the field 10 hours a day, he was put to pasture. The elder mules were treated well and farmer would reminisce about the mule’s accomplishments. The mule was almost (metaphorically speaking), a family member.

Thanks to modern miracles in medicine we all have a better chance of growing much older than our ancestors. However, the medical community has not factored in the cost of an aging on society. I know we shouldn’t care about the cost – and I wish we didn’t – but it is the number one topic our government focuses on every day Congress is in session. The older I get the more I feel like I, too, will eventually become a burden on society. This is not the pot (of something) at the end of the rainbow I envisioned years ago.

If we tout ourselves as the greatest nation on earth then we should remember who got us there. We all had to stand on someone’s shoulders along the way, to see beyond the horizon, to plan our good fortunes. Don’t we owe a debt of gratitude and generosity to the ones who made our future possible?

Random Nursing Facility Thoughts from a Random Mind

As I’m thinking about what I want to write for each blog, a billion random thoughts run through my mind. I try and stay topical and write about things that I know affects each Nursing Facility in today’s rough economic and regulatory climates. As nursing facilities, we are all faced with government cutbacks and the daily threat of this or that health plan ruining what we are trying to accomplish. With the environment already tough with staffing issues and financial shortfalls, it is a daunting task to get up each day and go into that often (seemingly) hostile workplace.

But, I got a letter today that reminded me of what it is all about…. why we get up each morning and put the smile on our face… (real or forced), why we do just what we do every single day and then come back the next day and the day after that. This letter was from someone who had read my last blog, I won’t name her name for privacy reasons, but she will know who I am talking about, (if I’m lucky enough for her to read my blog again!)

She is a nurse, like many of us, who has been in this business for a very long time, she is one of the “old timers”, who remembers what it was like to care about what we do and enjoyed going to work each day. This nurse, who is also a daughter, just very recently lost her father. Her father was in a nursing home, the scene she described is all too familiar these days, understaffed, (or at least seems to be) probably well intentioned, but was staffed by young, un-educated personnel, who without the proper supervision, took advantage of not only the facility they were being employed by, but took advantage of the residents they were assigned to take care of. I’m not trying to say they were negligent, but if you don’t supervise your staff and motivate them to do better, they will take advantage of the situation.

As a Corporate Director, I find myself in this situation too. I will have a situation come up, that is not harmful in any way, but because I’m “stressed” in that area, such as staffing, I let it slide by, until I’m better able to properly handle it. But, this isn’t fair to me, my staff and most importantly, my residents. The staff members at the facility where her father resided, said to her, ‘Why can’t we have someone like you, someone who care’s’? That is such a sad statement. So, I guess my question to you as Nursing Supervisor’s is what image do you project to your staff? Do they see only the negatives? Do they only see the stress? Do they ever get to see your silly side? How about the side that says, “ I really do care”? Do they see you make mistakes once in awhile, just like they do? Or are you someone that is stiff, ultra-professional, all business and has forgotten where your roots lie? One of my Director’s asked me on my Facebook page, if she could go to work in her pajama’s…and I laughed it off and told her no. But, you know what? It gave me an awesome idea for Nurse’s Week! I’m going to host a “Pajama Party” at each building for my nursing staff. They can wear respectable PJ’s, we’ll cook a brunch in the facility, fix virgin Mimosa’s and just pretend we are relaxing! I can’t think of a better way to show my staff I care, give them 30 minutes of silliness and pamper them in a way that is inexpensive and yet meaningful. This “mental health day”, will impact my residents just as much as it will my staff. I can’t think of a better random thought than that one! So thank you kind lady, not only for your thoughtful letter, but for reminding me of what this is all about. I’m so sorry for your loss, my heart goes out to you. But, from your kind words, maybe all of us can learn!