Recognizing Hearing Loss in Elderly Patients

Age-related hearing loss, known as presbycusis, is one of the most common chronic conditions occurring among older Americans,¹ a demographic that is most at risk for developing cancer. People who are older than age 65 comprise 60% of patients with cancer, and 60% of cancer survivors.² Estimates are that two-thirds of people in this age group suffer from hearing loss, with almost half of those older than 75 years afflicted. The condition is more common in older men, and, as expected, is especially prevalent among those in occupations with exposure to noise.³

When older people experience hearing loss they are more likely to have other health problems as well. Hospitalization may be necessary. Patients with hearing loss may have different disease courses than those with normal hearing. Studies have found that as these individuals age they are admitted to hospital more frequently and their stays are longer compared with those who hear well. There are also more medical events and 30-day readmission rates among this population.³

Hearing Loss Barriers

Writing in the Journal of Gerontological Nursing, Elaine Mormer, PhD, CCC-A, associate professor in the department of communication science and disorders at the School of Health and Rehabilitation Sciences, University of Pittsburgh in Pittsburgh, Pennsylvania, and colleagues discussed their study to ascertain the prevalence of hearing loss among older patients in a large medical center.³ They sought to determine how successful standard procedures were in identifying the presence of hearing loss among newly admitted patients.

“The invisibility of [hearing loss] poses a challenge to nurses in recognizing when older adult patients are at risk for communication breakdowns. Communication breakdowns associated with [hearing loss] can potentially impact patients’ adherence to treatment plans,” the authors wrote.³

One of the challenges of hearing loss can manifest when patients discuss their health history. Patients with presbycusis may omit important facts because they find their clinicians’ questions unclear. Further, they may not grasp their clinicians’ treatment plans. They may not understand or be able to follow instructions for medications and their potential side effects. They might miss appointments. Patients with hearing loss may find surgery especially difficult.

The researchers conducted a quality improvement study to ascertain how prevalent hearing loss was among newly admitted patients age 70 and older. They also sought to determine how well hospital staff identified their patients with hearing loss and how well they identified those at risk for the condition. They utilized electronic medical records of newly admitted patients as well as the advice of a bedside nurse on the study team who suggested patients eligible for the project. In addition to using audiometry to measure hearing loss they asked, “Are you having difficulty hearing your doctors and nurses during your stay?” For a while their department has routinely offered noncustom amplifiers to patients with difficulty hearing; this study also allowed the team to gauge the success of that service.³