Presbycusis Research Paper

Presbycusis: Causes and Management

Frequently, people encounter others that may have presbycusis and do not understand why the person with this impairment has difficulty hearing them. Presbycusis is not a world known impairment in individuals. Yet, even though it is often an unknown impairment, it is an important problem in society. Information on presbycusis along with its causes and different management techniques will be discussed in detail throughout this paper.

Information

According to Huang and Tang (2010), presbycusis is described as an age-related hearing loss, and is a very common sensory deficit in most of the elderly population (Huang and Tang 2010). Presbycusis is characterized by difficulty understanding speech and reduced

hearing sensitivity in noisy environments, slowed central processing of acoustic information, and impairment in the localization of sound.

Presbycusis has become a severe health and social problem in the elderly population. People that suffer from presbycusis have a high pitch hearing loss, which has a major effect on communication, particularly noisy situations and very reverberant rooms, such as, restaurants. If the loss progresses to the 2000 to 4000 Hertz range, understanding speech in any situation will be affected. The 2000 to 4000 Hertz range is very important because it can affect the vowel identification, voiceless consonants, and basically speech understanding in any environment (Huang and Tang, 2010). The ability to identify, detect and localize sound is affected, which is an important skill for associating with other people. Some of the older populations will say: "I can hear you, but I can not understand you" (Huang and Tang, 2010). Understanding high frequency sounds, such as, fire alarms, turn signals, and alarms on firetrucks and police cars can be a major problem. Even minor errors in words can make communication difficult and

make communication errors worse. In older adults, Presbycusis can lead to adverse effects on their physical, cognitive, behavioral, emotional, and social functioning. All of these effects can lead to social isolation, depression, and loss of the person's self esteem. The effects of presbycusis can vary based on whether hearing loss occurs in tiny increments or large increments. Conversations between people with presbycusis and other communication partners can suffer too (Huang and Tang, 2010).
Overall, 10% of the population has a hearing loss great enough to impair communication,and this rate increases to 40% in the population older than 65 years. 80% of hearing loss cases occur in elderly people (Huang and Tang, 2010).
Presbycusis occurs in 80% of the population, and even though it is a large amount, the exact cause is not known.
Causes
Although the cause is unknown there is still being research done to find an exact cause. Some research shows that most age-related hearing losses involve the 15,000 sensory hair cells that are found in the cochlea, which is a snail-like structure located in the inner ear. These hair cells are located on the basilar membrane, and can cause a loss in the high frequency sounds which can make an impact on speech perception because it causes a sensorineural hearing loss (Wingfield, Tun, and McCoy, 2005). As people age their cochlea can develop bald spots, which is the reason for the loss of hearing in the cochlea (President and fellows of Harvard college, 2000). According to Jungyung Ko (2010), hearing impairment can result from mechanical trauma or loud noises. These causes are a contributor to hearing problems in older adults, but is not the primary cause of auditory damage. The increase of other external incidents, such as, medical treatments, environmental factors, or disorders can accelerate the process of hearing loss. There are different types of medications that can cause irreversible damage to the hair cells and can cause sensorineural hearing loss. Some of these medications are amino-glycoside and loop diuretics that can cause the damage. According to Jungyung Ko (2010),
Genetics play an important pathological role in hearing loss; it is suggested that up to 25% of presbycusis is due to inheritance of predisposing genetic factors.

C57, a calcium- binding protein found primarily in the hair cell, is said to contribute to the development of hearing loss from a genetic perspective (Ko, 2010).

Presbycusis does tend to appear within families, and genetics does seem to play a role, aging and environmental influences are still the primary source of presbycusis. So now that the cause of presbycusis is determined it is important to learn how to manage it.

Management
There are many ways that a client can manage his or her presbycusis, and make it easier for people to learn how to cope. Unfortunately, there are not any types of medicine or drug therapies available for curing or restoring presbycusis. However, there are several management techniques, such as, multiple rehabilitation programs and devices that can be used to assist the clients with hearing impairments (Ko, 2010). According to Gates and Millis (2005), the first thing to do would be to have the person do rehabilitation. There are different ways that the people around the person with presbycusis can help them manage their impairment. The speaker and listener should work at improving the communication environment. One of the family members should be face to face with the listener, speak clearly and moderately paced, turn off any competing sound sources, and make sure that the message was received. The hearing-impaired listener should be serious about communicating with other people, and take steps to repeat what they heard so that if there was a misunderstanding it can be corrected. These are principles that can help with the hearing problem. There are ways to manipulate the environment to make it a better place for listening. Optimizing the listening environment can be anything as simple as, turning off the radio, turning off the TV, and speaking slower for the person to better hear (Gates and Millis, 2005). Another aspect of environmental factors is knowing that large rooms with high ceilings can increase sound reverberation and that can be a very poor environment with dealing with communication. In a poor acoustic environment, there must be a great amount of face to face time between the speaker and the listener ( Ko, 2010). These approaches can have some important effects on the person with presbycusis speech comprehension. There is also auditory training that can be used. Auditory training can be very beneficial. The person with a hearing impairment is trained to identify key words and speech sounds with some type of amplification device in place. The person with the hearing impairment can also use speech reading as an aid to manage their presbycusis. Speech has a great amount of redundancy, so facial expressions and lip contours provide assistance in filling gaps that may have resulted from unheard speech sounds (Ko, 2010). If in a hospital or rehabilitation center, nurses can also help intervene to make it easier for the person with presbycusis. A hearing impairment like presbycusis can tremendously limit an older person's communication and social interaction. Nurses have a key role in providing care for people with hearing impairment, and they have the ability to help a hearing impaired elderly person adapt to having their impairment. They can do this by suggesting helpful interventions and being available for support. The individuals around the people with presbycusis must also be careful to manage their physical comfort assessment. According to Jungyung Ko (2010), if the client is wearing a hearing aid the people around them, such as a nurse, should assess their level of comfort and knowledge of their device. The family needs to have the knowledge of checking the batteries and assess for proper functioning of the aid. Also, the ear canals have to be regularly inspected for cerumen which can clog the hearing aid. The basics, such as, troubleshooting and using the proper cleaning techniques of the hearing aid should be demonstrated to both the client and their families. Emotional support is another important aspect of presbycusis management. When the client is dealing with a hearing loss it can be a stressful and traumatic time in their lives as well as the family and caregivers. Dealing with a hearing loss can cause emotional and physical exhaustion which is shared with the person's family and caregivers because it can make the care of that person more complex. There are community support groups that can be beneficial for coping (Ko, 2010). According to Gates and Millis, cochlear implants are indicated for individuals 70 or older with bilateral severe hearing loss not being helped by hearing aids. The cochlear implant can help them manage their hearing and how many sounds they are able to hear (Gates and Millis, 2005).
Conclusion
In conclusion, presbycusis is a deterioration of hearing loss as a result of aging. There is not a known cause of presbycusis, but the most common is the balding of hair cells that are located inside of the cochlea. There are different types of medication that can cause presbycusis, also. Management also plays a very important part in taking care of the diagnosis of presbycusis, such as, emotional support, family support, and hearing aids. Information on presbycusis along with its causes and different management techniques have been what was discussed throughout this paper.