Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Communicating with Assistive Listening Devices and Age-Related Hearing Loss: Perceptions of Older Australians

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Communicating with Assistive Listening Devices and Age-Related Hearing Loss: Perceptions of Older Australians

Article excerpt

It is generally accepted that there is a professional and moral responsibility to maximize communication opportunities for older people. For nurses to fulfil this duty, they must be knowledgeable about age-related communication needs and problems as well as their possible solutions (Tolson, 1997, p. 1150).

Hearing loss in Australia represents a major public health concern. Currently an esti- mated one in six Australians has hearing difficul- ties. This figure is expected to reach one in four by 2050 as the population ages (Access Economics, 2006). Given the centrality of hearing to commu- nication and the quality of care for quality of life, this has significant implications for health care practice including nursing practice. The criti- cal importance of primary nursing in initiating treatment for age-related hearing loss has been identified in a number of studies (Tolson, 1997; Wallhagen & Pettengill, 2008). Further, mod- els of practice which incorporate nursing care in hearing rehabilitation of elderly people have been developed and include consideration of assistive listening technology to augment or substitute hearing aid technology (Hickson, 2009; Looi et al., 2004; Palumbo, 1990; Tolson & Stephens, 1997; Wallhagen, Pentengill, & Whiteside, 2006). However, there is limited research about how this kind of technology is perceived by older people who are hearing impaired themselves. This paper reports on a study of an assistive listening device (ALD) with older Australians living in a retire- ment complex in suburban Brisbane, QLD, Australia. In keeping with previous research, its findings highlight the importance of education to enable and improve communication and quality of care for older Australians living in community settings as well as between staff and residents in age care facilities.

The 'dresser drawer' syndrome and hearing aids

Nurse practitioners in primary health care set- tings are aware that many people with age-related hearing loss who are fitted with hearing aids do not wear them regularly or at all. The Australian Senate Community Affairs Reference Committee inquiry into the nation's hearing health (Senate Community Affairs Committee Secretariat [SCACS], 2010) reported that approximately 350,000 hearing aids are sold in Australia annually but estimated that 20-40% of hearing aids sup- plied are not used (SCACS, 2010, p. 75).

Under-use of hearing aids amongst those with aged-related hearing loss is not confined to Australia (Hartley, Rochtchina, Newall, Golding, & Mitchell, 2010, p. 643; Hindhede, 2010; Hogan et al., 2001; Smeeth et al., 2002) and is not new (see for example, Mann, 1997; Salzbrennan, Neuman, & Goldstein, 1991). In the United States this phenomenon is referred to as the 'dresser drawer syndrome' (Wayner, 2004, p. 43). Recent estimates indicate that <15% of the estimated 26.7 million people aged 50 years or older with clinically significant hearing loss are known to use hearing aids in the USA (Lin, 2012, p. 1147). One well established reason for this is dissatisfaction with hearing aid performance in particular listen- ing environments. As Lin notes:

The most advanced hearing aids will still preferentially amplify whichever sounds are loudest and closest - useful in some situations but disadvantageous in many others, particularly those where people are gathered in an echo-filled environment with multiple talkers (Lin, 2012, pp. 1147-1148).

These difficulties can be further compounded for hearing impaired people living in aged care facilities where the most residents have hearing impairments to some degree (Cohen-Mansfield & Taylor, 2004b). Such individuals may have auditory processing deficits that affect their ability to process sound into speech even when sound is audible to them (Welsh & Purdy, 2001, p. 59). Further, their communication difficulties may be misconstrued by medical and nursing staff as dementia (Burnip & Erber, 1996, p. …

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