Nursing And Elderly Diseases

Topic : Hearing Loss in Older Adults.

Answer the Question(s):

· Mention the different types of hearing loss (2 types).

· Mention at least 3 examples for each type of hearing loss and explain each one.

· Discuss the possible consequences of hearing impairment.

· How can we promote healthy hearing?


The answer should be based on the knowledge obtained from the book, not just your opinion. A chapter from the Book was attached and online literature with references included.

“0 % ” plagiarism.

Book: Ebersole and Hess’ Gerontological Nursing and Healthy Aging 5th

Author: Theris A. Touhy; Kathleen F. Jett.Edition: 5th, Fifth, 5e Year: 2017

APA style will be strictly enforced. Time New Roman 12 Font.
“0 % ” plagiarism.
I am expecting a minimum of 400 words. The question must be answered completely and in a professional and well-written presentation.
I am expecting at least 2 references plus the book.
References other than the book must include:
References must not be older than 5 years

· Serial/journal articles

· Volume number, in italics.

· Issue number. This is bracketed immediately after the volume number but not italicized.

· Month, season or other designation of publication if there is no volume or issue number.

· Include all page numbers. Ex: 7(1),24 Sergiev, P. V., Dontsova, O. A., & Berezkin, G. V. (2015).
Hearing loss is a common problem caused by noise, aging, disease, and heredity. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms.

Approximately one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 has difficulty hearing. But, some people may not want to admit they have trouble hearing.

Older people who can’t hear well may become depressed, or they may withdraw from others because they feel frustrated or embarrassed about not understanding what is being said. Sometimes, older people are mistakenly thought to be confused, unresponsive, or uncooperative because they don’t hear well.

Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, see your doctor. Hearing aids, special training, certain medicines, and surgery are some of the treatments that can help.

Studies have shown that older adults with hearing loss have a greater risk of developing dementia than older adults with normal hearing. Cognitive abilities (including memory and concentration) decline faster in older adults with hearing loss than in older adults with normal hearing. Treating hearing problems may be important for cognitive health.

Hearing loss occurs in approximately one in three people age 65 to 74 and nearly one in two people age 75 and older in the United States, making it one of the most common conditions affecting older adults. Last year, the National Academies of Sciences, Engineering, and Medicine released Hearing Health Care for Adults: Priorities for Improving Access and Affordability, a report that highlights the importance of hearing health to communication and overall quality of life, and proposes recommendations to increase the availability and affordability of hearing health care.

NIA-funded research has indicated that hearing loss may impact cognition and dementia risk in older adults. A 2011 study found that older adults with hearing loss were more likely to develop dementia than older adults with normal hearing. In fact, there was a relationship between level of uncorrected hearing loss and level of dementia risk: mild hearing loss was associated with a two-fold increase in risk; moderate hearing loss with a three-fold increase in risk, and severe hearing loss with a five-fold increase in risk. (Lin et al., 2011).

Furthermore, a more recent study found that cognitive abilities (including memory and concentration) declined faster in older adults with hearing loss, as compared to older adults with normal hearing (Lin et al., 2013). These observations by scientists raise the question: can cognitive decline and/or dementia onset be slowed or stopped by correcting hearing loss?

Signs of Hearing Loss

Some people have a hearing problem and don’t realize it. You should see your doctor if you:

· Have trouble hearing over the telephone

· Find it hard to follow conversations when two or more people are talking

· Often ask people to repeat what they are saying

· Need to turn up the TV volume so loud that others complain

· Have a problem hearing because of background noise

· Think that others seem to mumble

· Can’t understand when women and children speak to you

· Types of Hearing Loss

· Hearing loss comes in many forms. It can range from a mild loss, in which a person misses certain high-pitched sounds, such as the voices of women and children, to a total loss of hearing.

There are two general categories of hearing loss:

Sensorineural hearing loss occurs when there is damage to the inner ear or the auditory nerve. This type of hearing loss is usually permanent.

Conductive hearing loss occurs when sound waves cannot reach the inner ear. The cause may be earwax buildup, fluid, or a punctured eardrum. Medical treatment or surgery can usually restore conductive hearing loss.

Sudden Hearing Loss

Sudden sensorineural hearing loss, or sudden deafness, is a rapid loss of hearing. It can happen to a person all at once or over a period of up to 3 days. It should be considered a medical emergency. If you or someone you know experiences sudden sensorineural hearing loss, visit a doctor immediately.

Age-Related Hearing Loss (Presbycusis)

Presbycusis, or age-related hearing loss, comes on gradually as a person gets older. It seems to run in families and may occur because of changes in the inner ear and auditory nerve. Presbycusis may make it hard for a person to tolerate loud sounds or to hear what others are saying.

Age-related hearing loss usually occurs in both ears, affecting them equally. The loss is gradual, so someone with presbycusis may not realize that he or she has lost some of his or her ability to hear.

Ringing in the Ears (Tinnitus)

Tinnitus is also common in older people. It is typically described as ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It can come and go. It might be heard in one or both ears, and it may be loud or soft. Tinnitus is sometimes the first sign of hearing loss in older adults. Tinnitus can accompany any type of hearing loss and can be a sign of other health problems, such as high blood pressure, allergies, or as a side effect of medications.

Tinnitus is a symptom, not a disease. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus, but it can also be the result of a number of health conditions.

Causes of Hearing Loss

Loud noise is one of the most common causes of hearing loss. Noise from lawn mowers, snow blowers, or loud music can damage the inner ear, resulting in permanent hearing loss. Loud noise also contributes to tinnitus. You can prevent most noise-related hearing loss. Protect yourself by turning down the sound on your stereo, television, or headphones; moving away from loud noise; or using earplugs or other ear protection.

Earwax or fluid buildup can block sounds that are carried from the eardrum to the inner ear. If wax blockage is a problem, talk with your doctor. He or she may suggest mild treatments to soften earwax.

A punctured ear drum can also cause hearing loss. The eardrum can be damaged by infection, pressure, or putting objects in the ear, including cotton-tipped swabs. See your doctor if you have pain or fluid draining from the ear.

Health conditions common in older people, such as diabetes or high blood pressure, can contribute to hearing loss. Viruses and bacteria (including the ear infection otitis media), a heart condition, stroke, brain injury, or a tumor may also affect your hearing.

Hearing loss can also result from taking certain medications. “Ototoxic” medications damage the inner ear, sometimes permanently. Some ototoxic drugs include medicines used to treat serious infections, cancer, and heart disease. Some antibiotics are ototoxic. Even aspirin at some dosages can cause problems. Check with your doctor if you notice a problem while taking a medication.

Heredity can cause hearing loss, as well. But not all inherited forms of hearing loss take place at birth. Some forms can show up later in life. For example, in otosclerosis, which is thought to be a hereditary disease, an abnormal growth of bone prevents structures within the ear from working properly.

How to Cope with Hearing Loss

If you notice signs of hearing loss, talk to your doctor. If you have trouble hearing, you should:

· Let people know you have a hearing problem.

· Ask people to face you and to speak more slowly and clearly. Also, ask them to speak louder without shouting.

· Pay attention to what is being said and to facial expressions or gestures.

· Let the person talking know if you do not understand what he or she said.

· Ask the person speaking to reword a sentence and try again.

· Find a good location to listen. Place yourself between the speaker and sources of noise and look for quieter places to talk.

· The most important thing you can do if you think you have a hearing problem is to seek professional advice. Your family doctor may be able to diagnose and treat your hearing problem. Or, your doctor may refer you to other experts, like an otolaryngologist (ear, nose, and throat doctor) or an audiologist (health professional who can identify and measure hearing loss).

Devices to Help with Hearing Loss

Your doctor or specialist may suggest you get a hearing aid. Hearing aids are electronic, battery-run devices that make sounds louder. There are many types of hearing aids. Before buying a hearing aid, find out if your health insurance will cover the cost. Also, ask if you can have a trial period so you can make sure the device is right for you. An audiologist or hearing aid specialist will show you how to use your hearing aid.

Assistive-listening devices, mobile apps, alerting devices, and cochlear implants can help some people with hearing loss. Cochlear implants are electronic devices for people with severe hearing loss. They don’t work for all types of hearing loss. Alert systems can work with doorbells, smoke detectors, and alarm clocks to send you visual signals or vibrations. For example, a flashing light can let you know someone is at the door or the phone is ringing. Some people rely on the vibration setting on their cell phones to alert them to calls.

Over-the-counter (OTC) hearing aids are a new category of regulated hearing devices that adults with mild-to-moderate hearing loss will be able to buy without a prescription. OTC hearing aids will make certain sounds louder to help people with hearing loss listen, communicate, and take part more fully in daily activities.

Promoting Hearing Health Across the Lifespan

Globally, one in three adults has some level of measurable hearing loss, and 1.1 billion young persons are at risk for hearing loss attributable to noise exposure. Although noisy occupations such as construction, mining, and manufacturing are primary causes of hearing loss in adults, nonoccupational noise also can damage hearing. Loud noises can cause permanent hearing loss through metabolic exhaustion or mechanical destruction of the sensory cells within the cochlea. Some of the sounds of daily life, including those made by lawn mowers, recreational vehicles, power tools, and music, might play a role in the decline in hearing health. Hearing loss as a disability largely depends on a person’s communication needs and how hearing loss affects the ability to function in a job. The loss of critical middle and high frequencies can significantly impair communication in hearing-critical jobs (e.g., law enforcement and air traffic control).

Occupational Noise-Induced Hearing Loss

A recent analysis of 2011–2012 National Health and Nutrition Examination Survey (NHANES) data estimates that approximately 14% of U.S. adults aged 20–69 years (27.7 million persons) have hearing loss. After adjustments for age and sex, hearing impairment was nearly twice as prevalent in men as in women; age, sex, ethnicity, and firearm use were all important risk factors for hearing loss.

CDC’s National Institute for Occupational Safety and Health (NIOSH) estimates that 22 million workers are exposed to hazardous levels of noise in their workplaces (2). The estimated prevalence of hearing loss among noise-exposed workers is 12%–25%, depending on type of industry. Reductions in workplace noise and increased use of hearing protection might have contributed to a decreased prevalence of hearing loss over time in some sectors, including agriculture, forestry, fishing, and hunting and transportation, warehousing, and utilities (3). The risk for incident hearing loss (i.e., the likelihood of observing a new case of hearing loss in a worker’s longitudinal audiometric data) decreased by 46% from the periods 1986–1990 to 2006–2010 .

For high exposure levels such as firearm or aircraft noise above 140 decibels sound pressure level (dB SPL), engineering and administrative controls might not reduce noise exposures adequately. Such situations require hearing protection devices (HPDs) providing upwards of 30–40 dB of noise reduction when worn properly. Despite the existence of occupational regulations for hearing protection, many workers fail to achieve adequate protection because their earplugs or earmuffs do not fit properly. Hearing protector fit testing provides an opportunity to train workers to properly fit hearing protectors and to encourage effective use. The NIOSH HPD Well-Fit hearing protector fit-test system is a simple, portable solution for testing in quiet office spaces. Other fit-testing systems are commercially available.

Nonoccupational Noise-Induced Hearing Loss

Primary sources of nonoccupational hearing loss in the United States include noise exposure from recreational hunting or shooting, use of personal music players, overexposure at concerts and clubs, and certain hobbies (e.g., motorsports and woodworking with power tools). In 2016, CDC began initiatives to raise awareness about the risk for permanent hearing damage attributable to nonoccupational noise exposures, including the development of new communication tools about noise-induced hearing loss.

Persons with normal hearing can detect sounds equally soft at all frequencies. When hearing is damaged by noise, the hearing test will show a loss of acuity in a narrow range of middle to high frequencies (3–6 kHz) with better hearing at both lower and higher frequencies.

The weighted prevalence of an audiometric notch was 24%, extrapolated to represent nearly 40 million U.S. adults. Unilateral audiometric notches were three times more prevalent than were bilateral audiometric notches and were more prevalent in men than in women. Participants who reported having exposure to loud noise at work were twice as likely to have evidence of hearing damage as were those who did not. However, 20% of persons with no occupational exposure to loud noise had an audiometric notch, suggesting that 21 million U.S. adults likely have hearing damage from noise at home or in their communities.

The presence of an audiometric notch increased with age, ranging from 19% of participants aged 20–29 years to 29% of those aged 40–49 years. The prevalence of notches decreased among persons aged 50–59 years, as high-frequency hearing loss associated with aging increasingly masks the notch associated with noise-induced hearing loss.

Regardless of whether participants’ exposure was to work or recreational noise, 24% of those with such damage reported that their hearing was excellent or good, suggesting that many persons might be either unaware of or ignoring noise-induced hearing damage. Although most noise-induced hearing loss is preventable, the NHANES analysis found that 70% of persons exposed to loud noise in the past 12 months had seldom or never worn hearing protection (5).

Noise-induced hearing loss in youths is not a new problem. An analysis of 1988–1994 NHANES data identified audiometric notches in 20% of males and 12% of females aged 12–19 years among a population of 5,249 U.S. children and young adults aged 6–19 years (6). An analysis of 2005 and 2006 NHANES data found that 17% of both males and females had notched audiograms (7).

Hearing Loss Worldwide

Hearing loss affects tens of millions of persons in the United States and hundreds of millions of persons worldwide, and during the past few decades, the estimated number of persons with hearing loss has steadily increased. The World Health Organization (WHO) estimates that approximately 360 million persons live with disabling hearing loss, including approximately 328 million (91%) adults (56% males and 44% females) and 32 million (9%) children. As the population ages, it is estimated that approximately 320 million persons aged >65 years will have hearing loss by 2030 and approximately 500 million by 2050.

National Prevention Efforts

To ensure that all persons can benefit from efforts to prevent noise-induced hearing loss, a coordinated public health hearing loss reduction and mitigation approach should focus on effective population-based preventive interventions that go beyond clinical service and traditional areas of diagnosis, treatment, and research and focus on epidemiologic surveillance, health promotion, and disease prevention. Such an approach can help determine the needs of the population and the barriers to care, leading to policies for prevention and management of hearing loss. Health communication science provides a theoretical framework to study, develop, and evaluate interventions designed to change individual behavior. Some of these theories have been applied in the promotion of hearing health.

Dangerous Decibels ( icon) is an evidence-based intervention program that has changed knowledge, attitudes, beliefs, and behaviors of both youths and adults for the prevention of noise-induced hearing loss and tinnitus.

The messaging incorporates three strategies for hearing loss prevention:

1) turn it down

2) walk away

3) protect your ears.

Originally developed for youths, Dangerous Decibels has been successfully adapted for civilian adults and the military, and its effectiveness was demonstrated in randomized trials among children in the United States and in studies in New Zealand and Brazil. Comparison of responses to predelivery and two postdelivery questionnaires found that participants in the Dangerous Decibels presentation exhibited substantial improvements in knowledge, attitudes, and intended behaviors related to hearing and hearing loss prevention that were partially maintained 3 months after the presentation. Most recently, Dangerous Decibels expanded into a community-based intervention and is self-sustaining in U.S. Native American communities. The materials are in use in all 50 states, four U.S. territories, and 41 countries. Online games and activities are available, including Jolene, a system that measures music-listening sound levels and aids in educational outreach for hearing health.

CDC has developed tools and communication products to promote best practices for hearing loss prevention. In addition to practical engineering controls, administrative controls, and using hearing protectors, NIOSH promotes the Buy Quiet and Quiet-by-Design programs, designed for employers to take an inventory of their potentially harmful loud tools and replace them with quieter ones. Approximately 20 companies and individuals have been recognized for successful efforts by the Safe-in-Sound Excellence in Hearing Loss Prevention and Innovation Award ( icon) developed by NIOSH and the National Hearing Conservation Association.

In 2015, United Technologies, a corporation that serves customers in the commercial aerospace, defense, and building industries, received the award for promoting a hearing-loss prevention culture throughout the corporation. United Technologies reduced the number of persons exposed to hazardous noise by approximately 80%, thereby eliminating the need for a hearing conservation program for approximately 10,000 workers.

Other efforts include the promotion of recommended noise exposure standards for the workplace. NIOSH recommends an 85-dB limit for an average daily 8-hour exposure and a 3-dB exchange rate, which means that each increase of 3 dB in exposure level reduces the recommended exposure time by half (13). Thus, an 88-dB exposure limit is recommended for up to 4 hours and a 91-dB exposure limit for 2 hours. The National Hearing Conservation Association 85-3 Coalition, an organization of worker, professional, and industrial hygiene associations, promotes the use of an 85-dB limit and 3-dB exchange rate to protect the hearing of workers.

WHO focuses on undertaking evidence-based advocacy to raise awareness of deafness, hearing loss, and hearing care within all levels of society. WHO develops policy that advocates for hearing care provisions in its 194 member countries and develops standardized technical tools, recommendations, guidelines, and training resources to support policy development and implementation. It also engages directly with national ministries of health and other stakeholders to develop, implement, and monitor strategies for ear and hearing care.

Two principal advocacy initiatives promoted by WHO include World Hearing Day ( icon) and the Make Listening Safe initiative ( icon) (15). The Make Listening Safe initiative was launched in 2015 to reduce the growing risk for hearing loss posed by unsafe listening practices in recreational settings. As part of this initiative, WHO is working with partners to develop technical standards and applications for personal audio systems and to promote safe listening practices among application (app) users. World Hearing Day, observed each year on March 3, aims to increase hearing loss awareness among policymakers, professionals, and communities. The 2018 theme is “Hear the future,” drawing attention to the globally increasing number of persons with hearing loss, focusing on preventive strategies, and outlining steps to ensure access to necessary rehabilitation services and communication tools and products.

Noise reduction and avoidance can prevent hearing loss or slow its progression. Persons can protect themselves by moving away or taking breaks from loud sounds, using quieter consumer products, lowering volumes on personal listening devices, reducing time listening to loud levels of music, and using hearing protectors. Hearing protectors need to fit well to reduce noise exposures effectively. Health care providers can inform patients about hearing loss symptoms, early diagnosis of hearing loss, and prevention strategies.

Policymakers, governments, and manufacturers of equipment can develop policies to reduce noise levels and limit noise exposures of the public. In parts of Europe, community noise and the effect of urban soundscapes on public health have received considerable attention. In the United States, national, state, and local community noise-control efforts are largely uncoordinated, potentially resulting in higher levels of community noise. Increasing awareness and reducing needless exposures to loud noise might help the public take appropriate steps to protect their hearing.


Hearing Loss: A Common Problem for Older Adults. (2018, November 20). Retrieved November 4, 2019, from

Murphy, W. J., Meinke, J. E., undefined, D. K., undefined, S. C., & undefined, J. I. (2018, March 1). CDC Grand Rounds: Promoting Hearing Health Across the Lifespan. Retrieved November 4, 2019, from

What’s the connection between hearing and cognitive health? (2017, October 19). Retrieved November 4, 2019, from


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