Mechthild Decker-Maruska, Michael Lerch
JHS 2012; 2(4): EA40-42
Background: In providing medical care to senior citizens, the impact of demographic change has not been widely recognised. Whereas dementia and cognitive decline have become major concerns in caring for the elderly, sensory loss – especially decline of auditory function (in spite of its prevalence) – are still stigmatised by society and health care professionals. Although hearing aids have poor acceptance, elderly persons need them to maintain communication and social competency. Self-sufficiency in old age is the ultimate therapeutic goal in geriatrics, and so mobility, stability, emotional equilibrium, continence, nutrition, and cognition need to be targeted by multiprofessional teams. Often professionals do not recognise the prevalence of presbycusis and the options for its treatment and care, and elderly patients often ignore the symptoms of auditory decline. As a result, oral communication, as the basis of therapeutic interaction, becomes brittle. This could lead to frequent misunderstandings and behavioral changes (reduced compliance, inadequate reactions towards demands, lack of interest, social retreat, total isolation), as often experienced in dementia.
Results: All geriatric staff, as well as the caregiver, need to be educated about presbycusis (it has a prevalence of 52%; Lerch & Decker-Maruska 2008) and the need for handicap-adjusted communication skills.
Conclusions: Since hearing impairment carries a relative risk factor of 2.4 for the development of dementia, differentiating cognitive and auditory decline (or their comorbidity) in the elderly becomes crucial. Therefore geriatric patients should be screened for hearing impairment before any cognitive testing is done (Lerch & Decker-Maruska 2009). From a geriatric perspective, staff education, increase of awareness, early screening, and the most suitable augmentation of hearing (hearing aid, EAS, cochlear implant), matched with age-adapted audiotherapy, will bring benefits in terms of geriatric care and rehabilitation to the elderly.
Keywords: Geriatrics, Dementia, Presbycusis