Supporting older people with hearing loss in care settings

This guide has been produced to help staff working in longer-term care settings provide high-quality care and support to older people with hearing loss. It is written for care home managers | Action on Hearing Loss

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The guide covers the following:

  • The need to support older people with hearing loss
  • Identifying and checking for hearing loss
  • Improving hearing aid use and management
  • Meeting residents’ communication needs
  • Providing assistive listening devices
  • Managing tinnitus
  • Managing ear wax
  • Appointing Hearing Loss Champions
  • Meeting the requirements of the CQC Inspection Framework

Full document: Guidance for supporting older people with hearing loss in care settings: A guide for managers and staff


Older adults’ experiences with a new hearing aid

Jorunn Solheim, Caryl Gay & Louise Hickson | Older adults’ experiences and issues with hearing aids in the first six months after hearing aid fitting | International Journal of Audiology | Published online: 27 Sep 2017

Objectives: This study describes older adults’ experiences with a new hearing aid (HA) during the first 6 months after fitting.

Design: In a longitudinally designed study, experiences and issues with HA use were assessed at a six-month follow-up appointment in individual structured interviews lasting 30 min. Associations between HA experiences and demographic factors, degree of hearing loss, and an objective measure of HA use (datalogging) were also examined.

Study sample: 181 HA recipients (≥60 years) attending a six-month follow-up appointment.

Results: Participants reported an average of 1.4 issues with HA use, the most common pertaining to the earmold (26.5%), sound quality (26.0%) and handling (25.5%). Participants who reported at least one issue had fewer hours of use per day, but were not more likely to be non-users (<30 min/day). Non-users (15.5%) were more likely to report no need for a HA and handling issues.

Conclusions: Most older adults use their HAs regardless of reported issues. However, handling issues and no perceived need may interfere with HA usage among some adults with hearing impairment. Moreover, reported issues were associated with less frequent HA use. Follow-up support is thus important to address issues that may interfere with optimal use.

Change in loneliness after intervention with cochlear implants or hearing aids

The aim of the study was to investigate the impact of hearing aid (HA) and cochlear implant (CI) use on loneliness in adults| The Laryngoscope

Image source: Joonas Tikkanen – Flickr // CC BY-ND 2.0

One hundred and thirteen adults, aged ≥ 50 years, with postlingual hearing loss and receiving routine clinical care at a tertiary academic medical center, were evaluated with the University of California at Los Angeles Loneliness Scale before and 6 and 12 months after intervention with HAs or CIs. Change in score was assessed using linear mixed effect models adjusted for age; gender; education; and history of hypertension, diabetes, and smoking.

Treatment of hearing loss with CIs results in a significant reduction in loneliness symptoms. This improvement was not observed with HAs. We observed differential effects of treatment depending on the baseline loneliness score, with the greatest improvements observed in individuals with the most loneliness symptoms at baseline.

Full reference: Contrera, K.J. et al. (2017) Change in loneliness after intervention with cochlear implants or hearing aids. The Laryngoscope. Vol. 127 (Issue 8) pp. 1885–1889

Association of Hearing Impairment and Subsequent Driving Mobility in Older Adults

Hearing impairment (HI) is associated with driving safety (e.g., increased crashes and poor on-road driving performance). However, little is known about HI and driving mobility | The Gerontologist

Image source: Nicolas Alejandro - Flickr // CC BY 2.0
Image source: Nicolas Alejandro – Flickr // CC BY 2.0

Purpose of the Study: This study examined the longitudinal association of audiometric hearing with older adults’ driving mobility over 3 years.

Results: Individuals with moderate or greater HI performed poorly on the UFOV, indicating increased risk for adverse driving events (p < .001). No significant differences were found among older adults with varying levels of HI for driving mobility (p values > .05), including driving cessation rates (p = .38), across time.

Implications: Although prior research indicates older adults with HI may be at higher risk for crashes, they may not modify driving over time. Further exploration of this issue is required to optimize efforts to improve driving safety and mobility among older adults.

Full reference: Edwards, J.D. et al. (2017) Association of Hearing Impairment and Subsequent Driving Mobility in Older Adults. The Gerontologist. 57 (4)pp. 767-775. 

The Association between Hearing Loss, Postural Control, and Mobility in Older Adults

Degraded hearing in older adults has been associated with reduced postural control and higher risk of falls. Both hearing loss (HL) and falls have dramatic effects on older persons’ quality of life (QoL). A large body of research explored the comorbidity between the two domains | Journal of the American Academy of Audiology

Image source: Julita B.C. – Flickr // CC BY-SA 2.0

Purpose: The aim of the current review is to describe the comorbidity between HL and objective measures of postural control, to offer potential mechanisms underlying this relationship, and to discuss the clinical implications of this comorbidity.


Results: Of 211 screened articles, 7 were included in the systematic review. A significant, positive association between HL and several objective measures of postural control was found in all seven studies, even after controlling for major covariates. Severity of hearing impairment was connected to higher prevalence of difficulties in walking and falls. Physiological, cognitive, and behavioral processes that may influence auditory system and postural control were suggested as potential explanations for the association between HL and postural control.

Conclusions: There is evidence for the independent relationship between HL and objective measures of postural control in the elderly. However, a more comprehensive understanding of the mechanisms underlying this relationship is yet to be elucidated. Concurrent diagnosis, treatment, and rehabilitation of these two modalities may reduce falls and increase QoL in older adults.

Full reference: Agmon, M. et al. (2017) The Association between Hearing Loss, Postural Control, and Mobility in Older Adults: A Systematic Review. Journal of the American Academy of Audiology. Vol. 28 (no. 06) pp. 575-588

Talking about cost in audiology consultations with older adults

Financial cost is a barrier for many older adults in their decision to obtain hearing aids (HAs) | International Journal of Audiology 


Objective: This study aimed to examine conversations about the cost of HAs in detail within initial audiology appointments.

Results: Audiologists and clients displayed interactional difficulty during conversations about cost. Clients often had emotional responses to the cost of HAs, which were not attended to by audiologists. It was typical for audiologists to present one HA cost option at a time, which led to multiple rejections from clients which made the interactions difficult. Alternatively, when audiologists offered multiple cost options at once this led to a smoother interaction.

Conclusions: Audiologists and clients were observed to have difficulty talking about HA costs. Offering clients multiple HA cost options at the same time can engage clients in the decision-making process and lead to a smoother interaction between audiologist and client in the management phase of appointments.

Full reference: Ekberg, K. et al. (2017) Difficult conversations: talking about cost in audiology consultations with older adults. International Journal of Audiology. Published online: 23 Jun 2017

Social Support and Coping on Quality of Life Among Elderly With Age-Related Hearing Loss

The consequences of hearing loss hinder the everyday life of older adults and are associated with reduced well-being | American Journal of Audiology

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Image source: Andrea Squatrito – Flickr // CC BY-NC-ND 2.0

Aim: The research aim was to explore the influence of hearing problems, various coping strategies, and perceived social support on quality of life.

Results: Quality of life was predicted by perceived social support and the number of comorbid diseases (i.e., the physical, psychological, environmental, and social quality of life was better the greater the extent of perceived social support and poorer the more diseases from which the participants suffered).

Conclusions: Perceived social support may be a relevant factor to focus on in auditory rehabilitation programs, in particular, for participants who communicate little support in hearing-related situations and are, hence, at a relative disadvantage. The involvement of significant others in counseling could facilitate the everyday life for older adults with age-related hearing loss and their significant others

Full reference: Moser, S. et al. (2017) The Influence of Social Support and Coping on Quality of Life Among Elderly With Age-Related Hearing Loss. American Journal of Audiology. Vol. 26(6) pp. 170-179.