Columns

SENIOR POWER: Gerontology 101: Now Hear This

By Helen Rippier Wheeler

Friday May 11, 2012 - 12:49:00 PM

Recommended reading, available online:

"Hearing loss linked to 3-fold risk of falling." American Association for the Advancement of Science, Feb. 27, 2012.

“Hearing loss a hidden -- and correctable -- problem for seniors” by Anita Creamer. Sacramento Bee, April 16, 2012.

Evelyn Glennie’s Hearing essay, 1993. Glennie is a 47-year old Scottish virtuoso percussionist, the first full-time solo percussionist in 20th-century western society. She has been profoundly deaf since age 12.

"Geriatrician-managed program reduces falls and fractures," by Jim

Kling (Medscape Medical News, May 9, 2012).

“A hearing aid that cuts out all the clatter.” John Tierney, New York Times,

October 23, 2011.

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Discussion:

There is general agreement that nearly two-thirds of Americans age 70+ have hearing loss, and about half of all people age 75+ have some age-related hearing loss! Hearing loss affects 4 of every 5 people age 80+.

Hearing loss becomes more common with age, affecting 18% of adults 45-64 years old and 30% of adults age 65-74 as well. With the aging of baby boomers, the numbers will increase.

There are professional discussions on the Internet about what ‘it’ is and ‘how to’ cope. I want to focus here on several less-publicized aspects of senior citizens’ hearing loss —dizziness, balance, tripping and falling.

Presbycusis is a progressive hearing impairment accompanying aging, typically affecting sensitivity to higher frequencies. Within the deaf culture movement, the terms deaf and hard of hearing are preferred. Medicare, ADA, HUD, and I refer to hearing impairment. Gradual hearing loss is the most common chronic condition of old age after high blood pressure (hypertension) and arthritis. It can begin in early adulthood but usually does not interfere with ability to understand conversation until much later. Although genetically variable, it is a concomitant of aging, distinct from hearing losses caused by noise or disease.

Otosclerosis is a hardening of the stapes (or stirrup) in the middle ear, causing conductive hearing loss. Neither of these two types of change is considered a disease by the people who define disease, which is perhaps one non-reason for Medicare’s failure to cover hearing amplification.

As we grow older, many of the hair cells of the inner ear disappear or wither, causing words to sound mumbled. In most cases there is an increasing loss of sensitivity to high-pitched sounds. Severity of hearing loss tends to be greater for men than for women, although men’s voices are easier to hear. There is difficulty hearing in groups and in noisy areas. And there may be ringing in one or both ears -- tinnitus.

The main contributors to age-related hearing loss are repeated exposure to loud noises, smoking, some medical conditions (e.g. hypertension) and medications (e.g. some antibiotics and diuretics, likewise Viagra and Cialis), and its tendency to run in families. Sedatives significantly increase the risk of falling. Cardiovascular medications can contribute to falls. Commentators have speculated that radio talk show host Rush Limbaugh's hearing loss was at least in part caused by his admitted addiction to narcotic pain killers. Some medications cause irreversible damage to the ear. Some medications may reversibly affect hearing; they include some diuretics, aspirin, NSAIDs, and certain antibiotics.

Despite its prevalence among older adults, hearing loss remains largely untreated. Only 14% of seniors who need hearing devices actually have them. Severe hearing loss later in life may accompany an older adult's risk of dementia.

So why do such a small number of hearing-impaired older adults – only one of every seven – actually use hearing aids? The technology can overwhelm some older people. Experts contend that some seniors are too proud to acknowledge need for amplification and some too vain to wear hearing aids.

Having had one’s hearing tested by an audiologist and having received a clearance from a physician (usually an otolaryngologist) for dispensing of a hearing aid, we confront the third major reason that older adults do not purchase hearing aids—the considerable cost. They are not covered by Medicare.

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Fear of falling? Focus on balance… reads the senior center announcement of a new Feldenkrais awareness-through-movement class, a $30. series. Hearing loss and tripping and falling are often connected. Dizziness and hypertension too. People who can not hear well are unlikely to be aware of their overall environment, making tripping and falling more likely. A recent study suggests that hearing loss can upset fragile seniors' sense of balance, tripling their chances of falling.

Attention: city fathers, HUD magnates, developers, advocates, and low-income senior citizens. When one’s annual rent recertification is computed, costs associated with purchasing and maintaiing hearing aids may or may not be acceptable as health-related medical expenses. The projects in which they rent should be planned and built with concern for elders’ needs as they relate to dizziness, maintenance of balance, propensity for falls, and less-than-normal hearing… railings on both sides of corridors on all floors, smoke and fire alarms that can be heard and seen from every nook and cranny, flooring that is not slick or slippery, more than one elevator. Lights and heat should be maintained in community rooms.

The fact of life is that Medicare does not cover hearing aids. Diagnostic evaluations are covered if they are ordered by a physician for the purpose of assisting the physician in developing a treatment plan. Most private U.S. health care providers do not provide coverage for hearing aids, so all costs are usually borne by the recipient. For low-income, hearing-impaired, powerless senior citizens, the cost of batteries is also a consideration. For others, the cost of hearing aids is a tax-deductible medical expense.

The National Institute on Deafness and Other Communication Disorders (NIDCD) Information Clearinghouse, at nidcdinfo@icfi.com , has “identified … organizations as resources for financial assistance and information.”

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Review:

1. True or false? Hearing loss affects 4 of every 5 people age 80+.

2. Why is hearing loss considered one of the “hidden impairments of old age?”

3. T or F? With the aging of baby boomers, the incidence of hearing loss can be expected to decrease.

4. Does hearing impairment differ from deafness?

5. T or F? Hearing loss remains largely untreated.

6. #___ % of senior citizens who need hearing devices actually have them.

7. T or False? Hearing loss can be a cause of a senior’s loss of sense of balance.

8. Gradual hearing loss is the most common chronic condition of old age after

hypertension and __________, according to the American Association on Hearing Loss.

9. T or F? Research suggests severe hearing loss late in life goes hand in hand with an older adult's risk of dementia.

10. T or F? According to the U.S. Food and Drug Administration, Viagra and Cialis have been found to cause temporary or permanent hearing loss.

11. One of several reasons that older adults who have been tested and who acknowledge that they cannot hear nevertheless hesitate to buy hearing aids is ____________.

12. “Your hearing is not going to get better—it’s only going to get worse” is a

[check one] bromide, cliché, platitude, truism, all of these, none of these.

13. Age-related hearing loss is called __________.

T or F? Presbycusis usually occurs in both ears.

15. T or F? Medicare pays/reimburses for some but not all hearing aids._

16. In what way(s) does an otolaryngologist differ from an audiologist? ____

17. T or F? Age-related hearing loss is progressive, which means it slowly improves.

18. Hearing-impaired persons usually find [select one:] men's voices easier to hear than women’s, OR women’s voices easier to hear than men’s. ____ 19. The following are 3 of factors that can contribute to age-related hearing loss: family history, smoking, and _____________________.

20. T or F? Age-related hearing loss tends not to run in families.

Answers are within this column and will also appear in next week’s column.

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NEWS

Large majorities of older Americans experience significant gaps in their primary care, according to the national survey, “How Does It Feel? The Older Adult Health Care Experience,” released April 24, 2012 by the John A. Hartford Foundation. The poll of Americans age 65+ assessed whether, in the past 12 months, patients received important medical services to support healthy aging, including:

an annual medication review,
a falls risk assessment and history,
depression screening,
referral to community-based health resources, and
discussion of their ability to perform routine daily tasks and activities without help.

This type of low-cost, low-tech geriatric care can manage and lower patients’ risk of a number of preventable health problems that erode quality of life, increase health care costs, cause disability, and even kill. Only 7% of older adults surveyed received all recommended services, critical elements of a standard geriatric assessment. Fifty-two percent reported receiving none or only one, and a large majority (76%) received fewer than half. Take this list to your next visit.

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MARK YOUR CALENDAR: Be sure to confirm. Readers are welcome to share by email news of future events and deadlines that may interest boomers, seniors and elders. Daytime, free, and Bay Area events preferred. pen136@dslextreme.com.

Wednesdays, until and including May 16. 1:30-2:30 P.M. Fear of falling? Focus on balance in new Feldenkrais awareness through movement class series. $20. for the series. Albany Senior Center, 1247 Marin Ave. Rosie Rosenthal, instructor. 510-525-3867.

Friday, May 11. 8:30 A.M. – 2:30 P.M. The African American Caregiving and Wellness Forum V: The End of Alzheimer’s Starts With Me. West Oakland senior Center, 1724 Adeline Street. Registration required by April 27. 1-800-272-3900.

Sunday, May 13. 12-4:30 P.M., 1:30 - 2:45 P.M. Hertz Concert Hall. Concert and Commencement Ceremony. Sponsor: Department of Music. Concert featuring award winners in the performing arts. Open to all audiences. Event Contact: concerts@berkeley.edu, 510-642-4864.

Monday, May 14. 12:30 - 1:30 PM. Albany YMCA/Albany Library Brown Bag Lunch Speaker's Forum: SFMOMA's Peter Samis, associate curator of interpretation, discusses the topic: EXPERIENCING THE WORLD OF MODERN ART THROUGH NEW TECHNOLOGIES. The forum is co-sponsored by the Albany YMCA and the Albany Library, 1237 Marin Av. Contact: Ronnie Davis, 510-526-3720 x16

Monday, May 14. 7:00 P.M. Identity Theft Program. Barbara Jue, a Legal Shield associate, will offer information and advice on how to prevent identity theft and how to cope should it happen. She will also talk about children and computer use and cyber bullying. Q&A follows. Kensington Library, 61 Arlington Ave. Free. 510-524-3043.

Tuesday, May 15. 6 – 8 P.M. Free Legal Workshop: Alternatives to Foreclosure. Steven Mehlman, a local attorney, will offer an informational session to explain the pros and cons of each financial decision to help you make the right choice for your

situation. Sponsored by the Contra Costa County Bar Association. El Cerrito Library, 6510 Stockton Avenue. 510-526-7512.

Wednesday, May 16. 1:30 P.M. Berkeley Commission on Aging. South Berkeley Senior Center, 2939 Ellis Street. 510-981-5178 Check the community calendar to confirm.

Wednesday, May 16. 7-8 P.M. Evening Book Group. Women of the Silk by Gail Tsukiyama. Albany Library, 1247 Marin Av. Moderated by Rosalie Gonzales. 510-526-3720.

Saturday and Sunday, May 19 and 20. 10 A.M. – 4 P.M. Friends of the Albany Library BOOK SALE. 1247 Marin Ave. For information, email friendsalbany@yahoo.com or phone 510-526-3720. Please do not bring donations during the two weeks prior to the sale.

Monday May 21. 7 P.M. Kensington Library Book Club: Color of the Sea by John Hamamura. Each meeting starts with a poem selected and read by a member with a brief discussion following the reading. New members are always welcome. Free. 61 Arlington Av. 510-524-3043.

Tuesday, May 22. 3 – 4 P.M. Central Berkeley Public Library, 2090 Kittredge St. Tea and Cookies at the Library. A free monthly book club for people who want to share the books they have read. 510-981-6100.

Wednesday, May 23. 12:00 noon - 1:00 PM One-on-One Computer Tutoring: Reservation Required. Albany Library, 1247 Marin Av. Sign up at Reference Desk. 510-526-3720.

Wednesday, May 23. 1:30 P.M. Gray Panthers. North Berkeley Senior Center, 1901 Hearst. 510-981-5190.

Wednesday, May 23. 1:30 - 2:30 PM Great Books Discussion Group: Alexis de Tocqueville's Democracy in America. Group meets on the fourth Wednesday of the month. Rosalie Gonzales facilitates the discussion. Come to one meeting, or all meetings. Books are available at the Library. Contact: Ronnie Davis(510) 526-3720 x16

Sunday, May 27. 130-4:30 P.M. Book Into Film: Betty Smith’s A Tree Grows in Brooklyn at Central Berkeley Public Library, 2090 Kittredge. Read the book at home. Watch the movie together. Discuss the book, film and adaptation as a group. Registration required- call 510-981-6236 to sign up.

Wednesday, May 30. 12 Noon-1 P.M. Playreaders at Central Berkeley Public Library.