Having a loved one in a nursing home brings a variety of concerns. Are their needs being tended to? Are they eating well? Are they safe? Certainly you want the best care and quality of life for those you love. Unfortunately, urgent needs such as hygiene and medical care mean that hearing care is not treated as a pressing concern and is often put on the back burner. But being in a nursing home is not an easy transition for anyone; add hearing loss into the mix and you have a recipe for frustration, fear and isolation.
What the studies show
A 2004 study showed that 70 to 90 percent of patients in long-term care facilities have hearing loss, yet the majority of that hearing loss is unknown to the staff. A study of 279 nursing home residents revealed that only 30 out of the 279 home residents had hearing loss screening within the past year. Even more shocking, 81 percent of the residents had not received any hearing care whatsoever.
Even if a resident has hearing aids, sometimes the amount of effort it takes to maintain and use them in a nursing home environment seems insurmountable, which in itself leads to a lack of use. Some of the reasons given for not wearing hearing aids in the nursing home are:
- Poor fit
- Painful to wear
- Difficult to use
- Not functioning properly
- No help was given when needed
Detecting underlying issues
As we get older, nearly all of us will develop presbycusis, or age-related hearing loss. Being able to hear what is going on around you is vital to quality of life, especially for those in assisted living or nursing homes. In particular, those with hearing loss in addition to cognitive impairment are likely to experience even more difficulty in a long term care environment. Unfortunately hearing loss often goes undetected in Alzheimer’s patients, leading to further episodes of anger, anxiety and confusion. The fact that the symptoms of cognitive impairment can be greatly exacerbated by hearing loss means that the hearing needs of these patients should receive close attention, with regular hearing screenings and hearing aid use and maintenance treated as a priority.
Fortunately there are a few things you can do to ensure that your loved one is receiving the proper attention when it comes to their hearing. Think of it as a team effort; developing a positive relationship with the staff and keeping lines of communication open can go a long way. In addition, becoming familiar with the policies of the nursing home regarding hearing aids and hearing care can help ensure everyone is on the same page when it comes to your loved one’s hearing matters.
Tips for hearing aid care in the nursing home
Label the hearing aids: Lost hearing aids are difficult and expensive to replace. Unfortunately it is all too easy for them to be scooped up when the staff changes the bedding. Experts recommend writing the resident’s name on the hearing aids in permanent marker, so they can be easily returned. You can also paint the hearing aids a bright color so they are easy to spot if they do happen to fall out.
Nighttime storage: A small hard plastic case, such as the one that accompanied the hearing aids at the time of purchase, is a handy and safe storage space for storing hearing aids overnight and allows them to be easily located in the morning.
Retainer system: A cord and clip system such as the Earstay, that hooks onto the hearing aids on one end and clips to the resident’s clothing on the other, can keep hearing aids from hitting the floor (and possibly getting stepped on) if they fall out.
Maintenance: In an ideal world, the nursing home staff would handle each resident’s hearing aid needs, ensuring that the hearing aids are cleaned, functioning properly and actually being used. Unfortunately lack of time, lack of adequate staffing and lack of training means that your loved one’s hearing aids might be a low priority. In this case it becomes the responsibility of the family members to handle any hearing aid upkeep. Clean the devices with a soft toothbrush on a regular basis to remove debris, and check the batteries weekly to see if they need to be changed.
Your partners in care
Talk to the staff about seeing that the hearing aids are inserted in the morning and removed at night. Depending on the policy of the nursing home, this is something that could easily be taken care of by a staff member. Be sure to ask about the policies and protocols regarding hearing aids up front, so there are no surprises down the road. And most importantly, familiarize yourself with the rights of nursing home residents in your state.
“When someone enters into a nursing home they are not only entitled to the same rights they have in the community but they have 32 additional rights found in federal law in the Older Americans Act,” said Lauri Scharf, quality and training manager for the Long-Term Care Ombudsman covering a five county region in Northern Ohio. “So it’s their right to be entitled to have the devices that they need and to get the care that they need.”
It is important to work with the nursing home to make sure your loved one receives the services they need, and in a timely manner. All too often, nursing home residents are treated as tasks to be checked off of a list, and not as unique human beings. As Scharf puts it, “Don’t just say, ‘Well, Mom’s hard of hearing and it’s a natural progression of aging.’ No. It’s making sure the appointment is made with the audiologist, so that something can be put in place for her. Don’t just dismiss her just because she’s in a nursing home, or say that just because she’s in a nursing home she doesn’t get hearing aids.”
Perhaps the most common question about hearing aids is whether the purchased of hearing aids is covered by insurance, and unfortunately the answer is usually no. However, once hearing aids are purchased, they often come with loss or damage warranties. In addition, some nursing homes have policies through which they will cover a deductible for a lost or damaged hearing aid. Again, be sure to ask what the nursing home’s policy is regarding repair or replacement up front, so you are not caught off-guard if something happens.
Be an advocate for hearing care
Remember, the most important thing you can do for your loved one in a nursing home is to become an advocate for their care in its entirety, and that includes hearing care for age-related hearing loss. Scharf recommends being a participant in the initial plan of care meeting and in subsequent quarterly reviews as well. “It’s good for the families to be present to let them know, ‘Yes, this is my dad and my dad wears hearing aids. And he likes them out at night because he doesn’t want to hear a sound, or he wants only one in when he sleeps because he wants to be able to hear something that’s going on.’”
If you feel your loved one still is not getting the proper care and attention when it comes to hearing care, contact your local Long-Term Care Ombudsman. They are an excellent resource if you have any questions or issues regarding hearing care or patient rights. And, a visit with a hearing care professional in our directory from time to time goes a long way towards improving quality of life and making sure your loved one remains a part of the conversation.