Better Hearing Month

17 May 2021
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Better Hearing or Better Listening?

Hearing is a critically important sense for typical development of speech and language which carries us through the formative years of learning and socializing so unique to humankind.  Loss of hearing can come from illness, heredity, noise exposure, among a variety of other causes.  As we mature and approach retirement age, Age Related Hearing Loss is a very common cause of hearing loss and can impact our ability to easily communicate and continue the social life we have enjoyed.

Better Hearing Month is a time to consider prevention of hearing loss, how to recognize when we may be affected by it, and what to do about it when it interferes with the quality of our lives.  It is also a time to think about how to actively engage our ears and brains to hear and comprehend the spoken word.  Better Listening doesn’t cost anything, is cosmetically acceptable, doesn’t need batteries, and can markedly improve our ability to communicate.

“D.A.R.E.” to Listen Better!

Follow these simple steps to be a better listener:

Direct your focus: Listening is an active process and requires purposeful direction of our attention to what is being said by our conversation partners. Keep your mind on the conversation and stay engaged.  Look directly at the speaker to provide visual feedback that you are listening. 

Ask for repetition or rephrasing (with a smile.) Give others some feedback: “I heard ‘pink banana’ what did you really say?”

Read the face: If in a situation where protective masks are required, it is “eyebrow guessing” instead of speechreading but there is still information in the full frontal visual.

Exit an impossibly unfavorable environment.  Some situations are acoustically hostile making it impossible to hear, even when following all the rules.  Learn to recognize those situations and move to a better, quieter place.

10 May 2021
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Loneliness, Social Isolation and a Pandemic, Oh My!

The worldwide impact of implementation of unprecedented social distancing and limitations on social activities because of the COVID-19 pandemic may have helped control the spread of the disease but impacted older adults disproportionally.  In a report from May of last year Hwang and colleagues noted:  “…there is a high cost associated with the essential quarantine and social distancing interventions for COVID-19, especially in older adults, who have experienced an acute, severe sense of social isolation and loneliness with potentially serious mental and physical health consequences. The impact may be disproportionately amplified in those with pre-existing mental illness, who are often suffering from loneliness and social isolation prior to the enhanced distancing from others imposed by the COVID-19 pandemic public health measures. (Hwang et al, 2020)

Because many older adults are often dependent upon family members and community services for assistance with routine activities, social distancing should not equate to social disconnection. It is generally accepted that loneliness is the subjective feeling of being alone, and social isolation is a measurable assessment of individuals’ social contacts and interaction. Loneliness and isolation are not equal, but both can have a detrimental effect on health. Before the COVID-19 pandemic, Loneliness and isolation were found to be a “behavioral epidemic” across the USA, Europe and China (Jeste and colleagues, 2020.) The impact of COVID-19 social restrictions on top of the existing behavioral epidemic is impactful on many older adults, and especially so for individuals with pre-existing potential for mental illness. Loneliness has been found to be associated with increased risk for heart disease. Loneliness and social isolation have found to be factors in increased risk for coronary artery disease-associated death, even with younger individuals without prior history of heart disease (Heffner et al., 2011; Steptoe et al., 2013). Both loneliness and social isolation have been shown as independent risk factors for higher all-cause mortality (Yu et al., 2020).

In the face of these discouraging facts what can we do to prevent the detrimental effect of loneliness and social isolation? Hearing health care providers are in a unique position to spend more time with patients than their primary care physician or other health care providers. During interviews with individuals having trouble hearing, hearing care professionals may uncover symptoms that may not otherwise be discussed with a physician. There are several positive suggestions that are offered to patients and significant others that may help avoid loneliness and social isolation (Hwang et al, 2020):

  • Keep family and friend connections.  When routine visits are limited, telephone communication or Zoom and Skype connections can help sustain family and friend connections.
  • Technology is a big help with social connections.  Hearing aids today not only have the option for telecoils but have wireless connections with more Android and Apple devices than ever.  If face-to-face communication is limited, difficulties may be solved by designing a good technological solution.
  • Ensuring that basic needs such as food, medication, and telephone or tablet/computer availability is extremely important, especially for those who are living alone. Your hearing health care professional may help with outlining the best way to communicate your needs to others.
  • Maintain a regular structured daily routine. Participation in activities that are pleasurable adds benefits for physical, mental, and spiritual well-being.
  • Maintain activities that support physical and mental wellness.  Today’s hearing aids can monitor movement and social engagement.  Logging these parameters may serve as motivation for the user to seek out movement and engagement.

Hearing health care professionals are responsible for helping with devices and the techniques necessary for effective communication.  As such, they are a resource for advice beyond the gadgets they provide.  Please take advantage of their expertise and step into the world of better hearing!


References:

Hwang TJ, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr. 2020;32(10):1217-1220. doi:10.1017/S1041610220000988

Jeste, D. V., Lee, E. E. and Cacioppo, S. (2020). Battling the Modern Behavioral Epidemic of Loneliness: Suggestions for Research and Interventions. JAMA Psychiatry. doi: 10.1001/jamapsychiatry.2020.0027

Heffner, K. L., Waring, M. E., Roberts, M. B., Eaton, C. B. and Gramling, R. (2011). Social isolation, C-reactive protein, and coronary heart disease mortality among community-dwelling adults. Social Science & Medicine, 72, 1482–1488.

Steptoe, A., Shankar, A., Demakakos, P. and Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy Sciences of the United States of America, 110, 5797–5801

3 May 2021
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COVID Linked to Hearing Loss, Tinnitus

Throughout 2020 COVID-19 had us hiding out at home, washing our hands, wiping down surfaces and masking up.  Quite a bit wasn’t known for some time. We knew about flu-like symptoms and disturbances in smell and taste, but not enough about the full spectrum of effects. A year later now, evidence is emerging about symptoms of the disease beyond those that were initially reported.  Tinnitus, Hearing loss and balance disorders were noted in a review by the Manchester Centre for Audiology and Deafness (ManCAD) of 56 studies published in 2020.  The evidence remains tentative at this stage as it is only based on self-reports of problems. Their conclusion was that “There are multiple reports of audio-vestibular symptoms associated with COVID-19. However, there is a dearth of high-quality studies comparing COVID-19 cases and controls.” Senior Author Kevin Munro, professor of audiology at ManCAD states that there is a need for a carefully designed study to yield high quality data about the apparent association of these symptoms with COVID-19.  Professor Munro is leading a year-long study in the UK comparing control patients with recovered patients who were hospitalized with COVID-19.

Why does this disease apparently cause hearing and balance problems and tinnitus?  We have learned that the damage caused by COVID-19 can go beyond respiratory problems to immune reactions causing inflammation, and circulatory complications that may damage wide ranging sensory systems in the body.  The problems may result from direct viral infections of the ear and connecting nerve pathways, excessive cytokine production causing inflammation, or blood clots in pathways supporting delicate structures of the inner ear.

As more is learned about the nature and extent of the association of these symptoms with the disease, a better understanding of the root causes of the symptoms will emerge, bringing possible treatments into practice.

What should you do if you have had COVID-19 and think you may have trouble hearing or a change in tinnitus? Proactively scheduling a hearing check will establish an objective level to inform your physician and you about your hearing and establish a baseline for comparison in the future if necessary.

Reference:
Ibrahim Almufarrij & Kevin J. Munro (2021): One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms, International Journal of Audiology, DOI: 10.1080/14992027.2021.1896793