Week 5, Spring 2008

This week in clinic I saw an older gentleman who was having obvious difficuly understanding normal conversational speech during the case history interview. I found myself raising my voice substantially and repeating myself often in order to communicate with him. Direct view of my face was also needed for him to understand what I was saying.

The client had normal EACs and normal tympanograms. Acoustic reflex testing revealed elevated ipsilateral and bilateral ARTs. The client had sloping mild to moderately-severe sensorineural hearing loss bilaterally. His PTA and SRT were in good agreement for both ears, and his WR scores were fair (82% in the right ear and 78% in the left ear).

Significantly, the client noted that he and his wife had been fighting about his inability to hear lately. He said that she was constantly "nagging" him about not listening, and it was becoming an issue in their marriage. He also stated that he was no longer able to talk on the phone because of his hearing loss. According to the gentlemen, the purpose of his visit was mostly to appease his wife.

The following article titled "Effect of Hearing Aids on Hearing Disability and Quality of Life in the Elderly" describes a study that measured perceived benefits on social and emotional wellbeing following a hearing aid fitting. A total of 98 participants, who were first-time hearing aid users, were fit monaurally with a hearing aid. At the beginning of the study, prior to the fitting, the participants were given the Hearing Handicap Inventory for the Elderly short version (HHIE-S) and other questionnaires. All inventories were given again six months after the intial fitting. Most hearing aids used were BTEs, but ITEs were used as well. Some were digital and some were analog hearing aids.

Prior to the fitting, the HHIE-S revealed that almost 70% of the participants felt that their HL was handicapping, and over 50% noted that it limited their lives. The mean HHIE-S score was 28.7 prior to the fitting and 12.7 six months post-fitting. Lower scores in indicate lessening of a perceived handicap, which presented in 40-60% of the participants post-fit. Thus, being fit with hearing aids made most individuals feel substantially less handicapped.

Hopefully, being fit with hearing aids will also increase my patient's perceived quality of life. However, careful counseling will be needed to ensure that he has appropriate expectations.

http://web.ebscohost.com/ehost/pdf?vid=3&hid=114&sid=b45b12c1-d016-427f-aba0-46dfc4f04186%40sessionmgr109