Hearing loss and elder abuse

Australians of all ages deserve to be safe from harm, treated with respect, and heard. Yet the World Health Organization estimates that at least 1 in 6 people over 60 years of age experienced some form of abuse, exploitation or neglect in the last year.1

Elder abuse is often hard to spot. It is also more likely to occur when older people are physically frail, socially isolated, and/or have additional disabilities – such as hearing loss.2

Hearing loss in older people

Hearing loss is probably more common than you think, and most Australians will be touched by hearing loss at some point in their lifetime. One in six Australians have some form of hearing loss – that’s 3.6 million of us! And with our aging population, this is predicted to rise to 1 in 4 Australians by 2050.3

Hearing loss affects men more than women and is more common as we age,4 Hearing loss with age is called ‘presbycusis’.

By making up much of the loss, hearing aids, assistive devices and cochlear implants can enhance a person’s ability to communicate and connect with the people and the places they love. Yet many Australians who could benefit from hearing devices do not have them.5

What are the early signs of hearing loss?

Hearing loss is often called ‘the invisible handicap’. It can be surprisingly hard for other people to tell that a person cannot hear as well as they should.

Sometimes the person can hear, but not understand. Not all sounds are affected equally when hearing is lost, so the older person may hear some parts of speech but not others. For example, the high pitches (such as ‘s’ and ‘f’) are usually affected first, and these tend to make up the beginnings and endings of words. So if you’ve ever heard someone say, ‘she hears when she wants to’, it’s more likely to be a case of ‘she hears when she can’!

For this reason, some older Australians may be able to follow conversations fairly well in a quiet place when they are facing the speaker but struggle in noisy situations. This is especially true if they can’t see the speaker’s face, as they may have started to rely on lipreading cues.

Other signs include:

• needing the TV turned up louder than other people need

• struggling with phone conversations

• mishearing a speaker when their back is turned, because they can’t see any visual cues.

If one ear is worse than the other, the older person may also have trouble identifying which direction a sound is coming from.

What are the impacts of hearing loss?

Hearing loss can cause a range of psychological, social, emotional and physical effects –both on the hearing-impaired older person and on their families and friends.

It may cause people to miss key information and alerts and to struggle with taking turns in conversations. Unfortunately, these effects can put them at risk of exploitation, abuse, ridicule or social exclusion.

Other effects include:

• fatigue, tension, frustration, stress and depression

• social withdrawal, loneliness and isolation

• danger – they can’t hear the phone, smoke alarm or doorbell; they may have reduced alertness when out and about, which poses a risk to personal safety

• reduced opportunities to interact with others

• reduced quality of life, especially for those with a moderate or worse hearing loss that isn’t treated

• tiredness from the extra effort in listening and filling in the gaps.

The good news is that there is much we can do within our community to support older Australians with a hearing loss and their caregivers and support networks.

Hearing aids and assistive devices can also help! When worn and properly maintained, these allow the hearing-impaired person to feel empowered, more connected, and better able to enjoy the people and the places that they love.

Neglect and hearing loss in older Australians

For many hearing-impaired older Australians, elder abuse far too often occurs in the form of neglect.6 Neglect can happen unintentionally.

Older people are highly reliant on their hearing devices and other strategies (such as positioning and room acoustics) to communicate, understand what is happening around them, and express their preferences and opinions. If a caregiver fails to support them in accessing and using these strategies, the effect can amount to neglect.

For example, the caregiver may miss the older person’s scheduled hearing appointments or fail to help them manage, wear and care for their hearing aids. Either of these oversights would make the older person vulnerable in other settings.

A caregiver may also fail to support and assist with other aides such as glasses.7 With lipreading being so important to people with hearing loss, this would also have negative flow-on effects.

How can we support older people with hearing loss?

Help them access hearing services, including regular hearing checks

It’s important that older Australians have regular hearing checks and, where appropriate, an opportunity to trial hearing aids or other assistive devices (for example, a personal amplifier worn with headphones). Hearing-impaired older people who use hearing devices report higher confidence, reduced anxiety, and better relationships with others.8

Many older Australians are eligible for subsidised hearing services under the Commonwealth Hearing Services Program. For more information, see Hearing Services, or contact Hearing Australia for a free hearing check (ph 131 797 or click here).

Support older Australians to wear their hearing devices and stay connected

Hearing devices help older people to stay connected, communicate with others, and self-advocate. They are also sophisticated electronic instruments that require ongoing care and maintenance.

Older Australians often need the support of family and friends to maintain their hearing aids and to help them persevere if things go wrong, such as when the aids need repairs.9

Tips for keeping hearing devices in good working order:

• Keep them clean – wipe them over regularly with a dry tissue or cleaning cloth.

• Avoid storing the devices in extreme heat, such as in the glovebox of a car.

• Keep devices in their cases when not being used, and ensure the batteries are fresh.

• Clean plastic earpieces regularly.

• Ask your hearing provider for simplified operating instructions.

• Check for whistling – any whistling can mean the plastic earpiece isn’t fitting properly or that there is excessive wax in the ear canal.

• Consider hearing aid retainers or clip-accessories if the person is having trouble keeping their hearing aids in. The hearing provider will be able to help here.

• Ensure the GP regularly checks the ear canal for wax, which can affect a device’s reliability and sound quality.

Use hearing tactics and strategies when talking to people with hearing loss

We can all be better communicators! Use the following tips when talking to hearing-impaired people of all ages:

• Face the person and get their attention before you speak.

• Stand approximately 1.5 metres away from them and at the same eye level – this helps with lipreading and ensures the sound doesn’t have to travel too far.

• Turn down any background noise (such as TV or radio) or move to a quieter area. Soft furnishings can help by absorbing noise.

• Speak clearly and be prepared to repeat or rephrase parts of the message if needed.

• Be understanding – although hearing aids and assistive devices help enormously, they are an aid rather than a cure and don’t restore the hearing back to normal.

• Try technology – wireless devices or Bluetooth streaming can also help a hearing-impaired person follow conversation in less-than-ideal listening conditions.

Practical tips for older Australians in residential care

So what can families do to help prevent neglect and exploitation among hearing impaired older Australians in residential care?

• Develop a good working relationship with facility staff and visiting professionals.

• Ensure that hearing devices are clearly labelled and the facility has plenty of fresh batteries.

• Clean the device and change the batteries yourself weekly, where you can – choosing a certain day of the week for this task can make it easier to remember.

• See whether any of the facility staff are hearing impaired themselves – they may be good advocates and able to assist on site.

• If facility staff are inserting the resident’s hearing aids each morning, ask whether they also ensure the devices are working and checking each residents’ response.

• Find out whether hearing loss and communication strategies are included in resident care plans.

Catherine is a Clinical Leader Adult Specialist at Hearing Australia with more than 25 years’ experience in the hearing care and rehabilitation of adults and children, including clinic management and clinical quality and compliance roles.

Disclaimer: The information provided on this website is not a substitute for individual health advice from a doctor.