Many older individuals have some changes in hearing-many have hearing loss of one kind or another. There are many changes in elders which can affect a person's hearing. The following defines the changes which can occur.

The external structure of the ear, the auricle or pinna, loses flexibility and becomes longer and wider. The lobule sags, elongates, and develops wrinkles making it appear bigger. In men, the tragis becomes larger and wiry, stiff hair may be present. The auditory canal narrows. Cerumen glands atrophy causing thicker and dryer cerumen making removal more difficult and possibly leading to cerumen accumulation. The tympanic membrane becomes dull, less flexible, retracted, and slightly gray in appearance. The ossicle joints between the malleus and stapes can become calcified causing a fixation of this joint and a reduction in vibration of these bones and thus reduced sound transmission. There is a slight degeneration of the organ of Corti in the cochlea and the hair cells leading to impaired transmission of sound waves along the nerve pathways and is considered the most common cause of hearing loss or presbycusis. Atrophy of the organ of Corti can cause sensory hearing loss. Loss of cochlear neurons can cause neural hearing loss. Sometimes there is an impairment of the otic nerve which can lead to a constant or recurring high-pitched tinnitus (clicking, buzzing, roaring, or ringing sound in one or both ears). Medications, infections, cerumen accumulation, or a blow to the head can also cause this problem. Tinnitis can be more pronounced in quiet settings (MedicineNet, 2006).

Prebycusis is any hearing loss associated with aging and is more common in men. Presbycusis makes high pitched tones more difficult to hear as well as high-frequency sibilant consonant discrimination more impaired: more difficult to hear  are sounds such as ‘z’, ‘s’, ‘sh’, ‘f’, ‘p’, ‘k’, ‘t’, and ‘g’. Vowels which are low pitched are more easily heard. Rapid speech makes words sound like garbled or unintelligible speech (Strong, 2006). 

lFace the person and talk clearly

lSpeak at a reasonable speed; do not hide your mouth, eat, or chew gum

lStand in good lighting and reduce background noises

lUse facial expressions or gestures to give useful clues

lRepeat yourself if necessary, using different words

lBe patient; stay positive and relaxed

lInclude the hearing-impaired person when talking 

 

**talk with the person, not about the person, when you are with others l****helps keep the hearing-impaired person from feeling alone and excluded

lReferences:

Strong Health Audiology. Aging and Hearing Loss (Presbycusis). Available at http://www.stronghealth.com/services/Audiology/conditions/aging.cfm Cited July 24, 2011.

lMedicine.Net. Hearing loss and aging. Available at http://www.medicinenet.com/script/main/art.asp?articlekey=20432 Cited October 14, 2006.

lMayoClinic. Aging: What to expect as you get older. Available at http://www.mayoclinic.com/health/aging/HA00040 Cited October 14, 2006.

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