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Hearing Problems
Hearing Problems in Assisted Living

"Blindness separates people from things, but deafness separates them from other people." Helen Keller

Helen Keller's perception reaches the core of hearing loss. It is a communication disability. Hearing loss leaves a person with the inability to have an exchange with another human being, often threatening a resident's social and intellectual well-being.

Misperceptions and Issues about Hearing Loss:

Hearing Loss
Hearing Loss

It's deafness, which is not true

Deaf people hear very little to no sound.

The hard of hearing still hear some sounds well

  1. Older people lean-to defense mechanisms and deny their condition or put the blame on the other by saying "You're not speaking loud enough or you're mumbling."
  2. Residents living in assisted living avoid social events or purposely exclude themselves, or withdraw altogether. They'll remain in their apartment or room to feel secure. Hearing loss is an embarrassment for them.
  3. Hearing loss can lead to a lack of self-esteem for residents having a label of "deaf and dumb". The loss of hearing exacerbates anxiety, insecurity, confusion, self-doubt, and anger. How many people readily accept and wear eyeglasses but fiercely oppose wearing a hearing aid?

It's a leading chronic health condition in older adults and when left untreated and managed poorly, hearing loss affects a person's life quality, the care received, and how well they communicate and connect with others.

The Center for Disease Control surveyed Residential Care Facilities to find out more about residents and what issues they face while living in a care facility. In the survey, CDC discovered 14% of the residents have trouble with hearing, 29% of the residents report little trouble hearing and 56% of the residents claim good hearing.

Which statement on this card best describes the resident's hearing without a hearing aid?
Responses of don't know (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Resident Responses)

A study of the elderly population on hearing loss found at least 25% of those aged 65 to 74 have some degree of hearing impairment, and almost 40% of those over 75 suffer from hearing loss.

Hearing Impairment and the Elderly

Medical experts report that the common causes of hearing loss are getting older (aging) and constant noise. Other factors are injury, medications, disease, and heredity.

If you're looking for an assisted living facility for an aging loved one living with a hearing impairment, seek out one that offers communication training for staff and family members. The rest of the article gives a clear guide to follow.

How Assisted Living can Adjust

Assisted living facilities are a noisy place. It houses hundreds of residents. The staff is busy coordinating activities, cleaning, cooking, and doing their daily tasks which add more noise and distraction.

Staff Communication
Staff Communication

A facility can reduce the noise level by installing throw rugs, carpeting, matte surfaces on walls and floors, draperies, and sound absorbent ceiling tiles. Placing a tapestry on a wall helps absorb noise and sound.

When staff communicates with a hard of hearing resident, they can lower the sound on televisions and radios, close room doors, lessen the use of an intercom, and lower other noise like fans and heaters, especially when speaking directly to the resident.

Because the older person relies on lip-reading, make sure there's enough light to see you clearly. It should shine directly on the speaker. Another key point to conversation ease for the hard of hearing is to arrange furniture close together so that chairs face each other and residents can see the face.

In the Center for Disease Control survey of Residential Care Facilities, they found 7% of the residents use assistive listening devices for hearing. The assistive device does not include the use of a hearing aid.

Do any of the residents use any other types of assistive listening devices? Do not include 2 a hearing aid.
Responses of don't know (< 1%), and not ascertained (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Facility Responses)

For the elderly, difficulty hearing high-frequency sounds like "s" and "z" sounds are the problem. The effects of aging and noise are similar. The process of hearing loss first involves losing the ability to hear sounds of a high frequency. People can still hear the sounds, but they have trouble understanding the words.

In the survey of Residential Care Facilities, CDC found that 9% of the residents use a communication board which is a type of device sometimes used by individuals with speech or hearing impairments. Communication boards are plain boards that residents can use to draw or write out words or images or have painted pictures or words on them that the individual points to as a means of communication.

Do any of the residents use a communication board? A communication board is another type of device sometimes used by individuals with speech or hearing impairments. They can be plain boards that you erase or have pictures or words on them that the individual points to as a means of communication.
Responses of don't know (< 1%), and not ascertained (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Facility Responses)

Communication Boards Solves Speech and Hearing Issues

Speaking and understanding, reading and writing are skills that people use every day and we don't give it a second thought. It's embedded and we take it for granted. In assisted living, the residents use communication to express feelings, thoughts, and opinions, to ask questions, and to relate to another.

It's the center of socialization and the core of receiving good healthcare.

It's important for older adults to feel heard and understood. For example, a resident might ask for things she wants at mealtime, have a need to discuss her medical concerns with a doctor, understand her medications, interact with a professional about her finances or call out for help.

Assisted living facilities have few residents with disabilities that affect hearing, speaking, reading, writing, and/or understanding, and who use different ways to communicate than people who do not have these disabilities.

Residents have the same rights to communicate as those who speak.

There are multiple laws that address deafness and hearing loss as a disability. Resources available for deaf and hard of hearing people who want to research their legal rights, please visit The National Association of the Deaf Law Center, a source of legal information and representation, and the U.S. Equal Employment Opportunity Commission.

The facility caregivers and family members play an essential role in the resident's daily life, yet so many don't understand the effects of hearing loss.

  • What's needed in the facility?
  • Hands on staff and family training
  • Identification of residents with hearing loss
  • Quick screening methods for hearing loss by social workers

Facility modifications

CDC found that 19% of the residents use a use an amplifier for the telephone.

Do any of the residents use an amplifier for the telephone? Do not include a hearing aid.
Responses of don't know (< 1%), and not ascertained (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Facility Responses)

The training could teach the staff and family members that there are types and degrees of hearing loss; effects of hearing loss; hearing aid troubleshooting training; effective communication strategies; general hearing aid education.

  • Group audiology rehab for residents
  • Effective communication strategies
  • Overview of hearing aids, assistive listening devices, and coping/adjusting
  • Speech reading
  • Lip-reading
  • Individualized programs by facility
  • Put hearing loss identification process in place
  • Identify other medical conditions of the residents like meds
  • Trained personnel

In the survey of Residential Care Facilities, CDC found that 4% of the residents use a telecommunications device for the deaf, or TDD (an electronic device for text communication via a telephone line), also referred to as a TTY or teletype as a means of communication.

Do any of the residents use a Tdd, Tty or teletype? A telecommunications device for the deaf, or TDD, is an electronic device for text communication via a telephone line, used when one or more of the parties has hearing or speech difficulties. It is also referred to as a TTY or teletype.
Responses of don't know (< 1%), and not ascertained (< 1%) and are not shown.
Source: 2010 CDC National Survey of Residential Care Facilities Survey (Facility Responses)
Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.