OA Care week 11 P/PointNote
Fredablyee
1HearingandVisionImpairment_060821.pptxHearing and Vision Impairment Among Older Adults
By: Mariah Schwankl
Today I will be going through hearing and vision impairment among older adults. Many older adults experience either vision or hearing loss, or sometimes even both. Hearing loss is the third most common health disorder in the older adult population (Whitson et all., 2018). With sensory impairment comes safety concerns. Thankfully, there are ways to help older adults improve their impaired vision and or hearing. Interventions can also be considered and implemented to help the individual live a better life.
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How hearing and vision loss can affect activities of daily living
Loss of independency
Poor physical functioning
Safety concerns
Greater risk for hospitalization
Hearing and vision loss can affect the older adult's independence and create safety concerns. They are at greater risk for hospitalization and poor physical functioning (Deardorff et all., 2020). When an individual has vision loss, it may make it harder for them to cook for themselves. They could accidentally harm themselves by burning themselves on the stove or even cutting themselves while preparing a meal. They could be more at risk for falls by tripping on something on the floor or possibly missing a step going down the stairs. When vision is impaired, it may also be more difficult getting themselves ready in the morning. Hearing loss can also pose safety concerns by not hearing a warning signal if the hearing loss is severe enough.
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Psychosocial effects of sensory impairment
Depression
Social isolation
Cognitive impairment
Having impaired ability to see or hear affects how one may be able to physically do things, but it affects mental health as well. Not seeing or hearing very well can make older adults withdraw themselves from social events or outings because it may be difficult for them to communicate. Withdrawing themselves creates isolation which can cause depression and worsen social avoidance even more. Poor mental health has also predicted a poor health-related quality of life (Whitson et all., 2018). Effects of sensory impairment can affect older adults in many ways. When there is poor mental health, it can also be associated with decreased physical health (Whitson et all., 2018). It’s almost like a never-ending loop unless interventions to help the sensory impairment are put into play.
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Vision disorders that lead to vision loss
Cataracts
Primary open angle glaucoma
Presbyopia
Age related macular degeneration
Older adults can be more prone to vision disorders compared to younger people. Cataracts are when the lens of the eye becomes opaque, distorting vision and image quality. With aging, the lens loses water and becomes denser over time, resulting in cataracts (Workman, 2018). When the lens becomes dense, the lens fibers compress together and creates a loss of transparency. Primary open-angle glaucoma occurs when the aqueous humor in the eye builds up and causes pressure, cutting off the blood flow to the retinal blood vessels. Any individual over the age of 60 is at a greater risk of developing glaucoma (Workman, 2018). Primary open-angle glaucoma develops slowly with gradual vision loss and does not have signs and symptoms in the early stages. Presbyopia is farsightedness caused by the loss of elasticity in the lens of the eye. Older adults often have trouble seeing up close. You may notice that sometimes they hold things as far away as possible to try to read something. There are two types of age-related macular degeneration, dry and wet. Dry is more common and progresses faster in people who smoke versus those who do not smoke (Workman, 2018). It occurs when there is gradual blocking in the retinal capillaries, causing the retinal cells to die. This results in loss of central vision. Wet age-related macular degeneration is the growth of new blood vessels in the macula, which tend to have thin walls and begin to leak blood and fluid into the eye (Workman, 2018).
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Treatments and interventions for vision loss
Annual vision exams
Larger lettering
Eye surgery
Medications
Many of the disorders listed on the previous slide have interventions to help impair the vision. Cataracts have eye surgery that can be performed by removing the old lens and placing a fake one in the eye that acts as a real lens. Glaucoma has medication to take to help with the pressure in the eyes. However, the drug cannot undo the effects that have already occurred. For presbyopia, glasses may be able to help correct the vision. Unfortunately, there is no cure for dry age-related macular degeneration, but progression can be slowed by managing the community setting (Workman, 2018). Treatment for wet age-related macular degeneration is directed towards slowing the process. The blood and fluid may be reabsorbed, or sometimes a laser therapy may be performed to seal the leaking blood vessels.
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Types of hearing loss
Presbycusis
Sensorineural
Conductive
Hearing loss affects 1/3 of adults from age 60 to 70 and 2/3 of adults when they reach age 70 (Whitson et all., 2018). There are different types of hearing loss that they may experience. Presbycusis, sensorineural, and conductive are a few common types. Presbycusis is gradual hearing loss caused by degeneration of cochlear nerve cells that is often related to aging. Sensorineural is when there is damage to the acoustic nerve in the ear. Sensorineural is caused by infection, prolonged noise exposure, diabetes mellitus, and presbycusis (Workman, 2018). Conductive hearing loss is when there is a blockage in the ear, causing sound waves not to reach the inner ear. Conductive hearing loss is caused by excess amounts of cerumen, edema, perforation of the tympanic membrane, and foreign object (Workman, 2018). Older adults may experience either of these types depending on the lifestyle they once had or currently have.
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Treatments and interventions for hearing loss
Hearing aids
Environmental changes
Assistive hearing devices
Hearing loss can be helped with hearing aids, environmental changes, and other assistive hearing devices. Older adults can benefit from hearing aids once they are fitted for them by an audiologist. Hearing aids can help improve the quality of life and may also get the older adult back to getting back out into the community. When hearing loss isn’t severe but still noticeable, it might help by limiting background noises so that the older adult can focus on the person speaking directly to them. Some older adults may also read lips to help understand what an individual is saying, so facing the older adult may help with communicating. Talking in a lower tone pitch of voice may also help the individual hear what is said. Other assistive hearing devices may be pocket talkers. Pocket talkers are a device that can amplify the noises around the individual who is using and wearing it. They act as a hearing aid, but they aren’t as discrete or expensive as hearing aids.
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References
Deardorff, W. J., Sloane, R. J., Pavon, J. M., Hastings, S. N., & Whitson, H. E. (2020). Hospitalization risk among older adults with sensory impairments: Development of a prognostic model. Journal of the American Geriatrics Society, 68(11), 2650–2655. https://doi.org/10.1111/jgs.16800
Whitson, H. E., Cronin, G. A., Cruickshanks, K. J., Gilmore, G. C., Owsley, C., Peelle, J. E., Recanzone, G., Sharma, A., Swenor, B., Yaffe, K., & Lin, F. R. (2018). American Geriatrics Society and National Institute on Aging Bench‐to‐Bedside Conference: Sensory impairment and cognitive decline in older adults. Journal of the American Geriatrics Society, 66(11), 2052–2058. https://doi.org/10.1111/jgs.15506
Workman, C.R.D.I.M. L. Medical-Surgical Nursing. (2018). [Bookshelf Ambassadored]. Retrieved from https://ambassadored.vitalsource.com/#/books/9780323461580/
Here is a list of my references if you want to go back and look at more information on hearing and vision loss in older adults. I hope you found this presentation informative. Having an impairment in vision or hearing can take a toll on older adults by taking away independence and affecting their mental health. It can also affect their physical health further than just having a sensory impairment. Thankfully, there are ways to help with the sensory impairments they may experience, helping them gain back their independence and healthy state of mind.
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