Hearing loss for the elderly

it as part of the hearing process. In the first part of our discussion last time around, we zoomed in on how hearing problems can emerge for younger individuals. What about the older individual? That's my focus today as I welcome to the show, Hoen Ke, senior audiologist out of DS Audiology Private Limited. They're a hearing clinic. This is Health Matters, and if you have any questions on hearing health, you're welcome to WhatsApp across. Thank you. Welcome to the program. Hi there. Hey, hi,

thank you very much. Good to have you on board. I'm curious, like, I'm sure you've heard that as well, right? People will be like, of course, you're getting older, it's normal to lose a bit of the hearing. Is it per se? Um, I think hearing loss is very often, you know, in aging, you know, as we age, um, we will definitely lose some. Um, hearing, but it is usually in a very gradual form as well, you know, it's part of the aging process.

Is it so with the aging process, yes, you're going to get potentially some gradual hearing loss, but is it always about just aging? No, it's not just always about aging because there are other factors that actually contribute to You know, hearing loss as well, even in the um older population as well. I'll give you some examples. For example, one of the causes of hearing loss is actually um

exposure to loud noises, for example, prolonged exposure. For example, some of them, um, maybe in their younger days, they have been working in um heavy industries, for example, like. The shipping line, for example, like the construction line, and if hearing protection was not worn during that time, you know, very often, you know, with the exposure, it can actually lead to what we call noise-induced hearing loss as well.

So that's that's one of it. I think the other one would be ear infections, um, and then the other one would be actually medication as well. I give you some examples such as um there are certain drugs that are autotoxic in nature, yeah, so when we say autotoxic, that means they actually do affect the hair cells in the hearing organ as well. Here, right, the cilia we're talking about. And so when those vibrate sends a signal to the inner ear, blah blah blah. But the point is we need that to

be able to hear well. Yes, correct. So some of these um medication might be toxic to these, for example, like certain class of Antibiotics or certain um chemotherapy drugs. For example, you know, like um but then more people would have hearing loss.

These are quite rare side effects are, yeah, they are not, um, I mean, for example, if you, if you have to undergo, I'll give you some real examples, for example, if um nasopharyngeal cancer, you know, they have to undergo some radiation therapy, they have to undergo chemotherapy, and some of these drugs actually do affect that as well. So yeah. It it does occur, there can be reasons for this

as well outside of the aging process. Let's zoom back to that group where you can expect some hearing loss as you age, but like you said, it's gonna be gradual. So what are the signs or the symptoms that indicate

that this would be a gradual loss? OK, for example, you know, for some, how do hearing loss actually creep up gradually, you know, and what are some of the signs um that we can actually see in seniors, for example, You find that they have actually difficulty understanding speech, especially in the noisy environment. So we use some um day to day life experiences. You go to Kia, you know, try to talk to your, I try to talk to

my father, for example, he has some hearing loss. So for example, you ask him, dad, you know, what do you want to drink, then he doesn't catch you or he might misunderstand you. OK, so that's one, You find that they would have to frequently ask for repetitions as well. For example, I'm so sorry, Sanki, do you mind repeating what what do you say just now again? Yeah, or they do have, um, but you find that there

are some behavioral changes. I give you some examples, you turn up the volume um on the TV and then on the iPad or on their mobile phones, yeah. To them, it is soft, but actually to other people in the family or people around them it's actually loud. Um, some of them would be actually withdrawn as well because

they find it a bit embarrassing, right? You know, I always have to ask you so many times, you know, and then the problem is we respond in a very Social family way and you'd be like, ah, dad always cannot like dad's not paying attention or mom never listens or we respond in a very emotional way as opposed to it being a physical problem, but we don't, they can't tell, we can't tell. And then that causes, you know, people, the withdrawal could happen or the social isolation could happen.

This does happen with hearing loss. Yes, yes. So, so in reality, what happens is that I've seen certain cases whereby children actually share with us that, um, you know, when they go to um Maybe they go and eat, they want to ask their parents, and then there is a dilemma, the dilemma is that if I don't raise my voice, then maybe my dad is unable to hear. I raised my voice, he finds that, why is so rude, you know, you raising your voice

talking to me like that. Yeah. So that's that's also the other one, and then gradually what happens is that you will find that um they might be withdrawn, you know, they're not very keen because anyway, it's a bit embarrassing, right, over time. Um, some of it, some of the other things that you realize that they actually do miss a certain soft sounds, for example, like birds chirping, like the rain, the rain falling. OK, um, this part is in particular because um these sounds, some

of these sounds are soft, OK. So for example, it is raining outside, it might not be pouring or might be just drizzling. But they don't realize because the raindrops actually are a bit softer, yeah, and then it gets annoying if you're the kid living in the house like, Oh my God, Mom, Dad, it's raining. How come the clothes are still outside, you know, that kind of thing like you never notice that we respond in an emotional way, but maybe they didn't hear it.

I always tell our listener I've been hosting this whole show for 20 years. I'm like, look, as people get older and you're worried about these fights with your older loved ones and all that. Check out their hearing, their sense of sight, and their

dental issues as well. The dental can lead to malnutrition issues amongst the elderly, the visual issue can lead to so many problems like accidents and bumps, and the hearing can lead to social isolation or the, the, the root of some of these problems where you think it is the older person getting slow, but actually they didn't hear it. That is so powerful that we have. To understand how a health problem can be linked to so much more than just a health problem. I want

to talk about solutions for this. Obviously, for some of the more serious, is there always a solution is my point, when it comes to hearing loss as one ages. Um, there are actually a lot of good solutions out there. Yeah, but before we go there, I just wanted to add on a particular point that actually you mentioned, which is pretty good, actually. Um, you mentioned about visual, right? You know, hearing also

contributes a lot to safety as well. For example, you know, if you can't hear the bicycle actually ringing, the bicycle is there trying to ring and ring e-biker on the pathway, then, then the guy is like, Hey, auntie, why you never like, you know, stand on one side. You know, yeah, so that actually contributes to um a a very great level of awareness to your surroundings and

to safety as well. Now, going on to solutions, there are, there are actually many good solutions out there, for example, hearing aids in patients with hearing aids can't address all hearing loss. But you can address those that are functionally related to certain issues, right? Yes, so, so hearing aids won't be able to address every single hearing loss, OK, but they do actually help out with quite a significant chunk of

um hearing loss as well. So but there are, I mean, aside from hearing aids, there are other solutions such as cochlear implants, you know, bone-angle hearing aids, you know. This kind of things as well. But is that also cause dependent, you should only go for a cochlear implant issue if the problem is with the cochlear or can address a lot of it can address, um, OK, so

I give you some examples. For example, if um hearing aids, if they no longer are beneficial, you know, even if you got the best hearing aid, you know, but to a certain extent and certain level, what happens is that when the cochlear. Um, it's belly damage, OK, and um, hearing its benefits are very limited or very little. Now this is one of the other solutions would be like cochlear implant. Yeah, so this is, this is how actually it helps as well.

But um the easiest for a lot of people getting a referral from the EMT or the um and, and learning about the idea of, OK, maybe we'll recommend you for a hearing aid. This can work for a majority, a lot of hearing loss that is related. My problem and, and the thing that I've been talking about this on air is. The hurdle that an older person might have in terms of, oh no, I don't want to wear a hearing aid.

They feel that it looks a certain way or it ages them and they, I don't know, maybe they're still thinking of the old fashioned ones that are big and pink and behind your ear and that has feedback and, and everybody knows that you're wearing it and then you have to adjust it all the time, that kind of stuff. Things have changed though, right? How, how have you helped people adjust to this mental perception that hearing aids are very aging?

OK, I think um the thing about it is That um some um older adults, you know, they still resist, but I think one of the key things that there are a few key factors, for example, like education, like um it would be good, you know, as an audiologist or even ENT doctor, you know, it would be good to actually explain and help them to realize that actually In the hearing aid industry or in the hearing aid itself,

you know, things have changed a lot, you know. Gone are the days where I you know it's very big, chunky that's hanging behind the ear. Now they are a lot smaller, yeah. Are they still behind the ear? Yeah, they are still behind the ear, but they can they actually do get. Now significantly smaller that you actually have to really go very close to pay close attention to say that, hey,

maybe the guy is wearing a hearing aid. So there are like small little buds that you just put into the ear has a little antenna sticking out that kind of thing. That's about it, right? Yes, correct. So those are like what we call custom hearing aids, they're really small, um, whereby you are able to just put them into the ear. So that's one. Um, I think the other one is that um it is to address actually the stigma that is behind hearing

aids as well. You know, some of technology has gotten better, the big pink one no more. I got earpods, airports, all that kind of thing. Obviously the hearing aid is the technology is just easier and better. It it has moved along, you know, with technological advances.

Hearing industry has also moved along as well. You know, as I was mentioning, um, stigma, you know, for example, some of them will be afraid that, you know, other people know that I'm actually getting older, you know, I got hearing loss, um, or, you know, some of them because actually, in fact, um, many of our seniors are still working, so they might be worried that, you know, they might be maybe people might laugh at them, but cue them.

But I think this is something that as um healthcare professionals, especially hearing healthcare professionals, we should help them to understand this. It's more OK, so tell us like how it's really advanced today. What are some of the new features that really set it apart. Last time it used to be about amplification, just by amplification, and then unfortunately, you'll see in movies things like feedback happening and things like that it was a comedic thing which I didn't like.

But so, so now it's like, wow, Bluetooth connected and I mean there's all sorts of things that really happen with modern hearing aids, right? So maybe I'll share a few um advancements in this field as well. Um, I give you some examples. For example, you know, there's the buzzword of artificial intelligence, you know, machine learning. Um, this

is actually also incorporated um in hearing aids as well. No, very often what happens is that Now hearing aids have the capability to actually do real-time environmental analysis. I'll give you some examples. For example, I went to the zoo or I went to maybe the classroom, you know, hearing aids are able to collect huge amount of data points now and then make it um.

Actually make the algorithm on the programming itself very personalized, so you have personalized listening experience and very often now, it is also based on your individual preferences and habits as well. So what is the AI doing? OK, so what happens is that the AI part of it is that is scanning the environment, you know, it's trying to understand what kind of environment you are in. Um, how you can enhance the speech sound while trying

to dampen and lower the noise. So one of the key things about the hearing aid technolog technology is that it is the ability to actually differentiate between speech and noise. And so for certain, for some manufacturers whereby they have dual processing, you know, they're able to process the speech

and then they're able to process the noise as well. Great, because if you're in a quiet environment, great, it'll be easy to hear the voice, but if you're in a noisier environment, we need to be able to recognize the voice and this is going to help us do that. This is interesting and also contributes to the safety. Point you were talking about just now. You do want to hear the things around you like the bicycle whizzing near you or something like that. Um, I want to

end off in the next two minutes. Let's talk a little bit about your experience working with some of your clients. How can you tell when they're really thriving with the utility of, of the hearing aid? OK, so one of it is that um You know, in hearing it, there's actually um data logging. You can actually check the data in the sense that

how long have you been using it, right? Yeah, so you can use that kind of information to actually educate them and very often a few things that I would say that the sets, hearing it uses a part whereby they thrive or they don't thrive. For example, self-efficacy. A form of independence, a form of knowing that, you know,

I am able to handle this alone. I'm able to wear the hearing aid, I'm able to adjust using the app, you know, and this form of independence, you very often see that seniors who are able to do this better, they tend to do better with the hearing aids. Now the other one would be the social support that comes along with it as well. Like for example, you go for your appointments and I would strongly encourage hearing aid users to follow up with your audiologist, be it in the private, be in the

public hospitals, you know, go with a family member. Why? Because sometimes you might forget, oh, I forgot how to do this or do that, and you actually have a family member there to actually remind you, help you. Then the other thing is that how the hearing aids are also being properly fitted. And going um ongoing um for follow-ups, you know, are crucial for success as well. What have they told you about how they are thriving? Um, so for example, like, oh,

now I can, you know, there are less fights. I'm I'm talking more with people or I'm going out more. Have you heard that? Yes, of course, very often you see that people actually use them um well, um, they would give this kind of feedback whereby, you know, now I do enjoy. The kind of communication that I have with my children, with my grandchildren, yeah, and then I am now more active. I feel more confident going out for social um gatherings

with my family and friends. Yeah. See that's the power of, you see, if you thought what ages you is wearing the hearing aid, what actually is aging you is all those other things that would happen if you are. Experiencing hearing loss, like having asking somebody to repeat themselves, like turning the TV volume louder, that is a little bit, I mean, it's ironic, right? It's really actually ironic. Thank you. This has been very useful. Thank you so much for

your time today. Thank you very much. Joining us on today's edition of Health Matters, uh, has been Hoen Ke, senior audiologist from DNS Audiology Private Limited. It's a hearing clinic. This is Health Matters. Before making any decisions