Most of us will, at some point in our lives, encounter an older adult experiencing hearing loss. And often, that aging adult and those around them will not know how best to communicate.
The situation is even more dire for individuals in underserved populations, and can cause problems in relationships and with communication and memory, researchers say.
A University of Arizona team is working to address these issues under a research and outreach initiative with nearly $195,000 in the first year of a five-year, $1.9 million project supported by the National Institutes of Health. Pilot funding for the project came from a UA Foundation Community Connections grant.
The team will investigate barriers in access to care, support the development of cultural and language-specific interventions and increased access to hearing health care in Southern Arizona, and advocate for a wellness perspective among aging adults.
"There is very little information in our literature about how to connect underserved populations with audiologic rehabilitation, so the heart of this project is to work with community-health providers and collaborate on possible solutions," said Nicole Marrone, the UA James S. and Dyan Pignatelli/Unisource Clinical Chair in Audiologic Rehabilitation for Adults and principal investigator on the grant.
Team members working on the project, "Reducing Disparities in Access to Hearing Healthcare on the U.S.-Mexico Border," will develop and test an emergent model of community-based care that incorporates principles of advocacy and wellness.
The team will reach out to older adults in rural communities along the border, involving Mariposa Community Health Center community health workers, called promotoras, in Nogales, Ariz.
The project is timely and important for multiple reasons.
A sizable portion of aging adults in the U.S. are experiencing the gradual loss of their hearing – about one-third of those aged 65 to 75, according to estimates by the National Institutes of Health (NIH). The NIH also reports that nearly half of people above the age of 75 are experiencing hearing loss.
"You may not know someone who has had a stroke, who is dealing with a heart problem or is diabetic, but hearing loss is something we all will encounter in our lives," said Frances P. Harris, a UA clinical assistant professor in the UA Department of Speech, Language, and Hearing Sciences.
In fact, there exists an "epidemic of untreated hearing loss" across the nation, said Marrone, also an assistant professor in the same UA department.
"We know that hearing loss is extremely common, and it's an important public health issue and is far more undertreated than expected," Marrone said. "In the U.S., only about 20 percent of those who can benefit from treatment can actually access it."
That figure was estimated to be around 4 percent for Hispanic population in the 1980s, "so part of our current work is to update this information," Marrone added.
The UA project also is addressing critically important goals of the Healthy People 2020 initiative, a multi-year national effort that, among other things, seeks to improve the quality of life and health of people across the U.S. while advancing improved policies to inform best practices around public health.
The project builds on existing work done in the Department of Speech, Language, and Hearing Sciences. In 2009, Harris established a program to improve the quality of life of adults experiencing hearing loss by helping train them to use better methods for managing difficult communication situations. Through a collaboration with the Arizona Prevention Research Center, Marrone and Harris will extend the Living Well with Hearing Loss approach to rural communities.
This speaks directly to ways the team is advocating a wellness perspective for the benefit of those experiencing hearing loss.
"We need to help people think about hearing loss as any other chronic health condition in which a person must learn many different way to manage the change," Harris said.
For example, Harris said, when people with hearing loss are having trouble understanding, instead of responding with "huh?" or "what?" it is best that they repeat what they did hear, so the person speaking to them will know what specifically to repeat. For the speaker, talking slower, not necessarily louder, and repeating words and phrases is helpful, as well as facing the person with whom you are speaking, Harris said.
These types of effective communication tactics require that aging adults understand the importance of self-advocacy and of helping those around them to become more attentive to their needs. This improves communication for both the person and their communication partners, Harris said.
Thus, while there exists great advancements in the development of technology, like hearing aids, people may wait to seek help because of misconceptions, not knowing how to access quality care, or that there are additional methods that can help manage the quality of life effects, Marrone said.
Providing a hearing aid is not enough; aging adults must also learn how to both cope with and directly address their hearing loss, and that comes from education about communication strategies for speaking and hearing, she said.
Without such strategies in place, aging adults may experience a decline in their quality of life, Marrone said.
"With chronic hearing loss, a lot of times people will think there is an easy fix for it. Even when people seek treatment, there may still be a remaining chronic disability that has occurred and continues," Marrone said.
"So, from a wellness perspective, we work with people to develop strategies about how to manage the communication environment and to better cope day to day," she said. "This kind of intervention is usually only given after someone gets a hearing aid rather than before and sometimes, it may not be provided at all. We are proposing to provide education and support first, which will help people to feel more empowered as individuals."