Over the past decade, hearing loss has emerged as a key issue in aging and health. The problem affects over 80% of people aged 80 and over. Hearing loss is associated with social isolation, depression, and cognitive impairment — all problems that are common among nursing home residents.

Yet the problem of hearing loss has not received much attention in the nursing home world.

“Hearing loss is often seen as an inevitable consequence of aging,” said Professor Jan Blustein, M.D., Ph.D., professor of health policy and management at New York University’s Robert F. Wagner Graduate School of Public Service, the senior author of a study published in The BMJ. “Many people just don’t appreciate how much hearing loss disrupts understanding and communication, and what a toll that takes in the lives of vulnerable older people.”

Prior studies in single nursing homes have shown that staff are often unaware that residents are having difficulty hearing. But Blustein and her colleagues found that this appears to be a national trend. Using data that all US nursing homes are required to report to the federal government known as the Minimum Data Set (MDS), the researchers found that in 2016, over two-thirds (68%) of long-stay nursing home residents over the age of 70 reportedly had adequate hearing, meaning that “they had no difficulty in normal conversation, social interaction, or listening to TV.” The researchers compared this with previously reported data on elderly people outside of nursing homes, and argue that the reported rate in nursing homes is implausibly low.

“While prior small studies have shown that nursing home staff underestimate hearing problems, the data strongly point to a national problem,” said Blustein.

According to co-author and geriatrician Joshua Chodosh, M.D. of the NYU School of Medicine, recognition and treatment of hearing loss is “low hanging fruit for those who care for elderly people. Once you’re aware that hearing loss may be a problem, there are many ways to help,” said Chodosh. “Speaking clearly and facing the person when you talk is a good way to start. But patients should be referred to an audiologist. If buying hearing aids is within financial reach, that may be a good step. But there are other low-cost hearing assistance solutions such as pocket amplifiers that cost about $150 that can be very helpful in communicating with older people with hearing loss.”

As Blustein notes, “Hearing loss disrupts communication, leaving those affected especially vulnerable to social isolation and depression. Nursing homes could make a big difference in residents’ lives by attending to the issue. This would not only be good clinical practice; it would also be compliant with the law, since the Americans with Disabilities Act requires that homes offer ‘effective communication’ with residents.”