Hearing loss treatment options and interventions in aging adults

Sensory Loss in the Aged

Psychology

Take Home Exam

Hearing loss that interferes with the ability to understand spoken language is a disability that creates difficulty in a variety of circumstances. A hearing deficit is especially serious for children as it may interfere with their ability to learn necessary life skills. For the adult hearing loss may interfere with their social life or with their ability to work and remain a contributing member of society. The extent of the hearing loss and the degree to which it interferes with a person's ability to work determine which measures may be appropriate and in which circumstances.

The ultimate goal of hearing loss treatment is to improve the person's ability to function in life. The improvement in their quality of life must justify the cost. The following will explore the different treatment options available and when their use may justify the cost. The following will examine several cases of hearing loss and discuss appropriate interventions in each case.

Question of Cost

As with all types of medical decisions the benefit to the patient is the ultimate concern. However, this must also be weighed with the financial impact. The benefits of the procedure may not always outweigh the costs in some cases. According to the Hearing Aid Price Guide (2006) there are over 8 different manufacturers of different devices. Prices range from around $1,500 to $2,500 dollars, depending on the manufacturer and type. A hearing aid need replaced every 5-7 years, depending on care (Earinfo, 2006). This means that the earlier a person gets a hearing aid, the more it will costs over their lifetime. For a twenty-year-old, it may be cheaper over the person's lifetime to opt for a cochlear implant.

A cochlear implant has an average cost of $19, 745. Medicaid typically only pays $14,000, sometimes as low as $3,000 (Cochlear.org, 2006a). Costs can soar upwards of $60,000 depending on circumstances (Cochlear.org, 2006b).Various signal processors in the devices are responsible for different outcomes for patients (Spahr and Dorman, 2004). Summerfield and associates (2002) found that quality of life measured in unit costs was greater in unilateral, rather than bilateral cochlear implants.

The question of whether insurance should pay for hearing aids is a topic of considerable debate. The current standpoint on funding for hearing loss appear to be the same whether one requests funding for a hearing aid or a cochlear implant. There is little difference in the outcome between Medicare, Medicaid, or private insurance (Listen-up-org). The reasoning for this is that hearing loss is an inconvenience, but it not considered to pose any real threat to the person. It can be argued that the societal costs for either a hearing aid or a cochlear implant are offset by the productivity of the person in the workforce. Insurance should pay for either device as is determined to be appropriate by the physician.

Hair Regeneration new technique for restoring hearing has recently begun to be explored. Hair cell regeneration is the latest technique to be explored for a possible solution in cochlear hair loss. At the current time the technique has only been tried on mice (Bauman, 2004). Human cochlear hair regeneration is not as easy as it would at first seem. Researchers face many challenges in this process. The first is that the cochlea contains two types of cells, hair cells and supporting cells. When a hair cell dies the surviving support cell must receive the correct signals to be turned on (Bauman, 2004). Cell differentiation poses the greatest difficulty in the ability to regenerate human cochlear hairs.

It is likely that at some time in the future researchers will unlock the mystery to how to regenerate highly specialized cells such as these. However, at the current time, they are not even close to being able to devise something that is even close to workable in a human being. There are many challenges including the problem that sometimes the new cells fail to work in guinea pigs (Pobojewsky, 2003). This research is not likely to be abandoned, but it will be many years into the future before if provides a viable alternative for humans suffering hearing loss.

QUESTION 2.

The sense of smell is often placed low on the list of importance when it comes to sensory loss. The senses of hearing and sight are often much higher in importance with a loss of sense of smell hardly gaining any attention. Loss of a sense of smell and its accompanying loss of a sense of taste are a common complaint among the elderly. However, this typically receives little attention from the medical community.

A loss of the sense of smell can have an important impact on the lives of the elderly. The first effect that must be considered is the effect on the sense of taste. A majority of our sense of taste relies on the olfactory sense. When the sense of smell is reduced or gone, the person may report that food tastes bland. This may effect their appetite and be a culprit in unwanted weight loss (Mathey et al., 2001).

Another problem associated with a loss of sense of smell is that the person may not be able to detect odors that indicate danger, such as the smell of natural gas (Cain and Stephens, 1986). A loss of smell was found to be problematic in a large portion of elderly people taking part in the recent study (Murphy et al., 2002). Reiter and Constanzo (2003) found that a loss of smell significantly decreases a person's quality of life. They pointed out several professions that depend on a sense of smell, such as a chef. Loss of a sense of smell could have as much of an impact on the ability of the person to function in daily life and to hold a career as the loss of any other sense, yet many do not see it that way.

It is generally agreed among scholars and the medical profession that some loss of smell occurs as a natural part of the aging process (NIDCO, 2006). Exposure to chemicals can cause a loss of a sense of smell (NIDCO, 2006). Currently, there is no treatment for a loss of sense of smell. However, there are assistive devices available for those that may not smell natural gas (NIDCO). Vitamin deficiencies, malnutrition and diabetes are linked to a loss of smell (NIDCO). If an underlying condition is the cause of the loss, then the logical procedure would be to treat the underlying cause. In some cases the sense of smell may return and for others the loss will be permanent.

Research supports the existence of changes in smell due to age. The causes of this loss are varied. There has not been considerable research into searching for a treatment as with other sensory declines. Loss of out sense of smell is not considered to be of greater consequence in our society. With the rare exception of those whose careers depend on it, there is little societal impact caused by a loss of sense of smell. For the person, they may not enjoy all of the things that they used to, but it does not carry any significant impairment with it.

There has been no formal effort dedicated towards research to restore the sense of smell, exclusive of any underlying conditions. The loss of a sense of smell is considered to go along with certain diseases or physical abilities. The underlying condition for the loss is treated and the sense of smell may come back. However, a loss of sense of smell is not treated as a condition in itself, but is treated alongside another condition. A loss of sense of smell may mean placing the person in danger and may place them at greater risks for certain hazards, but in general, this is not considered to be something that cannot be overcome with assistive devices.