a condition characterized by a loss of hearing that makes it impossible for an individual to understand speech through hearing alone. In assessing deafness, the ears are examined for drainage, crusts, accumulation of cerumen, or structural abnormality. It is determined whether the hearing loss is conductive or sensory, temporary or permanent, and congenital or acquired in childhood, adolescence, or adulthood. The effect of aging is evaluated. A psychosocial assessment is conducted to ascertain whether the individual is well adjusted to hearing loss or reacts to the disability with fear, anxiety, frustration, depression, anger, or hostility. In all cases the degree of loss and the kind of impairment causing it are determined. See also conductive hearing loss
, sensorineural hearing loss
observations Many conditions and diseases may result in hearing loss. More than 21 million people in the United States have some degree of hearing loss; of them, more than 50% are above 65 years of age. The person with a slight hearing loss may be initially unaware of the problem. Recognition, diagnosis, and early treatment may help prevent further impairment and prevent frustration, embarrassment, and danger for the person. An older person with a hearing impairment usually has a sensorineural loss. High-frequency sounds are hard to hear, and discernment of such softer speech sounds such as /s/ and /f/ becomes difficult. A severe or sudden hearing loss usually drives the person to seek help. If the loss is sudden, confusion, fear, and even panic are common. The person's speech becomes loud and slurred. There is new danger because the person cannot hear horns, whistles, or sirens and has not developed a way to cope with the impairment safely. The congenitally deaf person needs special speech and language intervention before reaching school age.
interventions The treatment of hearing loss depends on the cause. Merely removing impacted cerumen from the external auditory canal may significantly improve hearing. Hearing aids, amplification of sound, or speech reading may be useful. Speech therapy is useful in teaching a person to speak or helping a person to retain the ability to speak.
nursing considerations Caring for a deaf person who is hospitalized for treatment of another problem requires certain adjustments in communication between nurse and patient. If the patient uses a hearing aid, its placement and operation are checked before the speaker begins to talk; the voice is modulated to a level that is comfortable for the patient, and the speaker stands or sits where the lips are visible to the deaf individual. If the patient uses sign language, an interpreter or another means of communication is sought; when a pad and pencil are used, a frequent practice with the newly deaf, the messages are written clearly in short, simple phrases, and adequate time is allowed for the patient to understand and answer. The bed is located so that the patient can see the door.