Hearing Loss Prevalence and Management in Nursing Home Residents

Garahan, Margaret Bunce; Waller, Julian A.; M, Houghton; Tisdale, William A.; Runge, C.

doi:10.1111/j.1532-5415.1992.tb01932.x

Cited by 41 publications

(37 citation statements)

References 7 publications

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“…In a study focusing on nursing home residents, Garahan et al (1992) reported that the prevalence of moderate to severe hearing loss was 51 percent, while another study reported that 22 percent of nursing home residents had moderate to severe hearing loss (Voeks et al, 1990). Differences in measurement and classification of hearing impairment may partly explain the dissimilar findings.…”

mentioning

confidence: 87%

Windows to their World: The Effect of Sensory Impairments on Social Engagement and Activity Time in Nursing Home Residents

Resnick

Fries

Verbrugge

1997

The Journals of Gerontology Series B: Psychological Sciences an

143

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mentioning

confidence: 87%

Windows to their World: The Effect of Sensory Impairments on Social Engagement and Activity Time in Nursing Home Residents

Resnick

Fries

Verbrugge

1997

The Journals of Gerontology Series B: Psychological Sciences an

143

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“…14 Cerumen impaction is more common in the elderly and in patients with cognitive impairment. Estimates suggest that between 19% and 65% of patients >65 years old have cerumen impaction 13,15 and that elderly patients in nursing homes are likely at the upper end of this spectrum. 10,18 In the developmentally delayed adult population, 28% to 36% have excessive or impacted cerumen.…”

Section: Health Care Burdenmentioning

confidence: 99%

“…3,10,11 About 12 million people in the United States annually seek medical care for problematic cerumen, resulting in nearly 8 million cerumen removal procedures. 12,13 Nearly $50 million was spent by Medicare in 2012 for cerumen-related procedures, and cerumen impaction was a diagnosis in up to 5% of Medicare patients. 14 Moreover, excessive or impacted cerumen in high-risk populations, such as the elderly and developmentally delayed, is underdiagnosed and likely undertreated.…”

Section: Introductionmentioning

confidence: 99%

“…13,18,19,64 In a random sample of 226 patients aged >65 years who were admitted to the nonintensive care units of a hospital in the United States, 35% had a cerumen impaction that blocked visualization of the tympanic membrane of 1 or both ears. After lavage with otoscopic confirmation of clearing, repeat hearing tests showed that subjects had improved hearing at several frequencies.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction)

Schwartz

Magit

Rosenfeld

et al. 2017

Otolaryngol.--head neck surg.

119

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Objective. This update of the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation cerumen impaction clinical practice guideline provides evidencebased recommendations on managing cerumen impaction. Cerumen impaction is defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. Changes from the prior guideline include• a consumer added to the development group;• new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials); • enhanced information on patient education and counseling; • a new algorithm to clarify action statement relationships;• expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; • an enhanced external review process to include public comment and journal peer review; and • 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.Purpose. The primary purpose of this guideline is to help clinicians identify patients with cerumen impaction who may benefit from intervention and to promote evidence-based management. Another purpose of the guideline is to highlight needs and management options in special populations or in patients who have modifying factors. The guideline is intended for all clinicians who are likely to diagnose and manage patients with cerumen impaction, and it applies to any setting in which cerumen impaction would be identified, monitored, or managed. The guideline does not apply to patients with cerumen impaction associated with the following conditions: dermatologic diseases of the ear canal; recurrent otitis externa; keratosis obturans; prior radiation therapy affecting the ear; previous tympanoplasty/myringoplasty, canal wall down mastoidectomy, or other surgery affecting the ear canal.Key Action Statements. The panel made a strong recommendation that clinicians should treat, or refer to a clinician who can treat, cerumen impaction, defined as an accumulation of cerumen that is associated with symptoms, prevents needed assessment of the ear, or both.The panel made the following recommendations: (1) Clinicians should explain proper ear hygiene to prevent cerumen impaction when patients have an accumulation of cerumen. (2) Clinicians should diagnose cerumen impaction when an accumulation of cerumen, as seen on otoscopy, is associated with symptoms, prevents needed assessment of the ear, or both. (3) Clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as ≥1 of the following: anticoagulant therapy, immunocompromised state, diabetes mellitus, prior radiation therapy to the head and neck, ear canal stenosis, exostoses, and nonintact tympanic membrane. (4) Clinicians should not routinely treat cerumen in patients who are asymptomatic and whose ears can be adequately examined. (5) Clinicians s...

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“…3,9,10 About 12 million people seek medical care annually for problematic cerumen in the United States, resulting in nearly 8 million cerumen removal procedures. 11,12 Nearly $50 million was spent by Medicare in 2012 for cerumen-related procedures, and cerumen impaction was a diagnosis in up to 5% of Medicare patients. 13 Moreover, excessive or impacted cerumen in high-risk populations, such as the elderly and developmentally delayed, is underdiagnosed and likely undertreated.…”

Section: Introductionmentioning

confidence: 99%

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary

Schwartz

Magit²,

Rosenfeld

et al. 2017

Otolaryngol.--head neck surg.

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The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated Clinical Practice Guideline: Earwax (Cerumen Impaction). To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations emphasize proper ear hygiene, diagnosis of cerumen impaction, factors that modify management, evaluating the need for intervention, and proper treatment. An updated guideline is needed due to new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials) and the need to add statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care. Differences from Prior GuidelineThis clinical practice guideline is as an update, and replacement, for an earlier guideline published in 2008 by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF).1 An update was planned for 5 years after the initial publication date and was further necessitated by new primary studies and systematic reviews that might suggest a need for modifying clinically important recommendations.2 Changes in content and methodology from the prior guideline include the following: addition of a consumer advocate to the guideline update group (GUG); 3 guidelines, 5 systematic reviews, and 6 randomized controlled trials (RCTs); emphasis on patient education and counseling with new explanatory tables; expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; enhanced external review process to include public comment and journal peer review; new algorithm to clarify decision making and action statement relationships; and 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.

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Hearing Loss Prevalence and Management in Nursing Home Residents

Abstract: Residents should have hearing evaluations with documentation of results on admission and periodically under the direction of a nurse trained as a hearing specialist. Environmental modifications of the NH plus use of hearing aids can improve hearing.

Cited by 41 publications

References 7 publications

Windows to their World: The Effect of Sensory Impairments on Social Engagement and Activity Time in Nursing Home Residents

Windows to their World: The Effect of Sensory Impairments on Social Engagement and Activity Time in Nursing Home Residents

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction)

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary

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