Chapter 37. Hearing and Vision Problems. Ear Disorders & Hearing Problems

Transcription

1 Chapter 37 Hearing and Vision Problems Hearing and Vision Problems Sight and hearing: Allow communication and learning Are important for most activities Are important for safety and security needs Many people have some degree of hearing or vision loss. Common causes are: Birth defects Accidents Infections Diseases Aging Slide 2 Ear Disorders & Hearing Problems The ear is needed for hearing and balance. Problems range form slight hearing impairment to complete deafness. Problems may occur suddenly, but usually are gradual in onset. One or both ears may be affected. Slide 3 1

2 Otitis Media Otitis media is infection of the middle ear. Common in infants and children Viruses and bacteria are causes. Otitis media is acute or chronic. Chronic otitis media can damage the Eardrum Bones of the middle ear that conduct sound Permanent hearing loss can result from chronic otitis media. Slide 4 Otosclerosis A hereditary condition in which the ossicles in the middle ear begin to harden A common cause of hearing loss in adults Gradual and progressive hearing loss Accompanied by tinnitus ( ringing in the ear) Surgery can often restore some hearing. Slide 5 Ménière s Disease An increase of fluid in the inner ear causing pressure in the middle ear Usually only one ear is affected. Symptoms include: Vertigo (dizziness) Tinnitus Hearing loss Pain or pressure in the affected ear Sever dizziness may cause nausea and vomiting. Safety is needed during vertigo. The person must lie down. Falls are a major concern. Slide 6 2

3 Hearing Loss Hearing loss is not being able to hear the range of sounds associated with normal hearing. Losses are mild to severe. Deafness is hearing loss in which it is impossible for the person to understand speech through hearing alone. Hearing loss occurs in all age groups. Common causes of hearing loss are: Damage to the outer, middle, or inner ear Damage to the auditory nerve Slide 7 Dominant Progressive Hearing Loss Impairment of nerves used to hear Hearing loss is progressive. Usually starts in early or middle adulthood Sometimes starts in early childhood Slide 8 Presbycusis Gradual hearing loss associated with aging Occurs after age 50 No cure Hearing aids and speech reading are helpful. Slide 9 3

4 Temporary Hearing Loss Blockage of the ear canal with earwax Common in older adults Hearing improves when wax is removed. Earwax is usually removed by doctor or nurse. Slide 10 Effects of Hearing Problems Signs/symptoms vary hearing loss may not be obvious. A client s behaviour, attitude may change due to hearing problems frustration, anger. May deny that they have a hearing problem Signs of hearing problems Speaking too loudly Leaning forward to hear Turning and cupping the unaffected ear toward the speaker Responding inappropriately Asking for words to be repeated Slide 11 Effects of Hearing Problems Hearing loss can affect all aspects of a person s heath Physical Emotional Social Intellectual Spiritual Hearing is needed for speech. Hearing loss may result in slurred speech. Words may be pronounced wrong. Some have monotone speech or drop word endings. It may be hard to understand what the person says. Canadian Hearing Society is an excellent resource. Slide 12 4

5 Aids for Hearing Loss Hearing aids are electronic devices that fit inside or behind the ear. They make sounds louder. They do not correct, restore, or cure hearing problems. The person hears better because the device makes sounds louder. Background noise and speech are louder. If a hearing aid does not seem to work properly, try these measures: Check if the hearing aid is on. It has an on/off switch. Check the battery position. Insert a new battery, if needed. Clean the hearing aid. Slide 13 Care of Hearing Aids Hearing aids are expensive handle with care. Look for visual signs of damage, cracks, or clogged openings. Insert battery, turn on check for whistling sound which indicates battery is working. Apply correctly incorrect insertion may cause the aid to fall out, or whistling sound may occur. Keep hearing aid in dry place, avoid getting the device wet. When not in use turn hearing aid off and keep the battery door open. Report missing or damaged hearing aid. Slide 14 Technology Devices Special telephone system Uses typed messages back and forth Signalling devices The device makes a sound, vibrates, or flashes a light to alert the person. s Computer software Dogs Alert to ringing phone, baby crying, door bell Closed captioning TV screen over 13 inches have built-in decoder. Slide 15 5

6 Caring for Client with Hearing Problems Alert client of your presence. Adjust the lighting. Reduce background noise. Focus your attention on the client. Speak in a normal tone. Check communication aid. Adjust your language. Use other communication methods. Watch for signs of fatigue. Slide 16 Eye Disorders & Vision Problems Vision loss occurs at all ages. Problems range from mild vision loss to complete blindness. Blind is the absence of sight. Vision loss is sudden or gradual in onset. One or both eyes are affected. The legally blind person sees at 6 m (20 ft) what a person with normal vision sees at 60 m (200 ft). Slide 17 Age-Related Macular Degeneration Also called AMD or ARMD A disease that blurs central vision and causes damage to the macula located in the centre of the retina The disease is usually gradual in onset. Central vision becomes fuzzy, shadowy. Client may lose central vision but have some peripheral vision. It is the leading cause of blindness in persons 50 years of age and older; for which there is no cure. The two types of AMD are: Wet AMD Dry AMD Slide 18 6

7 Retinal Detachment Separation of the retina from its supporting tissue Can result in permanent blindness Vision may be saved by surgical reattachment. Slide 19 Diabetic Retinopathy A complication of diabetes, it is a leading cause of blindness. Tiny blood vessels in the retina are damaged. Usually both eyes are affected. Everyone with diabetes is at risk. Blood can leak from the blood vessels creating scar tissue that pulls the retina away from the back of the eye. Slide 20 Glaucoma An eye disease that causes pressure within the eye, which damages the optic nerve Vision loss with eventual blindness occurs. Usually age-related, onset sudden or gradual Can develop in one or both eyes Peripheral vision (side vision) is lost tunnel vision (can only see straight ahead) Blue green halos around lights Glaucoma has no cure. Prior damage cannot be reversed. Medications and surgery can control glaucoma and prevent further damage to the optic nerve. Slide 21 7

8 Cataract A clouding of the lens in the eye that prevents light from entering the eye. A cataract can occur in one or both eyes. Signs and symptoms include: Sensitive to light and glares Cloudy, blurry, or dimmed vision Surgery is the only treatment. Removal of cloudy lens and implantation of new lens Slide 22 Presbyopia Gradual inability to focus on close objects Associated with aging usually occurs after age 40 Corrective lenses/contact lenses can help Slide 23 Effects of Vision Problems Vision loss affects physical, emotional, social, intellectual, and spiritual health. Clients can learn to move about, complete activities of daily care, and learn new reading methods. Guide dog and white cane with a red tip are recognized worldwide. Canadian National Institute for the Blind (CNIB) has good resources. Talking books Different types of aids Support to clients and families Slide 24 8

9 Aids for Vision Problems Eyeglasses correct vision problems Expensive keep in case when not worn. Plastic lenses scratch easily. Use special cleaning solutions/soft cloth to dry. Contact lenses hard or soft Fit directly on the eye Proper cleansing/soaking solution is important. May be worn for hours usually removed for swimming and sleeping. Report any eye redness or drainage, eye pain, or blurred vision. Slide 25 Aids for Reading Braille is a touch reading and writing system that uses raised dots for each letter of the alphabet. The first 10 letters also represent the numbers 0 through 9. Communication aids Large print clocks, oral clocks, large letters for playing cards Talking prescription devices Slide 26 Artificial Eyes Removal of an eyeball is sometimes necessary because of injury or disease. The client is fitted with an ocular prosthesis. Some prostheses are permanent implants. If removable, the client may be taught to remove, clean, and re-insert it. You need to protect the client s prosthesis from loss or damage. Slide 27 9

10 Caring for Clients with Vision Problems Sense of hearing, touch, smell, taste may become more developed with loss of vision. Client may be sensitive to the tone of a person s voice. Alert client to your presence. Walk slightly ahead, allow client to hold onto your arm, inform of approaching obstacles. Explain the location of food on a plate by relating to the time on a clock. Keep area free of clutter. Inform client if you close doors. Slide 28 10