Perceived disability from hearing and voice changes in the elderly

Aim: Dysphonia and hearing loss are underestimated conditions in the elderly, despite their significant prevalence (18% and 50%, respectively) and their sociopsychological implications. Previous studies have shown that the reason for this lack of consideration is related to the general misconception of a simple age-related issue, as well as to the reduced communication requirements of this population, which can result in infrequent requests/supply of care. The purpose of the present study was to evaluate, within an elderly population, the subjective perception of hearing and voice dysfunctions, the resulting changes in communication skills, and the perception of handicap and disability. Methods: Four anonymous questionnaires were administered to 400 participants (218 men, 182 women) aged older than 65 years, some of whom (276) were hospitalized and some of whom (124) were outpatients. The questionnaires consisted of questions regarding age-related changes in voice, multiple-choice questions on the qualitative characteristics of the voice, questions regarding verbo-acoustic communication (hearing), the Voice Handicap Index, and the Self Assessment of Communication regarding the perception of hearing loss-related handicap and disability. Statistical correlations were calculated for voice dysfunction between the perception of disability and the clinical assessment of voice quality obtained by the Grade, Roughness, Breathiness, Asthenia, Strain scale, and between the perception of disability and the demand for care. Results: More than half of the elderly patients reported not perceiving voice changes throughout their lives. Most of the participants were satisfied with their own voices, although 65% of them judged them to be qualitatively altered, and in 31.5% of the participants, pathology was found on phoniatric evaluation. Low scores for vocal handicap (Voice Handicap Index) were found, and the type of perceived disability was mainly physical, although the association between Voice Handicap Index scores and Grade, Roughness, Breathiness, Asthenia, Strain was statistically significant. A total of 62% of the patients perceived hearing changes over their lifetimes not related to previous ear infections, but significantly correlated with a family history of hearing problems and with the need for specialist consultations. However, the perception of hearing loss handicaps and disability showed lower mean values, showing that older patients recognized dysfunction, but did not consider it to be a disability. Conclusions: The present study showed that, despite the relevant incidence of hearing and voice disorders among the elderly population, the implications for communication abilities seems to be underestimated. Hence, it appears to be extremely important to undergo specialist screening consultations to detect eventual voice and hearing alterations, and to correct them with appropriate therapeutic strategies

Challenges in Developing Applications for Aging Populations

Elderly individuals can greatly benefit from the use of computer applications, which can assist in monitoring health conditions, staying in contact with friends and family, and even learning new things. However, developing accessible applications for an elderly user can be a daunting task for developers. Since the advent of the personal computer, the benefits and challenges of developing applications for older adults have been a hot topic of discussion. In this chapter, the authors discuss the various challenges developers who wish to create applications for the elderly computer user face, including age-related impairments, generational differences in computer use, and the hardware constraints mobile devices pose for application developers. Although these challenges are concerning, each can be overcome after being properly identified

Screening methods for age-related hearing loss in older patients with cancer: A review of the literature

© 2018 by the authors. As people grow older, they may experience loss in hearing sensitivity. Age-related hearing loss may negatively affect the patient's quality of life as it may lead to social isolation. In older patients with cancer, hearing loss can seriously interfere with the patient's ability to deal properly with all aspects of their disease, and may have a cumulative effect on their already decreased quality of life. Therefore, the proper screening of those conditions is essential in order to optimise the patient's comfort during and after treatment. This review article aims at providing a concise image of the nature of age-related hearing loss, and provides an overview of the screening methods that could be used in older patients with cancer

Painting the ideal home: using art to express visions of technologically supported independent living for older people in North East England

This paper describes the investigation of the development of future technological products to support older people in everyday living through the agency of a community art group. Recent research has identified a number of challenges facing designers seeking to use traditional participatory design approaches to gather technology requirements data from older people. Here, a project is described that sought to get a group of older people to think creatively about their needs and desires for technological support through the medium of paint. The artistic expression technique described in this article allowed the identification of issues that had also been found by previous research that used a range of different techniques. This indicates that the approach shows promise, as it allows information to be gathered in an environment that is comfortable and familiar using methods already known by the participants and which they find enjoyable. It provides a complement (or possible alternative) to standard protocols and has the potential benefit of extracting even richer information as the primary task for participants is enjoyable in its own right and is not associated with an interrogative process. Furthermore, it is argued that some of the key risks of traditional approaches are lessened or removed by the naturalistic setting of this approach

Republicanism and Markets

The republican tradition has long been ambivalent about markets and commercial society more generally: from the contrasting positions of Rousseau and Smith in the eighteenth century to recent neorepublican debates about capitalism, republicans have staked out diverse positions on fundamental issues of political economy. Rather than offering a systematic historical survey of these discussions, this chapter will instead focus on the leading neo-republican theory—that of Philip Pettit—and consider its implications for market society. As I will argue, Pettit’s theory is even friendlier to markets than most have believed: far from condemning commercial society, his theory recognizes that competitive markets and their institutional preconditions are an alternative means to limit arbitrary power across the domestic, economic, and even political spheres. While most republican theorists have focused on political means to limit such power—including both constitutional means (e.g., separation of powers, judicial review, the rule of law, federalism) and participatory ones (democratic elections and oversight)—I will examine here an economic model of republicanism that can complement, substitute for, and at times displace the standard political model. Whether we look at spousal markets, labor markets, or residential markets within federal systems, state policies that heighten competition among their participants and resource exit from abusive relationships within them can advance freedom as non-domination as effectively or even more effectively than social-democratic approaches that have recently gained enthusiasts among republicans. These conclusions suggest that democracy, be it social or political, is just one means among others for restraining arbitrary power and is consequently less central to (certain versions of) republicanism than we may have expected. So long as they counteract domination, economic inroads into notionally democratic territory are no more worrisome than constitutional ones

Ergonomic standards for pedestrian areas for disabled people: literature review and consultations

As part of the project for the Transport and Road Research Laboratory concerned with the development of design guidance for pedestrian areas and footways to satisfy the needs of disabled and elderly people, a thorough examination of the literature was required. In addition the literature search was to be complemented by a wide-ranging series of discussions with local authorities, organisations representing the interests of elderly and disabled people, and other interested agencies. This Working Paper sets out the findings of this exercise. The objective of the literature review and the consultations was to identify the key impediments for elderly and disabled people when using pedestrian areas and footways. The current guidelines and standards relating to footways, pedestrianised areas and access to buildings were to be identified and their adequacy commented upon, as were the conflicts such recommendations raise between various groups of disabled people and with able-bodied people. The consultations were intended to provide greater insights into what the literature highlighted, and to suggest possible solutions. The literature review produced over 400 key references and a list of 35 impediments. A more detailed examination of the literature and the consultations reduced this list to six key impediments namely: parking; public transport waiting areas; movement distances; surface conditions; ramps, and information provision. The type and scale of problem created by the above impediments for various groups of disabled and elderly people are discussed, together with their measurement and assessment. The type and adequacy of existing design standards and guidance relating to these impediments are also outlined

Influence of voice and hearing changes in the quality of life of active elderly individuals

This article seeks to verify the self-rated impact of voice and hearing changes of active elderly individuals in their daily lives, and the influence of this self-rating on quality of life. A cross-sectional study was conducted with 72 elderly individuals of an Open University for Senior Citizens in the state of São Paulo. The questionnaires applied were HHIE-S; VHI and WHOQoL-Old. The Pearson correlation coefficient was used adopting a p-level significance value of < 0.05. The impact of hearing difficulties on daily life was perceived by 45.8%, and moderate or severe voice handicap by 9.7% of the elderly individuals. The self-rating of hearing impact on daily life was correlated with the voice handicap index. Quality of life was negatively affected by the increase in self-rating of hearing and voice difficulties in daily life. The sample profile is typical of successful aging with the acceptance of aging changes and consequently less impact on daily lives than expected. The findings suggest that there is an impact of voice and hearing handicap on quality of life, although it has revealed high indices, bolstering the characteristic of adaptation of the sample to aging. The results justify the need for improving actions of self-care and empowerment for the elderly.O objetivo do artigo é verificar a autopercepção de idosos ativos sobre o impacto de mudanças vocais e auditivas senescentes em sua vida diária, e a influência desta autopercepção na qualidade de vida. Realizou-se um estudo transversal com 72 idosos de uma Universidade Aberta à Terceira Idade paulistana. Aplicaram-se os questionários HHIE-S; IDV e WHOQoL-Old. Utilizou-se a correlação de Pearson adotando-se como significante o p-valor de 0,05. O impacto das dificuldades auditivas na vida diária foi percebido por 45,8%, e a desvantagem vocal moderada ou severa, por 9,7% dos idosos. A autopercepção de impacto auditivo na vida diária correlacionou-se com o índice de desvantagem vocal. A qualidade de vida foi influenciada negativamente pelo aumento da autopercepção de dificuldades auditivas e vocais no cotidiano. O perfil da amostra é típico da velhice bem-sucedida, com a aceitação das mudanças senescentes e, assim, com menor impacto dessas no seu cotidiano do que o hipotetizado. Os achados sugerem impacto da restrição da participação decorrente da voz e audição na qualidade de vida, embora essa tenha apresentado índices elevados, reforçando a característica de adaptação da amostra à senescência. Os resultados justificam a necessidade de ações de autocuidado e empoderamento para os idosos.Universidade Federal de São Paulo (UNIFESP) Departamento de FonoaudiologiaUniversidade Federal Fluminense Polo Universitário de Nova FriburgoUniversidade Federal do Rio Grande do Sul Departamento de Saúde e Comunicação HumanaUNIFESP, Depto. de FonoaudiologiaSciEL