While hearing is not typically considered a risk factor for falls, recent research demonstrated that there is a strong association between audiometric hearing loss and falls. In this nationally representative study of adults aged 40 to 69 years, greater hearing loss was independently associated with self-reported falls over the preceding 12 months. The magnitude of the association of hearing loss with falls is clinically significant as a loss of “from normal to mild hearing loss” is associated with nearly 3-fold increased odds of reporting a fall over the preceding year.

The results of this study were consistent with other studies and demonstrated an association between hearing loss and falls after adjustment for multiple comorbidities. Obviously, as with all studies, there are limitations. However, maybe it is time for additional research to be conducted on this topic. If you think about falls and the cost of care post-fall, there is no question!

In the meantime, what can we do today? Let’s assume these studies are accurate and our residents with hearing loss are at significant risk of falling. Let’s assume too that many of your residents have something going on with their ears/hearing, what can we do?

• Many elders have an ongoing problem with ear wax buildup – what are you doing to be sure residents have appropriate ear care by a professional audiologist trained to remove excess ear wax? Some centers have monthly hearing aid clinics where an audiologist comes to the center and performs hearing tests, cleans ear canals of wax, cleans and repairs hearing aids, etc.
• Hearing aids are wonderful devices, however, if they aren’t properly cared for they just don’t work! What is your process for ensuring fresh batteries are available and installed as needed (many need replacements daily)? Who is cleaning the devices? Trust me, if you say the residents clean their own you are likely to be incorrect! Some centers have a policy where:
  • The afternoon shift nurse removes hearing aids at bedtime (residents should not sleep in them), cleans them, removes the batteries, and stores the hearing aid in individual containers with the resident name and room number, in a drawer on the med cart.
  • The midnight shift nurses are then responsible for replacing the batteries and returning the devices to the residents prior to the morning meal.
• How many of your residents identified as frequent fallers or the resident who never fell before but is now? Could it be related to hearing loss? Are they being screened by an audiologist on a scheduled basis?

There are probably hundreds of other ideas you could look at but first look at your resident fall log. What are you seeing? Could hearing have an impact on even one of the residents experiencing falls? Think about it, take the time to rule out hearing loss as a contributing factor! Remember, if you prevent one fall that is one less risk for resident injury! Stay well and stay informed!