Janice Trent, a clinically certified geriatric audiologist who owns a private practice in Bowie, Md., and provides on-site audiology services at a long term care facility, screened a long term care resident’s hearing, and she didn’t pass. But once the resident got her hearing aids, the initial trial period proved problematic. She said the hearing aids weren’t working right and that they were hard to put in and take out, “so we had to work with manual dexterity issues,” says Trent.

“A lot of the time the fact that residents are in a long term care facility means they have a list of things they cannot do, so many approach this process with a negative attitude. ‘I can no longer drive, do my laundry, or cook food; I’m probably not going to be able to use these hearing aids.’”

Trent reassures them that they really can do it, and that if they need help she’ll find someone to help them. “The resident was really flustered,” recalls Trent. “I’d go in on Saturdays and just sit down with her, and after a time she got the hang of it.”

One day Trent found the resident at a table talking to people. The resident pointed to Trent and told the table, “She’s very patient with you. You are going to be a successful hearing aid user.”

“I was pleased that she was using the hearing aids correctly, but I was more pleased that her attitude had changed,” Trent says. “She thought she couldn’t do it, and now she could, and she was communicating effectively with the people at the table, and she was enjoying herself. That’s why I have so much fun doing this work.”

Another resident had so much wax in his ears that it was impairing his hearing. After consulting with a doctor, Trent irrigated his ears, “and once the wax was out he was a completely different person. He was happy. Before that, he would kind of grunt at me when I would speak, and afterward he’d be ‘Hi, doc! What’s going on today?’ He was engaged with more people, and that’s my goal: to get people communicating with each other.”

Despite inadequate or entirely lacking Medicaid reimbursement, “Many of us in the profession would love to be able to provide those services” to long term care residents, says Trent, so all a nursing facility should need to do is make contact with an audiologist and make clear what their need is, she recommends.