Similarly, hearing loss and age-related vocal changes can impact every part of a patient’s life. “Elderly people who have hearing loss and dysphonia are more likely to have higher depression scores and quality of life issues than people who don’t have hearing loss or vocal changes,” Dr. Cohen said. Otolaryngologists who work with older patients must consider patients’ living environments, communication burden, cognitive ability, values and comorbidities when designing treatment plans.
—Karen Kost, MD, American Society of Geriatric Otolaryngology
Of course, developing a thorough understanding of the patient’s quality of life takes time. Conducting a full history and physical of an older patient takes longer than it does for younger patients, in part because older patients typically have more extensive medical histories. “An 80-year-old almost always has a more complicated history than a 35-year-old,” said Jerry Goldstein, MD, a founding member of ASGO. Older patients may also have communication difficulties, including hearing loss, weak voices and possible memory loss, which make it difficult to quickly and easily obtain information.
Busy otolaryngologists may feel hard pressed to come up with the extra time to spend with elderly patients, but physicians who work with the geriatric population on a regular basis say the time spent is a worthy investment.