May 2021 OutreachNC by OutreachNC

MAY 2021 - 1

Feature Intro: Hearing Loss: The Silent Epidemic

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A close friend called me last week and, after the exchange of pleasantries, she divulged an issue she’s struggling with: her husband has untreated hearing loss. Though he has hearing aids, he doesn’t regularly wear them. My friend’s voice was strained with emotion. She feels guilty for feeling frustrated, but she also feels frustrated when she must repeat herself multiple times, when plans are missed due to her husband’s confusion and when others become annoyed with her because of her husband’s limitation. Her husband, she tells me, doesn’t see a problem. He has learned to live with his hearing loss in a way that feels acceptable for him, but his wife feels she is left to live with the inevitable fallout. The conversation left me with several questions. Why would her husband not want to wear his hearing aids? Is hearing loss a normal part of aging? If it is normal, is there any way we can address it or prevent it from worsening so that everyone can have a better quality of life? And how can a loved one best help someone struggling with what is, ironically, a silent epidemic? We so seldom talk about hearing loss, learn about how to prevent it or understand how to engage with people who live with diminished hearing. It seemed time for research, conversations and exploring a common issue of aging so often overlooked. continued page 4

CONTENTS

ASK THE EXPERT: WHAT’S THE PASSWORD? FEATURE: HEARING LOSS

ENTERTAINMENT: BRINGING THE SYMPHONY HOME FAITH: ENDURANCE

LETTER FROM THE EDITOR

Amy Phariss, Editor-in-Chief, OutreachNC | editor@outreachnc.com

MAY 2021 - 2 I have to say, this has been a spring. My yard is awash in flowers, which is a real miracle given my lack of gardening skills. That I have kept a pothos alive for nearly six months is a sign, at least for my home, that the world continues thriving. None of it has been lost on me as I’ve enjoyed backyard badminton, outdoor cocktails and walks in the woods without gloves. Spring has sprung. This month ONC’s feature is the first in a two-part exploration of hearing loss. We dive deep into how to identify, treat, prevent and cope with hearing loss. How do we thrive when one of our senses has become diminished or nearly lost altogether? How do we, as family members and caregivers, support our loved ones who are experiencing this loss? Our feature gives concrete tips, advice and definitions to help anyone living with this issue. Colette Bachand reminds us of the joy that comes in the aftermath of struggle, in the morning, after the night has been long and dark. If you’re worried about password protection and how best to keep your accounts safe, Amy Natt provides tips and insight in Ask the Expert. Meredith Laing of the North Carolina Symphony provides a quick Q&A with ONC on the latest news and how we can all enjoy our beloved music during COVID. Finally, we remind readers of our upcoming pet issue! We love animals and the bond so many of us experience with pets, neighboring animals and the animals we see each day sitting in bird baths, flying overhead, crossing roads and generally reminding us how connected we are to the world outside our windows. Send us your favorite pet pics with descriptions, stories or anecdotes about the furry friends in your lives! As you all know, ONC loves a good story.

BE READY Create a plan for the unexpected TODAY!

Discover the peace of mind an AOS Cares membership provides during a crisis.

For any North Carolina residents, Mark Twain’s words will ring especially true:

In the spring, I have counted 136 different kinds of weather inside of 24 hours. Let us enjoy them all!

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910.692.0683 www.AOSNC.com The Experts in Aging Well

ASK THE EXPERT: WHAT’S THE PASSWORD?

Amy Natt, MS, CMC, CSA | amyn@agingoutreachservices.com

MAY 2021 - 3 My memory is not what it used to be, and I am having a difficult time keeping up with all of my passwords. It can be very frustrating to get locked out of an account or unable to access a website that I need to pay bills or grocery shop. With so many things going virtual, I need some help. Do you have any suggestions? This is a common problem across all ages. As more and more sites require a password to keep our information safe, it can be a real challenge to keep up with them all. The other thing to think about, is if something ever happened to you (like a medical emergency) and someone else in your family needed access to any of your accounts, would they be able to find them? There are a variety of things that you might try and programs available to help you. If you want to stay old school, you can keep a small notebook with all of your accounts, usernames and passwords written down. The trick is keeping this up to date and keeping it in a secure place. If you find a key easier to keep up with than passwords, you can lock your notebook in a fireproof safe. You could store other important documents in here as well. Many people have also opted to simplify passwords, by using the same one, but this is increasingly difficult to do, as many websites require you to change it periodically or have certain requirements that cause you to alter it. Another option is a program or application that is designed to help you keep all your passwords in one place. Some computer browsers will offer to remember passwords. You can also create a Word document or Excel spreadsheet and then password protect it. This way you only have to remember

that one password, to access the master list. Here are some other programs to consider: Last Pass – This is a password manager that generates strong passwords and safely stores them for you. You will still need a master password that you remember. You can use this on your browser or on your smartphone. Last Pass does offer a free version and a paid version with more options. https://www. lastpass.com/ 1Password – This is a trusted password manager app that will keep login information safe and secure. There is an annual subscription fee that comes with 1GB of storage and two-factor authentication options. This works across most platforms and you can create a guest account for password sharing. You could share this with your power of attorney or a trusted family member/friend. https://1password.com/ Dashlane – This is a simple, secure way to manage and autofill your passwords, payments, and other personal information while using the web. The free version covers one device and up to 50 passwords; beyond that, there are paid subscription options. https://www.dashlane.com/lp/neverforget-teal/ If you or someone you know has cognitive issues that compound the problem, you can have a partner or family member help you with any of these options. If a fingerprint or face ID is possible, opt for that, as you will not have to memorize a password. Be careful who you share this information with. If you have selected someone to serve as your power of attorney, that might be a good person to trust with password assistance. At the end of the day, minimize frustration and keep your information safe and accessible. Good luck.

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HEARING LOSS the silent epidemic by Amy Phariss

continued from page 1

WHAT IS HEARING LOSS? To begin, we must understand what hearing loss actually means. According to the World Health Organization, “‘Disabling’ hearing loss refers to hearing loss greater than 35 decibels (dB) in the better hearing ear.” Hearing loss can also be broken down into levels. WebMD defines mild hearing loss as measured between 26 and 40 decibels, and it includes not being able to hear things like a person who is whispering, a dishwasher running or trees rustling in the wind. Moderate hearing loss (between 41 – 55 decibels) means inability to hear people working around you (in an office, for example), rain falling and coffee brewing in a percolator. Moderate to severe hearing loss (between 56 – 70 decibels) is when hearing loss can affect one’s life and the lives of loved ones. According to WebMD, “Those with severe hearing loss miss out on the things in their lives that they would want to hear, like the laughter of their friends or grandkids.

MAY 2021 - 5 They’re likely to raise the volume on the TV to a level that will bother others in the room, just so that they can hear their shows.” People with moderate to severe hearing loss can’t hear doorbells ringing or a vacuum cleaner running. Finally, profound hearing loss (between 91 – 100 decibels) is marked by a mostly silent world. A person with profound hearing loss cannot hear someone shouting at them or a running lawn mower; however, they might be able to hear a clap of thunder or a loud boom of equipment. In America, it is estimated that 30 million people over the age of 12 live with hearing loss. The National Institute on Deafness and Other Communication Disorders writes, “Nearly 25 percent of those aged 65 to 74 and 50 percent of those who are 75 and older have disabling hearing loss.” Roughly 28 million U.S. adults could benefit from using hearing aids, and men are twice as likely to experience hearing loss than women between the ages of 20-69. According to the NC Division of Services for the Deaf and Hard of Hearing, roughly 1,621,853 North Carolinians live with hearing loss. This is approximately 17% of the entire population in our state.

HOW DOES HEARING LOSS AFFECT US? Hearing loss is marked by loss of many kinds. There is social loss when a person with disabling hearing loss finds social engagements exhausting or embarrassing. It’s difficult to feel left out of a conversation or to repeatedly ask for clarification. This can lead to social isolation, which has proven to have negative effects on both physical and mental health. Johns Hopkins Medicine notes, “Social isolation can increase the risk for poor eating, smoking, alcohol use, lack of exercise,

depression, dementia, poor sleep and heart disease.” In a study conducted by the National Council on Aging (NCOA), participants with hearing loss reported higher levels of depression and anxiety and were less likely to participate in social engagements. Thus, a cycle is created in which hearing loss limits socialization and increases isolation. Social isolation increases mental health concerns such as anxiety and depression, which in turn limit socializing and connection. It’s a negative feedback loop that goes well beyond hearing loss. Hearing loss can also contribute to physical losses including cognitive decline and memory loss, which are impacted by actual changes in the brain. When the brain struggles to hear (which it does when hearing loss is present), it stresses the brain. Think of the energy we feel when we’re searching for our lost keys. It’s an anxiety-inducing feeling. We are stressed until we find the keys so we can go on with our day. The brain feels similar stress when one of the senses is diminished. The brain attempts to orient and find the lost hearing, so to speak, so that it can make sense of the world around us. When this isn’t possible, the brain gets tired and frustrated. Brain scans show brain atrophy linked with hearing loss. This atrophy can be linked to dementia. According to Johns Hopkins Medicine, “In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., Ph.D and his colleagues found that mild hearing loss doubled dementia risk. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.” While the physical implications of hearing loss can be challenging, the body is amazingly adaptive. As Hard of Hearing Specialist Richard Watkins, Jr. notes,

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“I have cultivated many personal statements shared by Deaf, Hard of Hearing, and DeafBlind individuals that their other senses are heightened. These senses did not increase because one sense isn’t functioning right. Instead, the brain tends to make other senses work harder to ensure the person is getting all information equally.” Helping the body adapt by identifying and treating hearing loss can help improve a person’s overall quality of life, physically and mentally.

HOW CAN WE IDENTIFY HEARING LOSS? The first step in addressing hearing loss is recognizing it. For many adults, for whom age is the determining factor in hearing loss (rather than disease or reactions to medication), hearing loss happens so slowly it’s difficult to recognize. According to Jennifer Cabe, Hard of Hearing Services Specialist for the Division of Services for the Deaf and Hard of Hearing, the average number of years between the beginning of hearing loss and actual assessment/treatment is seven years. For seven years, someone may be losing hearing without recognizing it. Age-related hearing loss is called presbycusis and most often affects the ability to hear highpitched sounds such as a phone ringing or a timer dinging. You might miss, for example, the microwave timer beep and burn a bag of popcorn. A woman’s voice (which is higher pitched) may be more difficult to hear than a man’s voice, which makes for plentiful cartoons and jokes but does impact many relationships. Common signs of age-related hearing loss include: • voices sounding muffled or garbled • conversations being difficult to understand

(particularly when background noise is present such as music playing or the television being on) • ringing in the ears or pain in the ears • some sounds seem noticeably higher than others • yelling - a person with hearing loss may yell due to difficulty monitoring volume levels If you or someone you love is experiencing these symptoms, the next step is to seek an evaluation. A first stop can be a primary care provider or an ENT (who is typically the provider who can look further into possible hearing loss) who can use an otoscope (a lighted scope) to examine the outer ear canal and the ear drum. Your health care provider will look for any blockages, foreign objects or other issues that may be causing hearing loss. If no external factor is causing the hearing loss (build-up of ear wax, for example), you may be referred to a hearing specialist (audiologist) for an audiogram. The audiologist performs this test by using sounds played through headphones. This is called an audiometer test and is more conclusive than other types of testing. With an audiometer test, sounds are tested in one ear at a time, to determine the level of loss in each ear. If a person cannot hear certain tones (as discussed above), this is a key indication of some level of hearing loss. Based on the evaluation and test results, you may be fitted for hearing aids or recommended other or complimentary treatment options. Hearing aids are not the only treatment for hearing loss, which is a multi-dimensional health issue with multi-dimensional treatment options.

HOW IS HEARING LOSS TREATED? Hearing loss can be treated with products to help amplify sound (hearing aids) but also other

MAY 2021 - 7 treatments to prevent further loss and to enhance daily quality of life. Tips for treating hearing loss include: • Hearing aids (some are as small as a jellybean) • Assistive devices (such as telephones that convert speech to text) • Speech reading training • Tips for preventing the build-up of ear wax (which exacerbates hearing loss) • Cochlear implants (which work differently than hearing aids and can be prescribed when hearing aids provide limited benefit) • Surgical procedures (which are usually beneficial when hearing loss is associated with structural abnormalities within the ear) • PSAPs – personal sound amplification products The treatments above are helpful to address hearing loss that has already occurred. Prevention of further hearing loss is a key component to hearing loss treatment. Once hearing is lost, it cannot be recovered, but further loss can be prevented! Tips for preventing hearing loss includes: • Avoid noisy places or limit time and exposure to such places. • Wear hearing protection such earplugs or noise-canceling headphones when you are exposed to high levels of noise. • If using earbuds or headphones, keep the volume to a lower setting. • Stop smoking, which is linked to hearing loss. • Check medications – many prescription drugs can damage hearing including some antibiotics and cancer-fighting drugs. • Properly remove ear wax (as noted above).

GLOSSARY Presbycusis – age-related hearing loss Audiologist – a medical doctor trained to identify, evaluate and treat hearing loss and other hearing related disorders, balance and neural systems ENT – a medical doctor with specialized training in diagnosis and treatment of diseases of the ear, nose and throat. Also called an otolaryngologist. Audiometry Test – measures the softest or least audible sound a person can hear and uses headphones to test hearing in each ear Word Recognition Test – also known as a speech discrimination test, assesses person’s ability to identify speech from background noise Tympanometry Test – detects fluid/ wax buildup, eardrum perforation, tumors or bone damage in the ear Cochlear Implants – an auditory device that stimulates the auditory nerve of the inner ear through electrodes places in the cochlea of the inner ear

MAY 2021 - 8 • Pay attention to treatment of other health issues such as diabetes and high blood pressure, both of which are linked to hearing loss.

staff, community support, family and caregivers, hearing loss can be managed, treated and prevented, and quality of life can be dramatically improved!

• Take your vitamins, such as vitamin B12, which is linked to better hearing. Discuss vitamin and mineral supplementation with your audiologist.

Editor’s Note: Next month, we will explore how to cope and thrive with hearing loss. We’ll learn how family members and caregivers can support a loved one, and we’ll look at the latest hearing technology. Finally, ONC will explore hearing loss and the veteran community.

Identification, treatment and prevention are all key in living with hearing loss. Understanding hearing loss is a step-by-step process. Once identified, the work of treatment and prevention can begin. It’s important to remember that, like any health issue, hearing loss is not a onesize-fits-all experience. Each person will adjust differently, and there is no one “right” way to live with hearing loss. With the help of medical

We are incredibly grateful to Kim Calabretta of CapTel North Carolina for her insight into this issue. Also, a special thanks to Hard of Hearing Specialists Richard Watkins, Jr. and Jennifer Cabe with the North Carolina Department of Health and Human Services, both of whom provided much information and clarification of hearing loss and how to identify, treat and address this loss.

ASSIGNMENT

Pet Pics! Show us your best! Over here at OutreachNC, we're dedicating our upcoming June issue to pets, and we want to see yours - dogs, cats, birds, horses, bees and any other animal friend with a special place in your homes and hearts. Send your best pet pics to editor@outreachnc.com for your chance to win. The one winner will receive a PetSmart Gift Card!

Submission deadline: May 30th

ENTERTAINMENT: BRINGING THE SYMPHONY HOME

MAY 2021 - 9 The North Carolina Symphony has launched a new series for listeners and patrons titled Musical Meditations. The Musical Meditations series will include a bi-weekly performance from the Symphony’s archives paired with imagery of state parks from around North Carolina. Each video is several minutes long and includes an introduction to both the music and the art of meditation and mindfulness, including tips for listeners to enjoy the music in a fully present and mindful way. Available on the Symphony’s website and social media channels, the series aims to encourage a sense of calmness and awareness in listeners as we engage both with the music as well as the images of our beautiful state parks.

busy school or workday, providing moments of calm and focus.

Meredith Laing, Director of Communications for the North Carolina Symphony, answers questions about the new series and how listeners who have missed in-person concerts over the past year can connect with the music we love.

And of course, the Symphony is proud that we have kept the music playing on through our 2020/21 streaming concert series. Our virtual performances have allowed us to remain connected to our audiences—and our musicians have met the challenges of a virtual format, continuing to bring the highest level of artistry to their craft. Plus, in the fall, NCS musicians performed surprise outdoor concerts in communities around the state and we look forward to resuming those pop-up performances in the spring!

ONC: The pairing of music and meditation sounds lovely, Meredith. What prompted the Symphony to combine the two, and what do you hope to offer listeners through this new program? Meredith Laing: Emotional wellbeing is on many people’s minds these days— teachers, medical professionals, and business leaders are all sharing that focusing on emotional health is more important than ever. The North Carolina Symphony partnered with North Carolina State Parks and the North Carolina Department of Natural and Cultural Resources in order to support our fellow citizens with stress-management during the

ONC: Since the COVID pandemic began, we’ve had to curtail many of our beloved activities, including listening to live music. What has the Symphony been doing during this time? ML: Without missing a beat, the Symphony took action to support teachers and at-home learners, adapting each component of our education program to a virtual format. Since then, we have continued to innovate, developing new online music education resources that have reached people across the country and even around the globe—more than 134,000 altogether! We think the new Music Meditations series will be valuable to students, but also to people of all ages.

ONC: We know how soothing and comforting music is for people of all ages. With the current in-person restrictions, how can listeners enjoy the Symphony from home? ML: Our streaming series is available for just $20 per concert! Performances can be streamed to your TV, computer, or mobile device, and we have wonderful concerts still to come this season, including Copland’s Appalachian Spring, music of the Ragtime era, and Beethoven’s Violin Concerto with superstar Augustin Hadelich. No need to meditate on it—this is a great opportunity! For more information, visit ncsymphony.org.

FAITH: ENDURANCE

The Rev. Colette Bachand | revbachand@gmail.com

MAY 2021 - 10 Thank God this May things are so much better! Last May we couldn’t buy toilet paper anywhere; the likelihood of seeing loved ones was way off in the distance; we didn’t know how we’d survive months more of isolation but knew we had to. We told each other that every other hard thing we’d gone through in life had been manageable because we had people around us, but this was different. Not so fast forward a year and … whew! Thank God that’s over. Many of us have been vaccinated; we’ve been reunited with family; we’ve been out to our favorite restaurant; church has started up … so wow, everything is better! Right? Well, sort of, but you’re not alone if you find yourself wondering, “If things are better, why do I still feel so bad?” If everything is better, why aren’t I happier, why don’t I want to do anything, why is it I’d rather stay home even though a year ago, I’d given anything to go anywhere? The answer is, it isn’t easy to re-assimilate into our old lives and more so, the pandemic has made us reassess our lives, our schedules and our priorities.

We have been through a lot so the confidence to feel okay about getting back to what life looked like isn’t easy. If you’d rather stay in your Zoom yoga class than go live, you aren’t crazy, and my guess is you have a lot of company. Assimilating is going to take time, so be easy on yourself. Find some new practice of healing and wellness; reach out for help if you need support. God teaches that time can be our friend. “All things come of thee O Lord,” we often say, and life has proved time really does heal. At some point you will feel better because things are better, but if that hasn’t happened yet, that’s ok. It will. We will find what being us means in this moment and will honor it in new ways, including staying home if that is what our souls need and not filling our schedules with the chaos we thought made us feel important and productive.

Psalm 30 says, “Weeping may endure for a night, but joy comes in the morning.” We are still waking up, it is still morning, but joy will be ours again in its full measure. The pandemic was tough, but you’ve been tougher.

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RESOURCES. EXPERIENCE. SOLUTIONS.

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305 Page Road | Pinehurst, NC FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. IP Captioned Telephone Service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No cost is passed on to the CapTel user for using the service. CapTel is a registered trademark of Ultratec, Inc. NC Department of Health and Human Services • Division of Services for the Deaf and Hard of Hearing • ncdhhs.gov/divisions/dsdhh • NCDHHS is an equal opportunity employer and provider. • 04/2021

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42. Blockhead 44. Stagger 48. “20,000 Leagues” harpooner ___ Land 49. Mexican American 51. Victorian, for one 52. Anger 53. Appetite 54. Additions to usual pay 56. Caterpillar, for one 58. Morse code device 60. Saved on supper, perhaps (2 wds) 61. Barely gets, with “out” 62. On the safe side, at sea 63. Appears 64. ___ gestae 65. Amount to make do with DOWN 1. Gossip 2. Recently (2 wds) 3. Unit of apothecary volume 4. Hit 5. Having more rough

protuberances 6. “___ say!” (contraction) 7. Wood sugar 8. ___-ski 9. ___-tzu 10. Dilation of heart chambers 11. Core 12. Knock (hyphenated) 14. Double-reed woodwind 17. Loud electric horns 21. Something done to restore a broken chair 25. Excellent in all respects 28. Wading birds with long slender down-curved bills 32. Faust author 34. Everlasting

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Spring is on the Way and

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