| Research Abstract |
This study aims to investigate ear care needs among seniors who require home care support and long-term care (hereafter, seniors requiring support), and explores the importance of ear care services for such seniors.
First, a survey was conducted with 128 seniors who were categorized at care support level 2 and who were using day care services. The subject profiles were average age 80.0 years old, 30% males and 70% females, 20% of subjects reported functional disorders in both upper limbs, and 40% of subjects reported wet-type earwax. The level of earwax accumulation was classified into four categories: completely clogged; half clogged; one third clogged; no clogging. Among all subjects, 34 persons (26.6%) had no clogging in either ear, and 18 (14.1%) were half or completely clogged in both ears. Regarding care provision, 70% reported they cleaned their own ears, and that they took care of their ears “when feeling uncomfortable/itchy," or “after a bath." Regarding ear care tools, they us
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ed ear scoops (a traditional Japanese implement), cotton swabs, hair pins, or matchsticks. Over 20% reported they cleaned their ears between several times per month to a year. About 20% reported difficulties with “finger disabilities" and “incapacity to reach deep inside (the external auditory canal)." Accumulation of earwax seemed to be associated with functional disorders in the upper limbs (e. g., inability to perform finger-thumb opposition), male sex, wet-type earwax, and higher levels of care support needs. Regarding air hearing levels (the quartile system), right ear was 41.3dB, and left ear was 42.0dB. For the air/bone hearing gap of the right ear, completely clogged ears showed lower levels than non-clogged ears, which suggested deterioration of hearing due to earwax accumulation.
A second survey was conducted with 11 seniors who were categorized at care support levels 3 to 5 and who were using home visiting care services. The average age was 76.0 years old, and 50% had wet-type earwax. Regarding earwax accumulation, 3 persons had no clogging in either ear, and 2 persons had one ear completely clogged. About 40% of subjects reported ear care several times per month, done by themselves or by caregivers. The tools used were ear scoops, cotton swabs, and tweezers. Difficulty in caring for ears included “body movement" and “inability to take care of left ear (because of sleeping on left side)." It seems that subjects devised their own approaches, such as “cleaning only the surface areas because of pain complaints," or “using a curved hair pin." For those with completely clogged ears, common factors were non-oral alimentation, decline in self care, and need for caregiver support.
The findings of the study suggest service needs regarding ear care to home-staying seniors requiring support should start for those of lower care levels with wider dissemination of information about safe ear care methods, including the provision of safe tools. For those at higher care levels, providing caregivers and professional home-visit staff with more information about the importance of appropriate ear care is required. Less
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