Mr George is an elderly gentleman living in a residential home and has advanced Dementia, Glaucoma, Hypertension, Seborrheic dermatitis and recurrent episodes of impacted ear wax. His carer calls the GP practice saying that she thinks he likely has another episode of impacted wax. Looking at his medical records you can see he was seen six months ago for ear irrigation which successfully cleared his ear canals.

Which one of the following is not a risk factor for impacted ear wax?