Hearing impairment and dementia

Word of Mouth on Radio 4 today was about carers and language, and I already spoke about it a bit here.  It was such a goldmine of interesting discussion that it deserves a second post, looking at their discussion of hearing impairment and dementia.

They start off by saying that hearing problems can compound the communication problems in dementia.  So far this isn’t surprising, as anyone with a hearing impairment will have increased difficulty communicating.

But if you have dementia, your ability to process information coming in may have slowed, but the rest of the world keeps going as fast as it always did.  You have to comprehend, remember what has been said, decide what you want to say and then respond.  By the time you get to where you can respond, the conversation has moved on.

It’s easy to see why people give up, especially when helpful communication partners fill in the gaps all the time.

With a hearing impairment, you have a double whammy.  You add an extra layer of time and difficulty to the comprehension of language.  So then poor understanding may not be purely due to the dementia, though everyone around you may assume that it is.  Giving a hearing aid may actually reduce the cognitive capacity required to comprehend and improve function.

As a therapist, why should I care?

  • It’s my job to reveal competence where possible, and distinguishing between sensory difficulties and comprehension difficulties is something I should be aware of.
  • It gives me cold shivers to think about how many people with dementia and poor hearing I see every week.

On the other hand, this is a complex issue – hearing aids are not a magic wand and they cannot restore hearing as it was, particularly in presbycusis (age-related hearing loss), because delicate inner hair cells that are lost as we age don’t just make sound louder.  There is often poor compliance with wearing aids and I am told that it takes a while to learn to get the best from them.  Add technical difficulties such as remembering to change batteries and suddenly they don’t seem like such a no-brainer.

I suppose the answer is the same as in many aspects of dementia care – you have to get in there early and get the person used to the dentures/hearing aid/communication aid while they are finding it relatively easy to learn.

But add another action point:

  • I can teach carers strategies for use with hearing loss even if the person with dementia is not going to be wearing a hearing aid.
  1. Glad you thought the programme was useful. I had just been delivering the training to the staff from Chrisites who were talking to Chris Ledger. They were so enthusiastic and wanted to make a difference for people experiencing dementia. As you say add sensory impairments to dementia and communication becomes even more stressful. So often people can become locked in and give up trying to communicate. Have you followed “Norms” on Facebook ? He has dementia with Lewy Bodies and is really trying to share what it is like to experience dementia and he is one of many who speak with personal experience.

  2. Hello Alyson, I thought the programme was great! I work with people with dementia most days and I’m learning all the time, but I’m sure I don’t always do the best thing.

    I loved listening to the nurses being enthusiastic and also talking about the things they already do and about the things they’re going to start doing. It can be so challenging to make someone with dementia feel safe when they’re in hospital – ill and in a completely unfamiliar environment.

    I’ve just looked up Norm on facebook – I assume you mean ‘Norm Mac’? I will read with interest!

  3. Liz Stephensen-Payne said:

    Thank you so much for the information about dementia and hearing loss. My mother does not suffer from dementia but has hearing loss and is 84 years old. Becuase her cognative abilities have slowed down and she wears hearing aids she has difficulty processing things I and other people say to her. Understanding this has made feel less stressed in that I now try and communicate with her in short easy to process sentences(I remembered not to slow my voice down too much)and get less ‘stock’ type answers from her. All in all a very helpful programme. I am glad that Nurses and proffessional carers are getting training in this area. Is there any training, book or paper that is available for family members and carers.

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