How to Succeed With Hearing Aids and Dementia
Five Helpful Strategies
16 December 2020
When I was growing up, family gatherings often involved a lot of yelling. We weren’t an especially combative crowd: My mom and her brother lived with untreated hearing loss. Put them in a room with rowdy children and several simultaneous conversations, and they both inevitably found it hard to follow what was being said.
My mom’s coping strategy was to withdraw when she couldn’t follow the family banter. My uncle, on the other hand, asked everyone to repeat themselves at ever louder volumes until we all felt like we were inside an echo chamber of family jokes.
Eventually my uncle sought treatment, but my mom resisted seeing a specialist for decades, often insisting that her hearing loss wasn’t “that bad.” And who were we to argue? She was a speech therapist, so most of our pleas were met with lectures about the anatomy of the human ear and sound waves. The cost of hearing aids — not covered by her insurance — was another deterrent.
However, about 10 years ago we noticed that her hearing loss becoming more profound. Following conversations got harder, and she would frequently repeat the wrong words back to us to clarify what had been said. Her pattern of emotional withdrawal took a new turn when she would often start crying for no apparent reason. We later learned that she mistook our laughter as a sign that we had been "talking about her.”
Fortunately, she finally agreed to see an audiologist, first getting just one hearing aid, then later a full set. Sadly, communication didn't improve. A few years ago, we learned why: My mom was diagnosed with Frontotemporal Dementia, which presents as Primary Progressive Aphasia, impacting one’s ability to communicate. She still lives independently (a service helps check in on her), and by some small miracle, she manages to keep track of her hearing aids. She wears them about 75% of the time; on the days she doesn’t, it's a disaster.
I’ve learned some smart coping strategies to help my mom with her double diagnosis. I also got expert advice from Dawn Heiman, AuD, an audiologist in Woodridge, Illinois. Here, five ways to improve quality of life for your loved one and your whole family when hearing loss and dementia coincide.
Get an accurate diagnosis
Because a moderate hearing loss can present some of the same symptoms associated with dementia — like the conversational challenges and paranoia we experienced with my mom — it’s important to fully understand what’s going on. “It’s critical that hearing problems are identified and addressed before an accurate dementia diagnosis can be made,” Dr. Heiman told Hearing Tracker. “If a person sits down for a lengthy diagnostic interview and can’t hear the questions correctly, they may fake understanding of what is being said. It suddenly becomes challenging to get an accurate assessment of the dementia.” When I took my mom to see a neuropsychologist for such an evaluation, I double-checked her hearing aids beforehand and made sure the doctor was aware of her auditory challenges so that could be factored into her diagnosis.
It’s critical that hearing problems are identified and addressed before an accurate dementia diagnosis can be made.Dawn Heiman, AuD
Also worth noting: Getting an elder’s hearing checked could help prevent the onset of dementia. Research shows that older adults who get a hearing aid for newly diagnosed hearing loss have a lower risk of being diagnosed with dementia for the first time over the next three years.
Optimize your chats
As my mother’s dementia has progressed, I've found that when I slow down and make eye contact with her before speaking, she is far more likely to understand me. Dr. Heiman also suggests eliminating as many distractions as possible. “Turn off the television and make sure you get down at your loved one’s level if she has trouble moving her head,” she said. “When cognitive overload is at play, giving someone good input and enough time to process information is critical.”
Recent advances in hearing-aid technology offer many benefits to people with dementia, such as devices that can detect a fall and alert caregivers. Many new models also make life easier for those with cognitive issues. Thanks to wireless connectivity, they stream audio directly from a TV or other device to the wearer. Others have apps that allow technicians to adjust hearing aids remotely, thus bypassing the need for the wearer to fiddle with their devices – or make as many office visits. If your relative is in the market for hearing aids, inquire about these options.
Enjoy music together
Numerous studies indicate how music therapy can help those who are living with dementia. “When we look at MRIs, the whole brain lights up at once when someone listens to familiar music, and this can have a profound and positive impact on mood and well-being,” explained Dr. Heiman. Fortunately for my mom, my husband and I are musicians, so she enjoys regular concerts in her own living room. Since her hearing aids aren’t the kind that can stream music, we also bought her the most basic CD player we could find. We plastered it with instructions on Post-it notes so she can operate it on her own when we’re not with her. Any new technology can be challenging for someone with dementia, so make it as simple as possible. One-button radios are another helpful device to consider.
Rally the team
Teach everyone involved in your loved one’s care how to replace the batteries in the hearing aids and keep them clean and worn correctly. A person with dementia will have a harder time managing this — and remembering to use the hearing aids as well. (You can also use a free app like CareZone to upload instructions for easy reference and set reminders.)
“When we’re working with seniors, we make every effort to include all the caregivers who help support that person,” Dr. Heiman noted. “Improving hearing quality gives people with dementia the opportunity to stay engaged in the world around them.” As with many aspects of dementia, this is an evolving situation that requires monitoring. Right now, my mom is able to stay on top of her hearing-aid maintenance, but I know the time will come when it becomes a challenge. And when it does, I know I will be well prepared to help her.