Hearing loss or inability to understand?

Ginsamae

We've noticed that MIL has symptoms of hearing loss. She's 82 and has undiagnosed dementia of some sort. In the last 9 months we've noticed a sharp decline in her ability to hear the TV and in-person conversations. It's almost maddening the amount of time we are spending repeating ourselves - between her extreme short term memory loss and a seemingly inability to hear I feel we are are spending huge amounts of time having the same conversations! I'm wondering if her hearing loss is actual hearing loss or if it may be in some way related to the dementia - meaning that her brain doesn't comprehend what she's hearing. 

I'd like to get her hearing tested but she has always been (even pre-dementia) hesitant to go to doctors because she's never had good insurance and now she only has Medicare which won't pay for a hearing test or hearing aids. 

Has anyone else been through this?

LaurenB

Ginsamae, you are right to question if your LO has a hearing loss or if it is dementia related.  PWD have difficulty with language both in differentiating who is talking as well as with understanding what is being said.  Additionally, it could be something as simple as excess ear wax.  Since you are already concerned about an undiagnosed dementia I'd make an appointment with your LO's primary doctor to address the memory loss, difficulty with conversation, and a quick check to make sure that they don't have impacted ear wax.

Lauren

Ginsamae

Thanks for your response LaurenB. We've had MIL assessed by both her PCP (who referred her to a neurologist) and a neurologist who ran a battery of tests and noted the severe short term memory issues as well as "some" brain shrinkage. The neurologist has not yet diagnosed her with any sort of dementia; however, MIL has both a brother and a recently deceased sister both of whom has/had dementia/Alz. We see many of the same similarities in MIL that her siblings at their earlier stages so we are under the assumption that MIL is headed down the same path.

I will see if I can get close enough to MIL to see if she may have an ear wax problem.   She's very secretive and suspicious of anyone trying to "control" her and she is, of course, in complete denial about any hearing issues, so I'll probably have to come up with some fiblet to get her to check her ears.

LaurenB

You might be able to see some ear wax in the outer ear, but if she's been using q-tips, it's possible that she's pushed it further in than you can see.  Additionally, if she has been to the doctor, they most likely looked into her ears and would have noted if there was too much wax.  As as speech-language pathologist, I can tell you that I recommend that my families of patients with dementia turn off all excessive noise while trying to communicate and have only one person in the room speak at a time.

M1

We definitely have the same issue--my partner was a contractor and around loud power tools for years and years.  When we watch the news in the evening, it's like watching with a child--she constantly is asking me what they said, and mishears a number of words in that setting and in normal conversations (misheard "debt" for "death" yesterday, for example).  

However, after polling on this forum, I decided not to take her to an audiologist; I don't think she could manage hearing aids with her dementia (lost, put in wrong, etc etc).  So I would encourage you to think hard about this before you intervene, you will be the one having to keep up with the hearing aids and I think that ship has probably sailed.  On the other hand, a wax problem could be easily dealt with--it's probably worth taking that far, but maybe not beyond that.

Ginsamae

Hi LaurenB & M1 and thanks for the input. I doubt she has wax build up as she went to her PCP earlier in Jan for a check up (she's also diabetic and is on Metformin) and he routinely looks in her ears. I'm sure he would have said something to DH and cleaned out her ears if needed. I'll try to check if I get a chance though. 

 M1 I agree that I don't think hearing aids would work - even if she would agree to go to an audiologist there is NO WAY she would pay the thousands of $ that hearing aids would cost. DH and I have a hard enough time getting her to take her Metformin and Xanax without the added burden of trying to get her to wear hearing aids - she wears glasses but can't find them most of the time and she refuses to put them on a chain around her neck (she says that's for old people! LOL!) so I can imagine the stubbornness with hearing aids. 

I may try to get her to go to an audiologist just to satisfy my own curiosity as to whether this is loss of sense or related to brain deterioration.

jfkoc

You do not want to go to an audiologist. What you want is an Otolaryngologist and the visit will be paid for by Medicare.

Often the hearing problem is clarity. I myself have a problem understanding with what is being said. The speech is too fast. Now couple that with slow comprehension and you have a big problem.

When you talk to your MIL start by getting her attention. Then face her (sound waves travel in one direction). Speak simple sentences. clearly and in a low pitched voice. You may be amazed at her "comprehension". Do not talk to her with your back turned or from another room. 

If there is a hearing loss then hearing aids would help. They are expensive and easily misplaced. 

The other thing to try is Blue Tooth earphones for the TV. They worked beautifully for my very hard of hearing husband and I find ear buds (not Blue Tooth) are wonderful for cell phone and TV.

Try some of these and let us know

RobOT

Ginsamae, interesting that you bring this up now--for me, at least.    My father is hard of hearing and has pretty good hearing aids, if you judge by the price.  He also has dementia caused by a subcortical stroke years back.  He has a pair of blue tooth head phones that work well, but refuses to use them because he wore "the exact same s--t on my head" during WWII.  He cranks the TV up as loud as it will go, then gets mad when I leave the room (I listen to it at 12, he likes it at 90)  because he still needs me to explain what is going on.  The clue to this being more of an ability to process language is that the content can be explained three or four times before he throws his hands up and snarls "Whatever!"  It's frustrating for everyone, and sometimes I think I'll scream if I hear Huh? one more time.  TV and movies are a huge problem because they go fast and move along, whereas someone talking to him can try to adjust, although that's becoming difficult too.  I try to steer him to shows where the visuals are fairly self-evident, like guys pulling trucks out of a ditch, people rescuing animals, or cooking shows.  As usual with this wretched disease, everything's hard and no solution seems to last for long.

jfkoc

additionally, turn on the closed captions

Suzy23

I’m not sure this will help, but I thought I would add my experience here. My dad (now 77) started showing what we thought was signs of hearing loss a few years back. He would ignore what everyone else said and continue to make comments on his favorite few topics so it wasn’t really a conversational give and take. He would also ignore requests or misunderstand them and get angry about it. My mom took him to have his hearing evaluated and he was given hearing aids. He loses them a lot and also does not like to push them all the way into his ears as he says they itch. He initially  hated the way they magnified sounds such as rustling newspapers. My mom says that she can’t tell any difference between his ability to understand when he’s wearing the hearing aids or not. He continues to sit really near the TV and he is currently kind of obsessed with it, turning it on and off over and over and wanting to go back to the beginning of a movie 10 times because he is having problems following the dialog. I have suggested they just switch to really simple shows about animals perhaps, but so far my mom is unwilling. It is causing them a lot of stress. They do use close captions.  I have also urged her to try music instead to keep him occupied when she is busy cooking dinner perhaps.  I like to hope that songs from when he was a young man might engage him. She doesn’t want to mess with that either so far. 

Good luck. 

M1

I've definitely had to alter what we have on TV--we do watch the news and some PBS shows, but for instance Masterpiece she can't follow the plots and will usually fall asleep.  She does best with old sitcoms and westerns, but those don't interest me at all, so I usually read or play Sudoku--which drives her crazy, she doesn't like me looking at my phone.  She can occasionally follow a movie but I pick really simply family comedies, like you would for a child.  No serious drama.  Most comprehension is just not there, whether she can hear it or not.

David J

M1 you described us to a T!  I am sick of Hallmark but they are benign and on every night. DW picks up on any conflict or angst in the program so normal dramas are out.

RIM

This hearing device is used in hospitals and work very well.  Can be bought on Amazon for $60. 

https://www.sonictechnologyproducts.com/superear-se5000

Ginsamae

M1 - MIL has always been very selective about what she will watch on TV and refuses to watch an R rated movie of any type. Since she moved in with us in April 2019 we've watch so many rom-coms that I now hate them. She doesn't like to watch "tv shows that finish up in an episode" and absolutely LOVES most all reality shows - especially American Idol and The Bachelor...and neither DH or I likes those at all.  The really frustrating thing is that no matter what we watch she will end up falling asleep shortly into the show so DH and I have started watching what we want instead.

We did get the Hallmark channel on her TV in her bedroom so hopefully she'll start staying up there and watching it on her own.

Kaustin1741

Oh my gosh! We were having the TV conversation just yesterday. MIL pre dementia jumped at little things and got overly worried over action and drama. Now it's even worse! It seems we are at the point where everything she see's on TV is factual. Regardless of what we are watching, it is real life and they are real conversations people are having and real events happening in real time. Hallmark is fairly calm, but gets old. We were watching cooking shows for awhile, but then she kept asking why they weren't sharing with her. LOL. We were watching a movie the other day and she started getting concerned about the charicters. I tried to tell her it wasn't real and it was just a movie. "this is not a movie! " trying to understand I asked if it wasn't a movie , what was it. All she could come up with was "a recounting of what happened". She didn't say it with a lot of confidence so I think she know she is wrong but it doesn't make sense to her. We are not really sure what she can watch other than news and cooking shows and jeopordy. 

We were also questioning her hearing recently because she would ask did they just say.... and it would be a word that sounded close but didn't make any sense. We were repeating ourselves a lot or having to explain what was happening because she couldn't hear. But, of course she can hear us having a conversation in the other room clearly. I'm starting to think she just doesn't understand the words she is hearing and so she replaces them with something that sounds close.