When hearing loss affects the whole household
“Did my spouse ignore a request because they forgot it, or because they never heard it?”
“Did Mom respond strangely because she is experiencing cognitive changes, or because she misunderstood what was said?”
Photo courtesy of Dirigo Hearing Center
“Did I confuse the date and time again?”
At Dirigo Hearing Center in Biddeford, co-owners Dr. Tarja Oliver and Dr. Abigail Sedenka regularly see older patients and their families trying to answer questions like these, sometimes acting as relationship coaches as much as audiologists.
In fact, they say that the first call to the office often comes from a caregiver, a loved one, or a family member who notices the person struggling in whatever way and convinces them to get the appointment.
Sometimes the signs are obvious: The television keeps getting louder or conversations need to be repeated. Others are easier to miss. Someone who once dominated the conversation around the game table now plays quietly. Restaurant invitations are turned down. Family gatherings feel exhausting.
Age-related hearing loss often develops gradually, making it easy for someone to adapt without realizing how much they are missing.
“And then people gradually make changes that often make their world smaller and smaller,” Dr. Sedenka said. That shrinking world is one reason hearing loss can affect far more than the person’s ability to hear.
When someone’s world gets smaller
Age-related changes in hearing can sometimes look like changes in memory, comprehension or behavior, and the two can occur together.
A 12 year long study of 639 adults at John Hopkins University researchers found that even mild hearing loss, when untreated, doubled the risk of developing dementia. Moderate loss tripled the risk, and people with severe hearing impairment “were five times more likely to develop dementia.”
Scientists are still studying exactly why hearing loss in older adults is connected to greater cognitive decline. Johns Hopkins researchers point out that hearing helps us balance, so possible explanations include the additional cognitive effort required to move through the world or process degraded sound. Other reasons include physical changes to the brain and increased social isolation.
Photo courtesy of Dirigo Hearing Center
However, hearing aids and communication changes can help. An NIH-funded clinical trial followed nearly 1,000 adults ages 70 to 84 with untreated hearing loss for three years. While hearing intervention did not reduce cognitive decline across the study population as a whole, among a group of participants at higher risk for cognitive decline, it reduced the rate by nearly 50%.
Understanding a person’s hearing ability can help families and health care providers get a clearer picture of what may be happening. For individuals or caregivers who are noticing changes, Dr. Oliver recommends starting in two places: Talk with a primary care provider and request a hearing test.
“That way you can know, did they not do what I asked them to do, or did they respond in a weird way because they didn’t hear me?” Dr. Oliver said. “Is there something else going on? Or both?”
Dirigo Hearing Center does not perform cognitive assessments, but Dr. Sedenka and Dr. Oliver regularly work with patients experiencing cognitive decline.
Better communication can support hearing loss
A hearing test and hearing aids, when appropriate, are only part of the solution.
When caregivers or family members accompany patients to appointments at Dirigo Hearing Center, Dr. Sedenka and Dr. Oliver can also teach them how to make communication easier at home.
The strategies are simple (and perhaps good advice for all of our relationships).
• No more yelling across the house or talking over the television.
• Get the person’s attention before speaking.
• Pause or turn off the TV, headphones or other distracting sounds.
• Be in the same room and face each other directly.
“Our ultimate goal is that you put the hearing aid in your ear and you don’t have to touch it,” Dr. Sedenka said, but even with ever-advancing technology (see below) hearing aids cannot restore perfect hearing.
Instead, they make communication “less effortful,” as the doctors describe it, so people feel confident participating again. Patients return to Dirigo Hearing Center and say they could hear their grandchildren during a visit or are rediscovering sounds they hadn’t realized they were missing.
For an older adult, better hearing makes it easier to stay part of the conversation. For family, caregivers and friends, it can mean fewer misunderstandings and less frustration. And for the whole household, it keeps an important person connected to the experiences and relationships that make up their world.
Hearing aid technology is the best it’s ever been
According to the National Institute on Deafness and Other Communication Disorders, fewer than one in three adults age 70 and older with hearing loss who could benefit from hearing aids has ever used them. Among adults ages 20 to 69 who could benefit, the figure is just 16%.
For people whose image of a hearing aid comes from a grandparent constantly adjusting a bulky device, Dr. Oliver and Dr. Sedenka said sleek-to-near-invisible designs and modern technology can be a surprise.
Artificial intelligence is everywhere, so it’s not surprising that hearing aid manufacturers have put this type of computing to use in designing today’s devices.
Some use AI to distinguish speech from background noise and change settings accordingly, while directional microphones can help prioritize sound coming from the person a wearer is facing.
Meanwhile, Bluetooth technology is becoming more standard. Many hearing aids can connect to smartphones or Bluetooth-equipped televisions, allowing phone calls or TV audio to stream directly through the hearing aids.
Sponsored by Dirigo Hearing Center
Providing customized and compassionate care to our neighbors in Biddeford, Maine.
Learn more about Dirigo Hearing Center
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