Several years before my Mom was diagnosed with Alzheimer’s, my brother contacted me about Mom’s behavior at a family gathering (which I did not attend.)
He stated that he’d tried several times to have a conversation with our mother to no avail. She would either talk in circles, having no idea what my brother was saying despite his repeated attempts to make a simple point clear. Her answers were inappropriate and her comments didn’t match the conversation in progress.
My mom had worn a hearing aid for many years and both my brother and I agreed that it probably needed testing and perhaps an upgrade. I hadn’t seen any signs of confusion in my own conversations with her, but our topics of interest were pretty much the same all the time, so Mom could easily talk to me with her ears closed.
However, as I thought about it, she had been more intent on facing me as we spoke as of late, yet I assumed most people who wore hearing aids did their fair share of lip-reading and dismissed any thought that mom needed anything more than a new battery for her hearing aid.
Later in the week, I made a point of checking the batteries in Mom’s hearing-aid only to find that they were properly charged.
That very week, I scheduled an appointment with a specialist for a complete check of Mom’s hearing and her hearing-aid. Her protests to such testing were a little puzzling as Mom never had an issue with doctor’s appointments which always meant lunch at her favorite restaurant afterward.
During the hearing test that day, I gained quite an insight into Mom’s hesitancy to have her hearing tested at all.
- I was shocked to learn that Mom was totally deaf and when her old hearing-aid was tested it was totally dead as well. The battery was fine, but the hear aid itself was no longer working. Not a single sound could be heard from that antiquated hearing-aid even with brand new batteries.
When I stood directly behind Mom, where she was unable to read my lips, there was no reaction to my voice at all. She could not hear a word said.
- I was stunned, remembering that Mom had worn her hearing-aid religiously and touted the benefits of that hearing-aid on a daily basis.
Yet, it had all been a ruse, Mom had to know she was totally deaf, yet she resisted a doctor’s appointment or new hearing aid to bring her back into the “hearing world”. It seemed a complex and confusing proposition to me.
With the assistance of a temporary hearing-aid, Mom was given another test. The hearing specialist spoke 100 words, one at a time, while Mom repeated each word that she actually heard. Mom failed to repeat a single word correctly. Not one word repeated correctly out of 100! And Mom was wearing a hearing-aid that did work!
I later learned that such hearing problems often show up as an inability to understand speech against a background of other conversations, sometimes called the “cocktail party effect.” Amplification with hearing aids does not help this form of auditory defect.
The specialist who worked with Mom said Mom no longer recognized the sounds of consonants at all. As hearing loss progresses, the comprehension to hear and understand consonants and their sounds is the first to be lost. So when a word was repeated, Mom could only guess which “consonant” sound might be used, thus guessing wrongly on all 100 words.
The technician reassured me that a good electronic hearing-aid worn at a recommended sequence, might assist Mom in a return to hearing and the recognition of consonants. But the affirmative message was offered with a warning–some patient’s are deeply opposed to a return to hearing when they’ve learned to adjust in their silent world so well.
I found that hard to believe and never considered that my mother would choose a silent world over her cheerful friendships with other people.
Unfortunately, Mom was one of those in opposition to returning to a “hearing world.”
On the way home the very first day with her brand new all electronic hearing-aid, Mom removed it in the car because my auto air-conditioner’s buzz was deafening to her. A buzz, I might add, that I had never heard and strained to hear after Mom grudgingly acknowledged its existence.
Her prescribed schedule was to wear the new hearing-aid 4 hours a day for 3 days a week. And only 2 hours on weekends. Once they became accustom to hearing again, the technician said, they would gradually begin to wear the hearing-aid all the time.
Mom wore it if family was present, because we insisted, but she never wore it when she was alone. She read lips so well that I hadn’t known she was deaf and she continued to function well enough without the hearing-aid that she never wore it in the “Group Home,” where she finally resided.
Though Mom had not been diagnosed at the time of that hearing test, I wonder if the confusion in her answers of the 100 words was from dementia, rather than a lack of hearing consonants as the technician projected.
In a study of 313 patients at least 71 years old, several measures of central auditory processing were impaired in those diagnosed with Alzheimer’s disease and, to a lesser extent, those with memory impairment but not meeting criteria for Alzheimer’s, reported George A. Gates, M.D., of the University of Washington, and colleagues in a recent issue of Archives of Otolaryngology and Head and Neck state that: Central auditory processing is the brain function involved in interpreting complex sounds such as speech “Hearing speech involves detection, recognition, and comprehension, the latter being clearly a cognitive task,” said Dr. Gates.
Another paper from the same group has been accepted by Ear and Hearing for publication this fall, Dr. Gates said. “This leads me to believe that it is the brain effect on hearing that is the major problem in the elderly and wearing a hearing aid does not help,” he said. The study was supported by the National Institute of Deafness and Other Communication Disorders and the National Institute on aging.
So for me, the question still exists.
Does Dementia appear first and impair cognitive thinking, or does hearing loss appear first and impair cognitive thinking by the elimination of consonants and thus, cause Dementia. As with the chicken and the egg, we don’t know which comes first.
My brother and I have both discussed this issue and he has determined to have his hearing checked and get a hearing aid since he is having minimal hearing issues. So far, I don’t have hearing issues, but if I do, I believe I will follow his lead and seek hearing aids right away.
Even if Alzheimer’s or Dementia weren’t involved, it broke my heart to see Mom try so hard to wear the new hearing aid. She just couldn’t do it. She’d adjusted to a silent world. If a good hearing aid is sought at the first sign of hearing loss, that can be avoided.
And, I know from my own mother that it was gradual, many years of ignoring a continuing loss of hearing until she finally existed in a silent world. I’m certain she never realized she would one day be completely deaf.
If you’ve had any experience with hearing loss and symptoms of Dementia, I’d surely like to hear what you think on this issue. Feel free to leave Feedback or Comment!
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