Me: Mrs. Jones, Where Is Your Hearing Aid?
Mrs. Jones: What?
Me: YOUR HEARING AID! WHERE IS IT?
Mrs. Jones: The nurse has it in her closet.
Me: I’LL BE RIGHT BACK!
Research shows that people with untreated hearing loss have a higher risk of depression than those wearing hearing aids. I believe it. Imagine sitting in the hallway and you can’t hear a thing your neighbor is telling you, while everyone around you is laughing at the joke. Imagine the aides and the doctors talking to you and you realize it’s important, but have no idea what they’re saying. So you ask again, still can’t hear, and then fake it, pretending to understand.
If our residents can’t hear, let’s put in an ENT consult and get the hearing aid process started. And if they’ve got hearing aids, let’s take them out of the closet.
The good news is that a recent study showed that within three months of hearing aid use, residents showed a significant improvement in cognitive and psychosocial functioning.
One caveat is that sometimes people hate wearing hearing aids (It doesn’t look nice; it shows that they have a deficit; it interferes with other electronic devices; it is sometimes unpleasant to have everything amplified, including background noise…)
For some people, hearing aids don’t help much. It’s the same with glasses. Not all visual impairment can be effectively “resolved” even when glasses are available.
That makes me think of dentures. I had one resident who actually preferred eating without his dentures.
As much as possible, we’re taught to face the person when we speak. Some older adults can actually get more out of our facial expression, lip movement, and gestures. If they are literate and not visually impaired, writing things down may also help.
I went to a seminar last week. One of the risk factors for delirium in inpatient settings among geriatric patients, not surprisingly, is hearing and visual impairment. So, making sure they have their hearing aids and glasses often helps! 🙂
C — It’s certainly true that some residents don’t want to wear hearing aids for various reasons, but I’d guess there are more that want to wear them but they’re lost, put away for safe keeping, or the residents aren’t aware they can get hearing aids. And there are those who have become so withdrawn because they can’t hear the world around them that they lose cognitive functioning or appear to have, so no one talks to them. I think it’s remarkable that three months into getting a hearing aid, cognitive and emotional losses are reversed. You make a good point about facing the residents when we talk to them. We can also close the door and turn off the TV when there is something important to communicate.
More and more I have come to realize that hearing loss is right up there with dementia in terms of social isolation and just plain feeling “invisible” as we age , grapple and struggle with LOSS, in general. I sometimes ask myself do these “losses” somehow function appropriately on other levels. Does the brain appreciate a diminished capacity for sensory overload? I have observed as I am sure all of you have that sometimes our Residents are selective in terms of their hearing, what they are seeing and what they are understanding.. Quite simply, they don’t want “too much information” Don’t get me wrong, I am all for adaptive devices that improve the functioning of these aging senses,BUT are our Residents???? All too often, I find them to be resistive to trying or maintaining the usability of adaptive devices. Is there something to that?
Genie, there’s some thinking that as we get ready to leave this world, we withdraw from external stimuli and that it’s normal. Some residents are doing this when they stop reading the newspaper and focus more on their immediate surroundings. Sometimes when I ask someone the date, they tell me that time is meaningless to them so they’ve stopped keeping track. But sometimes their claim it doesn’t matter is a coverup for not being able to remember. Similarly, stating they don’t want to hear and so they don’t need a hearing aid could be a coverup for the concern that no one will talk to them even if they could hear. It could also be low self-esteem — the staff shouldn’t go to so much bother for them — or depression — what does it matter?
I ‘hear” what you are saying (no pun intended….,hehehe), but, I guess what I’m suggesting is that I honestly don’t think they are covering up a depression in all cases. Just because, as I age (59) I, too am less concerned or interested in absorbing and assimilating too much in the way of material things, pop culture/media option overload and useless babble/banter/conversation.(all of which requires good hearing, eyesight and good cognition) There is a part of me that thinks my brain isn’t the powerhouse sponge it used to be that could process it all in. And, I’m OK with that. I can only imagine that when I am in my 80’s or 90’s I will be more content with less static,, information and embrace simple pleasures that are more contemplative. Having said that, sometimes, I think we, as younger adults project our perceptions of what appears to be depression/boredom and mistake it for a natural and gradual “shut down” of the brain. This process, I think, helps people come to terms with and gradually navigate the end of life process.
Believe it or not, sometimes with very HOH Residents ( who don’t like/or have their hearing aides) I will use a paper towel cardboard roll and press it gently to their ear while I speak to them in a normal tone. It is amazing how they perk up and enjoy a clear dialogue!!
I agree, Genie — they’re not covering up depression in all cases. The sensory withdrawal from the world can be adaptive. David Solie talks about changing abilities and the changing of priorities in life as we age (and the generational communication difficulties they can cause) in his excellent book, How to Say It to Seniors. I do believe some of our residents don’t have interest in hearing, or seeing, as much and it’s okay. But I think more of our residents than we realize would become more active and engaged members of our nursing home communities if given the opportunity to hear what’s gong on.
Me: Mr. Smith, where Is Your Hearing Aid?
Mr. Smith: What?
Me: YOUR HEARING AID! WHERE IS IT?
Mr. Smith: The nurse has it. I’ve lost it twice already, she wants to hold on to it so it doesn’t get lost again.
LOL. I’ve heard this same conversation! It makes me think we need a better procedure for keeping track of hearing aids. For example, dentures go in those little blue cups and are kept in the residents’ rooms and my impression is that they don’t get lost as often or as easily as hearing aids. (At least not in the rooms — I’ve heard multiple stories of residents taking out their teeth to eat, wrapping them in a napkin on their tray, and then the tray was cleared along with the dentures.) Perhaps if we had a distinctive hearing aid holder that’s kept in resident rooms, we’d have better luck in keeping track of them.