By Roberta Marino, Audiologist, Ear Science Institute, WA© dementiacareinternational
‘Mavis’ sat in front of me wringing her soft, wrinkled hands together, the pain and frustration clear in her eyes, ‘I can’t hear like before, what’s happening?’
Mavis had come to our hearing clinic to get a second opinion and I had no answers. Five years earlier, she had been a cochlear implant success story, receiving the gift of renewed hearing after living without sound for twenty years.
Now that gift of hearing was fading away and with it, Mavis’s independence. She could no longer hear on the telephone or communicate with family without written notes. Her grandchildren’s voices were so distorted, Mavis described them as little ‘Daleks’ (from Doctor Who) because of their changed voices.
I checked all external and internal parts of the cochlear implant and nothing seemed wrong. I couldn’t explain the distortion or decrease in hearing though it was obvious something was amiss with Mavis.
Mavis had memory loss and found it difficult to retain even non-verbal information and it was difficult for her to understand tasks despite extensive written explanations. Mavis also demonstrated problems finding words and experienced abrupt changes in mood and behaviour within a session. She often appeared suspicious of our team and even her own daughter when she came to support her mother.
Everyone was starting to think that the changes in Mavis’s functioning and behaviour, together with her decline in being able to use the cochlear implant, were all due to the early signs of dementia. At 84, she was within the age range where this appeared the likely explanation.
After months of trying to find a solution, we decided that we could do no more for Mavis. She was becoming increasingly frustrated and aggressive to deal with and started to withdraw socially as communication became increasingly difficult. All the gains that Mavis had made over the years were starting to slip away and this sophisticated lady, who had a reputation for her wit and social skills, was becoming a recluse.
I organised an assessment with a psychologist to confirm that Mavis had the early signs of dementia. I do not know exactly what she was thinking but there was flash of understanding when I told her, ‘I think you should see the psychologist.’ She knew we thought that she was ‘losing it.
When the results came back, I was surprised! The psychologist had done a non-verbal test on a variety of different cognitive functions and all had come back normal! Our assumptions were wrong.
With professional support, we totally changed the way the implant delivered sound to Mavis and it worked. Immediately after the program was changed and activated, Mavis started responding appropriately to what we said. What was interesting is that her thought patterns and the way she understood situations were also completely different. The lights switched back on for Mavis! She was the vibrant, cheeky person her family knew and her comprehension, memory, and word-finding skills improved. For whatever reason, Mavis’s processing of sound had changed over time and it needed a new program to tap into this new way of processing.
Mavis’s story highlights that a loss in hearing ability can easily be mistaken for dementia. I know that we would have been less likely to jump to that conclusion if Mavis had been 30 years younger.
A hearing test is vital for all people who have symptoms of dementia as the symptoms of hearing loss and dementia can be quite similar. Hearing loss can also exaggerate the symptoms of dementia.
Having a hearing loss in itself can be a major challenge for affected individuals and misinterpreting hearing loss as dementia can be devastating. It is also important to deal with a hearing loss promptly if the person also has dementia, as this can hasten cognitive decline.
If there’s something amiss with a person’s hearing, the lights can be switched back on!
To organise a hearing test, contact an audiologist who is university trained to perform thorough hearing tests.
Hearing tests are free in Australia for pensioners through the Office of Hearing Services 1800 500 726.