Hearing Loss and Memory Loss

1. Hearing Loss and Memory Loss Presented by: Rich Diedrichsen; Deaf and Hard of Hearing Services Division; DHS

2. This workshop • The purpose of this workshop is to help you recognize similarities in the observed behaviors of people with hearing loss and people with dementia like symptoms. • I hope this information will help you better serve the people you work with. • Understanding the reason for behaviors can help you better work with the person.

3. What we know about hearing loss Hearing loss affects: • 15 percent of the total population • 1 of every 3 people over age 65 • 1 of every 2 people over age 70 • These numbers will grow in the next 20 years as Baby Boomers age

4. Relationship between hearing loss and dementia like symptoms • Age is a factor in likelihood of developing either condition • Nothing about developing hearing loss prevents one from developing dementia like symptoms and vice versa • Some research recently suggests correlation between development of dementia if someone has a untreated hearing loss • Studies also suggest that treating hearing loss leads to improvement in function for patients with Alzheimer's disease or Dementia

5. Untreated hearing loss often leads to… • Withdrawal and isolation • Misunderstandings and mistakes • Confusion that prevents us from doing what we are capable of doing (following directions) • Depression And the correlation between the symptoms listed above and memory loss symptoms is well documented

6. Quick Test; How to spot hearing loss • Often asks you to repeat things • Turns volume up loud on TV/Radio • Frequently responds with a smile and a nod without further comments • Seems to withdraw, especially during group discussions (activities) • Totally monopolizes the discussion • Frequently misunderstands similar sounding words

7. Treated hearing loss • There is much less evidence showing any link between people with treated hearing loss and the risk of developing memory loss symptoms – unless the person has memory loss conditions before they acquired the hearing loss • There is research showing that when people with hearing loss receive effective treatment, their memory loss symptoms can mitigate – even in cases where the person has a diagnosis of Alzheimer’s Disease

8. What is known about memory loss • Memory loss can be diagnosed (95% accuracy) • Gradual on-set is common with memory loss (and hearing loss) • Although the symptoms may mimic hearing loss, there are ways recognize what is likely the cause of these symptoms (later recall) • A person can have both hearing loss and memory loss at the same time.

9. Quick checks • If the person is given information visually, or clearly so they “hear” and “understand” it, do they still have memory problems related to the information? • If they misplace items, do they later remember where they left them? • Do they understand some of what they are told but confuse a few words? • Do they show any other of the behaviors or actions common for memory loss conditions?

10. Alzheimer’s or Hearing Loss?

11. Similarities-Risk Factors • Age (over 65 1-8 memory loss; 1-3 hearing loss) • Genetics • Head Trauma/Stroke • Damaged Heart Vessels • Diabetes

12. Differences • Memory loss more common in women; Hearing loss in men (this is changing) • Diabetes in mid-life more a factor in memory loss • Noise more a factor in hearing loss

13. we know.. • Not all memory loss is caused by Alzheimer’s Disease. • There are some treatable conditions (depression) that can lead to memory loss • Knowing the cause of the memory loss can lead to effective treatment – and programs • Knowing that hearing loss is the cause/contributing factor of behaviors can lead to effective treatment and programs

14. Thus… Because hearing loss and memory loss are Common Conditions in the same population we need to be sure we are recognizing and addressing the right condition when we design accommodations and programs. IF YOUR BATTERY IS DEAD, IT WILL NOT HELP TO CHANGE YOUR TIRE.

15. Assumptions are common; but not always accurate If the dog is in the room, it is easy to blame the dog. If someone has memory loss or a hearing loss, we should NOT Assume that everything unusual (abnormal) that they do is because of the memory loss or hearing loss.

16. The “Deaf Community” • Elderly Deaf persons make up about 9% of the whole elderly population of the U.S. • 45% of the Deaf population is “elderly”

17. Where to start • Check the person’s medical history • If something is not clear, do not guess; there are reliable tests for diagnosis of Alzheimer’s Disease or Dementia like symptoms • Payment could be an issue, but misdiagnosis is also and issue – and sometimes expensive • If the person has never been screened for hearing loss, this should be done • If there is no hearing loss, we have guidelines for treating and developing programs for memory care needs • If the person has both conditions, we may need to change the way we provide care

18. If there is no medical diagnosis or the diagnosis is old… • Has the person ever been evaluated for hearing loss? When? • If yes, what happen? Hearing loss does not go away on it’s own • Has a hearing aid ever been recommended/worn? • Does the person’s medical/life history indicate risk for hearing loss?

19. Why screen/test someone for hearing loss? • Self-reporting is not often accurate • People handle bad news (news they do not want) with fight or flight • Old news is often just that; People change, health changes • Some people do not know what they do not know; what they do not hear • Who told you that? Just because your situation seems like same thing Uncle Hugh has, does not mean it is the same thing!

20. What is recommended when checking for hearing loss? • Past history, family history (like memory loss, hearing loss can run in families), work history • Up-to-date medical and professional audiogram exam MEDICARE It is tricky to get testing for hearing loss; there is no coverage for checking for the need for hearing aids. This should not end your efforts!!

21. If Insurance/Medicare is not an option • Contact the person’s case worker – check on EW • Is the person a Veteran? • Contact PHN, University programs, Civic Clubs (Lions International has a clinic at the U of M), other options • Contact your local DHHSD Office • Ask the family if they can help

22. What to do: • Once it is determined if the person has a hearing loss disability; memory loss issue or a combination of both conditions, the next step is to design a program of services and activities to help them. • This is best accomplished with a multi-discipline team approach

23. Programming and care: • Program should keep the person physically, mentally and socially active as much as possible. • Continued mental and audio/speech stimulus will do the most to maximize ability to use the senses • What is possible for hearing aid(s); Assistive Technology and/or aural rehabilitation?

24. For the individual? • What are they capable of related to technology care? • Is there a risk they may discard/damage the devices? • Routines help • Where is the devices kept regularly • How are batteries checked • How is unit serviced • How is device set when turned on

25. For Staff/Caregivers: • What does the individual need related to technology care? • Does the individual need help to check the devices for damage? • Routines you can help with help • Where is the devices kept regularly • How are batteries checked - changed • How is unit serviced - cleaned • How is device set when turned on-set to the right setting

26. Key consideration Unless we make sure that the hearing loss is we cannot accurately know the extent and progression of the person’s memory loss

27. Food for thought People who are Deaf are more likely to have a caregiver who is a family member or close Friend Communication is needed!

28. Desert for Thought People with un-treated/undiagnosed hearing loss and hearing loss will; Progress more rapidly through stages Receive minimal benefit from programs and services Be a greater burden (stress) for caregivers because of communication problems

29. Notable quote “Well I forget things…but I don’t want to go in a home with hearing people; Being with hearing people is LONELY”

30. How to modify programs for people with MCI or Alzheimer’s Disease - Early • Reminders of appointments • Help remembering names/words • Managing money • Managing Medications • Organization help What are communication and safety needs?

31. Middle Stages • Adapt daily routines • Provide structure • Develop strategies for using coping techniques • Provide additional care • Provide more help with staying active, mentally and physically

32. Late/End Stages • Preserve quality of life • Soothing and Comforting • Provide full care You cannot do this without communication in their preferred mode

33. Your turn Do you have questions I have not answered or situations you would like to discuss? What can I do the make sure you walk away from this workshop with answers?

34. Resources: • DHHSD Offices • www.Caregiver.org • www.alz.org/care • www.meetingsofthemind (also look into their conferences • www.mayoclinic.com/health/dementia /DSO1131 • Rich.diedrichsen@state.mn.us

35. Finally: Thank you for allowing me to be a part of your day via this workshop As you learn new things, please share them with me and others so we can do the best possible job and assuring a quality of life for people with memory loss and hearing loss Rich Diedrichsen