HEARING LOSS AND MEMORY LOSS

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HEARING LOSS AND MEMORY LOSS

• PRESENTED BY
• Rich Diedrichsen
• Deaf and Hard of Hearing Services Division -- DHS

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DISCLAIMER

• This workshop will not offer you any information
  on the prevention, treatment of cure of hearing
  loss or memory loss. The purpose of this workshop
  is to help you to recognize the similarities in
  the outward behaviors of a person with either
  condition, or both conditions. The hope it that
  with this knowledge you will be able to better
  help the people you work with benefit from your
  programs and services.

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What we know about hearing loss

• Hearing loss affects 1 in 4 people over age 55
• Hearing loss affects 1 in 3 people over age 65
• Hearing loss affects 1 in 2 people over age 70
• There is nothing innate about hearing loss that
  prevents memory loss
• There is noting innate about memory loss that
  prevents hearing loss
• Both of the latter two conditions are most common
  in people that you are likely to serve with your
  programs or services

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What we know about memory loss

• Memory loss affects is more common in people who
  are older
• Memory loss like hearing loss can be a gradual or
  sudden on-set condition or both conditions could
  occur at the same time
• There is nothing innate about memory loss that
  prevents hearing loss
• There is noting innate about hearing loss that
  prevents memory loss
• Both of the latter two conditions are most common
  in people that you are likely to serve with your
  programs or services

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Symptomatic Similarities of Alzheimers Disease
and Untreated Hearing Loss

• Alzheimers Disease
• Depression, anxiety, disorientation
• Reduced Language comprehension
• Impaired memory (esp. short-term memory)
• Inappropriate psychosocial responses
• Loss of ability to recognize
• Denial, defensiveness, negativity
• Distrust and suspicion regarding others motives
• NATIONAL COUNCIL FOR BETTER HEARING

• Untreated Hearing Loss
• Depression, anxiety, feelings of isolation
• Reduced communication ability
• Reduced cognitive input
• Inappropriate psychosocial responses
• Reduced mental scores
• Denial, heightened defensiveness, negativity
• Distrust and paranoia (e.g. belief that others
  may be talking about them)
• Cartrqnd MS Alzheimers Hearing Loss.
  Professional Education Course, International
  Institute for Hearing Instrument Studies Livonia,
  MI

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ANOTHER DISCLAIMER

• Since the previous slide referred to the
  similarities between Alzheimers and Hearing
  Loss, it needs to be said that not all memory
  loss is the result of Alzheimers Disease, but
  many of the symptoms are the same and many times,
  no matter what the cause or extent of memory
  loss, the same misunderstandings can occur.

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Human Nature is Natural

• IF THE DOG IS IN THE ROOM,
• IT IS CONVENIENT TO BLAME THE DOG
• So
• If we know someone has memory loss or hearing
  loss, we should
• NOT
• Think that everything unusual that happens can be
  blamed on the condition we already know they have

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WHEREAS.

• Because Hearing Loss and
• Memory Loss are
• COMMON CONDITIONS
• In the same populations we need to be sure we are
  recognizing and addressing the the right
  condition when we design accommodations or
  programs to help.
• IF YOUR BATTERY IS DEAD, IT WILL NOT HELP TO
  CHANGE YOUR TIRE

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WHAT TO CONSIDER

• Hearing loss and memory loss are common in the
  same population
• Hearing loss and memory loss have some of the
  same outward symptoms
• The strategies for treating hearing loss and
  memory loss are not the same so we need to know
  what we are working with
• Sometimes both conditions may be present and we
  will have to adjust the service plan to work with
  both conditions

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In order for things to become memory they must

• Be communicated to the person
• Be heard by the person
• Be understood by the person
• Then the person can store the information for
  further retrieval
• Hearing loss can cause a breakdown at any point
  in this process and unless one knows that the
  breakdown was the result of hearing loss, one
  might assume that there is another cause

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Where to start

• Check the persons medical history, family
  history (both conditions are known to run in
  families and intake screening materials hold
  that thought about screenings
• If something is not clear, dont guess and dont
  let others guess. There are good tests out there
  for memory loss and hearing loss. Payment may be
  an issue, but misdiagnosis is also and issue
• If the coverage is JUST NOT THERE then maybe this
  workshop will give you some ideas that can help

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A WORD ABOUT SCREENINGS

• Screening data is self reported or reported by
  the family, or responsible individual, who is
  helping to check the person in.
• People handle bad news the way they do any threat
  fight or flight
• Some people do not know what they do not know
  this is not wrong
• Old news is no news how recent in the medical
  or other information?
• Who said that? And, just because it seems like
  the same thing uncle Hugh has, doesn't mean it is
  the same thing

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OH, BY THE WAY

• When doing the screening, if the person is
  answering for themselves, make sure you
• Set up the best communication setting
• Note if the person has hearing aids
• Ask if they have hearing aids and are they in
  good working order
• Use ALDs if you can/need to
• Use good communication practices
• In other words give them the best chance to show
  what they can do

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Checking for hearing loss

• TO THE EXTENT POSSIBLE, CHECKING FOR HEARING LOSS
  SOULD INCLUDE
• Past history, including accurate and up-to-date
  medical, family, work, etc.
• MEDICARE It is tricky to get testing of hearing
  and they will not cover testing if it is for the
  purpose of checking the need for hearing aids.
  This should not end the effort!

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What is included in a good hearing exam?

• There is tons of information on this on the
  internet, of contact a medical professional who
  specializes in this field. No coverage? Contact
  your local DHHS office, PHN, University, School
  Audiologist, Hearing Loss Association of America,
  Civic Club (Lions have a clinic at the U of M)
  etc. If the person is a vet, use the VAMC!

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Most common elements of a hearing exam

• Pure tone test
• Word recognition test this is a way to look at
  consistency and also will help with language
  check
• ALSO
• Tests with background noise
• Tests with/without hearing aids
• Re-test when results are doubtful
• Asks me why these are needed??!

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POSSIBLE GLITCH

• People with memory loss or Alzheimers Disease
  may not be able to give you and accurate test
  inconsistency is a red flag

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After ruling out hearing loss

• Check for other medical/mental health conditions
  that could be the problem depression is one,
  conditions that cause fatigue also could be an
  issue

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What if there is good reason to suspect memory
loss?

• Get a complete exam Contact your local chapter
  of the Alzheimers Association to find out what
  should be checked and how to check it
• Get information from someone who has the
  background and training in working with people
  with memory loss to help you design a program of
  service plan
• If is almost impossible to have a reliable exam
  if the testing was not done by a qualified
  medical professional

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Consistency should be consistent

• People with hearing loss may be able to do well
  in some settings and not too well in others
  dose the person do well when you are certain they
  understood the communication?
• People with true memory loss conditions will not
  always show this type of inconsistency.

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CONSISTINECY?

• It is possible to have inconsistency with hearing
  tests even when there is no memory loss concerns.
  Hearing can vary with fatigue, illness, etc.
  However, there should be some patterns and a good
  audiologist should be able to help you spot the
  common
• With memory loss the one thing that is consistent
  most of the time is that when you loose something
  it does not come back.

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QUICK CHECK ON INCONSISTANCY

• Try talking to the person using clear speech
• Clear speech is speech that is
• Accurate and fully formed
• Naturally slower (your voice raises automatically
  when you attempt to be clearer)
• Lively, with full range of voice intonations
  (tone) and stress on key words
• Characterized by pauses between all phases and
  sentences
• (I have an handout on this)

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More checks use the good communications tips

• Converse in a quiet environment free of
  distractions
• Communicate where light is good
• Get the persons attention
• Make sure your face is visible
• Clear speech
• Maintain eye contact
• Use facial expressions
• One fact at a time
• Rephrase your statements if the person does not
  understand (this could cause some problems with
  memory loss)
• Get some feedback
• SEE HANDOUT
• These tips could help with memory loss too

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So weve completed the testing and diagnosis now
what?

• Good communication techniques work for any
  conversation
• Memory aids help all of us
• If you are doing the same thing with the same
  results every time, it is easier to pick up
  changes
• Besides it is easier to do things the same way
  with everyone and not have to remember to change
  the rules from person to person

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What to expect.

• Normal is not always the norm and consistency is
  sometimes not consistent
• Allow for normal variances in human behavior, for
  normal fluctuations due to health, medication,
  energy, mood, etc.
• The difference between normal and abnormal
  behavior is frequency, duration and extent.
• Richs long ago psychology professor

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Other considerations

• Tools work, when tools are cared for, but some
  people dont know how to care for their tools.
• Richs Father
• Few people with hearing aids or assistive devices
  have been told how to care for them much beyond
  keep them clean and dry, change the batteries,
  and dont drop them. Even people with this
  information often forget. People with memory loss
  will should be expected to need help.

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More

• THE PROBLEM WITH FISHING TIPS IS THAT FISH DONT
  KNOW THEM. WHEN IS THE LAST TIME YOU SAW A FISH
  WITH A WATCH OR A CALENDAR?
• MAKE ADJUSTMENT, BUT DONT GET IN THE HABIT OF
  DOING SO BECAUSE IT IS CONVENIENT.

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Finally.

• Experts need to make a living too!
• Know what you know,
• Know what you dont know
• Know where to find it,
• Know when to refer
• Gail Anderson, SCSU

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Questions?

• What did I not answer?

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For more information..

• Rich Diedrichsen
• 3333 West Division
• Suite 209
• St. Cloud, MN 56301
• Rich.diedrichsen_at_state.mn.us
• 1-800-456-3690 (voice)
• 866-588-2282 (VP)
• www.dhhsd.org
• www.deafblindinfo.org