Dementia and difficulty with sounds

Many people with dementia have trouble hearing, distinguishing between and interpreting sounds, which can make the world a confusing place. We explain why this might happen, and how you can help.

What problems might a person with dementia have with sounds?

While hearing loss becomes increasingly common with age, people with dementia may experience additional difficulties with hearing and interpreting sounds.

Even if their hearing is fine, they may have trouble:

  • identifying what a sound is
  • picking out one sound from another
  • interpreting the information they hear, so they cannot understand what is being said, or take longer to process it
  • distinguishing between multiple sounds or conversations
  • being startled or frightened by loud or sudden noises

As a result, it can be difficult for them to process and understand what they are hearing and communicate their response.

This can lead to anxiety, frustration, confusion and distress, and to the person becoming withdrawn.

Hearing loss and dementia

Recent studies have suggested that people with hearing loss may have an increased risk of dementia, although it is unclear what the link is.

If a person with dementia appears to be having hearing difficulties, book them a hearing test.

They may simply have a build-up of wax, or they may have age-related hearing loss and would benefit from a hearing aid.

Taking a hearing test may be confusing or upsetting for a person with dementia, and if they are diagnosed with hearing loss and need a hearing aid, they may need extra support.

Although some opticians and supermarkets offer hearing tests – which are sometimes free – it may be better for the person’s GP to refer them to an audiologist (hearing specialist), some of whom specialise in dementia.

An audiologist with knowledge of dementia will be more understanding of these issues and be able to tailor the process to the person’s individual needs.

If the person is already a hearing aid user, it is important to get their hearing aid checked and maintained regularly.

If the batteries need to be changed, the hearing aid may beep, which may cause confusion.

Deafness and dementia

If a person was deaf before their diagnosis of dementia and uses British Sign Language (BSL), they may need more specialist support.

For example, if they need a carer, a person who understands sign language will be better placed to help them.

If this isn’t possible, the carer may need training in some basic signs, ie ‘toilet’, ‘thirsty’, ‘hungry’. Or they could show pictures to illustrate what they are going to do.

As with hearing people with dementia, sign language users may experience communication difficulties.

They may forget or mix up their signs, revert to signs they used in childhood, or have trouble making the necessary hand movements.

Giving the person lots of time for communication, and being aware of non-verbal cues, such as pointing or facial expressions, can be helpful.

Ways to help

If a person with dementia is having difficulty with sounds, here are some things you could try.

  • Avoid places with loud or distracting background noise, such as restaurants and shopping centres, which might overwhelm and confuse the person
  • Turn off the TV, radio or background music when you are talking to them
  • Face the person and make eye contact – up to 80% of communication is non-verbal, eg tone, gesture, body language
  • Speak slowly and clearly, using simple words
  • Give them time to process what you have said and give their answer
  • Use pictures to illustrate what you are saying – for example, you could print out pictures of food and drink to find out what they would like
  • Sometimes people with dementia hear sounds but are unable to give them context – such as a washing machine spinning or car doors slamming. This may cause anxiety if they cannot understand the cause of the noise. Sit together and calmly reassure them there is nothing to worry about
  • Write things down for the person – they may find it easier to understand written, rather than spoken, words
A note on safety

It is important to consider the person’s safety if they are having difficulty processing noises such as a smoke alarm beeping.

If this is the case, there are telecare systems that link to smoke alarms/carbon monoxide detectors and alert a call centre if they are activated.

If you think the person you care for would benefit from this, contact your local authority’s Social Services department and request a Needs Assessment – this is an assessment of someone’s care and support needs, and funding may be available to make some adaptations.

Sources of support

If you would like to speak to a dementia specialist Admiral Nurse about someone’s hearing or difficulty with sounds, or any other aspect of dementia, call our free Helpline on 0800 888 6678 (Monday-Friday 9am-9pm, Saturday and Sunday 9am-9pm) or email helpline@dementiauk.org.

If you prefer, you can book a phone or video appointment with an Admiral Nurse at dementiauk.org/get-support/closer-to-home/.

Dementia UK resources:

Tips for better communication
dementiauk.org/get-support/understanding-changes-in-behaviour/tips-for-better-communication/

How to handle communication challenges
dementiauk.org/how-to-handle-communication-challenges/

Coping with distress
dementiauk.org/get-support/understanding-changes-in-behaviour/coping-with-distress/

Changes in perception and hallucinations
dementiauk.org/get-support/understanding-changes-in-behaviour/changes-in-perception-and-hallucinations-in-dementia/

Other resources:

RNID – the national hearing loss charity
rnid.org.uk
Free online hearing check – rnid.org.uk/information-and-support/take-online-hearing-check/

NHS information on hearing aids
nhs.uk/conditions/hearing-aids-and-implants/

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Publication date: January 2021
Review date: January 2023