People with dementia can experience additional difficulties with their hearing, aside from those traditionally related to ageing. They may experience problems identifying what a sound is, or picking out one sound from another. As a result, it can be difficult for them to process and understand what they are hearing and communicate a response. This can lead to the person becoming withdrawn, as well as feelings of anxiety, frustration, confusion and distress.
Dementia can have an impact on the way a person interprets information, so their hearing may be fine, but they may find it difficult, or they may take longer, to work out what is being said to them. They may struggle to distinguish between multiple sounds or conversations. Loud or sudden noises may also startle or frighten them.
Hearing loss and dementia
Recent studies have revealed a link between hearing loss and dementia. People with hearing loss appear to have an increased risk of dementia. It is not clear yet if developing dementia is related directly to hearing loss, or if difficulty hearing occurs as a result of dementia.
If you believe that someone with dementia is struggling to communicate, try to recognise this and respond sensitively. It can help to give them lots of time and prompt them, if this seems helpful.
Organise a hearing test
The most important thing for anyone who appears to be having hearing difficulties is to organise a hearing test. It might simply be that the person has a build-up of wax, or it could be age-related hearing loss and they may benefit from a hearing aid. A person with dementia can be referred by their GP to an audiologist (hearing specialist), some of whom specialise in dementia. If someone with dementia goes on to be diagnosed with a hearing loss, they may find it harder to adapt to a hearing aid and need extra support.
If the person is already a hearing aid user, it is important to get their hearing aid checked and maintained regularly to make sure it is working properly. Hearing aid batteries need to be changed frequently and hearing aids often beep when they need to be changed. This may cause confusion for a person with dementia.
Deafness and dementia
If a person was deaf before their diagnosis of dementia, and a British Sign Language (BSL) user, they may need more specialist support. For example, if they need a carer to help them with personal care such as washing and dressing, someone that understands sign language might be better placed to help them. A carer may need educating in some basic signs ie, toilet, thirsty, hungry. Or the carer could show pictures to illustrate what they are going to do.
As with anyone with dementia, sign language users could experience communication difficulties and may forget or mix up their signs. Some people may revert to signs they used in earlier childhood or have reduced hand movements. Giving the person lots of time for communication, and being aware of non-verbal cues, such as pointing or facial expression can be helpful.
Ways you can help
Dementia can affect the way a person processes and interprets information. If someone is having difficulty with sounds, there are several things you can 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 television, radio or background music when you are talking to a person with dementia
Face the person and make eye contact: between 60-80% of communication is non-verbal (tone, gesture, body language). Speak slowly and clearly, using simple words
Use pictures if a person with dementia is struggling to understand what you are saying; for example, you could print out pictures of food and drink to find out what meals they prefer
Provide reassurance. Sometimes people with dementia hear sounds but are unable to give them context. For example, a washing machine beeping or car doors slamming could cause anxiety if they cannot understand the cause of the noise. Sit with the person and calmly reassure them there is nothing to worry about
Try to write things down for the person if they are struggling to hear. Many people with dementia can find it easier to understand written, rather than spoken, words
It is important to consider the person’s personal 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, so that a call centre is alerted if they are activated. If someone you care for would benefit from this, contact your local authority’s social services department.
If you are concerned about a person with dementia’s difficulty with sounds, you can contact your GP, an audiologist or Dementia UK’s Admiral Nurse Dementia Helpline on 0800 888 6678.
Sources of support
Dementia UK leaflet on Tips for better communication: