MGordon_MD
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Feb 8, 2008, 8:40 AM
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By Dr. Michael Gordon
It was a story I had heard many times before. “He cannot stand the hearing aid – it sits on his night table.”
When I ask how long he had it, the answer is, “A couple of years, and we keep going back for adjustments, but he says it is not for him.”
This is often the story I get when undertaking a geriatric assessment, including those for loss of memory and other cognitive difficulties.
Many years ago, the issue surfaced with my father, then 88 years old and now 96. First was the usual barrier of denying a hearing problem. “I hear fine” was his answer to the suggestion that sometimes there were problems, especially hearing people on the phone. My sister and I, who lived far away from him, commented on the number of times we would repeat ourselves during phone calls.
When we visited him, we tried various tactics, including my bringing to him in New York a simple external amplifier, which I bought years ago for $10 at K-Mart. My father put it on and after some simple adjustments, we could talk to him effectively in normal tones – but he still said an aid was not necessary.
We modified his phone and television for amplification, which helped a bit. He was reluctant to get an aid because of the cost – but mostly because he did not think he needed it.
During a visit to Toronto, he had a hearing assessment at Baycrest’s audiology department. It was explained to him that, indeed, his hearing was fine, but his ability to discriminate words was faulty. However, he would not accede to the need for a hearing aid and still does not have one.
I have seen patients over the years who were referred to me for dementia and who clearly had a substantial hearing impairment. Sometimes, in order to convince them that their hearing could be improved, I use the little amplifier gizmo that I used with my father, and in the office speak, to them through it. Not infrequently, they perk up and look at me and admit they are hearing better. But from there to a hearing aid are a number of big steps.
I have now had a few dramatic cases in which what was believed to be a problem with memory evaporated as soon as the person used a hearing aid consistently. When he/she could hear conversations, instructions and questions, then he/she responded knowingly rather than guessing.
Changes in hearing-aid technology may make elders more receptive to using hearing aids. Users of open-fit or non-occlusive aids often complain that their ear feels “full” or “stuffed” because the whole ear canal is blocked by the aid. With the new design, the receiver is a small unit behind the ear with a very fine, almost invisible, plastic tube that connects it to the part in the ear yet does not close it off – so that annoying “full” or “stuffed” feeling is absent.
Improving hearing is generally an important goal for elders. For those in whom the possibility of cognitive impairments exists, the goal of improving hearing becomes even more essential. It is worth pursuing available help and sticking to it, as eventually most people do get used to the aids and benefit from their use.
This article originally appeared in The Canadian Jewish News.
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Dr. Michael Gordon is Medical Program Director, Palliative Care Baycrest Geriatric Health Care System in Toronto, Canada and Professor of Medicine, at the University of Toronto. He is co-author with Bart Mindszenthy of Parenting Your Parents.
Parenting Your Parents is available in bookstores and online at: Indigo-Chapters, Amazon and Barnes & Noble. It is available in a US edition: Parenting Your Parents: Support Strategies for Meeting the Challenge of Aging in America.
For bulk orders email info@dundurn.com. Call: 416-214-5544 or Fax: 416-214-5556
(This post was edited by MGordon_MD on Feb 8, 2008, 8:46 AM)
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