When a person is living with dementia, it’s important to find out if they have hearing loss, sight loss, or both.
Only when these conditions are identified and managed can carers and family members communicate with
and support the person to live as well as possible.
This person centred approach can improve quality of life and well being.
It is important for care staff to get to know the individual through talking to them and their family,
finding out about their past and what they enjoy doing.
Dr Nansi Cope has been living with dementia and hearing loss for the past five years.
Nancy talks to Nicky, the care coordinator at Lofthouse Grange care home in Wakefield,
about her life, hearing loss and memory loss.
Well you remember what you studied to be? You remember what you studied to become?
Well it was partly for my um – I had to be, to be a doctor I had to, yes.
- You met your husband? - Yes, that’s right, and we both were doctors.
You did something quite special, you opened your own surgery together didn’t you?
Yes I think we did. I can’t remember the – really – it, when I was a doctor there at all now, my memory’s gone so badly.
In retirement, Nansi was very interested in music, painting, her cats,
and where there was a museum at which she was a volunteer.
She enjoyed very much her hobbies and shared them with other people. Unfortunately, with the onset of the deafness
and to some extent the dementia, her social contacts reduced considerably.
Obviously you had a very very busy profession, but you also had time for leisure. You had a love of classical music.
You still enjoy listening to music today don’t you. - Yes I do.
Even with your hearing being quite poor, you still enjoy listening to music.
- Music is my favourite. - You’ve done a lot of painting in the past, a lot of painting.
- Oh yes, I like painting very much. - Some of them displayed in your bedroom.
[laughs]
- We spoke earlier about hearing. And the - - About?
About your hearing. That it’s not as good as it used to be. Your hearing. Your hearing.
No. It isn’t as good. No.
- Does that make you feel isolated at times? - Sorry?
- Does that make you feel isolated at times? Quite lonely. - I do a bit, yes, definitely.
Nansi has had a problem with her hearing for around ten years and her GP has refered her in the past
to an audio clinic and also to a larger hospital for treatment.
- We’ve also spoke about memory loss and how confused you get. - Yes, my memory loss is very bad.
Nansi has had symptoms of dementia for around five years.
We were aware that Nansi was developing memory loss, but there wasn’t any specific diagnosis from the doctor.
In May 2012, she was formally diagnosed with dementia.
Would you say that it frustrates you, not being able to remember certain things?
- Get frustrated. - Yes it does, it certainly does.
- Do you feel sometimes that you miss out on social events, Nansi? - Yes, I do, a little bit.
As far as the hearing loss is concerned, Nansi prefers face to face conversations on a one to one basis.
If you speak slowly, or reasonably slowly, she can usually follow most things.
When someone has both dementia and hearing loss, care staff should be aware of the extra challenges this presents,
both for the individual and those caring for them.
Part of the dementia training is for staff to empathise on a level with residents in different predicaments
and different forms and stages of dementia. Making you actually understand how difficult it is
and realize how important communication between staff and residents really is.
It’s important that care staff get to know a person and find out how the person prefers to communicate
so that care can be adapted to fit their needs.
Caring for people who are living with dementia and hearing loss requires care, attention and patience. Remember, communication is key.
Sight loss is common among people with dementia. Living with both conditions can impact on a person’s confidence,
independence, emotional well being and ability to communicate.
Jim started off in the army and was in there for three years in the Royal Artillery.
He was in there about three years, and then he came out and done his ideal job as a stoker on steam trains.
That was one of his biggest passions.
He did that for many years, until he retired and he moved up to the Lake District,
where he started a B&B with his family, and he was a bar man, because he was a very social person.
He then retired in 1992.
And took the role on of looking after all of his grandchildren, five grandchildren.
Jim Hartshorn now lives in Dalton Court in Cumbria.
He is living with dementia and is almost completely blind.
We find out how life has changed for Jim, living with sight loss and dementia.
Jim has dementia, he has vascular dementia, and he also has blindness in both eyes.
It was diagnosed several years ago and he has arthritis in both his knees as well.
Jim’s sight loss went quite quick and it was confirmed by optician visits and the opthalmologist.
I think the dementia wasn’t far behind after losing his sight
and his dementia, his wife Jean became aware of it when he was attending a day centre
and he was going home and she was asking him what kind of a day he’d had and Jim would reply ‘I haven’t been’.
We try and keep Jim as independent as possible even if it’s just washing his face, or giving himself a shave with his electric razor.
Some days he’s very reluctant to accept his personal care,
and one of the good distraction techniques is talking about a trip to China he had.
He enjoys reminiscing about the time that he was there and the Great Wall of China and how he walked along it.
And so he likes to remember the past, and we often talk to Jim about what he used to do,
where he’s travelled and his vocations.
Lovely shopping, if you’ve not been and you can afford to go, go. You’ll get value for your money.
Jim likes to be in an environment where he’s able to hear what we say to him. And so when we try to communicate to him,
we do it in an area that’s quiet so that he doesn’t get agitated with all the background noise that’s going on around him.
Because of the dementia, he can become quite frustrated with things that are going on around him that he is not control of.
If Jim’s environment is getting rather too much for him he will ask to go down to his room and listen to his music.
[music in background, sings] There’ll be peace and laughter, There’ll be bluebirds over, the white cliffs of Dover…
In 2012 Jim had a lot of falls due to the fact that his dementia and his eyesight have impacted upon him so much.
He’d often try and get out of bed and not realise that firstly he’s not able to walk because of his arthritis
and that he couldn’t see. He often thinks that the lights are turned off. With the sight loss and the dementia
his care’s changed in that people have to be more understanding of the fact that he’s lost his sense.
So they’ve learnt to explain what’s in front of him.
Also with the dementia as well you have to be very patient, maybe more so than with somebody who just has dementia
because of that sensory loss. And so good effective communication is needed.
I think the carers really need to be patient, caring, and when they’re speaking to Jim to use
clear concise communication. To speak, one at a time,
to prompt Jim as much as possible throughout the day, let him know that we are here and we’re never far away.
And I think even just sitting down for five minutes and having that one to one chat can make a difference to Jim’s life.
A person living with both dementia and sight loss can live well with these impairments if they are given the right care and support.
Remember, get to know the person, consider how sight loss may cause additional challenges,
help them best use their remaining sight and tailor your care to their specific needs.
Sheila Gilbert is living with dementia and both sight and hearing loss.
Sheila lives independently in her own home.
Michelle, Sheila’s daughter, is her mother’s main carer.
Michelle has learnt to take into account the challenges that result from her mother’s hearing and sight loss, and dementia.
My mum’s got dementia, she was diagnosed in 2008. She was having tablets, and she wasn’t taking them,
so took her to doctors. And they er – the doctor said she thought she had a problem with her memory.
So she referred me to hospital, she had a brain scan and that’s when they said that there weren’t enough oxygen
going to her brain. So we went to a memory clinic and they asked her some questions and they said it was dementia she’d got.
She doesn’t know that she’s got all these problems, to my mum she thinks her hearing’s good, her eyesight’s good.
Only if I’ve got a cold or something like that, my ears feel clogged up, but that’s all. I don’t have much trouble at all.
You know, even though it isn’t, to my mum she’s happy. She’s happy in her own little world.
Oh I remember everything, I’m not, you know. I think I remember too much, when I shouldn’t, I remember it.
I think her hearing went before she was diagnosed with dementia. She had a hearing aid. They changed it to one of the digital ones.
She’s blind in one eye, she’s only got really one good eye. So we went to the hospital for eye tests and they said that she’s got a cataract
but they didn’t think it’s worth operating, because of her dementia.
So I don’t know actually what they mean by that. I don’t understand why they can’t operate because she’s got dementia.
Michelle is justified in questioning whether cataract surgery would be appropriate for her mother, as it can have benefits.
Darnall Dementia has been a lifeline. I think they encourage them at the centre to do things, sit with them,
I think they sit with them and encourage them to do things there. I mean if I gave her something to do and said ‘mum do this’
I don’t know if she could do it.
Lynsey Button is the manager at the Darnall Dementia Group in Sheffield.
She talks about the obstacles Sheila faced as a result of her hearing and sight loss and dementia, when she first came to the group.
Well Sheila, she’s been coming four years, which for somebody living with dementia is quite some time really.
Initially she came one day a week and she was quite quiet and reserved.
And I think with her deafness it took her a little bit longer to feel that she was part of our group
and it took us a little bit longer to get to know her. Although she does have hearing aids she won’t wear them,
and it was difficult to establish how much she could hear.
But I think Sheila’s very clever at reading people. She reads body language and she reads attitude.
And we’ve learnt that now. Gradually we’ve got to know her and we’ve got to know the things she likes to do. She lives to be mischievous,
and she’ll poke people with her stick and she’ll throw things at people when they’re not looking and stuff like that.
Or she’ll swap bowls over when we’re at the dining table.
The deafness sort of isolated her a bit I think. But initially she didn’t want to be reminded
and if I said to her ‘we’re talking about dancing’ she’d say ‘I know, I can hear’.
But actually I think what you learn is that she doesn’t want to be deaf.
And what we try and do is not draw attention to that fact. So what we’ll do is all the volunteers that work with us,
and obviously the paid staff, they’re aware that she’s deaf, and they’re aware that she doesn’t like it being drawn attention to.
And then they know that when they’re working with her, she doesn’t like people to move in very close. She’s very trusting with me and will allow that.
And we do sometimes have to write things down and what we would do then is pass that round to everybody,
so she’s not singled out as being the only one that can’t hear. And with her sight, Sheila will, she prefers visual activities obviously,
she likes the big piece jigsaws. She will have a go at the small ones as well, but gets very frustrated quite quickly,
so we tend to give her things that fit her needs more.
She will like the more visual games such the balls, things like that, things that she can get hold of, things that she can see.
I think in relation to her dementia, she often will say things like ‘I forget things more now’
and I think that’s demonstrating that awareness. I don’t think she’s got a label for it, that she knows it’s dementia or Alzheimer’s disease,
but she knows there’s a difference to how she was before.
He says we’re showing off. - Why shouldn’t we?
We’re showing off?
Lynsey and the staff at the Darnall Group, have adapted their communication methods to accommodate Sheila.
It’s important that staff get to know the person, and how they prefer to communicate.