Is it Dementia or Hearing Loss?

By Michael A. Bower, BA, ACC

Joe liked Catholic services, music and any activity

that involved food. He was a lovely gentleman

who lived at a facility where I worked as the Activity Director.

While generally pleasant, he usually fought the aides when they came to do personal care. Joe seldom spoke and when he did, he didn’t make much sense. He slept a lot.

One day, his daughter mentioned that each Saturday they played Gin Rummy and he often won. That stopped me cold! People with dementia who are non-verbal don’t have the cognitive ability to play complicated card games. We were missing something.

As we conversed, I asked about Joe’s hearing. She said that he had severe hearing loss, but had misplaced his hearing aids ages ago, and they couldn’t afford to replace them. Besides, he wouldn’t leave them in. That was my “Aha” moment.

I have always kept a personal amplification device for doing interviews with people with hearing loss, so I put the headset on Joe and, while talking to him in a normal voice, slowly turned the sound up. Suddenly his eyes lit up and he smiled. I asked questions, and he gave me appropriate answers.

I called the nurses and the social worker to have a conversation with Joe. They went away amazed at the transformation. We informed his daughter about how well he functioned with the hearing device, which was much less expensive than hearing aids, and she promptly purchased one for Joe. From then on, the staff placed the device on Joe whenever he was awake – which was far more often!

With better hearing, Joe was much more cooperative with care – he now understood what the aides were telling him when they explained what they were trying to do. His participation and enjoyment in activities increased, and he stayed awake during the day. This helped him sleep better at night. Joe’s quality of life bettered because of the small device.

Did Joe have dementia? Yes, but he was not nearly as advanced as everyone had thought. It is estimated that close to 20% of Americans have a hearing loss and nearly 2/3’s of the people over age 75 have significant hearing loss, often untreated. Studies indicate uncorrected hearing loss is a risk factor for developing dementia, and dementia in people with hearing loss progresses faster. Does your loved one have a hearing loss? Have you checked?

While hearing aids are expensive, difficult for older people to manage and frequently lost or destroyed by people with dementia, there are alternatives that are affordable and practical. For more information, please contact the Hearing Loss Association of America, Washington State Association ( for more information and support.

This is a true story, but Joe’s name has been changed to protect his privacy.

Michael Bower_resizeMichael A. Bower, BA, ACC, is an Education Coordinator at the Alzheimer’s Association Western & Central WA Chapter. She has served elders since 1987. She has led the movement to better understand how to care for those who suffer from Alzheimer’s disease and related dementias. She previously worked as Activity Director and Consultant for several skilled nursing facilities, including four with dementia care units. Ms. Bower speaks nationally on topics relating to eldercare, activities, and dementia.

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