By Joyce A. Cooley, BC-HIS, RN

As a Nurse, I know when you meet a new resident for the first time taking a complete history is vital to determining a proper care plan.  Likewise, as a Nutrition Center Administrator you make home visits to qualify Seniors in the community for your services.  Have you ever, like I have, caught yourself half way through an interview and wondered, is this person confused or is something else going on here?

Well you’re not the only one.  But you are the one that will significantly influence whether the cause of this individuals mental state is determined to be a disease process or perhaps a communication disorder or perhaps both.  It is note worthy that there have been recent studies to demonstrate that the behavior you are seeing should be taken more seriously than perhaps you many have thought.  Statically, the numbers of 85+ Seniors with Alzheimer’s and those with hearing loss are about the same.  This could mean that one problem could be confused with the other.  The key is testing to determine the problem.  Specialists will evaluate the possible Alzheimer’s patient with a battery of mental test.  But if the tested individual has difficulty hearing and understanding, those results could be skewed and a misdiagnosis the result.

Notice the similarities of symptoms:

Alzheimer’s Disease	Untreated Hearing Loss
Depression, anxiety, disorientation	Depression, anxiety, feelings of isolation
Reduced language comprehension	Reduced communication ability
Impaired memory (primarily short-term memory)	Lessened cognitive input
Inappropriate psychosocial responses	Inappropriate psychosocial responses
Loss of ability to recognize (agnosia)	Lessened Mental Scores
Denial, defensiveness, negativity	Denial, heightened defensiveness, negativity
Distrust, suspicious of others motives	Distrust, paranoid others are talking about them

It is amazing to me that I can visit a skilled care facility of 50 residents or more and no one has a hearing aid or assistive listening device.  It really defies reality.  A more meaningful life awaits those who can actively participate in their choices and communicate with family, friends, other residents and medical staff.  A simple hearing test can determine the hearing status of the majority of  Seniors.  Those not able to actively participate in testing can be evaluated by other means.  It might take some time and planning but it could mean a difference for all involved.  It starts with education for family and medical staff.
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