I’m planning to make a hearing appointment but the past few weeks, my FIL is asking us to repeat things as if he can’t hear us. But I know he can hear dogs barking outside or someone walking in the room, so I’m wondering if this is more of a problem that he is having processing what we are saying due to his vascular dementia.
He scored 5/30 last dementia screening and he’s definitely getting more confused these days too. His short term memory has really gotten worse these past few weeks. He will want to go get his glasses, I tell them they are on his nightstand and by the time he is at the top of the stairs he has forgotten what I said and what he was looking for. It’s all the time now.
As a young child my son could hears trucks from miles away but not his teacher. Hearing test picked up it was an *attention* problem (lack of), not hearing. He also scored lower end of normal range for processing speed. This was at a 1.5 hr apt, after referral after the quicker screening test.
You describe your FIL's behaviour in detail & my gut instinct is your clinical observations skills are spot on. The problem may be in processing &/or comprehension.
I found this many times working with the elderly with Dementia. When repeating doesn't work, I try shorter sentences or even just two words. Or props & actions eg holding up a cup rather than 'do you want a cup of tea?'
I have to communicate with my Mother this way now (suspected vascular or mixed dementia after stroke).
FIL may become increasingly frustrated at not 'hearing' you. Changing communication style will hopefully help.
I do need to remember to keep it simple and he is nearly blind so my gestures don’t help at all, sadly.
Repeat slow and clear. and be animated with non-verbal clues to reach him.
In fact, I am realizing that when he says “hmmm” to a story I tell, I may have lost him at some point in the story. I’ve been taking the response to mean he is interested. Sometimes, I talk just to talk, my family has always been big talkers, and he seems to like when I talk. but the conversation is almost always one-sided now.
When he has a story, that’s a different thing. It is not really two sided as you cannot interact with the story or get details, it is just the one memory stuck in his mind that he repeats over and over.
Watch this video -- it may give you an idea of what's going on in his head. I found it really upsetting but very helpful.
https://www.youtube.com/watch?v=LL_Gq7Shc-Y&ab_channel=Alzheimer%27sWeekly
My mother is 94 with moderately advanced dementia and quite a bit of hearing loss. While on the phone at a window visit 2 feet away, she kept saying WHAT? over and over again .....until it dawned on me. It wasn't that she couldn't HEAR me.....she couldn't UNDERSTAND the words I was saying. It's called auditory agnosia and/or aphasia and often accompanies dementia or brain disorders. With my mother, it comes and goes.
I bought her an Alzheimer's clock which tells her the day, time, AM or PM, and date in bright large neon. She forgets to look at it, so it's of no use anymore. Same with the large poster notes the staff leave for her about pulling the cord for help to use the toilet. She falls constantly because she doesn't look at the posters, and had to stop reading entirely about a year ago.
The trouble with hearing aids is losing them or not wearing them. And expense for replacement. So keep that in mind before investing. And hopefully the hearing test itself will tell if he HAS a hearing problem. My mother can't really respond to the questions about when do you hear the sounds?
When your FIL needs his glasses now, you'll have to go get them, most likely. Or get him alligator clips or a cord so they're on him all the time. Things only go downhill from here, unfortunately, and the steps down he takes can be dramatic. Read all you can and speak to his doctor about suggestions for what to do next. Sometimes swallowing deficits begin now and you'll notice choking incidents occurring regularly, meaning pureed food is in order. Lots to know, lots to consider about potentially placing him if need be.
Wishing you the best of luck with a difficult situation. I truly hate dementia and what it does to the people we love.
In the past month, we have started cutting up his food because cutting up meat has been hard with his eyesight. He is not choking at this point, but he is dropping his food more and more, plus slurping and smacking a lot when he eats. All new behaviors.
Even with his huge magnifying glass, he cannot pick people out of photos, and takes him a long time to sound out a word, and really cannot work the magnifying glass. If I tell them the names he struggles with who they are. Then he might remember for a second, then it’s gone again.
He also has a large clock, but does not remember to look at it. I hand him some books with large photos and he looks for a second then puts it down. If I go back and hand it to him again, he didn’t remember he just had it a few minutes ago.
What is amazing to me are the things he does every day that he can still do. It is like is all muscle memory from the routine if that makes sense. He can turn on the shower, dress himself, shave, brush his teeth, get a cup of coffee, take his plate and put it on the counter, and walk around our property (with me watching of course). I’m pretty sure he is not changing underwear until shower day, but he does pick out his shirts - he has 5 that hang on the wall. He can still button them and tie his shoes. He always comes down in the morning dressed well, belt, watch and all.
He likes the news on all day. He cannot tell you what they are talking about, he does not really watch the TV or listen to it it seems. He still prays at the dinner table. It’s the same prayer he has said in all the years I’ve known him.
We are blessed in a sense that he is physically healthy - had a nuclear stress test and echocardiogram and they said his heart is like a 40 year old, plus no other issues like diabetes, high cholesterol and such. He shuffles one minute, then walks the dog or goes up and down stairs at a good clip - wears me out trying to keep up. Today I dropped a knife and he bent down and picked it up for me as easily as if he were a kid.
He has an eye appointment coming up and it is the absolute hardest thing for him. It takes hours - he does not understand what they are asking him and he has to repeat the steps over and over. It confuses him terribly.
Anyway, sorry to ramble. I really have learned a lot in this post. Thank you! I have a lot to learn - we have a lot to do in the coming weeks to get his house ready to sell, get my college age son settled with his brother who rents a house from us (also frees up a room for a live in caregiver when that time comes). Once all that is settled I will have a lot more time to devote to learning, now it is in bits and spurts.
You are right, dementia is such a horrible disease. My FIL was literally a rocket scientist. He was an electronic engineer who worked on missiles that are still used by government today. I never knew him in those days but it has been really hard on his kids to see him like this. He is trying so hard to do everything exactly the same way, lifelong attention to detail, it frustrates him so much to need help.
I have become his daughter now, it seems. He sometimes talks about his late wife as my mom. That’s ok. I lost both my parents and I am privileged to get to have another ❤️
Yes, soup is the worst. He even slurps eating steak... how does that happen? Lol
He is still continent, but only after we took him off his prostrate medicine. It was so bad at one point, we laid down vinyl flooring on top of our hardwoods and bought depends. The med made him have to pee all the time. Doc said to take him off and just monitor for symptoms.
Another point about the routines he does from muscle memory - any diversion from his routine makes him freeze and unable to function. He would get confused, can’t brush his teeth, find his clothes, etc. It takes him an hour to do each thing but he does them. If I disrupt one activity, I have to walk him through every activity following and hand him each thing.
It can be something as his little pocket knife which he has put in his pocket every morning since he was a kid. If it falls on the floor, and he can’t put it in his pocket, he cannot do the next thing and the next, and ruins his whole day. It’s like he is on autopilot.
It reminds me of people with Parkinson’s who will walk following a laser... but freeze if it’s not there. The routine is like his laser.
As one of you said, he is a blessing, the disease is a curse, but it will never take away from the kind, gentle soul he is somewhere deep inside.