Saturday, June 25, 2011

Do we blame dementia for the hearing difficulties in the old?

While I was in rehab, I noticed the majority of patients were older. They would do what they were told, but often the therapist had to tell them 2-3 times before they heard the instruction clearly. This slowed down what they could accomplish in an hour.

Very few were proactive. One of the few was a vivacious 92-year-old woman who had fallen and broken her hip. She has always been active, and the fall and resulting break frightened her.

"I'm staying here as long as I can," she said. I don't blame her.

My therapist said he loved to see me coming because I was proactive. As we were going through a set of exercises one day, I talked to him about that.

"It seems to me one of your biggest problems is loss of hearing," I observed.

He said it was, but more than that, it was what it led to.

"People who can't hear tend to become passive and just go along to remain a part of things socially," he said. "They are embarassed to keep saying 'I can't hear you' and they also fear, quite realistically, that if they do, people will just quit trying to talk to them."

The habit is so engrained, he said, that it takes a while for them to realize the physical therapist isn't going to give up--if they even notice their habits by then.

(I remember the first morning in therapy I was walking with a therapist who smiled and pointed. "Why aren't you bending your knee?" she asked.

Right. I was walking the way I had before surgery and I was there to learn to walk differently.)

The therapist I talked to about hearing problems had more to say.

He said that when patients really don't hear well, he then has to determine if the problem he is working with is poor hearing, diminished mental capacity, or both.
This takes time. So the therapy I was able to do in a week usually takes them two weeks.

A few weeks ago, I heard a paper on dementia that said 40 percent of those who reach their 80s will develop dementia of some kind. But that means 60 percent will not. And we are talking 80s here, not 70s.

However, I know quite a few in their 70s who are deaf as posts.

It makes me wonder if a lot of the dottiness of old age is actually more attributable to hearing than diminished ability to think.

One thing I noticed about the oldsters in my classes--they were tough. Most did the exercises required without grumbling, whimpering or protest. Waiting for the next exercise, they would talk among themselves.

"This your first?"

"No, this is my second hip. I did the knees 10 years ago."

Then they would enumerate the heart surgeries, the appendix, the gall bladders before day surgery, and on and on. They would smile grimly at each other.

They knew full well they were survivors.

And I, doing my knee raises, or peddling, or whatever, just listened, marveled, and muttered to my Creator, "Lord, if it is possible, I don't wanna be that tough."

And it's time again for a bout of my daily exercises.

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