Welcome to “It’s My Turn To Care.” We know the challenges you face caring for someone with dementia. That's why each week we bring you tips, strategies, and most of all, support as you navigate your role as caregiver. Let's get started. [00:15.6]
Dave: Hello, and welcome to It’s My Turn To Care: Secrets for the Dementia Caregiver. My name is Dave Parks. I'm a certified senior advisor and I’m the owner of Home Care Assistance, and we're located in the northern part of Tarrant County in the great state of Texas. It's our goal to bring you tips, strategies, secrets and the support you need as you care for someone suffering from dementia.
I sincerely consider it an honor and privilege to host this podcast, and bring you some of the most knowledgeable and insightful people in the industry—and today I have one of my favorite audiologists with me. Her name is Dr. Amy Badstubner and she is the owner of Elite Audiology Resources, which is a private practice offering concierge care for hearing loss. [01:16.3]
She started the practice over six years ago with the primary goal of making house calls, something that was unheard of at the time. She has been featured in local magazines and has been an expert on a half-hour “ask the doctor” special on TV. Dr. Amy was just voted best audiologist in the area for the fifth year in a row. That's quite an honor.
So, Amy, welcome to the program.
Dr. Amy: Thank you.
Dave: It's great to have you. Amy, I've heard a lot of discussion and I've seen a lot of studies on kind of the link between hearing loss and dementia. Can you talk about that a little bit? [02:03.4]
Dr. Amy: Yes, and there's a lot of it. I know it's a hot topic and we know there's a link. We don't know why. We don't know what it is. We don't know if it's a cause and effect, but we know there is a connection and an association there between hearing loss and dementia.
We can even correlate it to different amounts or levels of hearing loss. Someone with a mild hearing loss is twice as likely of developing dementia as someone without hearing loss. You get to a moderate hearing loss, it's three times as likely, and with a severe hearing loss where you really have to shout at them, five times more likely to develop dementia.
Dave: That seems pretty significant.
Dr. Amy: It's a big deal.
Dave: And so, you say there's really no understanding of the why?
Dr. Amy: Right, there are different theories at this time, but really they haven't leveled on some certain cause of what it is. [03:03.8]
Dave: Okay, so let's talk about hearing aids a little bit. How can hearing aids help with dementia?
Dr. Amy: Yeah, so we hope that they can. There are studies. There was a big one out of France that has measured and watched people for 25 years, and over 3,000 people were in this study, so it's a pretty significant study. They found people that had hearing loss and were wearing hearing aids, were developing memory loss at the same rate as their normal hearing peers, so we think that it will help. At what point of starting hearing aids can it help dementia, can it help reverse dementia, we're not sure about those things, but we definitely know that wearing hearing aids can slow down the rate of dementia. My guess is probably if we start early enough. [04:02.1]
Dave: Sure.
Dr. Amy: Now, I don't want to give families this false hope that you put hearing aids on your loved one and, magically, their memory is going to come back and there goes the Alzheimer's. That's not the case, but I have seen a few cases where I misdiagnosed or misread a patient as having dementia. I very clearly remember I had a 102-year-old patient that came in with this 85-year-old son, and I was like, I couldn't even get his birth date out of him. It was just a blank stare.
Dave: Right.
Dr. Amy: Tested his hearing, put some hearing aids on him, and all of a sudden, he just lit up. He was alive. He was engaged in the conversation. I think sometimes it can mask the dementia or make us feel like maybe this is dementia when actually it's just untreated hearing loss. Again, that's not the norm that I've seen, but there's definitely a link there. [04:57.6]
Dave: Yeah. When I talked to people about it, I'm certainly no audiologists, but I say it's kind of like garbage in, garbage out, so if your hearing and your eyesight, if it's not clear, kind of coming into your brain, thinking of it as a computer, then what's going to come back out your thoughts, the way you perceive things isn't going to be clear either.
Dr. Amy: Right, and it's the same with glasses. I also have people that say, Oh, I'm only going to wear my hearing aids when I go out to dinner, and that's not a good idea. So, glasses, I wear glasses all the time and they're progressive lenses, so they took some getting used to, the same with hearing aids. If I only wore them, when I was driving, I would be a danger on the road, and because my brain is not used to the vision that my glasses create, it's the same with hearing aids.
Even if you're home alone, there are still sounds that you're hearing. Even if it's a knock on the door, your feet, it's still engaging your brain, and that way your brain gets used to hearing in an easy environment. You're home alone or you're just with a few family members, and then when you're really in a taxing environment, your brain's ready for it. [06:12.0]
Dave: Right, and then if you don't wear them, unless you feel like you absolutely have to, then my guess is they're uncomfortable or they're picking up sounds. It gets more confusing.
Dr. Amy: Absolutely.
Dave: Let's talk about hearing aids a little bit because we run into this a lot with families and I think there was a week where I did two care consultations, and part of our assessment is we ask if they have hearing loss, if they wear hearing aids. In both, I remember this distinctly, in both cases, they had hearing aids, but they didn't wear them. Are there any tips or any secrets to encourage folks to wear their hearing aids? [06:59.1]
Dr. Amy: That's a very loaded question. It goes back to a few things. First, you have to take into consideration the component of dementia. If they are in a very progressive state of their dementia, that's a completely different story of just difficulty there. But, in general, I see people not wearing their hearing aids for a few, just general reasons.
One is they weren't ready. They weren't committed. They weren't invested in it. Maybe they were pushed into it and hadn't bought into the idea that maybe I need help, so that's a huge one. Not getting the correct devices, or not going to someone that they could trust to give them the right advice or not taking that advice, and not getting follow-up. That is huge.
So, if someone's not wearing them, they're not comfortable or they don't like the sound. That's the time to go back to your audiologists and get it fixed. That’s what we're here for. We want you to wear the hearing aids and that's a huge thing. It's okay to call and say, I'm not happy with my hearing aids. They're not comfortable. I know I haven't worn them in two years, but can you please help me? I love those calls. It’s great. [08:10.3]
Dave: Yeah. Is there something, and if there's not, I understand, but is there something you could show someone that says, maybe it's a study of some sort that says here are people that use their hearing aids and here's some outcome, some physical outcome, maybe it's a mental outcome, and then here's some that didn't wear their hearing aids, in order to give them some encouragement?
Dr. Amy: Yes, and when I find when people are on the fence about it, I say, Let's talk about your brain health and the input that we need for your brain, and one way is through your hearing. Unfortunately, we don't have a zipper on our forehead to unzip it and let our brain have access to the outside world. The only way we're getting it is through our senses and one very one being you're hearing, which also shares pathways with memory. So, that's one way. There are shared pathways. [09:02.5]
Another thing is talking about that study in France that that was a big thing, over 3,000 people, and showing that their rates, not only of memory loss was less when they wore their hearing aids, but the rates of depression were less of self-reported isolation. So, it's just not a matter of, Oh, this is my hearing. It's not a big deal. This is a key part of your life. It’s communicating with those that you love, and most of us grew up talking to communicate and hearing to have a conversation, and when part of that is taken away, it can be very debilitating. Even though we can't see it, it's still a huge issue.
Dave: Right. Let's talk a little bit about Medicare. When you first go on Medicare, do you have a free exam?
Dr. Amy: Medicare will cover your hearing tests. They say, if it's medically necessary.
Dave: I see. [10:01.4]
Dr. Amy: Which most of the time it is, especially if you've never had your hearing tested and you suspect hearing loss. That's medically necessary and Medicare will cover that.
Dave: Okay. Let's talk a little bit about if people can't handle hearing aids due to worsening dementia symptoms. Talk a little bit about that.
Dr. Amy: Yes, and so that was the other caveat I was talking about earlier that sometimes maybe they were just stubborn and 20 years ago they could have handled it, but now hearing aids and that muscle memory required to put them on and also to not take them off and eat them like candy, it's just not feasible. Losing them, I found them in all kinds of places in people's houses. It's just not feasible and not worth the stress on everybody involved.
There are a lot of other devices that can help. With a phone, there's a closed caption phone that is covered by our tax dollars. We are paying for the service. People, there are a few requirements that people need to meet, which are very easy to meet, and then they will come and they'll install the phone. They'll give instructions on it, so that's great. [11:11.9]
Dave: Is that typically a landline phone?
Dr. Amy: Landline, although they have recently come out with options for cell phones as well, which is really nice with so many people going away from having landlines. So, that's one option, closed captions, so they can hear it as well as read it, and they'll also close caption your voicemails.
Dave: I think I've run into some folks that provide that. Would you be able to give someone a contact?
Dr. Amy: Absolutely, and they need an audiologist or their medical doctor to say, yes, they have hearing loss.
Dave: It’s kind of prescribed in a way. I got it.
Dr. Amy: Yeah, so that's one thing. If they are somebody that enjoys watching TV and everybody else in the house, caregivers, anybody that comes to visit, it's at a hundred percent and is just intolerable. [11:58.3]
There are devices that can help with the TV, such as TV ears, or Sennheiser has some wireless headphones that are great. Then they can put it at whatever volume they want in their ears and everybody else can listen to the TV at a normal volume, so things like that.
There are devices that are basically like a remote and they're called pocket Talkers, one brand, where you can put headphones on your loved one and you're holding a microphone and you can still talk to them. I know it's really hard to have a loving conversation with someone when you feel you need to raise your voice. Then the other person might say, Why are you screaming at me? And I know you're just doing it just so they can hear you, but that gives you the ability to have a conversation at a normal tone and for them to be able to still hear you. So, there are so, so many options out there.
Dave: Which kind of dovetails into the whole dementia diagnosis as well, because a lot of times people will raise their voice with folks that are suffering with dementia and all that does is create agitation. [13:07.6]
Dr. Amy: Of course. Nobody wants to be yelled at right and sometimes they're raising their voice because of the dementia component. Then add on hearing loss on top of that, yeah, it can be really difficult.
Dave: What are some things that we can do? If we're talking to those that are caring for someone with dementia, what are some things we can do to help us lower the risk of needing hearing aids?
Dr. Amy: Earlier in our lives?
Dave: Yeah, we'll say, in our fifties or in our forties, is there anything?
Dr. Amy: Yeah, there is. I think it's just being smart about your ears. Lawnmowers are too loud. Every construction site I drive by, I peek to see if they're wearing hearing protection. Lawnmowers are too loud. Even a dentist, their drills, we see hearing loss and dentists from their drills.
Dave: Interesting. [13:57.2]
Dr. Amy: Hair dryers with hairstylists, yes, so protecting that. It's very easy to just put on a set of foam earplugs that are cheap—or come by our office. We have them out on the table—or put on some earmuffs. Especially in Texas, hunting and shooting are a big deal. Protect your hearing, which most of the time starts back in teenagers. So, in our fifties and sixties, we can be also telling our kids and grandkids, You need to be smarter than I was and protect your hearing.
Dave: Yeah, I had this hedge tremor that is so loud and I did go buy some of those earphones or whatever they're called.
Dr. Amy: Earmuffs, yes.
Dave: Earmuffs, yeah, because it was so loud and I'm thinking, This can't be good.
Dr. Amy: Right.
Dave: Anything else besides noise?
Dr. Amy: There are also medical conditions that have links with hearing loss, so just briefly say like diabetes and heart health. I think just taking care of our bodies as a whole, which helps with dementia as well, can help with hearing loss, because our ears are sensitive. They're a little organ that needs to be protected, so full body health also can help protect our ears. [15:13.7]
Dave: Yeah. What we tell our clients is what's good for the heart is also good for the brain, so maybe what's good for the heart is good to have.
Dr. Amy: Add the ears and there, yes.
Dave: Just add the ears onto there.
Dr. Amy: Yes, yes.
Dave: Your practice seems a little unique in that you will physically basically bring your office to someone's home or a community where they live. Can you talk a little bit about that?
Dr. Amy: Yes, I was working at a private practice in Dallas before I started my own practice and one day one of my patients was dying, and I had her hearing aids in my office and her family was coming in to say goodbye. I said, “I'm going to take these to her. There's no reason I shouldn't,” and when I was doing that, I realized, Why am I not doing this all the time? Why aren't we doing this? We can make this work. [16:02.6]
I quit my job and started my practice, and did a hundred percent house calls for the first couple of years. Anything I can do in my office, I can do in the home. Now, sometimes we need to wait for the lawnmowers to go by or, of course, turn off the TV and things like that, but very rarely, I would say, less than five, have I said, “I'm sorry, I can't do the hearing test because it's so loud.”
There are state guidelines for the noise level in the room. I know I get that a lot, Well, what about that box, that soundproof box? The only point of that box is to make sure that the test results are valid, so I carry a sound level meter, which measures the environment, and then we can guarantee that the results are valid.
Even putting in that dementia piece where being more comfortable in their familiar surroundings, take them out into a different office, it's hard for me to get a feel for what their daily life is. [16:59.8]
When I'm in their home, I can see, Okay, let me see what the situation is? Let me see your TV, you're talking about it. Let me see, is it the TV? Let me see the setup of your life and your surroundings, and it can make a world of difference.
Dave: I know, in our previous show, we had Amber Johnson from Silverado, and I know your office is in the same parking lot essentially as Silverado, and she says that you've been over there several times and then you have several clients there. So, talk a little bit about that because we're talking to the caregivers of those that are suffering from dementia. How do you interact differently with someone with dementia?
Dr. Amy: Yes, and I think a lot of the cues at first come from family members who are usually making that appointment. Okay, what's the best approach for us? Can you be there? Do we need to FaceTime you in? Are you at work? And just taking their cues. [17:58.1]
Our initial appointments are an hour and a half long, and that reason, they're long for a reason to just let the conversations flow the way they need to. They were just all in such a rush and I think just being able to slow down, especially with someone with dementia, can give them that opportunity to have their brain catch up. Something that I tell caregivers and try and do myself is slowing down my speech speed, which I am not doing at the moment.
Dave: Sure, I understand.
Dr. Amy: But slowing it down, and also making some pauses. So, I'm going to the store and I think I'll get some grapes and apples. Okay, I got to this store and then I got grapes and apples. Just gives them a chance to catch up with the conversation. It’s really helpful.
Dave: Okay. Very good, yeah. Amy, thanks so much for being on our podcast.
Dr. Amy: My pleasure.
Dave: If someone wants to get in touch with you, and find out more about your practice and how you might be able to help them, how will they do that? [18:59.0]
Dr. Amy: They can call our office at (817) 421-3277 or they can get on our website. There are two ways to do it. Texas-Ears.com or the full business name of EliteAudiologyResources.com.
Dave: Great. Thanks so much, and congratulations on being named the best audiologists in the area again.
Dr. Amy: Thank you.
Dave: And this is Dave Parks with Home Care Assistance, and we always encourage you to visit our website HomeCareAssistanceFortWorth.com, or call our office and see how we might be able to help you or get you in touch with the resources you need on your journey through dementia care, and that number is (817) 349-7599.
We look forward to talking to you next week. Have a great week.
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