If We Could Make Just One Sound At A Time…

One of the issues my father struggles with is the inability to sort through the various stimuli in his environment, especially auditory. I believe this is a form of sensory processing disorder that accompanies vascular dementia. For example, if I am talking to him while my daughters are having a separate conversation in the same room, and his dog is “requesting” a treat, dad will either struggle to figure out what words were intended for him or he’ll close his eyes, grimace, and shut himself off. Since I only play a dementia specialist on the Internet, this is a somewhat-educated guess via online research that tells me he very well may have auditory integration issues.

While I don’t understand all the physiological reasons for this inability, it makes sense to me that strokes and alcoholism have impaired portions of his brain that would otherwise be able to differentiate, tune out selectively, or just hear it all and know it. As I watch my father’s responses, or lack of response, it’s becoming more apparent that busy environments are extremely challenging and frustrating for him, if not painful.

Part of me wonders if this issue hasn’t always been there in a milder form, and if it’s been exacerbated by the damage to his brain. I say this because I remember some of his behaviors during my younger years that may have been indications he had issues with auditory stimuli. I’ve also found that, with age, I struggle with feeling over-stimulated by lights and sounds, especially a combination of them at higher intensity. Frankly, I have trouble writing with any noise other than bird songs in my immediate environment. Just ask my kids.

I’ve often watched Dad cover his head, eyes, and ears with his arms and hands as if he’s in pain. I’m beginning to realize he may be trying to shut out some of the stimuli. Ever since mom died, he’s had a tendency to be reclusive, but now these changes in his brain seem to have made it physically painful for him to be in the presence of more than just a few people, especially if those people aren’t aware of his issues. At most, he seems to be able to manage having my two daughters, the dog, and me in his presence at the same time. In any other situation that would be too much for him, but I think the fact he enjoys hearing kid-noise makes it less painful for him. In fact, I think he enjoys listening to their chatter more than he does talking to me.

Wednesday, I visited Dad during lunch time. A very talkative man was sitting at the same table.  Initially, I tried to focus on dad, but this white-haired little guy kept talking to me. He’s just a talker. He’s a sweet man, too, and I do love seeing him.  So I spent most of the meal chatting with this gentleman and trying to bring my father in on the conversation.

As usual, Dad barely said a word. Every time I spoke to my father, the other gentleman spoke. Dad turned toward me, looked at me, closed his eyes then turned away without giving a verbal response. This may have been because Dad’s attention was immediately drawn towards the other man’s words and my father was then unable to get back to his thought . It may have been his frustration with being interrupted. I honestly can only guess because he didn’t speak.

JHP, JR and my daughters

On the other hand, it’s a completely different experience when Dad spends mealtime in his room with one voice speaking at a time or music playing. Wednesday evening, my daughters and I packed up our usual treats for dad and treats for his dog, along with my eldest daughter’s violin and my other daughter’s recorder. Dad was asleep. When I woke him up to announce our arrival, he was thrilled the girls were with me. I decided we would all sit together in his room while he ate, so he could interact with his granddaughters without being interrupted by other residents who love seeing my girls.

These really are some of our best visits with him, even though there is very little conversation. My oldest daughter played her new violin. My youngest daughter filled a plastic glove with water and drew a face on it. I worked on putting out chocolates for dad, putting away the remaining candy stash, and getting the dog treats put away.

Playing violin for Grandpa

Hardly a word was spoken the entire time, but Dad tapped his foot. He bobbed his head. It took me a while to realize what he was doing because I was concerned he was falling asleep and his dog would catch the sandwich as it hit the floor. As I watched to make sure Dad didn’t drop anything, I noticed he was intentionally bobbing his head to the music. When my daughter fumbled through a new piece of music, he popped his head a little more obviously. That’s all. He bobbed his head, he tapped his foot, and he listened to her play violin. He was being her metronome.

Later, as usual, silliness took over. My youngest did her circus act on his walker, jumping up and down doing her version of a “walker dance.” Then my older daughter jumped in and did some of her new Hip Hop moves. Dad smiled and clapped his hands, and he made it very clear that he likes it when the girls are silly and talkative. It’s like they are on stage. He gets to watch and even if he doesn’t understand exactly what they are saying, he can tell they are having fun and that they are doing it for him.

It’s such a different experience from spending time with him in the common areas of the facility.

This makes for a challenging situation, though. While I want him to be around people, I don’t want him to be miserable or uncomfortable. I want him to interact with people, but I prefer he interact with people who are sensitive to this part of his struggle. I’d love for the facility where he lives to have an employee designated specifically for people like my father who can’t handle being in the common areas, just to fill the gaps since families can’t be there all the time.  I’d like for all elder care facilities to have that service available to those more reclusive residents. But for now, the focus of our visits with Dad is to give him that type of interaction that seems to work best for him.

I think my daughter put it best. “Grandpa isn’t deaf. He hears everything all at once. So we have to make noises one-at-a-time.”


8 responses to “If We Could Make Just One Sound At A Time…

  1. Thank you for the insightful post! I am dealing with my husband’s early dementia symptoms, and sensory overload is becoming a significant issue as time goes on. He can no longer track group conversations, and retreats into another room if there is an animated discussion taking place among three or four people. Buttons and switches with lights in them seem to be especially problematic. His sister got him a laptop about a year ago and he proceeded to put a dot of dark nail polish over the buttons on the keyboard that light up. Our new car has a myriad of lighted switches and screens on the dashboard and he is having a terrible time with it. He also shouldn’t be driving anymore, but that’s a whole separate issue. I won’t put nail polish on a new car, so will have to come up with something else. I think we’;ll have the old one fixed for him. He is used to it. He basically cannot cope with any change to his environment at this point, and since he is at home, this can present some problems. I’m looking ahead to have some foresight as to what comes next. Thanks again.

  2. Suzie Miller

    I loved your daughter’s comment at the end. My head is spinning with comments. My son has sensory integration disorder and I have learned so much from him. I am working on not talking with my hands and not feeling the need to say everything 2-3 times because I did not get the feed back I expected. I have learned with my mom that often her sitting quietly and taking in all the chaos and noise (which is just how the rest of the family operates) is her way of being part of it all. I have spent much effort trying to get her to participate and “feeding” her lines to say at events. She always comments what a nice time she had when I thought she was bored or lost. And,my son likes to have music on when doing school but not classical because it bothers him that there are no words. He needs certain stimuli but not others like bright lights (begs to have the room dim which is hard for me with my old eyes). I love lots of light and wordless background music. It just makes each day exciting. Again, thank you!!!

  3. That sounds nice. Is there any way we can combine the best of all these places?

  4. I think you make a good point that your Dad may have always had a little trouble with too much auditory stimulation, and like you, I cannot work with the TV or even music in the background.

    It is true that many people with dementia have difficulty with all kinds of stimuli, and many dementia care units take this into consideration. There is one community I have been to with both assisted living and dementia care. When I enter the dementia unit, my mood always changes and I feel calmer. The carpet does not have patterns, there is less art on the walls, and the lighting is more muted.

  5. I have noticed similar things with my mother as well. However, for her, it doesn’t appear to be the noise (she is very hard of hearing and refuses to wear her hearing aids!), it’s more like the frenzy of activity just confuses her and exhausts her. She enjoys being around people, but she can not handle too much activity around her. As you know, it makes it difficult. And, as you have said, the more her dementia progresses, the more she is incapable of making even simple decisions. Like I did with my toddlers, I have learned to offer her two choices and if she can’t decide, then I offer suggestions GENTLY.

    Thanks for sharing your experiences!!

    • Yes…the beehive of activity is exhausting for him as well. That’s why I’m so open to taking him to his room or grabbing a wheelchair and going outside. It’s still stimulation, it’s just more comfortable for him.

  6. Wonderful post. I see those kinds of issues with my mom sometimes. Thanks for the writing as it helps me be able to understand what may be going on with my mother.

    • Thank you! Consider doing some follow-up research and getting info together. If you have doctors who specialize in dementia (not all geriatric specialists are dementia specialists), talk them about the possibility this is an issue for your mother. If treatment seems ineffective (my father can’t stand speech therapy, etc) maybe something can be customized to her specific needs.

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