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.
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.
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.”