Caregiver Connections
Helpful tips for family caregivers

Is it hearing loss or dementia?

Does the person you care for tend to forget things, such as appointments? Do they get easily confused? Are they withdrawing from social situations? These changes may be early signs of Alzheimer’s or some other dementia. But it’s equally possible that the problem is hearing loss.

That is, it may not be a matter of their forgetting. They may not have heard what was going on to begin with, or misheard so they misunderstood. When in a crowded room with competing conversations, they may have trouble following the thread of the discussion. Many people with hearing loss amiably agree to things or simply nod because they don’t want to call attention to the fact that they really aren’t hearing very well.

Rather than make assumptions about your loved one’s cognitive abilities, ask the doctor to conduct a hearing test. If your relative does have hearing loss, wearing hearing aids can be a tremendous help. And, oddly enough, wearing hearing aids also significantly decreases the risk of dementia and/or slows down its progression.

Scientists are not quite sure why untreated hearing loss and dementia seem to go together, but hearing loss has been firmly established as one of twelve key risk factors. Those with untreated, mild hearing loss are twice as likely to develop dementia. The likelihood triples for those with moderate loss and is five times more likely with severe hearing impairment. Possible reasons include the following:

• Lack of auditory stimulation causes parts of the brain that process sound and memory to atrophy or shrink.
• People with hearing loss tend to withdraw from social situations. Lack of social contact is associated with greater risk of dementia and also depression. Depression can cause mental fuzziness and confusion, looking a lot like dementia.
• When a brain is struggling to capture sounds, it “borrows” brain capacity from other regions, which then limits how well those regions of the brain can do their usual work.

Hearing aids can help. Among people at high risk for dementia—people with high blood pressure or diabetes, for instance—those who wore hearing aids were 50% less likely to develop cognitive decline. Hearing aids are not an immediate fix, like “glasses for ears.” They do take getting used to. But recognizing that hearing aids can not only improve hearing and social relationships, but also reduce the risk of dementia, may motivate your loved one to wear them.

Negotiating skills

Imagine your mom has fallen for the third time this year. To you, it’s obvious she needs more support, perhaps home care. Your sister thinks mom should come live with her in another state. Mom’s finances are slim and she doesn’t want to leave her home. Consider these tips from seasoned negotiators:

Prepare ahead for a discussion

• What do you fear the most? Be honest: Losing mom’s approval? Your sister “winning” (again!)? Awareness of your fears will help you monitor your sensitivities and reactions.
• What do you believe they fear the most? Your sister may fear losing her status as the “insightful one.” Your mother may fear losing her beloved neighborhood.
• Come to the meeting calm and centered. Have a strategy, such as deep breathing, to help you remain grounded.

During the meeting

• Remember to smile. It also shows up in your voice.
• Listen more. Talk less. People reveal more or offer more during an uncomfortable silence.
• What is valid about their point of view? Cultivate nonjudgmental curiosity. New insights may emerge. Is your sister’s nursing background helpful? Does mom care more about independence than safety?
• Take your ego out of the equation. Remove any relationship baggage. It’s not the person, just the issues.
• If you find everyone digging in, rise higher. Getting above the weeds may enable you to see new options. Ask yourself:
  • How can I address their fears?
  • What are our shared goals, beyond the details of the “solution”?
  • Is there a way to simplify? The simplest solution is often the best solution.
  • What might a win look like for all of us?
  • How can I be generous? Small gestures can engender trust and get a conversation moving again.
• Consider an objective third-party facilitator. A care manager can lead a family meeting. You can also hire an eldercare mediator.

"Tech support" scam

The multilayered “phantom hacker” or “tech support” scam is by far the most lucrative scam to date—$542 million was transferred to fraudsters between January and June 2023. Two-thirds of those victimized were persons over age sixty-five! Here is the typical scenario:

1. Tech support. A call, email, or text is received “from tech support” at a company such as Microsoft, telling the victim their computer has been hacked. The scammer requests the victim download special computer-sharing software “to allow a virus scan.” In fact, this allows the hackers to see the victim’s financial information.
2. Financial institution. Scammer No. 2 contacts the victim “from” their bank or brokerage firm, falsely confirming they have been hacked. The victim is told to transfer funds to a “protected third-party account.”
3. Government agency. Scammer No. 3, “from” the IRS, Federal Reserve, or other agency, contacts the victim saying their money can be protected by transferring it to special foreign accounts set up for this very purpose. Methods include wire transfer, cash, or cryptocurrency. Sometimes a letter is sent by mail on official-looking letterhead. Sadly, this step drains the victim’s accounts.

Tips to share with your family member

• Do not respond to calls, emails, or texts advising “you’ve been hacked.” Do not take any steps suggested.
• If you receive a message alerting you to problems, do not use any phone number or link that’s provided. Use another device to get the phone number of the company in question, and call directly.
• Never let a person unknown to you download computer-sharing software.
• Credible institutions do not ask you to transfer money by cash, gift card, or cryptocurrency.

If your loved one is at all suspicious, they should hang up immediately and contact you. You can contact the FBI at www.ic3.gov to investigate whether this is a fraud call or not.