|Care Advocate Newsletter|
|Past Issues | Download PDF||May 2013|
Not only can noise intrude on our peace and quiet, it can get in the way of everyday communication by blocking, distorting or changing what we are trying to hear. For the person with Alzheimer’s, these problems with noise can be magnified because of the person’s loss of the ability to understand or distinguish among sounds in the environment. As Al Power, M.D. notes:
"Competing sounds in the environment can lead to difficulty in focusing one’s thoughts or attending to conversation. Beyond the sounds that are considered “intrusive,” it is also important to look at our conversation. What is the tone of our voices? Do we sound relaxed, positive, warm and engaging? Or do we sound harried, stressed, angry or abrupt? As one’s ability to process the details of language becomes challenged, the tone of the voices in the environment creates a stronger effect than the actual content of the comments.”
The problem of noise in healthcare facilities evidently goes back many decades. Florence Nightingale in her Notes on Nursing wrote about how unnecessary noise can damage a patient and the importance of quiet. In your visits to your relative or friend, you may have noticed certain sources of noise, including call-bell systems, squeaky wheels, loud TVs and radios, oxygen concentrators, ice machines, overhead pagers, bed/chair alarms, air/heat ventilation systems, ventilator alarms, cleaning equipment, meal trays, staff conversations and vocal patients. Imagine being subjected to a constant barrage day and night, especially if you came from a calmer, tranquil home environment—is it any wonder you would feel anxious or agitated, even without suffering from dementia?
As noted, people with dementia are less able to handle multiple and competing stimuli and may be overwhelmed by too much activity. It has also been shown that hearing is the sense that has the most significant impact on people with dementia in terms of quality of life. It is therefore important to realize that even noise levels that seem tolerable to staff and caregivers may be distressing and disorienting for your relative, particularly at certain times of the day, e.g., shift changes and mealtimes. This could result in troubling behaviors, including wandering, which may be a way for the person to try to escape an untenable situation.
The workgroups also looked at the noise created by residents who, because they are in distress, often call out or moan. Not surprisingly, they concluded that the only effective approach is to learn as much about the resident as possible, including investigating the potential causes of the resident’s distress, as well as what brings him or her comfort. This takes time and requires the participation of family, friends, and staff who interact with the resident; however, it can bring about a real improvement for the person who is suffering.
To help ensure their comfort, you can focus on specific approaches for your relative:
Understanding your relative’s needs and capacity to tolerate noise and working closely with staff to identify and alleviate offending sources will go a long way toward solving the noise dilemma and improving their overall quality of life.
|We wish to acknowledge Forest Laboratories, Inc. for making this newsletter possible.|
|Visit the Care Advocate Homepage for past issues.|
|Resources & Events|
Dementia Beyond Drugs: Changing the Culture of Care
“Rethinking the Use of Position Change Alarms”
For more information on the work done by Isabella, contact: