Be aware of noise pollution when caring for the elderly.
In my last post, I wrote about music as a beneficial form of therapy for the elderly who suffer from memory disorders, which begs the question: what about the sounds of everyday life?
The Environmental Protection Agency explains the consequences of unwanted and disturbing sound, which is the basic definition of noise pollution — an environmental stressor we cannot taste, smell or see: “Sound becomes unwanted when it either interferes with normal activities such as sleeping, conversation, or disrupts or diminishes one’s quality of life.”
Noise pollution can lead to health problems, too. “Studies have shown that there are direct links between noise and health. Problems related to noise include stress related illnesses, high blood pressure, speech interference, hearing loss, sleep disruption, and lost productivity.”
Alzheimer’s and dementia patients are particularly sensitive to stimuli that a healthy person can normally filter. In creating a safe and comfortable environment for my parents, I found myself thinking like a parent creating a healthy environment for her children: routines, which are so important for kids to feel stable, are just as important for the elderly. A typical day for my parents revolved around “quiet” time and “noisy” time.
As caregivers, we shouldn’t take any of the five senses for granted when developing strategies for care — including hearing. Patients will react differently to auditory input and so we should be keenly aware of sound “hazards” in the patient’s surroundings.
NOISE POLLUTION AS ENVIRONMENTAL STRESS
When I was caring for my mother, I noticed that some ordinary sounds – such as a loud TV — were particularly disturbing for her. She would grimace and want to retreat to what I can only describe as her “safe space” where she detached from the world.
To help her, I avoided over-stimulation without completely dulling surrounding noises. Agitation and discomfort might otherwise have affected her cardiovascular health and emotional well-being.
I knew my mother well and so I could gauge what I thought she would like or wouldn’t like based on how she reacted to the world before Alzheimer’s disease. Neurologists had no answer for me, but all I really needed to know was old-fashioned common sense. In short, just keep the patient comfortable.
Sound is energy and vibration. While an Alzheimer’s patient may not be able to cognitively understand a sound — a spoken word may be interpreted as just that, a sound with no meaning — they may certainly be able to “feel” it, which explains the positive effects of music.
CONVERSATION AS NOISE POLLUTION
Noise pollution isn’t just about unwanted sounds; it’s also about conversation. I would always ask our health aides to refrain from any conversation when standing within earshot of my father, who was then in the beginning stages of dementia and my mother, who had advanced Alzheimer’s.
Imagine being surrounded by negative conservation or even a pleasant chat that your brain can’t process for context. Eventually, the meaningless “sound” may become jarring. You’re powerless to make it go away if you’re “stuck” in your body.
In one instance, my father overheard one side of a stressful conversation an aide was having over her cellphone about money. Because he was confused at that moment, he couldn’t properly interpret what he had heard. Later, he spoke to me as if he had been involved in her dilemma, which was a needless source of stress and anxiety for him and for me as well, as I had to go to great lengths to clarify that no one was stealing his money. (This is a major stressor for the elderly who perceive they are “losing” their possessions as they gradually let go of what they once managed.)
It’s crucial, then, to watch one’s words when speaking in front of dementia patients who are still aware of surroundings.
In my mother’s case, it was impossible to tell in the advanced stages of the disease if and how her brain could interpret sound. I erred on the side of caution: even in a state of stupor in which she was completely unresponsive, I encouraged everyone who came near her to keep unpleasant sounds and conversations at bay.
While it may seem obvious that no patient or even a healthy individual would want to tolerate noise pollution, consider this: the elderly in many nursing homes who do not enjoy private rooms must endure an almost constant stream of distracting and unpleasant noises that interfere with peace and quiet: working staff, sick roommates and their visitors, loud television sets, beeping medical equipment and other sounds create a cacophony of noise.
This situation is yet another reason to consider in-home healthcare alternatives for the elderly where caregivers can control the environment.
Some Alzheimer’s and dementia patients tend to yell or wail loudly when they feel nervous, which is a whole other aspect of elder care. My parents were relatively quiet but in all cases, it’s imperative to be conscious of noise levels. (Read what worked or didn’t work for some caregivers at Caring.com’s support group.)
In my experience, I simply tried to imagine how I would feel if I were sick and bewildered, not just for the sake of empathy, but also to gauge what would be an appropriate level of noise for my parents.
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— Maria de los Angeles is an award-winning writer based in Miami who became a caregiver to her parents in 2008. Since then, she has been a passionate advocate for eldercare and caregiver issues.
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