COMING OUT OF LOCKDOWN – COPING WITH NOISE SENSITIVITY

COMING OUT OF LOCKDOWN – COPING WITH NOISE SENSITIVITY
Many people struggle with hearing in background noise and some people also
have a sensitivity to loud sounds. Please be assured that this is really common,
you are not alone. At this time in Spring 2021, you may have just experienced more
than a year of quiet at home.
This information has been written at the request of people living with dementia that
are worried about going back into the noisy social world. We hope this gives you
some ideas to get started, but please keep talking about it too. If you need more
help, please speak to either your Audiologist or Occupational Therapist, or ask your
GP for a referral to your local Audiology service.
Giving it a name can help. When we have a sensitivity to loud sounds it brings,
anxiety and stress in those situations; we call this hyperacusis.
People living with dementia may experience the same noise sensitivity that many
people do, but it seems to be experienced more often. This perhaps results from
changes in sound perception in the brain, making loud or unwanted sounds more
noticeable. It also seems that reactions to this may be stronger and, if the result is to
stop socialising, the risks are greater - people are left isolated and risk losing
confidence and important social skills. There is no quick fix to remedy this sensitivity,
and people living with dementia may need a slightly different approach than others
typically use.
Dealing with noise sensitivity starts at home. While we are waiting to be able to meet
up with friends and travel about again, this is a perfect time to start preparing. A
suggested approach is divided into 4 stages, which are all equally important.
1. Prepare your ears
4. If things get too much
1. PREPARE YOUR EARS
Practise being in noise at home. You can start by putting the television on in the
background, or have some music playing for part of each day. To make the sounds
more realistic, you can use online or mobile phone music apps (such as Spotify or
Amazon) to play background sounds, including irritating ones like café noises! Play
your chosen sound quietly while you focus on an enjoyable activity, such as reading
or crafts. Test this out, did you manage ok? Play these sounds for a little while every
day, starting with a quiet volume and building up as you get more used to it. You are
aiming to help your ears and brain to start to ignore these sounds again, while you
focus on the fun activity you are doing. You might use a diary to record progress.
2
If you have hearing aids, wear them at home. Even if you are not talking to
someone, this will help your ears to get used to hearing all the little background
sounds again. Start a little each day, and gradually build up to wearing them all day
long. Make sure you have enough batteries and everything is working well – most
Audiology services can post batteries and tubes out to you.
Avoid ear defenders. Ear defenders and earplugs can be good in some situations,
such as on noisy underground trains. But using them regularly will make your ears
more sensitive to loud sounds. Perhaps just have them in your going out bag, just in
case you need them if things get too much (see stage 4).
2. PREPARE YOURSELF
Use your breathing to calm yourself. Breathing exercises help you learn to
breathe in and out in a calm way, slowing your heart rate and distracting your mind.
You can find many exercises online. Teach yourself to do this by practising at home,
first in quiet, and then with sound playing. Then, when you go out and a noise
triggers your feelings, you will already be good at using your breathing to take away
the heat.
If you have difficulties with breathing like this, you can instead find something else
that you can focus on when you are feeling overwhelmed, such as moving your ring
on your finger, playing with a bracelet or watch, or sucking on a peppermint.
Some people use mindfulness or other relaxation techniques help reduce anxiety.
Tips and exercises are available online or via mobile phone apps, and can help to
practise in a guided way. Scents and pleasant smells help too. You can add a
favourite scent to a handkerchief and keep this with you.
Bust those anxious thoughts. It is ok to feel anxious, but having a way to deal with
your thoughts will help. Some people use cognitive behaviour therapy techniques
(CBT). These recognise that you have feelings, naturally, but teaches you to control
the thoughts that go with them. This does takes practice though!
Prepare at home by thinking of a “thought buster sentence” that makes you feel
better, something you might say to a friend in the same situation. One example is
“You were great at going out before and, with practice, you will be great again”. Use
your sentence each day, so that you are ready to think it to yourself when you feel
stressed. You may wish to write the sentence down, or add it to a phone alert. This
aims to give you more ammunition when you feel overwhelmed, to help you to feel
less stressed.
Gather good support around you. It helps to get other people to help you, both for
support and for practice. Tell them what is worrying you about going out in noise.
Practise having conversations with friends or family with your noise playing – this
might be at home, or on video calls. Start with quiet noise for a little time, and
gradually build it up. When you are ready and able to go out, go with a trusted
“buddy” or companion. Agree with them beforehand what they will do – they could
3
reassure you, prompt you to breathe, or give them the words to use if it gets too
much.
What is your phrase? We all need a phrase to say to other people when noise is
too much, such as “I’ve got sensitive ears, can you speak a little quieter” or “Is there
somewhere quieter we can sit, as I’m finding it difficult with the noise level”. If this
doesn’t come easily, write your “too noisy phrase” down, perhaps record it on your
phone, or practice saying it to a friend. Some people create a laminated card and
attach it to a sunflower lanyard. Others have it written on their phone, so that they
can show it to someone when they are stressed or feeling overwhelmed.
Now make a plan. Think through the problems or difficulties that can arise when you
go out. You now have strategies to use to overcome these. These are:
Breathe
Too noisy phrase
When you have practised these at home and you have prepared your ears, make a
plan: What am I going to do? When am I going to do it? How am I going to
remember? Who will help me? Your plan doesn’t have to be perfect first time, just a
way to get started. When you do start going out, you will need to come back and
practice again. You may also need to adjust the plan until you find a way that works
really well for you.
3. STARTING TO GO OUT
Start easy. Choose a good place to start, such as sitting in the garden. Perhaps play
some music or those café noises while you enjoy the scene. Next you could move to
a conversation in the street, or a quiet table outside a café. Plan to be there just a
short time, and choose understanding friends or family to meet! Build up gradually,
one place at a time, saving your noisiest place for last!
Set the scene. When you do start to meet inside, go somewhere familiar. Try sitting
with your back to a wall, so that you can see what is happening. Look for soft
cushions or curtains to absorb noise, and sit away from the music player or coffee
machine. If you need to, use your “too noisy phrase” - ask people to turn the music
down, or ask where would be a good quiet spot.
Be ready. Try to immerse yourself in the situation and have fun being out! But keep
your plan to hand – breathe, thought buster sentence, buddy, too noisy phrase.
Take breaks. Every now and again, go outside or to another room to take a break.
While you are there, take deep breaths, say your thought buster sentence. You can
come and go a few times if needed. If you have a buddy, ask them to walk with you
perhaps.
4
Test your plan. When a noise triggers your feelings, you are ready for this! Use your
plan. Use your breathing exercise to take away its power. Use your thought buster to
get your thoughts back on track. Use your buddy to reassure you, or speak up for
you. Use your noise phrase to ask for the noise to stop. Or take another break. Once
you are back in control, you may find that you can carry on.
4. IF THINGS GET TOO MUCH
Leave it for the day. If things get too much, it is okay to leave. After a few moments
to yourself, you may find you can come back in again for a short time. Or you may
feel this is enough for one day. This will be a gradual process, so it is good to spend
short times in each situation, and increase them over weeks and months. Feel good
for the minutes you spent in the situation, you are doing well!
If you can’t leave. For situations where you feel you can’t leave, e.g. on public
transport, it can help to have a back-up option in your bag or pocket. Ear defenders
are not helpful in everyday situations, but it can help to reassure you to have them
on hand if everything gets too much. If you have hearing aids, taking them out can
have the same quietening effect. Just make sure that you can still hear
announcements of where to get off the train. Ask someone else to prompt you if
needed. Asking others is a sign of strength not weakness.
How did it go? Once you have left, you can review how this went. It can help to note
this down on the same day (see the internet link to a worksheet at the end.)
Did you use your plan?
If you did, what went well? Be proud of this achievement!
What didn’t go well? What have you learned?
If you didn’t use your plan, what stopped you?
What did your buddy see? Asking others can help to know what happened.
Relax. You can use the breathing or mindfulness exercises to also restore your calm
afterwards. Once you have learnt from the situation, leave it behind. Tomorrow will
be a new day to try out your plan again. When you are rested, you can practice
again. But make sure you take a break first!
It is likely to take a few months to gradually get back into your everyday social and
business situations. Be patient and kind to yourself, and enjoy the times that you do
have out and about.
If you are not finding these self-management tips helpful, or need help to work
through this, please do speak to either your Audiologist or Occupational Therapist, or
ask your GP for a referral to your local Audiology service.
5
Hyperacusis - http://www.tinnitus.org.uk/hyperacusis
with-dementia/dementia-friendly-environments/noise.asp
Worksheets (to help with thought busting, planning, and reviewing “how did it go?”) -
http://llttf.com/wp-content/uploads/7-sheets-worksheets-English.pdf
With thanks
Sarah Bant (Clinical Scientist in Audiology),
Vicky Sadler, (Hearing Therapist),
Karen Shearsmith-Farthing (Occupational Therapist)
and Kathryn Fackrell (Researcher),
with the help of people living with dementia who have noise sensitivity themselves.