CAVEAT DVMPTRVCK

We finished the last of Arthur’s various appointments with specialists at the VA hospital in Portland, this morning. This last appointment was with audiology. They admitted that their past efforts had fallen a bit short – which was reassuring. Nevertheless, we have had to schedule a follow-up appointment for February, back here in Portland. So we’ll have to travel at that time.

The diagnosis is not far off from what I expected. He’s “profoundly deaf” in the right ear, and “severely impaired” in the left. I’d actually already concluded that he must be deafer in the right than the left, given occasional unintentional experiments. Interestingly, Arthur lucidly commented that it made sense – he observed that the right ear was often “closer to the helicopter” – as a pilot, I guess the volume from the engines was stronger on the right side?

I’m moderately hopeful (but not extremely hopeful) that they have understood some of the behavioral issues that prevent Arthur from successfully using fancy, smartphone-connected hearing aids, due to his challenges in taking on new (unfamiliar), “fiddly” interfaces, etc. He can’t even activate his smartphone successfully. Basically, any technology newer than what he was comfortable with circa 2018 is going to be completely unlearnable. I’ve seen this with his efforts with his computer, with his banking websites, etc. “Updates” that alter the user experience render the new version unusable for him.

So despite the suffering and inconvenience, we’ll be traveling back to Portland in February.

Meanwhile, he’s without hearing aids (the repair I attempted to the ones we wrecked in the washing mashine last week didn’t stick, and both hearing aids were entirely nonfunctional as of two days ago). They will attempt a “repair” of the broken ones, which they’ll mail to us, but I’m not very optimistic on that front.

We now look forward to a couple Thanksgiving feasts, and return travel to Southeast Alaska next Monday.

As a postscript… one small lesson: never report the loss of just one hearing aid to a healthcare provider; always report both lost, that way you’ll get a proper pair as a replacement, instead of a mis-matched singleton.

It’s been a difficult couple of days. Yesterday I took Arthur to the VA clinic to see the Neurology department. This was something we were supposed to have done last year, but they’d been unable to schedule an appointment during the window of our time down here in Portland, and after an extended back-and-forth over the telephone, it had been decided to just wait until this year and try again.

The challenge was that, for really the first time, the doctors were addressing Arthur directly while using the term dementia. Arthur couldn’t really engage in denial in the moment, which is his standard strategy. He flat out denies he ever had a stroke, still, for example. He often comically denies that he is going deaf: “I’m not going deaf! There’s just some problem with my ears!” is a literal quote.

In the moment, he’s too polite to directly or combatively deny that he has dementia, but I could tell he was deeply upset and afterward and since, he’s been exceptionally obstreperous.

I messed things up much further, this morning, because I did the mistake I’ve been successfully avoiding for more than 4 years: I ran his hearing aids through the laundry. The problem here is that Arthur often takes out his hearing aids and instead of putting them into the little case they’re supposed to live in, he puts them into a pocket. When I do laundry at home, I have a fixed habit of going through his pockets to make sure nothing is in them – I’ve intercepted his hearing aids many times, this way. But here at Juli’s, thrown off my regular routine, and responding to Arthur’s complaint about a lack of clean clothes, I failed in my pocket inspection. His hearing aids went through the wash. One of them was quite damaged – plastic parts broken off and one bit missing. And of course who knows what damage to the electronics inside.

As things stand, I did a MacGuyveresque repair on the broken one, using some scotch tape and super glue, and we’ve tested them. One of them seems to work, the other seems to be stuck in some kind of reboot cycle. Good thing we’re scheduled to see an audiologist in a week. But… I’m super frustrated with VA audiology support, and skeptical that they’ll offer anything truly useful. As I remarked to Juli in the wake of the washing machine incident, “It’s not like Arthur was really using the hearing aids effectively, anyway.” The problem is that in combination with his cognitive deficits, it’s very, very difficult for Arthur to build new habits or learn new, fiddly procedures related to the correct use and care of his hearing aids. The result is that he doesn’t ever reach a point where he’s using them the way the designers imagined: always in, with all kinds of “bells and whistles” around an app on the smartphone that can link it to audiobooks, music, the TV, whatever. None of that is anything we can ever expect Arthur to master, at this point. He can’t even figure out how to turn on his smartphone, much less use it. Anything that wasn’t in his technological repertoire before 2018 will NEVER be in his repertoire. Old dog, no new tricks.

I feel terrible that all this is happening – that I was insufficiently diligent in doing things I knew needed to be done (i.e. about inspecting pockets, about getting anything useful from VA audiology). A failure of care.