This is not as unusual as you might think. In fact, many patients can sing right along. There are two primary reasons why people hear music, voices, or sounds in their head. In seniors, more likely than not, hearing loss exists (even if minor) and the damaged nerves in the ears have created tinnitus (ringing in the ears) that is being incorrectly channeled to memory centers in the brain, but does not represent brain damage! This results in exquisite musical overtures and familiar songs or voices that are not unpleasant, but sometimes constant and annoying. In some cases, the sound are unformed and interfere with communication. The phenomenon happens as a result of sound deprivation from hearing loss, a lack of social engagement and isolation, and an inability to hear normal environmental sounds that connect all of us to our surroundings and heighten electrical activity in the brain. Auditory hallucination occur in about 10% of the hard of hearing senior population. Unlike the hearing loss group, patients with schizophrenia hear voices that are unpleasant, threatening, disturbing, and cause them to be reactive.
For those with auditory hallucinations like your mom, the physician should be alerted to the condition and an Audiologist should be consulted. Most importantly, the hearing loss should be corrected, and sound therapy should be applied in the same manner as in patients with tinnitus. The objective is to flood the brain with normal levels of sound so that the internal musical memory is competing with normal levels of electrical activity from outside sources. This allows the brain to switch attention away from the guy inside! Eventually with consistent competition, the brain will have a chance to habituate or manage the hallucinations.
Start by letting your mom know that its ok to have these hallucinations, they are not that uncommon, and that she can be helped. Let her know that it is not a disease or sign of a mental disorder, although hearing loss can beget memory loss and dementia. Remarkably, hearing better also improves these functions too! Take her to her doctor who will review her health status, get her hearing tested by an Audiologist, and let her know that she might need hearing aids, if necessary, and make sure she can talk on the phone and hear the TV clearly. Have her listen to music and pay attention to the world of sound around her so that she can teach her brain to blend normal outside sounds and music with her internal memories (hallucinations). Let them compete, but don’t try to mask the hallucinations away with loud music or noise, you can’t. Let her know that she will automatically shift back and forth for a while, but as the weeks and months of good hearing and stimulation invade the brain, this will improve, make the situation more manageable, or habituate the hallucinations altogether. If your mom doesn’t hear the hallucination, tell her to stop looking for them, because she will always be able to tap into that memory, let it go. Most importantly, the use of hearing aids and sound therapy must be reasonably continuous, but especially whenever the hallucinations start. Should the hallucinations produce an overly reactive psychological response and distress, your mom should see a Psychologist or Neuro-Psychologist for cognitive behavioral therapy to help her manage her anxiety, take control of her feelings, and reduce the occurance of the hallucinations. This can be extremely beneficial for some patients.