I think the author included the old lady in the story given that she doesn't see or hear Andy at all. This is because the author is trying Andy to probably think her as Laura his girlfriend in his condition.
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The old lady's significance in the story is that she is representing people who cannot hear what's around them and only focus on what's in front of them. The whole theme is like: "hear no evil, see no evil, speak no evil. It represents what the characters do or don't do in this story.
Good luck :)