Assessing and managing concurrent hearing, vision and cognitive impairments in older people: an international perspective from healthcare professionals

Abstract

Background there is a significant gap in the understanding, assessment and management of people with dementia and concurrent hearing and vision impairments. Objective from the perspective of professionals in dementia, hearing and vision care, we aimed to: (1) explore the perceptions of gaps in assessment and service provision in ageing-related hearing, vision and cognitive impairment; (2) consider potential solutions regarding this overlap and (3) ascertain the attitudes, awareness and practice, with a view to implementing change. Methods our two-part investigation with hearing, vision, and dementia care professionals involved: (1) an in-depth, interdisciplinary, international Expert Reference Group (ERG; n = 17) and (2) a wide-scale knowledge, attitudes and practice survey ( n = 653). The ERG involved consensus discussions around prototypic clinical vignettes drawn from a memory centre, an audiology clinic, and an optometry clinic, analysed using an applied content approach. Results the ERG revealed several gaps in assessment and service provision, including a lack of validated assessment tools for concurrent impairments, poor interdisciplinary communication and care pathways, and a lack of evidence-based interventions. Consensus centred on the need for flexible, individualised, patient-centred solutions, using an interdisciplinary approach. The survey data validated these findings, highlighting the need for clear guidelines for assessing and managing concurrent impairments. Conclusions this is the first international study exploring professionals’ views of the assessment and care of individuals with age-related hearing, vision and hearing impairment. The findings will inform the adaptation of assessments, the development of supportive interventions, and the new provision of services.

Time for dinner: the communal dining room in care homes and its impact on nutritional outcomes

“…Recently, we explored the perspectives of professionals from the fields of hearing, vision, and cognitive health regarding the design of an intervention to improve the quality of life of people with dementia and concurrent sensory impairment. The notion of a "sensory appropriate environment" emerged as an important consideration (Leroi et al, 2019a), consistent with the findings regarding nutritional outcomes. This has led to a multimodality hearing and vision optimization intervention for people with dementia that includes environmental modification (Leroi et al, 2019b;Hooper et al, 2019;Regan et al, 2019).…”

A randomised controlled trial of hearing and vision support in dementia: Protocol for a process evaluation in the SENSE-Cog trial

“…We developed the SI iteratively over 24 months. This involved: (1) a scoping review of the literature [9]; (2) an in-depth qualitative exploration of the support care needs of PwD with sensory impairment in three European countries [10]; (3) an international survey (n = 653); and (4) an interdisciplinary Expert Reference Group (n = 17) [11,12]. The findings were synthesized into a draft SI that was then field tested in the UK, France and Cyprus [13][14][15], prior to development of the protocol for the full multi-site RCT [16], the SENSE-Cog trial.…”

A randomised controlled trial of hearing and vision support in dementia: Protocol for a process evaluation in the SENSE-Cog Trial

“…This involved: (1) a scoping review of the literature [9]; (2) an in-depth qualitative exploration of the support care needs of PwD with sensory impairment in three European countries [10]; (3) an international survey (n=653); and (4) an interdisciplinary Expert Reference Group (n=17) [11,12].…”