“It’s Huge, in a Way.” Conflicting Stakeholder Priorities for Managing Hearing Impairment for People Living with Dementia in Residential Aged Care Facilities

Abstract

Objectives:The aims of this study were to a) explore the impact of hearing impairment on people living with dementia in residential aged care facilities (RACFs) and b) investigate management of hearing impairment for this population.Methods: A descriptive qualitative approach, consisting of semi-structured interviews, was conducted with 23 participants across four stakeholder groups (audiologists, care staff, family members and individuals with dementia and hearing impairment living in RACFs).Results: Thematic analysis revealed an overarching theme of "different priorities for managing hearing impairment" that emerged from the data. Audiologists and care staff prioritised different practices for managing hearing impairment: audiologists emphasised hearing aids and care staff emphasised communication strategies. Care staff also identified that current management of hearing impairment was sub-optimal as they do not prioritise managing it. Conclusions:Residents with dementia and hearing impairment living in RACFs are not receiving optimal hearing management. Further research is required to understand the factors that influence this. Clinical implications:Changes in practices of both care staff and audiologists are required to improve hearing impairment management for this population.

Hearing Assessment and Rehabilitation for People Living With Dementia

“…Clinicians also have differing opinions over an optimal choice of hearing aid features for PwD ( Bott, Meyer et al 2020 ). A pragmatic solution is that if advanced features are activated, these features should not present a barrier to use for the PwD.…”

Effectiveness of Hearing Rehabilitation for Care Home Residents With Dementia: A Systematic Review

“…Ten studies discussed sound amplification with hearing aids or PSAPs. 6,7,14,21,24,43,46,47,48,49 Both hearing aids and PSAPs amplify sound, but PSAPs are simpler to use, sold over the counter at a lower cost and do not require fitting by an audiologist. 50 Low rates of hearing aid use were found across studies, particularly for residents with severe cognitive impairment compared to mild impairment or normal cognition.…”

“…17,24,44 Residents with dementia required additional support from caregivers to use and manage hearing devices. 7,24,46,49 PSAPs were used as a stepping-stone to hearing aid use for some residents with dementia. 7,14 Several studies exploring amplification reported improvements in communication, 7,43,46,49 reductions in anxiety, agitation and hallucinations, 6,7,43,49 improvements in speech recognition, 46,47,48 and quality of life and wellbeing.…”

“…7,24,46,49 PSAPs were used as a stepping-stone to hearing aid use for some residents with dementia. 7,14 Several studies exploring amplification reported improvements in communication, 7,43,46,49 reductions in anxiety, agitation and hallucinations, 6,7,43,49 improvements in speech recognition, 46,47,48 and quality of life and wellbeing. 6,7,43,49 PSAP use did not improve quality of life in Jupiter's 14 pilot study.…”

“…7,14 Several studies exploring amplification reported improvements in communication, 7,43,46,49 reductions in anxiety, agitation and hallucinations, 6,7,43,49 improvements in speech recognition, 46,47,48 and quality of life and wellbeing. 6,7,43,49 PSAP use did not improve quality of life in Jupiter's 14 pilot study. Weinstein and Amsel 47 found improvements in Mental Status Questionnaire scores 51 when using PSAPs.…”