Nursing Management of Hearing Impairment in Nursing Facility Residents

Adams-Wendling, Linda; Pimple, Cathy; Adams, Susan; Titler, Marita G.

doi:10.3928/00989134-20081101-09

Cited by 17 publications

(11 citation statements)

References 31 publications

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“… [ 61 ] Allan et al UK Deafness and dementia: what you need to know 2006 Patient and public information document Advice to professional and layperson on managing dementia and hearing loss. [ 64 ] Adams-Wendling et al USA Nursing management of hearing impairment in nursing facility residents 2008 Journal article—evidence-based practice guideline The report provides evidence-based practice guidelines to front-line staff in nursing homes, highlighting the competencies need to communicate effectively with hearing-impaired residents. [ 43 ] Beer et al USA Communicating with patients who have advanced dementia: training nurse aide students 2012 Journal article—survey-based quantitative study Findings indicate a need for a person-centred approach to dementia education; limited time was cited as a barrier to education and training; flexible small group training which is practically based.…”

Section: Resultsmentioning

confidence: 99%

Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication

Crosbie

Ferguson

Wong

et al. 2019

BMC Med

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Background Managing hearing communication for residents living with hearing loss and dementia in long-term care settings is challenging. This paper explores how care can be effective in optimising hearing communication for residents living with dementia. We argue that the underlying notion of permission or authorisation allows care staff to do what they know will be effective in providing person-centred care that enhances hearing communication. The paper also indicates that this notion of permission can usefully be applied to other areas of care home practice. Methods To address hearing-related communication in care homes, we conducted a realist synthesis (RS). As a theory-driven approach to reviewing literature, it also uses expert opinion to understand complex health situations. Using RS, we developed a theory surrounding the management of hearing-related communication in care homes. Applying formal processes to the literature search and data extraction, the analysis uncovered relevant mechanisms and contexts to help confirm, refute or refine our understanding of how hearing communication could be improved. Results Forty-three papers were selected for the realist synthesis. The documents were analysed to construct five context-mechanism-outcome configurations (CMOCs). The CMOCs represent possible care interventions to optimise hearing-related communication in care homes for person living with dementia and hearing loss (PLWDHL). They include leadership promoting positive regard and empathy through person-centred care, communication training for staff, ‘knowing the person’ and relationship building for responsive awareness of residents’ hearing needs, maintaining and monitoring hearing communication through care planning, and managing noise in the care home environment. Conclusions Leadership that provides appropriate training and resources is likely to enhance knowledge and skills, leading to staff feeling able and equipped to respond to the hearing-related communication needs of PLWDHL. Collaboration with local hearing services is likely to raise awareness of hearing loss among care home staff. Importantly, care staff require a sense of permission from leadership, to work with knowledge and autonomy in the interest of residents living with dementia and hearing loss. Electronic supplementary material The online version of this article (10.1186/s12916-019-1286-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication

Crosbie

Ferguson

Wong

et al. 2019

BMC Med

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“…These results consolidate the findings from previous research, in which nurses have reported feeling inadequately trained to care for residents with sensory impairment [ 43 ], and frontline healthcare providers reported difficulties in distinguishing the relative contributions of sensory loss and dementia to breakdowns in communication [ 44 , 45 ]. Despite the evidenced sensitivity and appropriateness of some sensory screening measures in older and non-communicative populations [ 27 , 46 – 49 ], as well as the feasibility of in-service training for healthcare providers who are willing to engage in these [ 16 ], and its benefit to residents with cognitive and physical fragility [ 50 ], relevant evidence-based practice guidelines have not yet been adopted in these LTCH settings [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the sensory screening experiences of nurses working in long-term care homes with residents who have dementia: a qualitative study

et al. 2018

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BackgroundThe prevalence of vision and hearing loss is higher amongst older individuals with dementia, as well as higher in long-term care settings than in the wider community. However, the incidence of sensory impairment is underreported and often goes untreated. In this study, we aimed to understand nurses’ current experiences of screening and caring for long-term care residents who have dementia and sensory impairment.MethodsAs part of a larger study on the sensory screening of long-term care residents with dementia, an environmental scan was conducted with front-line healthcare providers. We report here on the findings from the content analysis of individual, semi-structured interviews with nurses working in two long-term care homes in Southern Ontario, Canada. Twenty regulated nurses, including designated resident assessment coordinators, working full- or part-time with individuals who have dementia, participated across the two sites. All interviews were transcribed, and their contents reviewed and coded for themes by means of inductive thematic analysis.ResultsFollowing a systematic and recursive approach, three analysts identified several themes relating to: 1) the sensory screening process, 2) communication strategies, and 3) quality of life, sensory loss, and dementia. Participants reported on the strengths and limitations of screening procedures, what improvements should be made, which informal strategies are effective, and the continued professional development that is needed.ConclusionsNurses demonstrated insight into the facilitators and barriers to effective screening and care of residents with dementia and sensory impairments, and expressed the need for further education, more suitable screening tools, and formalised accountability within the screening process for vision and hearing loss in these long-term care residents.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0917-x) contains supplementary material, which is available to authorized users.

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“…Additionally, the cerumen migration is disrupted by the aid, causing the cerumen to be trapped and accumulate in the canal. A management protocol 84 is described in …”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction)

Schwartz

Magit

Rosenfeld

et al. 2017

Otolaryngol.--head neck surg.

119

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Objective. This update of the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation cerumen impaction clinical practice guideline provides evidencebased recommendations on managing cerumen impaction. Cerumen impaction is defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. Changes from the prior guideline include• a consumer added to the development group;• new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials); • enhanced information on patient education and counseling; • a new algorithm to clarify action statement relationships;• expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; • an enhanced external review process to include public comment and journal peer review; and • 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.Purpose. The primary purpose of this guideline is to help clinicians identify patients with cerumen impaction who may benefit from intervention and to promote evidence-based management. Another purpose of the guideline is to highlight needs and management options in special populations or in patients who have modifying factors. The guideline is intended for all clinicians who are likely to diagnose and manage patients with cerumen impaction, and it applies to any setting in which cerumen impaction would be identified, monitored, or managed. The guideline does not apply to patients with cerumen impaction associated with the following conditions: dermatologic diseases of the ear canal; recurrent otitis externa; keratosis obturans; prior radiation therapy affecting the ear; previous tympanoplasty/myringoplasty, canal wall down mastoidectomy, or other surgery affecting the ear canal.Key Action Statements. The panel made a strong recommendation that clinicians should treat, or refer to a clinician who can treat, cerumen impaction, defined as an accumulation of cerumen that is associated with symptoms, prevents needed assessment of the ear, or both.The panel made the following recommendations: (1) Clinicians should explain proper ear hygiene to prevent cerumen impaction when patients have an accumulation of cerumen. (2) Clinicians should diagnose cerumen impaction when an accumulation of cerumen, as seen on otoscopy, is associated with symptoms, prevents needed assessment of the ear, or both. (3) Clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as ≥1 of the following: anticoagulant therapy, immunocompromised state, diabetes mellitus, prior radiation therapy to the head and neck, ear canal stenosis, exostoses, and nonintact tympanic membrane. (4) Clinicians should not routinely treat cerumen in patients who are asymptomatic and whose ears can be adequately examined. (5) Clinicians s...

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Nursing Management of Hearing Impairment in Nursing Facility Residents

Cited by 17 publications

References 31 publications

Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication

Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication

Exploring the sensory screening experiences of nurses working in long-term care homes with residents who have dementia: a qualitative study

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction)

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