Project Summary

Ensuring that long-term care home (LTCH) residents with dementia receive appropriate and effective hearing care is an essential but unaddressed issue. The impact of untreated hearing loss on residents with dementia can include increased confusion, depression and agitation, difficulties interacting with their caregivers and peers and increased risk of social withdrawal. Meeting the hearing-related needs of residents with dementia is vital to maintaining their communication abilities, independence, and quality-of-life as much as possible. The aims of this thesis were to explore current practices surrounding the provision of hearing care to long-term care home residents with dementia, understand the barriers and facilitators to this provision and to make evidence-based recommendations for intervention. The work presented in this thesis provides a novel, holistic understanding of the barriers experienced by residents with dementia and their formal and informal caregivers. The thesis also outlines the development of the first evidence based, behaviour change intervention for LTCH staffs in improving their provision of hearing support for residents with dementia. This thesis includes five studies; A systematic review, three original research studies using survey and interview methods and the development of a behaviour change intervention. This thesis underscores the complexity of providing effective hearing care to residents with dementia, and the need for improvement of often inconsistent and poor-quality support. The research identified several interacting, multi-level barriers relating to caregivers’ knowledge of hearing loss, opportunities for LTCHs to work effectively alongside audiologists, unclear responsibilities relating to hearing care and residents’ difficulties adapting to, or being comfortable wearing, hearing aids. Addressing these difficulties can only be achieved through multi-component person-centred interventions co-developed with PPI contributors. The intervention outlined in this thesis has the potential to improve mood, communication abilities, social interaction and reduced behavioural symptoms and distress of residents living with dementia and hearing loss in care homes.

Outputs / expected Outputs

Cross, H., Armitage, C., Dawes, P., Leroi, I., & Millman, R. (2024). Improving the provision of hearing care to long-term care home residents with dementia: Development of a behaviour change intervention for care staff. Journal of Long Term Care.

Cross, H., Armitage, C. J., Dawes, P., Leroi, I., & Millman, R. E. (2023). “We’re just winging it”. Identifying targets for intervention to improve the provision of hearing support for residents living with dementia in long-term care: an interview study with care staff. Disability and Rehabilitation, 1-11.

Cross, H., Armitage, C. J., Dawes, P., Leroi, I., & Millman, R. E. (2023). Capabilities, opportunities and motivations of staff to provide hearing support to long-term care home residents with dementia. International Journal of Audiology, 1-8.

Cross, H., Dawes, P., Hooper, E., Armitage, C. J., Leroi, I., & Millman, R. E. (2022). Effectiveness of hearing rehabilitation for care home residents with dementia: a systematic review. Journal of the American Medical Directors Association, 23(3), 450-460.