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Hughes MC, ScheckLong D, Chung K. Hearing Aid Loan Program for Hearing Loss at the End of Life. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2023; 19:182-189. [PMID: 37368863 DOI: 10.1080/15524256.2023.2229038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
This article describes a hearing aid loan program to provide free amplification devices for patients at the end of life to help them communicate more effectively at this critical time. It includes steps for establishing such a program, addressing challenges, and the role of the informal caregiver throughout the intervention. Healthcare professionals and social workers are encouraged to develop similar programs and use the information here as helpful suggestions to consider for their programs.
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Affiliation(s)
- M Courtney Hughes
- School of Health Studies, Northern Illinois University, DeKalb, Illinois, USA
| | - Diane ScheckLong
- Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois, USA
| | - King Chung
- Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois, USA
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Hu M, Freedman VA, Ehrlich JR, Reed NS, Billington C, Kasper JD. Collecting Objective Measures of Visual and Auditory Function in a National in-Home Survey of Older Adults. JOURNAL OF SURVEY STATISTICS AND METHODOLOGY 2021; 9:309-334. [PMID: 33869640 PMCID: PMC8027590 DOI: 10.1093/jssam/smaa044] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Maintenance of visual and auditory function is important for preventing the onset of activity limitations and preserving quality of life in later life. To date, national panel studies focused on health and aging have mostly collected subjective (self-reported) measures of visual and auditory function. The National Health and Aging Trends Study (NHATS), a study of Medicare beneficiaries ages sixty-five and older, recently developed a protocol for measuring objective visual and auditory function for its annual, in-home data collection conducted by trained interviewers. The protocol includes three vision tests-distance and near acuity and contrast sensitivity-and one hearing test-pure-tone audiometry-conducted using a tablet platform with results recorded in a scannable booklet. To identify operational issues and evaluate data quality for the proposed set of vision and hearing tests, NHATS incorporated a pilot study into its 2019 round (N = 417 participants and N = 9 interviewers). Using these pilot study data, the objectives of this paper are to: (1) describe the NHATS protocols to collect objective measures of visual and auditory function; (2) evaluate the quality of the data collected; and (3) assess whether results are influenced by interviewers. We found that respondents were highly likely to participate, with cooperation rates for each test about 90 percent. Data were high quality, with low rates of missingness, test results significantly associated with age and self-reported items, and percentages with poor vision or hearing consistent with prior population-based studies. Objective measures were more likely than self-reports to classify participants as having visual and auditory impairments and had stronger relationships with demographic correlates. Interviewer effects were small and not statistically significant in this small sample. Results of this study have demonstrated that objective visual and auditory functioning can be successfully incorporated into an interviewer-administered home-based protocol.
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Affiliation(s)
- Mengyao Hu
- Assistant Research Scientist with the Survey Research Center, Institute for Social Research, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Vicki A Freedman
- Research Professor with the Survey Research Center, Institute for Social Research, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Joshua R Ehrlich
- Assistant Professor with the Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan-Ann Arbor, MI, USA
| | - Nicholas S Reed
- Assistant Professor with the Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Judith D Kasper
- Professor with the Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Höbler F, McGilton KS, Wittich W, Dupuis K, Reed M, Dumassais S, Mick P, Pichora-Fuller MK. Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review. J Alzheimers Dis 2021; 84:1115-1138. [PMID: 34633326 PMCID: PMC8673512 DOI: 10.3233/jad-215087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. OBJECTIVE To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. METHODS Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O'Malley's scoping review and appraisal process was followed. RESULTS There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. CONCLUSION Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.
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Affiliation(s)
- Fiona Höbler
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katherine S. McGilton
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Kate Dupuis
- Sheridan Centre for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Marilyn Reed
- Audiology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Shirley Dumassais
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
| | - Paul Mick
- Department of Surgery, Faculty of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Blustein J, Wallhagen MI, Weinstein BE, Chodosh J. Time to Take Hearing Loss Seriously. Jt Comm J Qual Patient Saf 2019; 46:53-58. [PMID: 31732478 DOI: 10.1016/j.jcjq.2019.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
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Wallhagen MI, Ritchie CS, Smith AK. Hearing Loss: Effect on Hospice and Palliative Care Through the Eyes of Practitioners. J Pain Symptom Manage 2019; 57:724-730. [PMID: 30630051 DOI: 10.1016/j.jpainsymman.2018.12.340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/28/2018] [Accepted: 12/29/2018] [Indexed: 11/25/2022]
Abstract
CONTEXT Discussions regarding values and goals of care are central to providing quality palliative care. An inability to hear during these sensitive discussions may significantly impair the quality of care provided, yet hearing loss (HL) is not formally addressed in these settings or in programs designed to assist practitioners gain advanced communication skills. OBJECTIVE To gain an understanding of hospice and palliative care practitioners' experiences with HL and its impact on the care provided. METHOD SurveyMonkey questionnaire eliciting whether and how HL impacted care provided with an open-ended question asking for descriptions of a situation where HL created a problem in communication with an older patient. Responses were analyzed using constant comparative techniques. RESULTS Of 510 respondents, 464 (91%) reported HL had some or great impact on the quality of care provided, 449 (88%) noted encountering a situation where HL impaired communication with an older adult, and 99 of these participants (22%) provided a specific example. The overarching theme was "Diagnostic and Treatment Uncertainty." Nonmutually exclusive categories underpinning this theme included the following: unable to get needed information, misinterpreting level of understanding, patient misunderstanding of instructions, and goals-of-care errors. CONCLUSION HL impacts the quality of care provided to persons with serious illness by disrupting the identification, assessment, and treatment of the physical, psychosocial, and spiritual symptoms an individual is experiencing. HL should be formally addressed in programs designed to develop skills in conducting sensitive conversations. Practitioners should screen for HL, use practices that facilitate comprehension, and use assistive listening devices as needed.
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Affiliation(s)
- Margaret I Wallhagen
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, California, USA.
| | - Christine S Ritchie
- Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA; Jewish Home San Francisco, San Francisco, California, USA
| | - Alexander K Smith
- Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA; Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, California, USA
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Bikbov MM, Fayzrakhmanov RR, Kazakbaeva GM, Zainullin RM, Salavatova VF, Gilmanshin TR, Arslangareeva II, Nikitin NA, Panda-Jonas S, Mukhamadieva SR, Yakupova DF, Khikmatullin RI, Aminev SK, Nuriev IF, Zaynetdinov AF, Uzianbaeva YV, Jonas JB. Self-reported hearing loss in Russians: the population-based Ural Eye and Medical Study. BMJ Open 2019; 9:e024644. [PMID: 30898811 PMCID: PMC6475155 DOI: 10.1136/bmjopen-2018-024644] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE With data on frequency of hearing loss in Russia and Eastern Europe generally lacking, we assessed the prevalence of hearing loss in a Russian population. SETTING The population-based Ural Eye and Medical Study was conducted in the rural and urban regions of Bashkortostan, Russia. PARTICIPANTS With an inclusion criterion of age 40+ years, the study included 5899 (80.5%) out of 7328 eligible individuals (mean age: 59.0±10.7 years; range: 40-94 years). PRIMARY AND SECONDARY OUTCOME MEASURES Hearing loss was examined in 5397 (91.5%) study participants, assessed using a standardised interview with questions from the 'Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S)'. RESULTS The prevalence of self-reported hearing loss (26.1%, 95% CI 24.2 to 27.2) increased from 10.9% (95% CI 8.0 to 13.7) in participants aged 40-45 years old to 59.0% (95% CI 51.6 to 66.4) in those aged 80+ years old. It was higher for men than for women in the 60-80 years age group (38.93%, 95% CI 35.8 to 42.1, vs 32.8%, 95% CI 30.2 to 35.3; p=0.003). On multivariable analysis, higher prevalence of hearing loss was associated with older age (p<0.001; OR [per year of age]: 1.06 [1.06 to 1.07]), male gender (p<0.001; OR: 1.26 [1.09 to 1.47]), higher depression score (p<0.001; OR: 1.06 [1.04 to 1.08]), higher prevalence of headache (p=0.001; OR: 1.27 [1.10 to 1.47]), history of cardiovascular diseases including stroke (p=0.001; OR: 1.32 [1.13 to 1.55]), and osteoarthritis (p<0.001; OR: 1.40 [1.18 to 1.67]), physically vigorous activity during work (p<0.001; OR: 1.40 [1.21 to 1.62]), alcohol consumption (p<0.001; OR: 1.51 [1.28 to 1.78]), and dry eye feeling (p<0.001; OR: 1.67 [1.30 to 2.16]). It was marginally correlated with a higher anxiety score (p=0.07; OR: 1.03 [0.998 to 1.06]). It was independent of diabetes (p=0.52), arterial hypertension (p=0.20), level of education (p=0.11), region of habitation (p=0.70), blood concentration of high-density lipoproteins (p=0.17) and low-density lipoproteins (p=0.52), current smoking (p=0.95) and smoking pack-years (p=0.37), and best corrected visual acuity (p=0.93). CONCLUSIONS As in other countries the prevalence of hearing loss is high in this elderly population in Russia. It is primarily or secondarily associated with older age, depression, male gender, cardiovascular disease and alcohol consumption.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
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Weinstein BE. The cost of age related hearing loss: to treat or not to treat? SPEECH LANGUAGE AND HEARING 2018. [DOI: 10.1080/2050571x.2018.1533622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Davies HR, Cadar D, Herbert A, Orrell M, Steptoe A. Hearing Impairment and Incident Dementia: Findings from the English Longitudinal Study of Ageing. J Am Geriatr Soc 2017; 65:2074-2081. [PMID: 28734053 PMCID: PMC5637915 DOI: 10.1111/jgs.14986] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine whether hearing loss is associated with incident physician-diagnosed dementia in a representative sample. DESIGN Retrospective cohort study. SETTING English Longitudinal Study of Ageing. PARTICIPANTS Adults aged 50 and older. MEASUREMENTS Cross-sectional associations between self-reported (n = 7,865) and objective hearing measures (n = 6,902) and dementia were examined using multinomial-logistic regression. The longitudinal association between self-reported hearing at Wave 2 (2004/05) and cumulative physician-diagnosed dementia up to Wave 7 (2014/15) was modelled using Cox proportional hazards regression. RESULTS After adjustment for potential confounders, in cross-sectional analysis, participants who had self-reported or objective moderate and poor hearing were more likely to have a dementia diagnosis than those with normal hearing (self-reported: odds ratio OR = 1.6, 95% CI = 1.1-2.4 moderate hearing; OR = 2.6, 95% CI = 1.7-3.9 poor hearing, objective: OR = 1.6, 95% CI = 1.0-2.8 moderate hearing; OR = 4.4, 95% CI = 1.9-9.9 poor hearing). Longitudinally, the hazard of developing dementia was 1.4 (95% CI = 1.0-1.9) times as high in individuals who reported moderate hearing and 1.6 (95% CI = 1.1-2.0) times as high in those who reported poor hearing. CONCLUSION Older adults with hearing loss are at greater risk of dementia than those with normal hearing. These findings are consistent with the rationale that correction of hearing loss could help delay the onset of dementia, or that hearing loss itself could serve as a risk indicator for cognitive decline.
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Affiliation(s)
- Hilary R Davies
- Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Dorina Cadar
- Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Annie Herbert
- Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Andrew Steptoe
- Institute of Epidemiology and Public Health, University College London, London, United Kingdom
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Smith AK, Ritchie CS, Wallhagen ML. Hearing Loss in Hospice and Palliative Care: A National Survey of Providers. J Pain Symptom Manage 2016; 52:254-8. [PMID: 27046300 PMCID: PMC5069696 DOI: 10.1016/j.jpainsymman.2016.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/03/2016] [Accepted: 02/29/2016] [Indexed: 11/18/2022]
Abstract
CONTEXT Age-related hearing loss can impair patient-provider communication about symptom management, goals of care, and end-of-life decision-making. OBJECTIVES To determine whether hospice and palliative care providers screen for or received training about hearing loss, believe it impacts patient care, and use strategies to optimize communication. METHODS This was a national survey of hospice and palliative care providers conducted via email and social media. Survey questions were pilot tested with multidisciplinary providers in San Francisco. RESULTS Of 510 responses (55% age 50+ years, 65% female, 64% in practice 5+ years, 57% practiced hospital-based palliative care, 45% hospice), 315 were physicians, 50 nurses, 48 nurse practitioners, 58 social workers, and 39 chaplains. Ninety-one percent reported that hearing loss has some or great impact on the quality of care for older adults. Eighty-eight percent recalled a situation where hearing loss created a communication problem with a patient and 56% a communication problem with a caregiver. Eighty-seven percent of physicians, nurses, and nurse practitioners reported not screening for hearing loss. Although 61% felt comfortable with their communication skills for patients with hearing loss, only 21% reported having received formal training in its management, 31% were unfamiliar with resources for patients with hearing loss, and 38% had never heard of a pocket talker amplification device. CONCLUSION Hospice and palliative medicine providers believe age-related hearing loss impacts care yet most do not screen. Although they feel they are managing well, few have formal training. Knowledge about management approaches and resources is suboptimal.
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Affiliation(s)
- Alexander K Smith
- Division of Geriatrics, University of California at San Francisco, San Francisco, California, USA; Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, California, USA.
| | - Christine S Ritchie
- Division of Geriatrics, University of California at San Francisco, San Francisco, California, USA; Jewish Home San Francisco, San Francisco, California, USA
| | - Margaret L Wallhagen
- Department of Physiological Nursing, University of California at San Francisco, San Francisco, California, USA
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