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Smith SK, Pryce H, O'Connell GB, Hussain S, Shaw R, Straus J. 'The burden is very much on yourself': A qualitative study to understand the illness and treatment burden of hearing loss across the life course. Health Expect 2024; 27:e14067. [PMID: 38715316 PMCID: PMC11076985 DOI: 10.1111/hex.14067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Hearing loss is a chronic health condition that rises sharply with age. The way people respond to and cope with health conditions is influenced by their capacity to perform illness and treatment-related work. The aim was to explore the cumulative burdens of living with hearing loss and the resources mobilised to ease the burdens. METHODS A qualitative design was used with semi-structured interviews (online or in-person) with participants recruited through audiology services and nonclinical services, such as lip-reading classes. Forty-six participants with hearing loss aged between 16 and 96 years were interviewed. An abductive approach, informed by May et al.'s burden of treatment theory, was used to analyse the data. RESULTS The illness burden involved participants working to make sense of their hearing loss, engaging in emotional work in response to changes in sound, social interactions and identity and coping with the daily frustrations required to communicate with others. Abandonment and uncertainty characterised the treatment burden; participants engaged in emotional work to adjust to hearing technology and deal with the uncertainty of how their hearing might progress. To ameliorate the burdens, participants drew on internal resources (psychological, health literacy, cognitive) and external resources (social support, financial, information, technology). CONCLUSIONS The workload of hearing loss appears largely devolved to the patient and is not always visible. Our work indicates the need to widen approaches in audiological care through the implementation of lifeworld-led care, family-centred care and peer support to build support for those with hearing loss. PATIENT OR PUBLIC CONTRIBUTION We developed the project in consultation with members of the public who have lived experience of hearing loss recruited through Aston University and volunteer links to audiology services. We also consulted people more likely to be affected by hearing loss adults including adults with learning disabilities, older adults in residential care and people from South Asia (Bangladeshi, Indian and Pakistani communities). These individuals commented on the study aims, interview schedule and participant recruitment practices. One of our co-authors (expert by experience) contributed to the development and interpretation of themes and preparation of the final manuscript.
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Affiliation(s)
- Sian K. Smith
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
| | - Helen Pryce
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
| | | | - Saira Hussain
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
| | - Rachel Shaw
- Aston Institute of Health and Neurodevelopment and School of Psychology, College of Health and Life SciencesAston UniversityBirminghamUK
| | - Jean Straus
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
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Haanes GG. Multidisciplinary Approaches and Community-Based Interventions: Adaptable Strategies for Managing Sensory Impairments in Older Adults. J Multidiscip Healthc 2023; 16:2701-2705. [PMID: 37724317 PMCID: PMC10505404 DOI: 10.2147/jmdh.s416762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/16/2023] [Indexed: 09/20/2023] Open
Abstract
Sensory impairments including hearing and vision loss are becoming increasingly prevalent among older adults worldwide, and are adversely affecting their quality of life, independence and cognitive health. This article focuses on the global rise of sensory impairments in the ageing population and evaluates the efficacy of multidisciplinary interventions for management and prevention, including assistive-technology-based medicine, exercise programs and cognitive strategies. Drawing from a wide range of studies, we emphasize the importance of developing globally adaptable, community-based solutions that not only address the direct challenges posed by sensory impairments but also their broader implications for cognitive decline. Additionally, we highlight the need for continuous international research to fine-tune these interventions, to ensure they are holistic and responsive to the diverse needs of older adults across different regions worldwide.
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Affiliation(s)
- Gro Gade Haanes
- Faculty of Health and Social Sciences, Department of Social and Welfare Studies, Institute for Nursing and Health Science, University of South-Eastern Norway, Campus Vestfold, Horten, Norway
- USN Research Group of Older Peoples’ Health, University of South-Eastern Norway Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Wang Z, Wei H, Liu Z. Older Adults' Demand for Community-Based Adult Services (CBAS) Integrated with Medical Care and Its Influencing Factors: A Pilot Qualitative Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14869. [PMID: 36429594 PMCID: PMC9691106 DOI: 10.3390/ijerph192214869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The number of older people in China who require formal care is increasing. In response, China is creating a service delivery mode of health and social care combination for older people-community-based adult services (CBAS) integrated with medical care-in some provincial capital cities, such as Changsha. However, the needs of most older people for this service delivery mode are not well understood. AIM To assess older people's awareness of and demand for CBAS integrated with medical care and to determine influencing factors. METHODS Semi-structured guideline interviews were conducted with 20 older people (aged 65+ years) from two communities at different economic development levels and from a nursing home in Changsha, China. Interviews were analyzed using qualitative content analysis. RESULTS The specific needs that older adults expect from CBAS integrated with medical care involve daily care, primary care, self-management guidance, rehabilitation therapy services, and mental health services. Contrary to expectations, most interviewees showed low awareness of and demand for CBAS integrated with medical care. Individual, family, and community factors influence older people's demand, as do exogenous variables such as gender and number of children. DISCUSSION The influencing mechanism of older people's demand for CBAS integrated with medical care is complex and multifaceted. To implement and promote CBAS integrated with medical care, attention should be given to older people's individual needs, family backgrounds and community environment improvement. Furthermore, improving awareness of integrated care and increasing ageing-in-place opportunities for more older adults is essential and urgent.
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Affiliation(s)
- Zhenyu Wang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou 510006, China
| | - Hanchun Wei
- School of Public Administration, Central South University, Changsha 410075, China
| | - Zhihan Liu
- School of Public Administration, Central South University, Changsha 410075, China
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Shin JW, Kim EY, Son YJ. Home-dwelling older adults' experiences of living with both frailty and multimorbidity: A meta-ethnography. Geriatr Nurs 2022; 47:191-200. [PMID: 35940037 DOI: 10.1016/j.gerinurse.2022.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To systematically review qualitative studies about home-dwelling older adults' experiences of living with both frailty and multimorbidity. METHODS This study adopted a meta-ethnography; the databases included PubMed, Embase, CINAHL, Web of Science, PsycINFO, SCOPUS, and Google Scholar. Qualitative peer-reviewed articles in English were searched up to December 31, 2021. Themes and concepts were extracted through constant comparison across the included studies by three reviewers. RESULTS Of the 147 articles screened, nine qualitative articles, encompassing a total sample of 173 participants, were included. The four final synthesised themes were 'Being isolated in a closed life,' 'Being dependent on help from others,' 'Rebuilding to maximise quality of life,' and 'Struggling to live a meaningful life.' CONCLUSION Home-dwelling older adults with both frailty and multimorbidity are more likely to be socially isolated due to their physical limitations and lack of integration between hospital-based care and community healthcare services.
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Affiliation(s)
| | | | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok ro, Dongjak-gu, Seoul 06974, South Korea.
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Dual Sensory Impairment and Ways to Enhance Therapy Services. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Verbeek E, Drewes YM, Gussekloo J. Visual impairment as a predictor for deterioration in functioning: the Leiden 85-plus Study. BMC Geriatr 2022; 22:397. [PMID: 35524168 PMCID: PMC9074345 DOI: 10.1186/s12877-022-03071-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visual impairment frequently occurs amongst older people. Therefore, the aim of this study was to investigate the predictive value of visual impairment on functioning, quality of life and mortality in people aged 85 years. METHODS From the Leiden 85-plus Study, 548 people aged 85 years were eligible for this study. Visual acuity was measured at baseline by Early Treatment Diabetic Retinopathy Study charts (ETDRS). According to the visual acuity (VA) three groups were made, defined as no (VA > 0.7), moderate (0.5 ≤ VA ≤ 0.7) or severe visual impairment (VA < 0.5). Quality of life, physical, cognitive, psychological and social functioning were measured annually for 5 years. For mortality, participants were followed until the age of 95. RESULTS At baseline, participants with visual impairment scored lower on physical, cognitive, psychological and social functioning and quality of life (p < 0.001). Compared to participants with no visual impairment, participants with moderate and severe visual impairment had an accelerated deterioration in basic activities of daily living (respectively 0.27-point (p = 0.017) and 0.35 point (p = 0.018)). In addition, compared to participants with no visual impairment, the mortality risk was 1.83 (95% CI 1.43, 2.35) for participants with severe visual impairment. DISCUSSION In very older adults, visual impairment predicts accelerated deterioration in physical functioning. In addition, severely visually impaired adults had an increased mortality risk. A pro-active attitude, focussing on preventing and treating visual impairment could possibly contribute to the improvement of physical independence, wellbeing and successful aging in very old age.
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Affiliation(s)
- Erj Verbeek
- Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Y M Drewes
- Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands. .,Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
| | - J Gussekloo
- Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.,Department of Public Health and Primary Care and Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
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Siira HJ, Kyngäs HA, Falck AAK. Characteristics of individual low-vision rehabilitation counseling among older adults: A qualitative 2-year follow-up study. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221085852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Visual impairments (VI) burden particularly the aging population globally. To ensure healthy aging despite disability, the health care systems must provide effective low-vision rehabilitation services (LVR) for those in need. Low-vision rehabilitation counseling (LVRC) requires specialized multidisciplinary teamwork and has not been studied in detail among the elderly. This study aims to provide a comprehensive picture of individual LVRC actions and introduce a LVRC classification to use for attempts to improve the LVRC processes. This study employed a qualitative follow-up design. Data describing the individual LVRC processes in a prospective cohort of elderly patients with VI ( n = 39) were collected individually over 2 years during the years 2016–2019. The data were analyzed through deductive content analysis. The analyzed LVRC provided assistive devices, services, and home modifications, but problems related to independent movement in the living environment, psychosocial burdens, adaptation to disability, and learning new compensatory skills received less attention. To ensure effective LVRC, the multiprofessional team providing the rehabilitation should emphasize goal-setting and continuous assessment. LVRC should be seen as a process of adaptation, adherence, and learning. LVRC should support and promote older adults to participate and function to their full potential in the modern society, which includes utilizing digital technologies.
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Kawata NYS, Nouchi R, Saito T, Kawashima R. Subjective hearing handicap is associated with processing speed and visuospatial performance in older adults without severe hearing handicap. Exp Gerontol 2021; 156:111614. [PMID: 34728338 DOI: 10.1016/j.exger.2021.111614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 01/11/2021] [Accepted: 10/26/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Age-related hearing loss is a common disorder with significant consequences for quality of life. This study assessed the Hearing Handicap Inventory for the Elderly (HHIE) and cognition (Mini Mental State Exam; MMSE, Logical Memory; LM, Symbol Search; SS, Stroop Test; ST, and Mental Rotation; MR) to investigate which cognitive domains are most strongly involved with hearing self-assessment in older adults. METHODS The HHIE and cognitive measures were administered to 196 older adults (average age = 67.7 ± 4.3 years, male 56, female 140) without cognitive impairment and without severe hearing handicap. We conducted permutation tests of multiple regression analysis of the standardized scores on the HHIE and cognitive tests. RESULTS HHIE showed a significant negative correlation between processing speed performance on the SS (standardized β = -0.095, adjusted p = 0.04) and visuospatial performance on the MR (standardized β = -0.145, adjusted p = 0.04), and no correlation between the scores of the HHIE and either episodic memory performance on the LM (standardized β = 0.060, adjusted p = 0.22) or executive function performance on the ST (standardized β = 0.053, adjusted p = 0.32). CONCLUSION People reporting higher hearing handicaps should watch for poor cognitive function in processing speed and visuospatial abilities. These results imply that higher HHIE can have adverse effects on age-related cognitive decline.
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Affiliation(s)
- Natasha Y S Kawata
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Rui Nouchi
- Department of Cognitive Health Science, IDAC, Tohoku University, Sendai, Japan; Smart Aging Research Center, Tohoku University, Sendai, Japan.
| | - Toshiki Saito
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan; Smart Aging Research Center, Tohoku University, Sendai, Japan
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Haanes GG, Roin Á, Petersen MS. Preventive Home Visit (PHV) Screening of Hearing and Vision Among Older Adults in Tórshavn, Faroe Islands: A Feasibility Study in a Small-Scale Community. J Multidiscip Healthc 2021; 14:1691-1699. [PMID: 34234456 PMCID: PMC8257060 DOI: 10.2147/jmdh.s298374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/21/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose Hearing and vision loss are common in later life but often overlooked and undertreated. The study aims to examine hearing and vision as part of preventive home visits (PHV) among 76-year-old home-dwelling citizens in Tórshavn, the capital of Faroe Islands. Patients and Methods In this cross-sectional study, three specially trained nurses conducted the examinations and tests, for this purpose, in the community health-centre. Results A total of 74 individuals participated (56% participation rate) of whom 77% had some degree of hearing impairment, 89% had visual impairment and 22% had dual sensory loss. A significant correlation between self-reported hearing ability and clinical findings was found, whereas self-reported vision did not correlate significantly with test-results. Conclusion Results indicate that implementing clinical assessments of hearing and vision as part of preventive home visits would benefit people receiving visits, and society by helping maintain the conditions that allow them to stay in their own homes for as long as possible.
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Affiliation(s)
- Gro Gade Haanes
- Faculty of Health and Social Science, Institute for Nursing and Health Science, University of Southeast-Norway (USN), Borre, NO-3199, Norway
| | - Ása Roin
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, FO-100, Faroe Islands
| | - Maria Skaalum Petersen
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, FO-100, Faroe Islands.,Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, FO-100, Faroe Islands
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Haanes GG, Hall EO, Eilertsen G. Acceptance and adjustment: A qualitative study of experiences of hearing and vision impairments and daily life among oldest old recipients of home care. Int J Older People Nurs 2019; 14:e12236. [PMID: 31099486 PMCID: PMC6767382 DOI: 10.1111/opn.12236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 02/01/2019] [Accepted: 04/05/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The severity of age-related hearing and vision impairments increases with age. Such sensory impairments are risk factors for functional decline, reduced social participation, withdrawal, depression and accidents, and hence they make people vulnerable and adversely affect their quality of life. AIM The aim of this study was to explore how the oldest old recipients of home care experience sensory impairments in daily life. DESIGN An inductive, descriptive research design was used. METHOD Ten recipients of home care with a mean age of 89 years were interviewed in their homes. The study was implemented in accordance with the suggestions from Elo and Kyngäs for inductive content analysis. FINDINGS The main theme concerned acceptance and adjustment in daily life. Subcategories concerning the category of reduced hearing were identified as "acceptable though annoying" and "hesitant about using hearing aids." Subcategories concerning the category of reduced vision were "reading is increasingly challenging" and "living with vision diseases." The third category of feeling weak was elucidated in the subcategories "troublesome bodily changes" and "strenuous days with limited energy." CONCLUSIONS It is imperative to recognise that the oldest old are in a distinct phase of the lifespan. Despite this population being aware of their hearing and vision impairments, they do not always have the strength to alter the situation. Instead they accept it; they often struggle with more serious health challenges. Therefore, they are not prioritising using their limited energy reserves to try to improve or optimise their hearing and vision impairments themselves. IMPLICATIONS FOR PRACTICE The oldest old with sensory impairments cannot be expected to perform all the necessary activities of daily living or address their functional sensory impairments. Close monitoring and assistance need to be applied to the oldest old.
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Affiliation(s)
- Gro Gade Haanes
- Faculty of Natural and Health Sciences, Department of NursingUniversity of the Faroe IslandsTórshavnFaroe Islands
| | - Elisabeth O.C. Hall
- Faculty of Natural and Health Sciences, Department of NursingUniversity of the Faroe IslandsTórshavnFaroe Islands
- Section of Nursing, Department of Public HealthAarhus UniversityAarhusDenmark
| | - Grethe Eilertsen
- Faculty of Health and Social Sciences, Department of Nursing and Health SciencesUniversity of South‐Eastern NorwayDrammenNorway
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