Effectiveness of Hearing Rehabilitation for Care Home Residents With Dementia: A Systematic Review
Journal of the American Medical Directors Association
Cross, H., Dawes, P., et al. (2022).
Journal of the American Medical Directors Association, 23(3), 450-460.e4.
This systematic review investigates the effects of, and facilitators and barriers to, hearing rehabilitation programs for nursing home residents with dementia.
Alzheimer’s Society (United Kingdom); Constance Owens Charitable Trust (United Kingdom); National Institute for Health Research (United Kingdom); European Union’s Horizon 2020 Research and Innovation Program; Global Brain Health Institute
From database inception to January 2021
Studies with quantitative, qualitative, or mixed methodology
16
Findings demonstrated that amplification via hearing aids or personal sound amplification products for adults with dementia living within nursing homes was associated with reported improvements in communication and speech recognition, patient quality of life, and patient well-being. Amplification was additionally associated with reductions in anxiety, agitation, and hallucinations. Mixed findings were noted for the impact of amplification on performance on cognitive measures. Patient lack of access to hearing evaluation and follow-up, refusal to wear amplification, the loss of or damage to devices, impact of cognitive impairment on ability to engage in training, and/or patient and staff lack of familiarity with devices were notable barriers to access. Family member support of hearing aid management was a notable facilitator. Further research is needed due to overall reduced quality of research, heterogeneity between studies, and small sample sizes.
"A well-managed care home, including staff delegation, interdisciplinary collaboration, staff knowledge, and skill also facilitated hearing rehabilitation" (p. 458), especially when providers placed an emphasis on the importance of individual management plans.
Limited, reduced quality research was found regarding the use of visual supports for communication in the care of adults with dementia in skilled nursing homes. In both included studies, visual word or picture supports were used in cases where patients experienced difficulty using amplification. Mixed results for outcomes regarding communication and agitation were noted. Further research is indicated.
The use of verbal and nonverbal communication strategies for people with dementia living within nursing homes was associated with greater resident quality of life and improved staff confidence in providing hearing support in a small number of low to moderate quality studies. Further research is warranted.
