Hearing Assessment at Nursing Homes

The hearing assessments at the nursing homes were carried out as planned, and collaboration with the various units worked well. Individual reports were prepared for each nursing home and also shared with local hearing associations affiliated with the relevant institutions. Several of the hearing associations have taken the findings forward in their local efforts to strengthen hearing care in nursing homes.

The results show that a significant proportion of residents had both hearing loss and a diagnosis of dementia, without appropriately fitted hearing aids. Of nearly 400 registered residents, approximately 89% had a diagnosis of mild to severe dementia. 60% completed the hearing assessment, while 40% were unable to participate. More than half (56%) were found to have hearing loss, while only 4% had normal hearing. As many as 80% of the residents did not have hearing aids. Among those who did have hearing aids, only 13% actually used them, and just 7% reported hearing well with their devices. Furthermore, 98% did not use any other hearing-related assistive devices.

In several cases, hearing aids were adjusted during the assessment, enabling residents who had previously had limited ability to communicate to participate in conversations. This may indicate that, in addition to their dementia diagnosis, some residents may also have experienced reduced functioning as a result of untreated hearing loss. Overall, the findings raise the question of whether earlier hearing aid fitting could have contributed to better quality of life and potentially reduced care needs. It is well established that untreated hearing loss can increase the risk of cognitive decline.

You can read more about the background to the project further down this page.

The Dam Project – Mobile Practical Hearing Courses in Nursing Homes, aimed at healthcare professionals, has raised several important questions: There is currently no standard procedure for assessing the hearing status of residents when they move into a nursing home.

We have observed that there are relatively few hearing aid users among residents at the nursing homes in question compared with the total number of residents. Does this mean that many residents are living with untreated hearing loss? Why is there no requirement to assess and test the hearing of nursing home residents, in the same way that their blood pressure is measured and a range of other tests are carried out?

Many nursing home residents have a diagnosis of dementia, limited speech, anxiety, and reduced ability to cooperate, which can be a natural consequence of ageing. At the same time, we have also seen several residents “come back to life” after having their hearing tested and their hearing aids adjusted. This raises the question of how many residents may have been given a so-called “false dementia diagnosis” due to a lack of hearing assessment and appropriate measures to improve their hearing ability.

Against this background, this new project will assess the hearing health of residents at ten nursing homes in Trøndelag County. The target group consists of 500 residents and 500 healthcare professionals who live or work at the nursing homes.

The following activities will be carried out: Otoscopy of the ear canals and a simple hearing test to determine the hearing status of each resident who is able to participate, either through an adequate response or through body language during the hearing test.

The following assessment points will also be included for each resident:

• Has hearing loss and uses hearing aids and/or other hearing-related assistive devices?

• Has hearing loss but has no hearing aids or other hearing-related assistive devices?

• Does not have hearing loss?

• Has or does not have a diagnosis of dementia?

• Is unable to complete a hearing test due to health-related challenges such as cognitive or physical impairment?

• Has cerumen (earwax) in the ear canal prior to the hearing test?

• How many residents receive hearing aids or other hearing-related assistive devices following the hearing assessment?

• What routines and level of expertise does the nursing home have for monitoring and following up residents’ hearing health?
  

A simple survey will also be conducted among healthcare professionals to assess their knowledge and competence regarding hearing health and hearing aids.

Based on the data collected, a report will be prepared describing and evaluating the findings and measures implemented. The report will also describe the methodology and provide recommendations on how hearing health in nursing homes can be assessed, improved, and maintained in the future. The report and individual findings will be sent to unit managers, municipal hearing contacts, and nursing home physicians for further implementation of measures and possible integration into existing routines. The report will also be distributed to other healthcare professionals and health authorities who may have an interest in the findings.

It is expected that nursing home residents will experience better hearing health as a result of having their hearing assessed. This may provide a basis for residents to have their existing hearing aids updated or adjusted, or to be fitted with new hearing aids or other hearing-related assistive devices. This could lead to better communication between residents, healthcare professionals, and relatives, which in turn may contribute to greater enjoyment of life for residents. Many residents may also experience less anxiety and resistance during visits or personal care situations when they are able to hear better.

It would be a very positive outcome if this project resulted in the introduction of routine hearing health assessments for every new resident moving into a nursing home, regardless of location in Norway. Healthcare professionals at nursing homes would also gain updated knowledge and competence in hearing health and would be better equipped to initiate appropriate internal or external measures when necessary to improve the hearing health of individual residents. Best regards, All of us in AudioPlus Norge AS