An ethnography study exploring factors that influence social isolation in care home residents living with dementia and hearing loss

Abstract

Background Hearing loss and dementia are highly prevalent conditions amongst older adults living in residential care. The consequences of living with these conditions may include social withdrawal and reduced communication opportunities. We sought to examine patterns of communication and interaction in residential care and explore resident, staff, and relative perspectives within two care homes located in Birmingham, UK. This enabled an understanding of how communication environments contributed to social isolation. Methods This work used ethnography methodology to explore mechanisms that created and maintained social isolation in older adults living with dementia and hearing loss. A planning and engagement phase took place in four care homes. This was followed by an environmental audit, observations, and interviews. Data generated were analysed using Grounded Theory methods. Results There were 33 participants (16 residents, 11 care staff, and six relatives) who took part in the observations and interviews. Residents experienced social isolation through lack of meaningful conversation with others and being misunderstood. Additionally, observations of residents’ interactions informed the overall findings. A Grounded Theory model was employed to explain the core phenomenon of social isolation. The main contributors were internal and external barriers to communication, and reduced opportunities for meaningful conversation. Conclusions There is a wide range of social isolation that care home residents experience. This was not always associated with the severity of hearing loss but rather communication ability. Simple interventions such as staff dining with residents and focussing on improving communication could reduce social isolation within residential care settings.

Does social isolation mediate the association between hearing loss and cognition in adults? A systematic review and meta-analysis of longitudinal studies

“…They have estimated the return on investment from hearing screening for adults aged above 50 years and indicated that in a high-income setting, every dollar invested in hearing screening among older adults could yield a possible return of 1.62 International dollars. Many older adults living with dementia will have hearing loss, regardless of the role that hearing aids play in the prevention of dementia or the underlying mechanisms that link hearing loss and dementia ( 67 ). Therefore, there is an urgent need for research into treatments that will improve the health of those who have dementia and hearing loss as well as their carers ( 12 ).…”