Exploring the sensory screening experiences of nurses working in long-term care homes with residents who have dementia: a qualitative study

Abstract

BackgroundThe prevalence of vision and hearing loss is higher amongst older individuals with dementia, as well as higher in long-term care settings than in the wider community. However, the incidence of sensory impairment is underreported and often goes untreated. In this study, we aimed to understand nurses’ current experiences of screening and caring for long-term care residents who have dementia and sensory impairment.MethodsAs part of a larger study on the sensory screening of long-term care residents with dementia, an environmental scan was conducted with front-line healthcare providers. We report here on the findings from the content analysis of individual, semi-structured interviews with nurses working in two long-term care homes in Southern Ontario, Canada. Twenty regulated nurses, including designated resident assessment coordinators, working full- or part-time with individuals who have dementia, participated across the two sites. All interviews were transcribed, and their contents reviewed and coded for themes by means of inductive thematic analysis.ResultsFollowing a systematic and recursive approach, three analysts identified several themes relating to: 1) the sensory screening process, 2) communication strategies, and 3) quality of life, sensory loss, and dementia. Participants reported on the strengths and limitations of screening procedures, what improvements should be made, which informal strategies are effective, and the continued professional development that is needed.ConclusionsNurses demonstrated insight into the facilitators and barriers to effective screening and care of residents with dementia and sensory impairments, and expressed the need for further education, more suitable screening tools, and formalised accountability within the screening process for vision and hearing loss in these long-term care residents.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0917-x) contains supplementary material, which is available to authorized users.

Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

“…Those responding also stated that their knowledge was lacking in certain areas. Firstly, the majority were not con dent in identifying and managing both hearing and vision impairments in their residents, which could contribute to the poor care of residents hearing and vision di culties in care home residents (22). This further highlights, that despite interventions aiming to improve knowledge in staff being reported as effective (11,12,13), these have not been implemented effectively into practice across the country.…”

Screening for Vision Impairments in Individuals with Dementia Living in Long-Term Care: A Scoping Review

“…The ability to travel off-site for professional vision assessments can be hampered by the reduced mobility of the residents and the time and resources required of their care providers. An alternative would be screening of residents on-site, within their care facilities, by members of their care team (i.e., nurses), resulting in referrals to vision care specialists for full assessments as required [30]. To optimize the screening of visual impairments in individuals with dementia living in LTC, there are several categories of unique factors to consider, including those attributable to the individual (i.e., dementia diagnosis), the test administrator (i.e., nurses), and the context (i.e., LTC).…”

“…In other words, it is important to ensure that a positive result on a screening test for vision impairment is truly due to sensory loss and not due to an inability to comprehend or perform the test procedures. Recommended strategies for minimizing confounds due to cognitive impairment include using concise directions, repeating instructions, speaking clearly, providing encouragement, and limiting the time required to complete the test [24,30,31].…”

Optimising hearing services for adults living with dementia and hearing impairment in residential aged care facilities

“…This study investigated the underlying barriers and facilitators that influence aids has been identified as a barrier (Crosbie et al, 2019;Slaughter et al, 2014;Höbler et al, 2018). To our knowledge, this is the first time that family caregiver knowledge has been identified as a barrier too.…”

“…Shared decision-making is a process that is used when multiple treatment options are available for managing a health condition (Stacey et al, 2017), such as the treatment options available for managing hearing impairment (Laplante-Lévesque, Hickson, & Worrall, 2010c). RACFs (Höbler et al, 2018;Pryce & Gooberman-Hill, 2013). Thus, developing a resource that promotes shared decision-making practices and increases caregiver knowledge on the options available for treating hearing impairment may have benefits for implementation science.…”