Hearing and vision screening tools for long-term care residents with dementia: protocol for a scoping review

Abstract

IntroductionHearing and vision loss among long-term care (LTC) residents with dementia frequently goes unnoticed and untreated. Despite negative consequences for these residents, there is little information available about their sensory abilities and care assessments and practices seldom take these abilities or accessibility needs into account. Without adequate knowledge regarding such sensory loss, it is difficult for LTC staff to determine the level of an individual's residual basic competence for communication and independent functioning. We will conduct a scoping review to identify the screening measures used in research and clinical contexts that test hearing and vision in adults aged over 65 years with dementia, aiming to: (1) provide an overview of hearing and vision screening in older adults with dementia; and (2) evaluate the sensibility of the screening tools.Methods and analysisThis scoping review will be conducted using the framework by Arksey and O'Malley and furthered by methodological enhancements from cited researchers. We will conduct electronic database searches in CENTRAL, CINAHL, EMBASE, MEDLINE and PsycINFO. We will also carry out a ‘grey literature’ search for studies or materials not formally published, both online and through interview discussions with healthcare professionals and research clinicians working in the field. Our aim is to find new and existing hearing and vision screening measures used in research and by clinical professionals of optometry and audiology. Abstracts will be independently reviewed twice for acceptance by a multidisciplinary team of researchers and research clinicians.Ethics and disseminationThis review will inform health professionals working with this growing population. With the review findings, we aim to develop a toolkit and an algorithmic process to select the most appropriate hearing and vision screening assessments for LTC residents with dementia that will facilitate accurate testing and can inform care planning, thereby improving residents’ quality of life.

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

“…Overall, very little is known about the optimal way to screen visual abilities in individuals with dementia, particularly within an LTC setting [29]. In an effort to tackle this problem, our team has employed a mixed-methods approach to identify and evalu-ate existing screening tools and approaches.…”

“…This scoping review followed the protocol outlined by McGilton et al [29]. The methodological framework by Arksey and O'Malley [40] was used to guide a literature search of all relevant research, regardless of study design, by iterative and reflexive means.…”

“…A broad search strategy with clearly defined concepts was employed [40], whereby search terms were continuously refined by group consensus within a multidisciplinary team of reviewers [29]. The team engaged in group consultation to inform the search criteria and clinical applicability of data for extraction, and to allow for post-hoc development of inclusion and exclusion criteria and data synthesis in terms of the value yielded by qualitative or quantitative analyses of results.…”

“…Electronic databases of Embase, Medline, Psyc-INFO, CENTRAL, and CINAHL were searched by an Information Specialist at the Toronto Rehabilitation Institute-University Health Network (JB), using both subject headings (Mesh, Emtree) and keywords to search for the concepts of vision tests, long-term care settings, and neurodegenerative diseases in studies published between 1995 and 2017 [29]. Based on the initial search results from several trialed database searches, a recursive process of revising and extending key search terms by definition was used and adapted to those appropriate to each database (Supplementary Material).…”

“…Members of the review team with clinical experience in the use of vision screening measures (two optometrists and one certified low vision therapist) evaluated suitability for each of the identified vision tests. Suitability was defined by the test's efficiency and effectiveness of purpose in the specified screening context (i.e., screening vision in individuals with dementia in LTC), as well as the acceptability of its content and interpretation by nurses in LTC [29,41]. The evaluation of suitability also included consideration of each tool's determinants of sensibility.…”