This research project aims to explore the communication needs of people with dementia and their family and professional caregivers; and how these needs are currently being addressed in their audiological management.

1. Evaluating audiological intervention options for
people with dementia living in aged care homes
Anthea Bott,1,2 Carly Meyer,1,2 Louise Hickson1,2
1 The University of Queensland, School of Health and Rehabilitation Sciences
2 The HEARing Cooperative Research Centre
Background
Within aged-care homes (ACHs), prevalence of hearing
impairment and dementia is 83% and 50%, respectively.
Accordingly, HI and dementia is the most commonly reported
dual communication disability within ACHs (1).
Current gold-standard for audiological rehabilitation (fitting
hearing aids) has poor uptake and outcomes within ACHs (2-4).
Limited research exploring the uptake and outcomes of
alternative audiological interventions for people with dementia
within ACHs, such as assistive listening devices (ALDs) or
communication programs.
In order to provide client-centered care in audiological
rehabilitation clients need to be provided with options. One way
audiologists can facilitate a discussion regarding options is by
using a decision aid (5).
Impact when dementia and HI co-occur and are
not appropriately addressed
Negative effects of HI on communication are superimposed on
the negative impacts of dementia, a concept referred to as
excess disability (6).
Dementia negatively impacts on memory and language, which
can result in the following communication difficulties: word-
finding difficulties, difficulty initiating and following conversations
and restricted verbal output.
When not addressed, higher rates of depression & social
isolation (7).
Study 1
Aim: To explore the communication needs of people with
dementia and their family and professional caregivers; and how
these needs are currently being addressed in their audiological
management.
Participants: There are three groups of participants including:
people with dementia and HI who live in an ACH, ACH staff and
audiologists who provide services to residents with dementia in
the ACH.
Method: Semi-structured, in-depth interviews followed by
thematic analysis. People with dementia will be interviewed with
a personal/professional caregiver.
Anticipated outcome: An in-depth understanding of the unmet
needs of people with dementia and HI, and their family and
professional caregivers, within an ACH. This knowledge will then
inform which audiological options should be presented to this
population.
Create, pilot and refine an e-based audiological decision
aid for people with dementia living in ACHs (see figure 1 for
example of a decision aid)
Study 2
Aim: To examine the uptake and outcomes of audiological
rehabilitative options provided to people with dementia and HI
who live in an ACH.
Participants: People with dementia and HI living in an ACH and
an accompanying family member or professional caregiver.
Method:
Anticipated outcome:
1) Evidence for e-based shared decision making in audiology
for people with dementia .
2) Evidence base for a range of audiological rehabilitation
interventions for people with dementia and HI who reside in
ACHs.
creating sound value www.hearingcrc.org
References
1.Worrall L, Hickson L, Dodd B. Screening for Communication Impairment in Nursing Homes and Hostels. Australian Journal of Human Communication Disorders. 1993;21(2):53-64
2.Linssen AM, Joore MA, Theunissen EJJM, Anteunis LJC. The effects and costs of a hearing screening and rehabilitation program in residential care homes for the elderly in the Netherlands. American
Journal of Audiology. 2013;22(1):186-9.
3. Cohen-Mansfield J, Taylor JW. Hearing aid use in nursing homes. Part 1: Prevalence rates of hearing impairment and hearing aid use. J Am Med Dir Assoc. 2004;5(5):283-8.
4. Cohen-Mansfield J, Taylor JW. Hearing aid use in nursing homes. Part 2: Barriers to effective utilization of hearing AIDS. J Am Med Dir Assoc. 2004;5(5):289-96.
5.Laplante-Lévesque, A., Hickson, L., Worrall, L. (2010). A qualitative study of shared decision making in rehabilitative audiology. Journal of the Academy of Rehabilitative Audiology, 48, 27-43.
6.Slaughter S, Bankes J. The Functional Transitions Model: maximizing ability in the context of progressive disability associated with Alzheimer disease. Can J Aging. 2007;26(1):39e47.
7. Gopinath B, Hickson L, Schneider J, McMahon CM, Burlutsky G, Leeder SR, et al. Hearing-impaired adults are at increased risk of experiencing emotional distress and social engagement restrictions five
years later. Age and ageing. 2012;41(5):618-23.
8. Slaughter SE, Hopper T, Ickert C, Erin DF. Identification of hearing loss among residents with dementia: perceptions of health care aides. Geriatr Nurs. 2014;35(6):434-40.
Figure 1. Decision aid excerpt (5).
Use e-based decision aid to discuss
rehabilitation options with participant dyad
Elicit decision with dyad and provide further
information on how to access chosen option
Explore outcome of audiological rehabilitation
option with participant dyad
Quantitative Outcomes
 Proportion of people who
choose each option
 Change in hearing
disability (e.g. HHQ)
 Change in third-party
disability (e.g. SOS-
HEAR)
 Change in caregiving
experience (e.g. Positive
Aspects of Caregiving)
Qualitative Outcomes
 Semi-structured
interviews with
participant dyads