The article tackles the critical issue of hearing loss in treating patients in the end stage of life
Salter School of Nursing and Allied Health is proud to announce that its instructor Mary A. McKeich, BSN, MS, has published an article in the February 2017 issue of the Journal of Hospice & Palliative Nursing. “Assessment and Intervention for Patients With Hearing Loss in Hospice” describes the unique needs of patients with hearing loss who are receiving end-of-life care.
Hearing loss is very common among older adults—the third-most chronic condition in this population. The article addresses how an untreated hearing loss can make it difficult for patients to communicate with their caregivers about critical aspects of care. This can mean challenges in relaying information needed to care for them at home, while they’re receiving inpatient care at a hospital, or during the essential admissions process to a hospice facility.
As the article points out, the goal is for the patient as well as the family and entire team of healthcare providers to have successful interactions. (At a hospice care facility, the authors note, this can include “numerous multidisciplinary team workers such as oncologists, cardiologists, nephrologists, neurologists, primary care physicians, nurses, nursing assistants, social work, case management, and chaplains.”) This higher quality of life can translate to better care at the end of life.
The authors address the major topics that require communication in hospice care:
- advance care planning (including whether the patient has a living will or an advance directive, and whom the patient wishes to be their health care
- assessment and control of symptoms as well as pain management
- shared decision making (where “the patient and/or family members are involved in the plan of care based on the individual’s goals”)
The article also features practical suggestions for how caregivers can improve their interactions with patients, through giving visual cues, managing sound in the environment, and mindful approaches to verbal communications. In the context of case scenarios of three older adults, the authors provide options for specific interventions, including:
- having hearing aids repaired, or finding the patient the assistance they need to insert them
- arranging for a nurse or doctor to remove wax that may have built up in the patients’ ears
- using a personal sound amplifier (a portable device)
- downloading an amplification app to a smartphone, which the patient uses by listening to earphones connected to the phone.
Additional article highlights include:
- “Persons with hearing loss…are particularly vulnerable to communication breakdown.”
- “Studies [document that] less than 40% of persons over the age of 70 years have even had a hearing test in the past 4 years….[and] men are at particular risk for untreated hearing loss.”
- “In a medical setting…[or] in the home or…over the telephone with a triage nurse…communication exchanges are required to ascertain intensity and description of patient symptoms as well as adherence to prescribed medicine routines.”
- “In health care settings where shared decision making was implemented, patients reported improved quality of care.”
McKeich received as master’s degree in counseling psychology from Palm Beach Atlantic University in West Palm Beach, FL, and a Bachelor’s degree in nursing from Russel Sage College in Troy, NY. She co-authored the article with audiologist Anne D. Olson, PhD, who is associate professor of Rehabilitation Sciences at the University of Kentucky, Lexington. Olson is also director of the Division of Communication Sciences and Disorders at the University of Kentucky College of Health Sciences.
This article is part of the weekly blog of the Salter School of Nursing and Allied Health. We are dedicated to the well-being of our students as well as to supporting them in creating meaningful, satisfying professional lives. Please contact us for more information about our various programs.