The Circle of Care for Older Adults With Hearing Loss and Comorbidities: A Case Study of a Geriatric Audiology Clinic.

Autor: Dupuis K; Hearing Services, Baycrest Health Sciences, Toronto, Ontario, Canada.; Department of Psychology, University of Toronto, Ontario, Canada.; Sheridan Centre for Elder Research, Sheridan College, Oakville, Ontario, Canada., Reed M; Hearing Services, Baycrest Health Sciences, Toronto, Ontario, Canada., Bachmann F; Phonak AG, Stäfa, Switzerland., Lemke U; Phonak AG, Stäfa, Switzerland., Pichora-Fuller MK; Department of Psychology, University of Toronto, Ontario, Canada.; Rotman Research Institute, Toronto, ON, Canada.
Jazyk: angličtina
Zdroj: Journal of speech, language, and hearing research : JSLHR [J Speech Lang Hear Res] 2019 Apr 26; Vol. 62 (4S), pp. 1203-1220.
DOI: 10.1044/2018_JSLHR-H-ASCC7-18-0140
Abstrakt: Purpose Older adults seeking audiologic rehabilitation often present with medical comorbidities, yet these realities of practice are poorly understood. Study aims were to examine (a) the frequency of identification of selected comorbidities in clients of a geriatric audiology clinic, (b) the influence of comorbidities on audiology practice, and (c) the effect of comorbidities on rehabilitation outcomes. Method The records of 135 clients ( M age = 86 years) were examined. Information about comorbidities came from audiology charts (physical paper files) and hospital electronic health records (EHRs). Data about rehabilitation recommendations and outcomes came from the charts. Focus groups with audiologists probed their views of how comorbidities influenced their practice. Results The frequency of identification was 68% for visual, 50% for cognitive, and 42% for manual dexterity issues; 84% had more than one comorbidity. Also noted were hypertension (43%), falls (33%), diabetes (13%), and depression (16%). Integrating information from the audiology chart and EHR provided a more complete understanding of comorbidities. Information about hearing in the EHR included logs of outpatient audiology visits (75% of 135 cases), audiologists' care notes for inpatients and long-term care residents (25%), and entries by other health professionals (60%). Modifications to audiology practice were common and varied depending on comorbidity. High rates of success were achieved regardless of comorbidities. Conclusions In this clinic, successful outcomes were achieved by modifying audiology practice for clients with comorbidities. Increased interprofessional communication among clinicians in the circle of care could improve care planning and outcomes for older adults with hearing loss.
Databáze: MEDLINE