Original Title: Avis: Pratiques pertinentes pour favoriser la santé auditive en milieu d’hébergement de longue durée

Authors' objectives: Hearing difficulties are common in the adult population. According to a Canadian survey, 40% of adults between the ages of 20 and 79 have such difficulties in at least one ear, and this prevalence increases with age. Among Canadians aged 60 to 79, 78% have at least mild hearing difficulties. In addition, it is estimated that between 60% and 80% of people living in residential and long-term care centres (CHSLDs) in Québec have hearing difficulties that are significant enough to interfere with their daily activities. These problems may be caused by ageing and may be associated with certain diseases or health conditions, including diabetes, autoimmune diseases, major neurocognitive disorder intellectual disability or autism spectrum disorder. The consequences of hearing difficulties are numerous. The resulting communication difficulties influence interactions with others and can lead to social isolation. Hearing difficulties may also be associated with decreased motor and cognitive function, reduced quality of life, other disorders, and an increased mortality rate. In people with cognitive impairment, hearing difficulties can exacerbate behavioural and psychological symptoms. Various characteristics of long-term residential care settings (e.g., noisy and crowded environments, wearing masks to prevent infection) create particular communication challenges for people with hearing difficulties. Given the high prevalence of hearing difficulties and their consequences, the needs of this population should be better understood and addressed. In 2020, the Ministère de la Santé et des Services sociaux (MSSS) tabled the Politique d’hébergement et de soins et services de longue durée and, in May 2022, the accompanying action plan. As part of this action plan, the MSSS wishes to adapt practices that will promote the hearing health of people in residential care. In this context, the objectives of this report are to identify relevant practices for promoting the hearing health of all residents living in the various types of long-term care settings (i.e., CHSLDs, intermediate resources [RIs], and family-type resources [RTFs], senior and alternative housing), as defined by the Politique d’hébergement et de soins et services de longue durée, and to specify implementation procedures that will help to achieve or enhance practice effectiveness.

Authors' results and conclusions: RESULTS: The work made it possible to highlight general cross-cutting principles. General principles (Facilitating access to information): It is important that residents and their informal/family caregivers understand the information they are provided so that they can take part of the decision-making process. Access to information can be facilitated by adjusting formats and literacy levels. Making clinical information available to relevant stakeholders is also critical. (Integrating practices into protocols and routines): Integrating practices into protocols and routines optimizes and systematizes the implementation of such routines, clarifies the responsibilities, and facilitates their sustainability. (Adapting practices according to the preferences, abilities, and skills of people in residential care): Adapting practices is essential, especially for those with cognitive, intellectual, mental health or dual sensory disabilities. (Defining the roles and responsibilities of stakeholders): Various stakeholders and individuals responsible of RIs/RTFs are involved in providing long-term care. Clearly defining their roles and responsibilities, based on the competencies of each individual and how work is organized with the various settings, is vital. (Establishing and consolidating collaborations and partnerships): Throughout the continuum of services, it is essential to consider the involvement of residents and informal/family caregivers, especially about intervention-related decisions. It is also important to promote the value of interprofessional collaboration in order to move towards integrated hearing health services. (Planning and implementing continuous improvement activities): Conducting continuous improvement activities is a key element in implementing and enhancing the practices recommended for people in residential care.

Authors' recommendations: RESULTS: The work made it possible to highlight general cross-cutting principles. General principles (Facilitating access to information): It is important that residents and their informal/family caregivers understand the information they are provided so that they can take part of the decision-making process. Access to information can be facilitated by adjusting formats and literacy levels. Making clinical information available to relevant stakeholders is also critical. (Integrating practices into protocols and routines): Integrating practices into protocols and routines optimizes and systematizes the implementation of such routines, clarifies the responsibilities, and facilitates their sustainability. (Adapting practices according to the preferences, abilities, and skills of people in residential care): Adapting practices is essential, especially for those with cognitive, intellectual, mental health or dual sensory disabilities. (Defining the roles and responsibilities of stakeholders): Various stakeholders and individuals responsible of RIs/RTFs are involved in providing long-term care. Clearly defining their roles and responsibilities, based on the competencies of each individual and how work is organized with the various settings, is vital. (Establishing and consolidating collaborations and partnerships): Throughout the continuum of services, it is essential to consider the involvement of residents and informal/family caregivers, especially about intervention-related decisions. It is also important to promote the value of interprofessional collaboration in order to move towards integrated hearing health services. (Planning and implementing continuous improvement activities): Conducting continuous improvement activities is a key element in implementing and enhancing the practices recommended for people in residential care.

Authors' methods: This report was produced in three stages. First, practices to promote the hearing health of people in residential care, as documented in the literature or as currently implemented, were identified. Next, a non-systematic review of the literature and consultations with various stakeholders were used to identify the characteristics of these practices in terms of the following five aspects: populational, clinical, organizational, economic, and sociocultural. Finally, a systematic review was conducted on the effectiveness of the various practices. Each was given an overall value assessment. Recommendations were made based on these assessments, and implementation details were identified to enhance or achieve the effectiveness of the respective practices in long-term residential care settings.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/pratiques-pertinentes-pour-favoriser-la-sante-auditive-en-milieu-dhebergement-de-longue-duree.html

Year Published: 2023

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/pratiques-pertinentes-pour-favoriser-la-sante-auditive-en-milieu-dhebergement-de-longue-duree.html

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)