Many people with dementia living in supported residential care homes have significant hearing and/or vision impairment. Often unrecognized and unaddressed, poor sensory function can worsen quality of life for residents with dementia by making communication more difficult and by increasing confusion.
Several barriers and facilitators to sensory health within residential care have been identified. Barriers include the loss of glasses and hearing aids, as well as systemic barriers such as staffing levels and limited access to staff training. Facilitators include staff knowledge and sensory-enabling environments.
Taking this together, by addressing sensory function through staff skills training, systemic pathways, and correcting the local environment, in addition to correction of the sensory deficit, we may be able to significantly improve quality of life and other key outcomes for residents with dementia.
SENSE-Cog Residential Care, an Irish-based 2-year feasibility pilot study, aims to do just that! SENSE-Cog Residential Care hopes to improve quality of life for residents with dementia living in residential care by supporting hearing and vision function. This will be carried out through the development of a Sensory Support Intervention for Residential Care (SSI-RC) and a pilot study to assess its feasibility.
The intervention
Guided by the sensory-cognitive model of place, as well as consultation with expert professionals and people with lived experience, the SSI-RC comprises of four elements:
- Personalized resident sensory support (i.e., screening, assessment, device fitting and adherence support)
- Staff training: awareness-raising and training in sensory-cognitive healthcare
- Sensory-friendly environmental design: correcting the local environment for sensory challenges
- Vision and hearing care pathway development: ensuring seamless referral pathways to community professional hearing and vision care providers.
The intervention is designed to be delivered by Sensory Champions. Sensory Champions will be existing staff members who will receive training and support in the delivery of the intervention.
The pilot study
To examine the feasibility of the SSI-RC for residents with dementia living in nursing homes (supported residential care for older people in Ireland), we hope to recruit about ten homes to conduct a feasibility-pilot cluster randomized trial. Within these homes, researchers will recruit both staff and residents with dementia to take part.
Homes will be randomly assigned into two groups: about five in the intervention group and five in the care as usual group. Those in the intervention group will receive the intervention and those in the care as usual will continue their usual care.
Participants, both staff and residents, will be asked to provide information about their perceptions of the intervention to ascertain if the intervention is feasible, acceptable, and tolerated. As well as this, exploratory factors such as changes in quality of life, behavior and cognition, and quality and culture of care will be assessed using questionnaires given at the beginning of the intervention, after the intervention, and at 3 months follow up. Findings will inform progression to a larger definitive trial and contribute to emerging evidence of care home research methodology.
November 2021 saw the launch of SENSE-Cog CARE: A feasibility study of hearing and vision support to improve quality of life in care home RwD, led by Professor Iracema Leroi, Consultant Geriatric Psychiatrist and Associate Professor at Trinity College Dublin. Recruitment will begin in Ireland Summer 2022. If you would like to learn more about this project, please contact Helen Tormey, SENSE-Cog RC study coordinator, at tormeyh@tcd.ie.
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