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Giving permission to care for people with dementia in residential homes: learning from a realistic synthesis of hearing-related communication’

Giving permission to care for people with dementia in residential homes: learning from a realistic synthesis of hearing-related communication’
Giving permission to care for people with dementia in residential homes: learning from a realistic synthesis of hearing-related communication’
Background
Managing hearing communication for residents living with hearing loss and dementia in long-term care settings is challenging. This paper explores how care can be effective in optimising hearing communication for residents living with dementia. We argue that the underlying notion of permission or authorisation allows care staff to do what they know will be effective in providing person-centred care that enhances hearing communication. The paper also indicates that this notion of permission can usefully be applied to other areas of care home practice.

Methods
To address hearing-related communication in care homes, we conducted a realist synthesis (RS). As a theory-driven approach to reviewing literature, it also uses expert opinion to understand complex health situations. Using RS, we developed a theory surrounding the management of hearing-related communication in care homes. Applying formal processes to the literature search and data extraction, the analysis uncovered relevant mechanisms and contexts to help confirm, refute or refine our understanding of how hearing communication could be improved.

Results
Forty-three papers were selected for the realist synthesis. The documents were analysed to construct five context-mechanism-outcome configurations (CMOCs). The CMOCs represent possible care interventions to optimise hearing-related communication in care homes for person living with dementia and hearing loss (PLWDHL). They include leadership promoting positive regard and empathy through person-centred care, communication training for staff, ‘knowing the person’ and relationship building for responsive awareness of residents’ hearing needs, maintaining and monitoring hearing communication through care planning, and managing noise in the care home environment.

Conclusions
Leadership that provides appropriate training and resources is likely to enhance knowledge and skills, leading to staff feeling able and equipped to respond to the hearing-related communication needs of PLWDHL. Collaboration with local hearing services is likely to raise awareness of hearing loss among care home staff. Importantly, care staff require a sense of permission from leadership, to work with knowledge and autonomy in the interest of residents living with dementia and hearing loss.
Crosbie, Brian
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Ferguson, Melanie A.
d80a0d2e-3102-40cd-b412-b24bc55f556f
Wong, Geoff
ac4a1787-d2cb-48e7-9060-81d89dd6ce6f
Walker, Dawn-Marie
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Vanhegan, Stevie
8a2f0e6a-2571-49fe-beb6-2be8abb76e66
Dening, Tom
9a76d578-8130-4559-928a-752bbc2db082
Crosbie, Brian
2a2a0fec-2f7e-404c-ab84-fc642ccb0d8f
Ferguson, Melanie A.
d80a0d2e-3102-40cd-b412-b24bc55f556f
Wong, Geoff
ac4a1787-d2cb-48e7-9060-81d89dd6ce6f
Walker, Dawn-Marie
5d4c78b7-4411-493e-8844-b64efc72a1e8
Vanhegan, Stevie
8a2f0e6a-2571-49fe-beb6-2be8abb76e66
Dening, Tom
9a76d578-8130-4559-928a-752bbc2db082

Crosbie, Brian, Ferguson, Melanie A., Wong, Geoff, Walker, Dawn-Marie, Vanhegan, Stevie and Dening, Tom (2019) Giving permission to care for people with dementia in residential homes: learning from a realistic synthesis of hearing-related communication’. BMC Medicine, 17, [54]. (doi:10.1186/s12916-019-1286-9).

Record type: Article

Abstract

Background
Managing hearing communication for residents living with hearing loss and dementia in long-term care settings is challenging. This paper explores how care can be effective in optimising hearing communication for residents living with dementia. We argue that the underlying notion of permission or authorisation allows care staff to do what they know will be effective in providing person-centred care that enhances hearing communication. The paper also indicates that this notion of permission can usefully be applied to other areas of care home practice.

Methods
To address hearing-related communication in care homes, we conducted a realist synthesis (RS). As a theory-driven approach to reviewing literature, it also uses expert opinion to understand complex health situations. Using RS, we developed a theory surrounding the management of hearing-related communication in care homes. Applying formal processes to the literature search and data extraction, the analysis uncovered relevant mechanisms and contexts to help confirm, refute or refine our understanding of how hearing communication could be improved.

Results
Forty-three papers were selected for the realist synthesis. The documents were analysed to construct five context-mechanism-outcome configurations (CMOCs). The CMOCs represent possible care interventions to optimise hearing-related communication in care homes for person living with dementia and hearing loss (PLWDHL). They include leadership promoting positive regard and empathy through person-centred care, communication training for staff, ‘knowing the person’ and relationship building for responsive awareness of residents’ hearing needs, maintaining and monitoring hearing communication through care planning, and managing noise in the care home environment.

Conclusions
Leadership that provides appropriate training and resources is likely to enhance knowledge and skills, leading to staff feeling able and equipped to respond to the hearing-related communication needs of PLWDHL. Collaboration with local hearing services is likely to raise awareness of hearing loss among care home staff. Importantly, care staff require a sense of permission from leadership, to work with knowledge and autonomy in the interest of residents living with dementia and hearing loss.

Text
Giving permission to care for people with dementia in residential homes learning from - Accepted Manuscript
Available under License Creative Commons Attribution.
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More information

Accepted/In Press date: 11 February 2019
e-pub ahead of print date: 4 March 2019

Identifiers

Local EPrints ID: 428409
URI: http://eprints.soton.ac.uk/id/eprint/428409
PURE UUID: 4665fecd-b933-4205-8f6b-1bfaeb05bbbb
ORCID for Dawn-Marie Walker: ORCID iD orcid.org/0000-0003-2135-1363

Catalogue record

Date deposited: 22 Feb 2019 17:30
Last modified: 28 Apr 2022 02:12

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Contributors

Author: Brian Crosbie
Author: Melanie A. Ferguson
Author: Geoff Wong
Author: Dawn-Marie Walker ORCID iD
Author: Stevie Vanhegan
Author: Tom Dening

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