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H. K. Falkenberg, I. Langeggen, J. Dugstad; Vision and Hearing Loss in Nursing Home Residents:Do We Care?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3205.
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The health care and social services in Norway are amongst the best in the world and require that nursing homes provide health care based on individual needs. We wanted to assess vision and hearing in nursing home residents and the eye and ear care they receive.
In a pilot study vision and hearing was assessed in 30 nursing home residents aged 72-101 years in Eikertun nursing home. All performed with informed consent. Visual measurements included habitual and best corrected logMAR visual acuity, log contrast sensitivity, refractive errors and reading speed, and were assessed by an optometrist. Pure tone audiometry was used to measure hearing function by an audiologist. A questionnaire or case history was used to assess subjective symptoms and present level of care. Vision and hearing aids and/or referrals to an ophthalmologist/ENT specialist were provided as appropriate.
Nursing home residents suffer from both vision and hearing impairments. Best corrected binocular visual acuity (0.56±0.2), contrast sensitivity (1.05±0.15), and reading speeds (86±60 wpm) are poor, and pure tone hearing thresholds were increased (>25 dB, 250-4000 Hz). 20 of the residents had not had an eye test during the last 5 years, 17 residents were visually impaired (VA<0.3), and 18 were referred to an ophthalmologist. 30 residents were given new glasses, which improved their vision significantly (p<0.05). 27 residents had impairment hearing in one or both ears; only 3 of these had a hearing aid. All 30 residents were recommended a new hearing aid. The in-house general practitioner and staff were notified of the findings.
The results show that dual sensory loss is common in nursing home residents. This study also indicates that the eye/ear care could be improved by regular examinations to ensure that residents have appropriate vision and hearing aids. Health care routines, record keeping and follow-up routines needs to be improved. More information on how to recognise and care for patients with vision and hearing loss needs to be given to nursing home staff.
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