PP415 - Evaluation of Using Tablet-Based Hearing Screening Technology in Aged Care and with the Healthy@Home Leading to Person-Centric Hearing Care

Abstract:
For people ageing at home or in assistive living facilities, the degree of hearing loss and its impact on daily living activities and communication are critical.

Through codesign with our aged care partners, we developed a tablet-based hearing screening tool to identify the hearing, and amplification needs of people with declining cognitive capabilities to implement fit for purpose hearing services. We will discuss our findings from whole of centre evaluations, implementation strategies and technology solutions assisting the prioritisation of hearing healthcare.

Summary:
For the healthy at home or residents of aged care facilities, clinical hearing loss impacts daily living activities and communication with carers/staff and family. The prioritisation of hearing health has increased following the 2020 Lancet publication, identifying hearing loss as the largest modifiable risk factor for cognitive decline.

Recent Government policy into ageing and aged care, recommended equitable access to care and access to audiological services and technology. Specifically calling out timely detection of hearing loss and prioritizing follow-up as crucial for access to remediation and/or management of identified loss, so that social isolation and cognitive decline are not exacerbated by reduced access to amplification.

Importantly, hearing services are not equitably distributed between metropolitan and regional, rural, and remote locations. Therefore, the ability to prioritize referral pathways using scalable technology greatly improves access through awareness of the older adult’s hearing status and prioritisation of services.

Working with our aged care (e.g. Meals on Wheels) and residential care partners (e.g. Maroba Caring Communities) we identified three objectives to investigate for the implementation of scalable hearing care services.

Objectives
(1) Validate the effectiveness of a tablet-based hearing screening solution delivered by care staff. (2) Implement resident-based hearing screening into healthy at home and residential care facilities. (3) Evaluate the ongoing effectiveness of both programs.

Methods
Using co-design methodologies, led by the University of Newcastle, involving staff and residents, the team were provided with ideas and guidance for modifying the automated tablet-based hearing assessment specifically for an elderly population, including those with mild cognitive impairment (n=50). The technological combination of evaluating hearing performance, together with motivation, cognitive capacity, and physical constraints (e.g. vision, hemiplegia, motoric degeneration) provided a significantly greater evidence base for prioritization. We evaluated the performance of staff conducting screening in residential care facilities and delivered by outside agencies (e.g. Meals on Wheels).

Results
Assessment of the tablet-based software led to recommendations for implementation to improve the usability for adults with mild cognitive impairment. Unlike previous hearing screening initiatives, we documented the success of care staff and carers in taking responsibility for the screening, referrals, and ongoing management of hearing loss. Increased ownership by carers reduced the reliance on audiological resources (especially scarce in regional areas) and transferred ownership of hearing health to the care facility. The inclusion of the results from hearing screening into management dashboards provided carers with the hearing information required to improve communication.

Conclusions
The outcomes of the Project were invaluable for the support of a point of care hearing screening for older adults, in care facilities and in the home. Three key implementation outcomes to assist clinical usability in other settings were gained. First, based on co-design, we evaluated screening at point of care and made changes to the hearing screening process to better accommodate the needs of adults with cognitive decline. Second, ownership and implementation into healthy at home and residential care pathways was key for implementation success. Third, the dissemination of easy-to-follow information regarding hearing status was key to improving communication with older adults.

Brief Summary of Clinical Takeaways:
The clinical takeaways for this session are to share best practice using hearing screening technology by carers and staff to provide population-based hearing screening services. Alignment with existing hearing aid services is crucial to address the unique needs of each older adult.

Assumptions
We encourage attendees with enthusiasm for novel methods of service delivery. We will focus on audience participation to discuss project outcomes and together we will co-design solutions that could be implemented irrespective of technology used.