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Giving permission to care for people with dementia in residential homes: learning from a realist 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 permi...

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Autores principales: Crosbie, Brian, Ferguson, Melanie, Wong, Geoff, Walker, Dawn-Marie, Vanhegan, Stevie, Dening, Tom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398258/
https://www.ncbi.nlm.nih.gov/pubmed/30827280
http://dx.doi.org/10.1186/s12916-019-1286-9
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author Crosbie, Brian
Ferguson, Melanie
Wong, Geoff
Walker, Dawn-Marie
Vanhegan, Stevie
Dening, Tom
author_facet Crosbie, Brian
Ferguson, Melanie
Wong, Geoff
Walker, Dawn-Marie
Vanhegan, Stevie
Dening, Tom
author_sort Crosbie, Brian
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12916-019-1286-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-63982582019-03-13 Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication Crosbie, Brian Ferguson, Melanie Wong, Geoff Walker, Dawn-Marie Vanhegan, Stevie Dening, Tom BMC Med Research Article 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12916-019-1286-9) contains supplementary material, which is available to authorized users. BioMed Central 2019-03-04 /pmc/articles/PMC6398258/ /pubmed/30827280 http://dx.doi.org/10.1186/s12916-019-1286-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Crosbie, Brian
Ferguson, Melanie
Wong, Geoff
Walker, Dawn-Marie
Vanhegan, Stevie
Dening, Tom
Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication
title Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication
title_full Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication
title_fullStr Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication
title_full_unstemmed Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication
title_short Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication
title_sort giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398258/
https://www.ncbi.nlm.nih.gov/pubmed/30827280
http://dx.doi.org/10.1186/s12916-019-1286-9
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