Hearing impairment ranks among the top four chronic conditions experienced by older adults, and rapidly increases with age; 50% of those aged 85 and over report hearing impairment. Hearing impairment alters one's ability to communicate with others, and data consistently demonstrate its negative impact on psychosocial and physical functioning. However, although hearing impairment can alter long standing relationships and mandate re-negotiation of roles and communication patterns, minimal data are available on the experience of hearing impairment in older adults and their communication partners (CPs) (partner/spouse/caregiver). To address this critical gap in our understanding, this longitudinal qualitative study with a naturalistic (non-manipulated) intervention will investigate the experience and consequences (psychosocial, functional, clinical) of hearing impairment for community dwelling hearing impaired elders (aged 60 and over) and their CPs across one year. One hundred dyads will be recruited from participating audiology clinics when they make a first time appointment for a hearing assessment and evaluation for a hearing aid. Interviews will occur before the hearing assessment (T1), at 3 months post assessment and hearing aid recommendation (T2), and again at 12 months (T3). Through in-depth interviews the meaning of heating impairment, its effects on salient aspects of each partner's life, and its effects on each partner's psychosocial, functional, and clinical status will be explored at each data collection point. In addition, factors that facilitate or hinder adaptation to a hearing aid and processes by which roles and relationships are re-negotiated will also be investigated. Post hearing assessment interviews will explore the processes by which changes (if any) have occurred as a result of a hearing aid. Select quantitative data on the effects of hearing impairment will be collected to augment the qualitative data and allow for triangulation of methods. This study will fill a critical gap in our understanding of the experience of hearing impairment: it will inform health professionals regarding this meaning of hearing impairment and how older adults and their CPs manage this chronic condition within the context of their on-going lives, and will underpin the development of targeted interventions to facilitate adaptation to hearing impairment and thereby enhance quality of life.
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