Sensory impairments, particularly vision and hearing impairments, are common in long-term care (LTC) elders due to changes of aging, chronic illness, or toxic exposure. Despite high prevalence rates, sensory impairments are poorly addressed in LTC. This leads to unnecessary dysfunction in cognitive, psychological, social and physical domains. The purpose of this study is to test the efficacy of a nursing intervention, Individualized-Sensory Enhancement for the Elderly (I-SEE), in improving hearing and visual function, cognitive performance, social engagement, physical function, and in reducing depression and delirium. The study is a repeated-measures 2-group I-SEE intervention and attention control (AC) control group design. Six LTC facilities will participate. All facilities will be used twice, once for the AC group (n=25) and once for the I-SEE group (n=25) for a total of 300 participants (150 I-SEE and 150 AC participants). Baseline screening includes assessment for vision and hearing impairment, cognitive performance, delirium, depression, social engagement, and physical performance. The AC group receives 16 weeks of visits three times a week to monitor for delirium. The I-SEE group also receives three visits a week for 16 weeks to implement the intervention to address sensory impairments (nursing assessments, actions, and referrals) and monitor for delirium. The I-SEE intervention includes functional goal setting with the participant, such as being able to read the T.V. guide; nursing assessment; basic nursing interventions such as cleaning eyeglasses and hearing aids, removing cerumen from ears, providing amplification and magnification devices, supplying an activity box with sensory stimulating music, videos and large print materials; and referring to specialists to address cataracts, low vision and hearing impairment. All baseline measures are reevaluated in the I-SEE group and AC group at 8 weeks and at the end of 16-weeks. A combination of statistical methods will be used to determine the efficacy of the I-SEE intervention. Repeated measures analysis of covariance, multiple regression analyses, and structural equations modeling methods will be conducted to describe the efficacy of the intervention. ? ?
| Cacchione, Pamela Z; Willoughby, Lisa M; Langan, Joanne C et al. (2011) Disaster strikes! Long-term care resident outcomes following a natural disaster. J Gerontol Nurs 37:16-24; quiz 26-7 |
