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      Guidance for residential care homes

      Deafness and hearing loss shouldn’t stop older people living well in residential care homes. Our guide provides practical tips and advice for care staff on improving the quality of care for older people who are deaf or have hearing loss.

      More than two-thirds of older people have hearing loss. Unaddressed, it can lead to social isolation and an increased risk of other health problems, such as depression and dementia. There's good evidence that hearing aids can reduce these risks, but many older people are waiting too long to get their hearing tested or face barriers seeking help because of other conditions.

      People who are deaf who use British Sign Language (BSL) may be at risk of loneliness and loss of cultural identity if they are unable to communicate in a meaningful way in BSL with care staff or other people in their care home.

      How care staff can help

      1. Be alert to the early signs of the hearing loss

      When new residents arrive, be aware of the signs of hearing loss, such as asking others to repeat things, failing to follow conversation in noisy places and behavioural changes, such as withdrawal from social activities.

      Care staff should encourage older people to seek help and be aware of the role of the GP in referring people for a hearing test. Our 'Hearing check' can help identify people who may need a hearing test. Portable hearing screening devices are also available.

      2. Provide support to make sure older people get the most out of their hearing aids

      If the person has a hearing aid, record this in their care plan and make a note of other accessories that may be needed, such as replacement batteries or tubing. When someone is fitted with hearing aids by their audiologist, they should be provided with written instructions on how to operate and maintain their hearing aids.

      Carry out regular checks to make sure their hearing aids are functioning and fitted correctly. If hearing aids are worn continuously, hearing aid batteries typically last no more than a week and hearing aid earmoulds and tubing require regular cleaning.

      3. Ask older people if they need help to communicate or understand information

      If older people who are deaf or have hearing loss need staff to follow simple communication tips or if they need more communication time when receiving care, make sure this is recorded in their care plan.

      In England, ensuring communication and information needs are recorded and met is a legal requirement under NHS England’s Accessible Information Standard.

      4. Make sure the care home environment is welcoming for older people with hearing loss

      A high level of background noise can make it difficult for older people with hearing loss to understand what is being said and participate fully in conversations and social activities. Carpeted floors, padded tablecloths and soft furnishings should be used wherever possible to help absorb background noise.

      Older people with hearing loss may also benefit from assistive technology, such as hearing loops, personal listeners and flashing smoke alarms

      5. Take account of the cultural and communication needs of older people who are Deaf

      Older people who are Deaf are less likely to benefit from hearing aids and they may need specialist care and support that recognises the unique language and culture of the Deaf community.

      They may also need support from a qualified BSL interpreter, as well as help to contact family and friends and local Deaf clubs or other community groups.

      Resources and support

      • Our factsheet Caring for Older People with Hearing Loss
      • Our Help with hearing aids tips card
      • Action on Hearing Loss Cymru and Age Cymru’s booklet Quality of life for residents with hearing loss