Optimizing Evaluation of Older Adults With Vision and/or Hearing Loss Using the interRAI Community Health Assessment and Deafblind Supplement.
Andrea Urqueta Alfaro, Cathy McGraw, Dawn M Guthrie and 1 others
PMID 36188820WHAT IT FOUND
Assessing older adults with vision or hearing loss can miss real-world difficulty if based on one ability or a quiet interview.
Ask about distance vision, multiple sounds, noisy settings, preferred communication, and night mobility before scoring.
Key findings
01Focusing on only one sensory ability, such as near vision, can give an incomplete picture or miss an impairment.
02Sensory performance can look better in a quiet interview than in everyday noisy or distant contexts, so assessors need information from multiple settings.
03The daily communication mode may not be the person's preferred mode, and daytime mobility performance may not show twilight or night difficulty.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The recommendations come from one expert assessor's case notes and team discussion, not from a comparison group or patient outcome measure. The idea for the study emerged after data collection, so the notes were not collected for this purpose. All participants were already receiving sensory rehabilitation services and had to communicate verbally by phone, so the sample excluded people who mainly used sign language or had very profound hearing loss. Participants had to manage a long interview and cognitive screening, so the findings may apply mainly to higher-functioning older adults with acquired sensory loss. The paper did not test whether the suggested changes improve assessment accuracy, service planning, or patient outcomes.
Declared interests
Funded by the Canadian Consortium on Neurodegeneration and Aging, with CIHR grant CNA-137794, and by foundations linked to the Lethbridge-Layton-Mackay and Institut Nazareth et Louis-Braille rehabilitation centers. No author conflict declaration appears in the supplied text. The interRAI CHA and DbS are copyrighted, and the manual is sold by interRAI, described as a not-for-profit network.
The easy way to misread this
Do not read these suggestions as proof that the interRAI CHA and DbS improve patient outcomes. They are recommendations from one expert assessor's reflections on 200 interviews, not a tested intervention.