Project Description
Older Adult—Caregiver Dyads: Effects of Hearing Loss on Communication Related to Goals of Care in the Context of Serious Illness
This
pilot addresses the NPCRC priority on improving communication by gaining an
in-depth understanding of the ways hearing loss (HL) affects communication
regarding care preferences and goals within the older adult patient-informal
caregiver dyad in the context of serious illness. Its premise is that older
adults with HL and serious illness cannot participate effectively in care
discussions and are at risk of not receiving patient-centered, goal-directed
care. Informal caregivers are also essential to the decision-making processes
and should understand the patient’s wishes, so the impact of HL on dyadic
communication must be considered. Yet almost no data are available on the
impact of HL in the context of serious illness. This pilot addresses this data
gap. Qualitative interviews with 10-15 dyads – older adults with HL and serious
illness and their caregiver – will be conducted to: Aim 1: Obtain in-depth descriptions that will
elucidate the specific ways HL affects discussions of care, care preferences,
and goals of care with a health care provider and with each other from the
individual viewpoints of both the a) older adult patient and b) caregiver; Aim 2: Obtain preliminary data on the use and
usefulness of a brief educational session on HL and a pocket-talker provided at
the end of the interview on subsequent communication within the dyad and with
health care providers, assessed at 3 months. These data are essential for the
development of a longitudinal cohort study to examine the impact of HL on
communication in greater depth, over time, with a large and diverse population,
and that includes the patient, caregiver, and clinician. Data from both the Cohort study and pilot
will underpin development of targeted interventions to be tested in a RCT.
Bio
Margaret Wallhagen, Ph.D., GNP-BC, is a professor in the School of
Nursing, University of California San Francisco where she teaches
gerontological nursing at the master’s and doctoral level. She also serves as
director of the UCSF/Hartford Center of Gerontological Nursing Excellence and
is Senior Nurse Scholar for the VA Quality Scholars program in SF. Her research
focuses on how older individuals and their families manage chronic illnesses
and changes that occur with age, and has explored issues related to informal
caregiving, diabetes, and the construct of successful aging. However, for the
last several decades she has focused specifically on the impact of hearing loss
(HL) on older adults. Her most recent work addresses the benefits of
integrating screening for HL into primary care, the impact of HL on the
provision of quality palliative care, and the impact of HL on the
caregiver-individual with HL dyad in the context of a serious illness.
Email: meg.wallhagen@ucsf.edu