A qualitative investigation of the barriers and facilitators to managing hearing loss for older adults living with frailty

AIM To explore the barriers and facilitators to managing hearing loss for older people living with frailty using the Burden of Treatment Theory, to identify how to better meet their support needs. BACKGROUND Hearing loss and frailty are common in later life. Frailty is a condition in which individuals have low grip strength, low energy, and low physical activity. Both hearing loss and frailty can affect quality of life and wellbeing, and many older adults with frailty live with other health conditions. However, there is little information on the specific challenges faced by older adults who have both hearing loss and frailty, including the extra effort this requires, and the support needed to use hearing aids effectively and regularly. To prepare for this study, we spoke with older adults with hearing loss who shared their challenges in communicating with family, caregivers, and healthcare professionals, as well as the difficulties of managing their hearing aids. DESIGN AND METHODS This study will include in-depth qualitative interviews (up to 25) with older adults aged 65+ who are living with frailty and hearing loss. Eligible participants will have either a diagnosis of hearing loss, or be current or past users of hearing aids. They will also be living with some level of frailty, as indicated by their electronic Frailty Index (eFI) score or a questionnaire-based frailty measure (PRISMA7). Managing hearing loss often involves support from spouses, family members, friends, or informal carers (communication partners), so we aim to include some communication partners (up to 10) in the study. Interviews will take place in the older adult’s home or a location of their choice. Topics will cover their reasons for seeking help with hearing loss, experiences with audiology services, challenges using hearing aids, support considered helpful, awareness of other hearing supportive aids / technology, and what they feel is important for managing hearing loss. Thematic analysis will identify barriers and facilitators to managing hearing loss. Themes and case vignettes will be taken to a stakeholder workshop (older adults and audiologists). This group will consider the facilitators required to managing hearing loss well and the support older people consider to be important, derived from the interview data, to ensure these areas are considered within recommendations or future research plans. The workshop will also explore potential areas for intervention development, particularly to address the challenges faced by older adults living with frailty.