David Oliver: Admission should allow for patient aids
BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3953 (Published 19 September 2017) Cite this as: BMJ 2017;358:j3953All rapid responses
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"We’re not always knowledgeable about using, checking, or adjusting hearing aids."
Nice to see the issue raised, hopefully the recent drip, drip of comments will result in improved attitudes to hearing loss among clinical staff.
This is important. 60% of 70-79 year olds and 94% of over-80s have significant hearing problems (Hearing Matters. Action on Hearing Loss, 2011; Davis AC, 1995. Hearing in adults). The figures are higher in those admitted to hospital or care homes.
Action on Hearing Loss is keen to improve such understanding, and can provide education sessions - locally we have given them to GP practices, postgraduate groups, care homes, community teams, and NHS referral centres. Notably we have talked to the NHS complaints team, who made changes to the way they work to make it easier for members of the public with hearing loss to contact them. Telephones are a especially difficult when your hearing is in trouble, so the public who use NHS call centres can benefit from such advice.
Competing interests: No competing interests
David Oliver must be congratulated on his most recent article. My late father spent two and a half months in hospital recovering from a fractured neck of femur. Prior to his admission, he was forgetful but had numerous coping strategies which allowed him to function effectively in the community and to look after my mother. The clinical care he received was excellent. However, not one but two pairs of hearing aids were lost during his illness and recovery. Even with his hearing aids, he needed the person speaking to him to stand close by his side and to speak slowly and clearly in the lowest tone they were capable of. None of the doctors, nurses or other staff ever did this. I suspect they had no idea how helpful such an approach would have been for my father and for all the other elderly people in our hospitals today. Surely educating staff about how to talk patients who are hard of hearing should form part of all student training courses and the message reinforced during induction programmes.
My father's illness and admission also deprived him of many of his other coping strategies. He became increasingly confused and disorientated. Snow lay on the ground for most of his hospital stay but as time passed he became convinced he was in a Nursing Home and that it was July. Even when I reminded him that he was in hospital and told him about the snow, he quickly forgot. As I sat by his bed, I pondered on how, given his poor short term memory, his disorientation could have been prevented or at least minimised. Each bed space has a TV screen. Would it be possible for the TV screen to be positioned where the patient could see it during the day? When not in use for its current intended purpose, would it be a good idea to show information in large text on a loop with day, date, time and current location interspersed with live web cam views of a local park with some deciduous trees that would provide non-verbal information about weather conditions and the season? Last but not least, perhaps some news headlines could also be shown. I am sure this would have helped my father a lot. Perhaps it could benefit other elderly patients too.
If this suggestion is impractical, I hope my rambling thoughts provoke others to propose alternative solutions. To complete my father's story, he was discharged to a Nursing Home where it took him over a year to recover from his confusion and disorientation. He was happy in the Home and had a wonderful party to celebrate his 100th birthday which he did not forget and often talked about. He died peacefully aged 101years and 4 days.
Competing interests: No competing interests
Re: David Oliver: Admission should allow for patient aids
Our family has personal experience of the impact loosing essential aids can have on patients. When our Mother was hospitalised with a serious femur fracture after a fall, she lost her hearing aid within the first two days making her more disabled, disoriented and more dependent on both staff and her family to enable her to play an active role in her recovery. It took many weeks to source and make a replacement, long after Mum had left hospital.
Researching this problem, I found that our Mum 's loss was not an isolated incident. In fact, everyone I spoke to who had experienced an elderly relative in hospital also suffered the devastating effects the loss of dentures, hearing aids or glasses causes. Factual evidence is easily established. Typing the issue into a search engine reveals many articles and the true extent of the problem. This one included both the loss of patients essential aids and the effect the loss has on the patient's dignity and hospital experience.
Not one to sit by when I identify a problem, I looked to see if there was anything available on the market which would reduce the loss of essential aids. Finding nothing, I designed a box, which i have called Aidsafe. The box has identified space for glasses, hearing aids and dentures, giving nursing staff a designated place to put all the patients essentials when preparing them for sleep or surgery. Oncoming staff will then know exactly where to find everything when preparing the patient for the day ahead. The box also has a space for a patient label on the lid, forever linking the contents to the correct patient. Let's face it, who would want to be wearing someone else's dentures, which happens. Keeping essential aids safe will prevent compromised dignity and enable patients to take an active role in their own recovery and be part of the hospital community during their stay.
Caring for the environment, I have ensured that the Aidsafe box is both 100% paper recyclable and biodegradable. The Aidsafe box was designed specifically to enhance patient care, whilst at the same time, attempting to save the NHS money by preventing the millions spent compensating patients for the loss of their vital aids.
Professor David Oliver evoked a strong response with his article as he accurately identified a prolific problem effecting so many vulnerable people.
Aidsafe aims to enhance the patient experience by preventing the loss of essential aids highlighted in the article.
Competing interests: EAH is Managing Director, Aidsafe Limited