The challenge of audiology care for care home residents

Key findings

• Limited access to routine audiology services: Private audiology care is the only option for some care homes, which is financially unviable for some. A manager we spoke to said, “The cost of earwax removal used to be a free and regular service provided by the GP, but this is no longer available.”
• Routine audiology care is not always delivered. One care home manager noted, “We are supposed to have 12-month routine visits for all residents, but they are not always carried out.”
• Challenges accessing community services: Some residents are unable to visit community services due to advanced dementia and mobility issues. A manager stated, “It is sometimes difficult for our residents to access community services, usually due to a change in their environment; dementia, a lack of capacity, and a lack of support from families.”
• Many residents with advanced dementia cannot tolerate leaving the care home. Some managers told us they deem it too unsafe for residents to go out.
• Some care homes do not have the resources to take residents out into the community and must rely on residents' family members.
• Care homes receiving timely audiology services: The GP service is sometimes quicker to get appointments and support than hospital services. A manager told us, “Residents can contact their local GP to prescribe olive oil straight away, whereas West Park Hospital can take some time to get an appointment.”
• Some care homes choose to go private for quicker appointments for their residents. Another manager said, “Private appointments are made within a week, whereas West Park Hospital appointments can take up to 2 weeks, but in the meantime, the GP will prescribe Olive oil to prevent any ear blockage.”
• Mixed views on earwax removal services: Some care homes can access earwax removal services easily. One manager said “The local GP would do the referral for us, and in-house support would be provided if a resident is bedridden.”  
• Some care homes stated that they do not have in-house earwax removal support, so they must rely on outside community services, which can come with difficulties for some residents. One manager noted, “Residents who are diagnosed with dementia find it difficult to get to their [earwax removal service] location; most are elderly and depend on family for support.”
• Private audiology services are sometimes not financially viable for many care home residents. One manager stated, “We have a private service that comes onsite to offer ear wax removal for our residents, it is £55 for one ear and £65 for both ears, this is really expensive.”