Improving the Quality of Life in the Elderly

Image Gallery Pamela Cacchione, Ph.D., Saint Louis University   Click image to view fullsize   Image 1 of 1

Newswise — If nurses focus intensive attention on helping nursing home residents enhance their eyesight and hearing, will those residents be more fully engaged in their lives? Researchers from the School of Nursing at the Doisy College of Health Sciences at Saint Louis University hope to find out in an upcoming study.

SLU has received a $1.47 million grant from the National Institute of Nursing Research to study the impact “Individualized-Sensory Enhancement for the Elderly” (I-SEE), a nursing intervention designed by SLU researchers, will have on nursing home residents.

Between 50 and 90 percent of nursing home residents have problems with their eyesight and/or hearing, says Pamela Cacchione, Ph.D., associate professor of nursing and principal investigator of the study. In many nursing homes, caregivers focus their attention on residents with life-threatening physical problems, and hearing and vision problems go untreated because they are thought to be less pressing, she says.

“There’s a significant relationship between depression, confusion and functional decline with a lack of visual and auditory stimulation,” says Cacchione, a geriatric nurse practitioner. “Social engagement can have a dramatic impact on the fullness of an individual’s life.”

Cacchione and her team of nurse researchers and consultants are recruiting 300 participants from nursing homes across the St. Louis area. Half will receive visits three times a week for 16 weeks from research nurses, who will take vital signs and check the residents’ vision and hearing, as well as check for earwax, which Cacchione says is a common problem for the elderly.

They also will provide the residents with hearing amplifiers, better lighting and lighted magnifying glasses and will clean their eyeglasses regularly. The intervention group will also receive two trips to ophthalmologist and/or audiologist appointments.

The other half will be the control group and will receive vision/hearing assessments as well as 15-minute social visits three times a week to monitor for acute confusion.

Cacchione, who already has conducted a similar pilot study that showed dramatic improvements in residents’ quality of life, hypothesizes that over the course of the study, the I-SEE participants will demonstrate better physical function, cognitive performance, mood and social engagement and less acute confusion.

Nursing homes face a number of hurdles when trying to improve residents’ sensory status and physical and mental health, Cacchione says. The costs associated with sensory aids – hearing aids, for example – and the not-so-simple matter of convincing residents they would be better off with those aids can be significant challenges.

“Many older people think they’re functioning just fine without those aids,” Cacchione admits. “And then they become isolated from other people because they have increased difficulty with their hearing or vision. They think that if they can’t hear or see properly, they shouldn’t even bother (being social).”

While Cacchione predicts an overall improvement in cognitive performance, the goal of the study is not to improve cognitive function. For example, when dealing with participants with mild dementia, she expects to optimize vision and hearing rather than lessen the degree of their illness.

“What we want to show is that by attending to nursing home residents’ sensory capabilities, you can really improve their lives,” Cacchione says. “You want their days to be the best they can be.”

Long a leader in health professions education, Saint Louis University began its nursing program in 1928 and the first baccalaureate degree program in an allied health profession in 1929. Today the Doisy College of Health Sciences offers degrees in nursing, clinical laboratory sciences, health information management, investigative and medical sciences, nuclear medicine technology, nutrition and dietetics, occupational science and occupational therapy, physical therapy and a physician assistant program.