Co-Designing a Sensory Support Intervention for Older Adults With Hearing and Vision Impairment Living in Australian Home Care Settings

Abstract

Background: Home care services help older adults remain living independently in their own homes. Approximately 70% of home care recipients have hearing and/or vision impairments, and 20% likely have cognitive impairments. A home-based hearing and vision intervention (SENSE-Cog), incorporating impairment identification and correction, device and communication training, goal setting, referrals, provision of supplementary devices, and fostering social inclusion, was originally co-developed with people with dementia in Europe. Aim: We aimed to co-design an adaptation of the intervention for older Australians in home care settings. Methods: An iterative co-design process with audiologists, eye care professionals, home carers and research experts identified modifications required for the intervention. Themes from workshops guided modifications, and feedback from research experts and three public and patient involvement workshops provided additional usability insights. Results: Thematic analysis indicated the potential benefits of the intervention related to establishing a strong foundation, decision support, timely access to care and effective communication. Challenge-related themes centred around resistance and denial, cultural and linguistic barriers, cognition, age, implementation, and sensory therapist-related challenges. Modification themes closely paralleled the challenges of incorporating topics such as tailored support, information provision, extended training, addressing disparities and sensory therapist development. Discussion: The co-design process led to modifications of intervention components to meet the needs of the Australian population and the creation of a Sensory Therapist training module. A field trial is planned to assess the efficacy of the adapted intervention. Patient or Public Contribution: Older adults with lived experience caring for a family member with dementia played a central role in reviewing the developed intervention materials as part of PPI workshops. They provided unique insights into the usability of the materials, and these were used to refine the intervention to better suit the older adult population. Key differences existed between the insights offered by the public and by research experts, highlighting the value of public contributions to intervention development.