Sensory loss and dementia: insights into long-term care nurses’ experiences of care and assessment

More than half of long-term care (LTC) residents are reported to be living with dementia, affecting their ability to understand and express information, thereby having profound implications for effective interactions. This is further compounded by hearing and vision loss which also affects two thirds of residents. Persons living with dementia have identified the assessment of such sensory impairment, along with its treatment and care, as a key research priority. As part of a larger project aiming to develop a package of effective sensory screening tools to identify LTC residents with dementia in need of specialist referral, an environmental scan was conducted to capture the tools and strategies currently being used by front line staff in this setting. A purposive sample of 20 registered nurses and registered practical nurses was interviewed across 2 facilities in Ontario, Canada, and asked about: their experiences of working with persons who have dementia and sensory loss; how they identify which residents have sensory impairment; ways in which current screening procedures could be improved; and, key elements to include in a sensory screening package. Using a strength-based analytical framework, we highlight “pockets of excellence” in nurses’ practices of care and assessment. Results from a two-step qualitative content analysis reveal diverging institutional frameworks of practice, along with shared barriers and enablers to the care and identification of sensory loss in this population. We also discuss examples of effective and creative strategies used by nurses to conduct informal assessments and enable communication with older adults who have dementia.