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#LDnursechat - hearing impairments in the learning disabled population

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#LDnursechat discussed hearing impairments in the learning disabled population.

Along with relief that I wasn’t facilitating this #LDnursechat, I was very excited about what I would learn and share. I have both personal and professional experience of supporting people with hearing impairments and how it is diagnosed and treated.

The additional impact of a hearing impairment on top of a LD must be devastatingly difficult for people to recognise, diagnose and manage.

As is our custom now, we shared some useful links before the chat and the chat started with a link to the NMC guidelines for use of social media, and a link to @WeNurses netiquette. We all introduced ourselves and the chat began to flow.

@SteveHardyLDN delivered an interesting statistic which generated much discussion: “estimated 40% of PWLD have hearing impairment, but many go unrecognised”. This could be as a result of a lack of robust audiology testing.

Also we discussed the lack of carer understanding regarding hearing impairment, poor quality health checks and GP’s not referring on to audiology services, as well as the often cited problem of physical health in the LD population being misinterpreted as behavioural, mental health or cognitive decline.

So why does the LD population experience more hearing impairments? This is a good question, and certainly one which requires more quantitative research to establish the causes. The auditory memory was mentioned, as in PWLD do not get enough time to process sound, so although they can hear, are misdiagnosed as hearing impaired. There is also the anatomy of the ear, which can increase the prevalence of ear wax.

Certainly in my experience, people with Down syndrome frequently have narrow ear canals which make aural examinations quite tricky and ear wax frequently becomes impacted. People with Down syndrome also seem to have a higher incidence of ear infections, although these statements remain anecdotal and need some research to establish accurate statistics.

Ear wax is commonly found on the annual health checks for PWLD, and health action plans assist support staff in the management of this simple to treat, yet devastating if left, condition. @brennan_sk highlighted that impacted ear wax “causes hearing loss” as well as preventing accurate testing and potentially hiding infection.

GP training in LD awareness and how to deliver quality health checks was also discussed. A valid point was made by @donnadd69 about how carers and family who advocate for the PWLD at appointments can mean any hearing impairment is overshadowed. So along with ‘Top Tips’ for GP’s delivering health checks, maybe some ‘Top Tips’ for carers too are needed?

Although I have so much more to say about this topic, the summary of the chat is really that we, as LD professionals, need to create or improve collaborative audiology links, including referral processes. Audiologists need LD awareness training, and to complete yearly clinics in special schools. The audiology tests need to be adapted to encompass individual’s specific reasonable adjustments; indeed, “the tests should be adapted for the person, and there’s lots of different ones we can try” @brennan_sk pointed out.

Initial feedback from this chat suggested several of us will be adapting our practice for the better following this discussion. In my opinion this is exactly what @LDnursechat set out to do from the start, and I’m delighted we achieved it with this inspirational chat. Special thanks to @LDstudentnurse for suggesting this topic, and facilitating it so excellently.

Read the transcript of this chat and see the forthcoming #ldnursechat schedule here.

@LDnursechat owned and facilitated by Michelle Parker @LDstudentnurse, Daniel Marsden RNLD @dmarsden49, Sally Wilson RNLD @salsa442, Sam Abdulla RNLD @samabdulla.

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