Challenges and Opportunities to Support Communication and Reduce Background Noise in Residential Aged Care

Abstract

Using communication strategies and reducing background noise are key staff behaviors to improve communication among aged care residents, a population with high levels of hearing loss. Effective communication between staff and residents is essential for quality care, as communication difficulties increase the risk of misunderstandings, reduce treatment adherence, and negatively impact health outcomes and quality of life. This study aimed to identify barriers and enablers to these behaviors in Australian residential aged care.Semi-structured interviews were conducted with 23 aged care staff. Data were analyzed using a hybrid approach, combining deductive thematic analysis based on the Capability, Opportunity, and Motivation model of Behavior (COM-B), with inductive thematic analysis.Capability barriers included limited use of effective communication strategies, knowledge gaps, and forgetting to adapt communication and to reduce background noise. Opportunity barriers related to linguistic diversity, time constraints, lack of clear protocols, and residents’ cognition, and mood. Enablers included supportive management, colleagues and visual cues. Staff were motivated by the positive impacts, though some reported concerns about negative resident reactions. A multi-component intervention, including targeted training, organizational support, and environmental modifications is required to promote staff use of communication strategies and reduce background noise.

Keywords: communication, hearing loss, dementia, residential aged care, behavior change.