"I don't really know how to help her." Family caregivers' capabilities, opportunities and motivations to provide hearing support to long-term care home residents with dementia.

Abstract

Hearing loss is highly prevalent in long-term care home (LTCH) residents with dementia ("residents") and exacerbates confusion and communication difficulties. Residents rely on caregivers, including family, for hearing-related care. This study aims to understand the drivers of family caregivers' provision of hearing support to LTCH residents using the Behaviour Change Wheel. This exploratory two-stage study was guided by the Capability, Opportunity, Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). A self-report survey (<i>N</i> = 87) and interviews (<i>N</i> = 6) explored drivers behind the provision of hearing support. Quantitative data were analysed using descriptive statistics and a within-participants ANOVA. Deductive coding of TDF domains alongside thematic analysis was used for qualitative data. Provision of hearing support was variable. Gaps in family caregivers' psychological capability, reflective motivation and physical opportunity were identified. Barriers included lacking knowledge, unclear caregiver responsibilities, deprioritising hearing support, COVID-19 restrictions and fragmented collaborations with audiology services. Future behaviour-change interventions to facilitate family caregivers' provision of hearing support to LTCH residents should include: Improving knowledge of how to provide effective hearing support, establishing caregiver responsibilities and increasing the resources for hearing support within LTCHs.