Failure to Update Communication Strategies for Resident with Hearing Loss
Penalty
Summary
The facility failed to ensure that a resident with severe cognitive impairment and significant hearing loss was provided with effective communication strategies after the loss of her hearing aids. The resident, diagnosed with dementia, Alzheimer's disease, depression, and muscle weakness, had a history of losing her hearing aids, which were not replaced after the most recent loss due to cost and repeated incidents. Despite the resident's care plan initially including interventions for hearing aid use and communication strategies, there was no documented update or revision to the care plan after the hearing aids were lost, nor were alternative communication methods formally implemented or communicated to all staff. Observations and interviews revealed that staff had to speak loudly and repeat questions for the resident to understand, and some staff began using written communication, such as a whiteboard, to facilitate interaction. However, this intervention was not consistently communicated to or utilized by all staff, and it was not incorporated into the resident's care plan. Key staff members, including the social worker and MDS nurse, were unaware of the use of the whiteboard until the time of the survey, and the care plan did not reflect this new communication strategy. The lack of a coordinated approach and failure to update the care plan resulted in inconsistent communication support for the resident. Documentation in the resident's medical record and progress notes confirmed ongoing difficulties with communication, including challenges during assessments and daily interactions. Staff interviews indicated that while some were aware of the resident's needs and attempted to adapt, there was no systematic or care-planned approach to address the resident's hearing loss after the loss of her hearing aids. This deficiency in updating and implementing effective communication strategies directly impacted the resident's ability to convey her needs and participate in her care, as observed and reported by both staff and the resident herself.