Background: Due to age, immobility, multimorbidity and sector structures, residents of nursing homes often have disadvantages in accessing hearing aid care.

Methods: This study was conducted in three nursing homes in the greater Hanover area. Three different scenarios were evaluated for their potential to improve hearing-related healthcare: A) enabling nurses and caregivers by teaching them about hearing loss, hearing-related healthcare, and hearing aids; B) recruiting an acoustician, who visits the nursing home 1x/month; C) recruiting a "guide", who visits 1x/month to offer audiograms, hearing (aid) advice and education. All three scenarios were provided for the duration of 6 months.

Results: A total of 37 residents were included. Residents in scenarios A and B reported increased awareness for the topic of hearing in general. Most residents talked to nurses and family first, when hearing (aid) problems occurred. In line with this, residents in scenario A received more help with their hearing aids, hearing aid provision was increased by 16.7% and barriers to having or wearing hearing aids were reduced. Many residents in scenario B reported the acoustician to be their official contact concerning the topic of hearing, whereas the external "guide" in scenario C was not considered as a contact for this topic. The on-site care by an acoustician improved access to acoustic care, improved hearing aid provision (by 33.3%) and reduced arguments against having or wearing hearing aids. Scenario C could not improve hearing aid care.

Conclusion: Teaching caregivers and providing on-site care by an acoustician can raise awareness for the topic of hearing and can improve hearing aid use while reducing barriers to hearing aid provision.

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