Walk into almost any care home in England and you’ll find someone who has slowly but surely stopped joining in. Not because they’ve lost interest, or because they’re unwell. Because they can no longer follow the conversation. Sadly, nobody has noticed or known what to do about it.
Hearing loss among older people in residential care is not a niche issue. It is one of the most prevalent, most overlooked and most consequential challenges facing the adult social care sector. And for too long, it has been treated as an inevitability rather than something that can – and should – be addressed.
That’s why we’re encouraged to see Care England and hearing loss specialists Engage launch Small Changes. Big Difference: a national campaign calling on care homes across England to take five practical, achievable steps to improve hearing support for residents. They aren’t calling for a sweeping systemic overhaul or significant investment; rather, small changes, made consistently, that can fundamentally alter someone’s quality of life.
Evidence shows that only half of care home residents with dementia receive any hearing support at all and fewer than a quarter of those who would benefit from hearing instruments use them. The consequences – isolation, withdrawal, accelerated cognitive decline, loss of independence – are well documented. The solutions, in many cases, are not complicated.
Speaking about the rollout of the campaign, Professor Martin Green – CEO of Care England – said: “Care England is determined to make sure that people with hearing impairments are not excluded or isolated when they need care and support. The “Small Changes Big Difference Campaign” is committed to improving care and support services for people with hearing impairments.
“We have an ambitious programme to roll this work out across the care sector. We are starting with our own members, many of whom are enthusiastically embracing and implementing the recommendations in this campaign, and we want to go as wide as possible, so we are engaging with voluntary sector organisations at both a national and local level, and ensuring that local authority and health commissioners are also acquainted with the messages of this campaign, and are incorporating them into their commissioning processes and in the services they deliver.”
Paul Surridge, Chairman at BIHIMA, said: “We see this as an issue that sits right at the heart of what we exist to do. Our members invest in developing hearing technology that can transform lives – but that technology only delivers its full potential when the people supporting those who wear it understand its importance. A hearing device that isn’t maintained, isn’t charged, or isn’t encouraged is a hearing aid that isn’t helping anyone.
“Better hearing support in care settings isn’t just good clinical practice. It’s the difference between a resident who participates in daily life and one who disappears from it.”
The Small Changes Big Difference national launch event takes place in London on 17 November 2026, bringing together senior leaders from across adult social care to move from awareness into action.
If you work in or alongside the care sector, we’d encourage you to explore the campaign and consider what might be possible in your own setting.
Find out more at careengland.org.uk/small-changes-big-difference
