Hearing healthcare professional toolkit (CUNY - US)
Hearing healthcare toolkit for use in primary and geriatric care
& Coleman, 2007). People with age-related hearing loss by virtue of the cognitive and central changes which compromise auditory processing will by definition be at a considerable disadvantage.
Similarly, the hearing loss makes him feel isolated and lonely even though objectively his social network is relatively large in terms of number of social contacts. The HHCIR score of 26 suggested that he is handicapped by his hearing loss, is a good candidate for a hearing aid and feels somewhat confident that he would be able to learn how to use hearing aids. We administered the De Jong Gierveld Loneliness Scale. The baseline score suggested that he is feeling isolated and lonely. Hearing health care intervention options ranging from situation specific hearing assistive technologies (e.g., for the phone and the television) to hearing aids were presented using a Decision Aid listing options and evidence of outcomes. Mr. X decided to purchase hearing aids for each ear. As part of the hearing aid fitting he and his wife were instructed on use, care and operation of the hearing aids. Communication strategies to promote more effective communication were outlined. The follow up: Mr. X returned three weeks after the hearing aid fitting. When tested with the hearing aids, speech understanding ability improved dramatically in noise, the score on the De Jong Gierveld Loneliness Scale revealed that he was no longer feeling isolated, this was also confirmed by a score of 4 on the HHCIR suggesting that he was no longer feeling lonely or having difficulty in the majority of listening situations. The self-reported improvement also coincided with a report that he no longer feels as depressed. interventions. We spoke to Dr. Jones following the hearing aid fitting to communicate our findings and he volunteered that it requires less effort to communicate with Mr. X and that his mood seems to have improved according to the impressions relayed by his wife. His wife also reported that the volume of the television no longer has to be turned up and conversations with family members reveal that Mr. X is more engaged. Implications: This case highlights a number of important features of hearing loss and hearing health care
Background Information: The oldest old (85 years and older) represent the fastest growing segment of the United States population. Mr. X an 86-year-old man is typical of individuals in this age cohort. He suffers frommultiple chronic conditions including cerebrovascular disease and has experienced multiple falls over a period of one year. He lives with his wife and is committed to aging in place. He is socially engaged in that he visits with his children and does have dinner with friends approximately once a week. Having first noted difficulty hearing when he was 80 years of age, he chose to ignore it as it was his understanding that hearing loss was to be expected with advancing age. While performing otoscopy, Dr. Jones asked Mr. X about his hearing. Mr. X, did not understand the question so he asked his doctor to repeat the question. Mr. X then proceeded to describe the many situations which were problematic for him. Dr. Jones suggested that he schedule an appointment for a hearing test with a local audiologist. Mr. X asked for a recommendation, but Dr. Jones was unable to provide any names. After about six months, Mr. X was finally able to find a local audiologist with whom he scheduled an appointment. recognition ability in quiet was poor in both ears and speech understanding in noise testing confirmed considerable difficulty in suboptimal (noisy) listening environments. The Hearing Health Care Intervention Readiness (HHCIR) scale which assesses perceived social and emotional effects of hearing loss, self-efficacy, social isolation and readiness to proceed with a hearing health care intervention was administered. Responses to the HHCIR suggested that Mr. X experiences difficulty understanding in most social situations and is very frustrated by the difficulty communicating. He also feels that his hearing loss is interfering with the ability to hear environmental sounds, compromising a sense of security. The Assessment: Pure tone tests revealed a mild sloping to profound sensorineural hearing loss in each ear. Word
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