EDITOR'S NOTE: This Special Section is based on the featured session, “Managing Patient Anxiety, Ambivalence and Lack of Awareness of Hearing Loss: An Audiology/Psychology/Patient Collaboration,” from the Academy of Doctors of Audiology (ADA) Annual Conference on Nov. 14-16, 2019.
I first noticed my hearing issues in my mid-20s while in graduate school. I was missing things in class—mostly those made as an aside or under one's breath. Sometimes the whole class would burst out laughing, and I would be left looking around trying to figure out what was so funny. I knew what the problem was: I was losing my hearing. My father had developed hearing loss as a young adult, as had his mother. I was hoping it would skip my generation, but no such luck. I went to see an audiologist and was told that I had mild hearing loss, but that it was too early to treat. I was thrilled and used this as an excuse to ignore and deny my hearing loss for many years.
For most people with hearing loss, an audiologist is the first hearing care provider they see. The influence an audiologist has on a new patient's hearing loss journey cannot be overstated. It certainly was very important to me.
I arrived at my first audiologist appointment scared, uninformed, and bogged down in the baggage of stigma. Despite a real concern that I was missing things in class, I was sent home without any new skills or devices that could help. The audiologist did not even suggest that perhaps a different seat in the classroom could be helpful. Thinking back on it, the standard of care I received was very disappointing.
Over the years, I have seen several audiologists since that first visit. Only one asked me which hearing situations were the most important to me. Only one—a different one—checked how well I hear when wearing my hearing aids. None recommended that I seek out a hearing loss support group or shared communication best practices with me. The care I received focused on which hearing aid to purchase rather than solving my communication problems. Or at least that was how it felt to me.
Person-centered care could have alleviated many of the problems I faced in the early years of my hearing loss. From a patient's perspective, these simple efforts could go a long way in helping ease a new patient's journey.
1. Partner with your patient. Nobody understands a person's hearing difficulties better than the person experiencing them, making their input of paramount importance. People want solutions for their specific communication challenges, not just amplification. The first step in creating a successful treatment plan is finding out what the most important problems are from the perspective of patients—something only they can provide.
2. Make your office hearing loss-friendly. People come to your office because they cannot hear well, so make sure they get the appropriate assistance from the moment they contact your office and throughout their appointment. Train your staff to use communication best practices, both in person and over the phone. Patients often arrive with anxiety about their hearing loss. Make sure your office gives them confidence that they have found the right partner to share their journey.
3. Embrace creativity. Audiology training may be focused on very specific tests, measurements, and procedures, thereby overlooking a more flexible approach to patient care. Don't get trapped in a hearing aid-only approach. Introducing other assistive listening devices gives patients greater access to hearing for various situations. For some patients, non-traditional devices may be the right first step.
4. Think beyond the technology. Hearing aids are miraculous tools, but communication best practices are equally important, particularly when your patient is in a difficult listening environment like a restaurant, office meeting, or party. Small changes in behavior, such as making sure to get a person's attention first, can have a huge impact in making conversations successful and more enjoyable.