Mythbusters | July 2018 Hearing Review
Editor’s Note: As reported in The Hearing Review online, Phonak has convened a select group of hearing healthcare experts to provide evidence-based recommendations to hearing care providers on how to better engage family members. The group proposes an audiologic treatment shift from a site-of-lesion focus to a family-centered care perspective as a means of increasing the value of our services and the uptake of hearing devices. This paper is the fifth in a series of several common (mis-)beliefs or myths challenged by the authors. Click here to access Mythbusters #1, Mythbusters #2, Mythbusters #3, and Mythbusters #4.
Time is the great enemy for many hearing healthcare clinicians. There is much to be done in an appointment, and little or no time for “stopping to smell the roses.” There are clinical and organizational pressures on clinicians to maintain the distinction between “nice-to-do” and “need-to-do.” Not surprisingly, colleagues complain that, while it may seem like a nice idea to include family members in the audiologic assessment and rehabilitation process (ie, nice-to-do), it is just too time consuming. Certainly appointment length and time management are real issues in professional practice and are critical for a practice to succeed.
But what if family involvement in the rehabilitation process not only provides more efficient use of time, but results in better outcomes, and thus be considered a “need-to-do’” rather than a “nice-to-do”?
Given a limited amount of time available for appointments, it is the use of that time in the most productive manner that sits at the heart of our decisions about what to include in the process. Previous Mythbuster papers in this series (#1 and #4) have suggested that reviewing audiograms and hearing test results is not an effective way to enhance the chance for patient and family engagement,1,2 thus limiting the opportunity for counseling and shared decision making.
Reformatting the treatment process at the front-end by inviting family to participate in the intake and treatment decisions has been suggested to result in reduced time spent in later appointments and follow-up. Not only might this improve time management and outcomes, but patient satisfaction can be increased.3
There are two additional points to keep in mind. First, 9 out of 10 patients want family members, and 9 out of 10 family members want to participate in audiology appointments.4 Second, when family members attend appointments, hearing aid adoption rates tend to increase. Regardless of the degree of hearing loss, hearing aid adoption rates may increase by as much as 13 percentage points when family accompanies individuals with hearing impairment to audiology appointments.5 This number may rise to as much as 96% for individuals with mild hearing losses!
Our clients come to us with concerns about their hearing that are embedded in their daily lives. These concerns—which most commonly involve difficulties in communication—also impact their families and friends. Our reliance on those close to our clients to support/assist in this rehabilitation process is likely to be enhanced by our attention to their views of the key issues addressing the impact of the hearing impairment. Inviting family members into the hearing rehabilitation process is an opportunity to build therapeutic relationships and result in a reinforcement of the clients desire to achieve the shared goals created together as a team. Their involvement influences our outcomes, so let’s invite them in!
Montano J, English K, Hickson L. Mythbusters’ Myth # 1 : I would like to do more counseling but time just won’t allow for it. Hearing Review. 2017;25(1):28.
Jennings MB, Lind C, Scarinci N. Mythbusters’ Myth #4: I have to discuss the audiogram. Hearing Review. 2018;25(5):22.
Singh G, Lau ST, Pichora-Fuller MK. Social support predicts hearing aid satisfaction. Ear Hear. 2015;36:664-676.
Hickson L, & Singh G. Mythbusters’ Myth #3: Many patients do not want their family in the room. Hearing Review. 2018;25(3):26.
Singh G, Launer S. Social context and hearing aid adoption. Trends in Hearing. 2016;20:1-10.
About the authors: Christopher Lind, PhD, is Senior Lecturer in Audiology in the Department of Speech Pathology and Audiology at Flinders University, Adelaide, Australia; Joseph Montano, EdD, is Associate Professor of Audiology and Director of Hearing and Speech at Weill Cornell Medical College, New York Presbyterian Hospital; and Gurgit Singh, PhD, is a Senior Research Audiologist at Phonak Canada, and an adjunct professor at Ryerson University and adjunct lecturer at the University of Toronto.