Characteristics of baby boomers
lose their hearing gradually; most have high frequency losses; most are mild to moderate that worsens with age
What factors influence the effect of a hearing loss as the baby boomer get older (Life Factors)
age; socioeconomic factors, attitude; gender; race; grieving cycle( denial, depression, anger and guilt,acceptance... people generally don't go through steps in order)
Hearing loss happens in 4 phases...
1. Pre-hearing loss: age, attitude, gender; etc
2. Onset of hearing loss: may not realize
3. Diagnosis: time when identified, reactions vary; time to decide on amplification, Assistive listening devices, "communication strategies", psychological counseling; look at the whole person using "PEMICS" ; this is the time to do the "communication handicap, and "communication disability".
4. Adjustment-counseling provides information, technology that have value; aural rehab happening in this stage; must show value
How to look at the whole person
perception- visual and hearing
motor skills-adjust hearing aids
communication skills (communication style)
What are the principles of managing a hearing loss? What do we need to recognize?
1. amplification is not a cure all
2. recognition of speech is most important
3. speech is bi-sensory
4. people learn by doing and practicing
5. people learn best in one on one situations
6. people change behavior best in a group
Model of aural rehab (remediation)
PACO- psychosocial. amplification, communication, overall coordination
What are the 4 essential components of rehabilitation?
#1. Effective amplification(helps more than anything)
#2. Auditory-Visual Integration (speech reading)
#3. Assertive Listening-"communication strategies"
#4. Consumer awareness- knowledge-knowing the laws
Group therapy should include 3 types of experiences.
#1. share feelings, experiences, successes, failures
#2. structured practice in speech reading, communication repair
#3. information on hearing loss, aids, issues
How do we access those with hearing loss?
We look at:
#1. communication handicap (questionnaire)
#2. communication disability(compared to normal)
#3. conversational fluency( how well can they carry on conversations)?
#4. style of communication (passive, agressive, assertive)
#5. expectations, knowledge
#6. hearing aid benefit
What is a communication handicap?
overall effect of a hearing loss on the person's overall well being-self assessment questionnaire
What is a communication disability?
how a hearing loss "deviates" from a normal hearing persons hearing; this speak of physical limitation
degree a person can participate in a conversation; not often assessed; mild to moderate loss doesn't affect the person too much;
What are the costs of hearing loss to the patient
*family member adjustments
*psychosocial well-being (badge of elderly)
How do we get information from patients so we can set up therapy goals and establish baseline measurements and educate?
*communication handicap through questionnaires
*communication disability- performance tests
*conversation fluency- good structured conversations?
*communication style- passive, agressive, assertive
*access benefit of hearing aid
*interviews (PEMICS is good here)
*structured communication experience
*observation in natural environment
*information from frequent partners
*expectations and knowledge
What does CARA stand for?
C communication status
A associated variables
R related conditions
How long should group therapy last? How many people in a group is ideal?
6 weeks 2 hours per week
5-6 hearing impaired with spouses or friends