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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)
social skills

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 for evaluation


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

Two types of counseling

#1 informational counseling
#2 personal adjustment counseling

Goal of Aural rehabilitation

increase the probability that communication will occur

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

Conversational fluency

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 3 styles of conversation?

passive, aggressive, assertive

What are the costs of hearing loss to the patient

*vocational status
*family member adjustments
*financial cost
*psychosocial well-being (badge of elderly)

What is the goal of aural rehabilitation?

to increase the probability that hearing will occur

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
*discuss expectations
*access benefit of hearing aid
*interviews (PEMICS is good here)
*daily logs
*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
A attitude

What does PACO stand for?

P psychosocial
A amplificatiion
C communication
O overall coordination

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

What are the 4 steps in the grieving process?

anger, guilt

What are the types of assessment

*daily logs
*structured communication experience
*observation in natural environment
*information for frequent speaking partners

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