The same elderly man from last week came in for a follow-up (this would be the third week in a row). He seemed to be in a better mind-frame in this session and participated without reluctance. I believe that his confidence is getting better which will help him accept his hearing loss. We worked on inserting the hearing aids again and also reprogrammed them because the patient said they were too loud.
Reprogramming included decreasing the gain in the lows and mids for loud sounds. After the change, the patient seemed to be happier. He also seems to need some time to adjust to the new hearing aids. His complaints included rustling of his clothes, an obnoxious laugher, and crowds of people talking too loud. However, these sounds have always been there but were not noticeable to him or they are annoying sounds no matter what level. Aural rehabilitation would be excellent for this patient but he does not seem interested in a weekly plan (even though he has been coming in weekly).
Since this patient has been having some problems, I went to the Widex (his hearing aids are Widex) and found their suggestions for first-time users. So here are some tips...
http://www.widex.com/is-bin/INTERSHOP.enfinity/WFS/Widex-COM-Site/en_GB/-/EUR/SVCPresentationPipeline-Start?Page=issite%3a%2f%2fWidex-COM-Site%2fWidexEnglishDic%2fDic%2f0_0_Index%2f0_0_1_IndexPages%2fAdviseForFirstTimeHearingAidUsers%2epage
The two tips that seemed most important for this patient were adjusting to new sounds and practice makes perfect.
In addition, I also read an article on hearing aid services and satisfaction because I was unsure if the problem was with me or him...which, most likely, it is both. I can not be with him everyday to make sure he is practicing so I'm not doing enough and he started out unmotivated. In this article, hearing aid users were asked to evaluate the service that they received when purchasing a hearing aid. I have seen this article before in class and possibly on someone else's blog. However, I never really noticed that the audiologists and hearing aid dealers were not giving the patient the opportunity for group aural rehabilitation. Also, communication strategies were also not top priority for the professionals to discuss with their patients. I believe that my patient needs both of these pieces of information. In fact, it was more important for me to discuss expectations, communication strategies, and aural rehab than how many programs the hearing aid had or how to change the wax guard. Here's the article:
http://www.hearingresearch.org/Dr.Ross/HAsatisfaction_consumers.htm
Stika, C.J. & Ross, M. (nd) Hearing Aid Services and Satisfaction: The Consumer Viewpoint.
Friday, November 30, 2007
Monday, November 26, 2007
Hearing Aid Orientation for New User
An elderly man came in for a hearing aid orientation and then the next week for a hearing aid check. Many factors effected the way the session went. His general health is not very good and he has been taking chemotherapy over the summer. His wife is the main person in his life and attended the appointment with him. However, she is also the only reason he purchased hearing aids to begin with since she is very opinionated (may be the best way to put it).
After introducing the concept of hearing aids, I showed how to insert the batteries, put on the hearing aids, and change the programs. The patient seemed reluctant to try these things for himself. Instead he would hand the instrument to his wife. Putting the hearing aids on was very difficult for the patient. He got very distraught and anxious to leave. Once he had the hearing aids in, he was out the door. Continuous reinstruction and patience was the key for this patient. The next session went much smoother. He actually put the hearing aids in himself several times. I believe that this patient needed to be seen more than others. He may have had some memory problems due to chemo treatments and because he is elderly. Also, he was not motivated or confident in the beginning. Once he realized that he could not break the hearing aids, he did much better.
The article that I've found is one that I believe someone else used for patient counseling. It is a very good article in this instance because it discusses normal, healthy patients. Just imagine the effects on someone who has other difficulties. Patients were tested to see how much they could remember right after a hearing aid orientation and then a month after. Around 75% was recognized overall after the orientation. I believe that you can't say important information enough. I used repetition to help me. I repeated instructions and I also scheduled for another appointment to reitterate the information. Do you think your patients remember what you say?? What's your method to help a patient insert their hearing aids??
Reese, J.L. & Hnath-Chisolm, T. (2005). Recognition of hearing aid orientation content by first-time users. American Journal of Audiology, 14 (1): 94.
http://aja.asha.org/cgi/reprint/14/1/94
After introducing the concept of hearing aids, I showed how to insert the batteries, put on the hearing aids, and change the programs. The patient seemed reluctant to try these things for himself. Instead he would hand the instrument to his wife. Putting the hearing aids on was very difficult for the patient. He got very distraught and anxious to leave. Once he had the hearing aids in, he was out the door. Continuous reinstruction and patience was the key for this patient. The next session went much smoother. He actually put the hearing aids in himself several times. I believe that this patient needed to be seen more than others. He may have had some memory problems due to chemo treatments and because he is elderly. Also, he was not motivated or confident in the beginning. Once he realized that he could not break the hearing aids, he did much better.
The article that I've found is one that I believe someone else used for patient counseling. It is a very good article in this instance because it discusses normal, healthy patients. Just imagine the effects on someone who has other difficulties. Patients were tested to see how much they could remember right after a hearing aid orientation and then a month after. Around 75% was recognized overall after the orientation. I believe that you can't say important information enough. I used repetition to help me. I repeated instructions and I also scheduled for another appointment to reitterate the information. Do you think your patients remember what you say?? What's your method to help a patient insert their hearing aids??
Reese, J.L. & Hnath-Chisolm, T. (2005). Recognition of hearing aid orientation content by first-time users. American Journal of Audiology, 14 (1): 94.
http://aja.asha.org/cgi/reprint/14/1/94
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