HIS 230 - Hearing Instrument Candidacy

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HIS 230 - Hearing Instrument Candidacy

  1. 1. Hearing InstrumentHearing Instrument CandidacyCandidacy To fit a hearing instrument? Or, not fit aTo fit a hearing instrument? Or, not fit a hearing instrument?hearing instrument? More precisely, when should the HearingMore precisely, when should the Hearing Instrument Specialist advise aInstrument Specialist advise a hearing/communication challengedhearing/communication challenged individual to pursue hearing instruments?individual to pursue hearing instruments?
  2. 2. Hearing InstrumentHearing Instrument CandidacyCandidacy The Better Hearing Institute (betterhearing.org)The Better Hearing Institute (betterhearing.org) has provided decades of research regardinghas provided decades of research regarding the hearing impaired market in the Unitedthe hearing impaired market in the United States.States. The fundamental results consistently revealThe fundamental results consistently reveal that there are more than twice the number ofthat there are more than twice the number of those that should be wearing hearingthose that should be wearing hearing instruments compared to those who actuallyinstruments compared to those who actually own them.own them.
  3. 3. Hearing InstrumentHearing Instrument CandidacyCandidacy There are two broad aspectsThere are two broad aspects addressing the candidacy question.addressing the candidacy question. They are:They are: 1.1. Is the candidate deaf enough?Is the candidate deaf enough? 2.2. Is the candidate too deaf?Is the candidate too deaf? Neither of these questions may beNeither of these questions may be quantified/answered based solely uponquantified/answered based solely upon audiogram information.audiogram information.
  4. 4. Hearing InstrumentHearing Instrument CandidacyCandidacy Besides the audiogram, there are eight otherBesides the audiogram, there are eight other factors to define when investigating thefactors to define when investigating the candidacy for hearing instruments. They are:candidacy for hearing instruments. They are: 1) Acceptance of the hearing loss/past the1) Acceptance of the hearing loss/past the denial stage of loss, 2) Need to functiondenial stage of loss, 2) Need to function effectively with audibility, 3) Currenteffectively with audibility, 3) Current circumstances/consequences which havecircumstances/consequences which have resulted due to the hearing loss, 4) Self image,resulted due to the hearing loss, 4) Self image, 5) Expected benefit—not encouraged by5) Expected benefit—not encouraged by others, 6) Have been “coerced” by others toothers, 6) Have been “coerced” by others to purchase hearing instruments 7) Uncertainty ofpurchase hearing instruments 7) Uncertainty of success with hearing instrument use,success with hearing instrument use, 8) Cost vs. perceived benefit.8) Cost vs. perceived benefit.
  5. 5. Hearing InstrumentHearing Instrument CandidacyCandidacy The number of hours/day of hearingThe number of hours/day of hearing instrument use is influenced by theinstrument use is influenced by the audiogram results i.e. the greater theaudiogram results i.e. the greater the hearing loss the more dependant onehearing loss the more dependant one becomes upon hearing instrument use.becomes upon hearing instrument use.
  6. 6. Hearing InstrumentHearing Instrument CandidacyCandidacy However, one recent study revealed 90However, one recent study revealed 90 out of 98 people with less than twentyout of 98 people with less than twenty decibel pure tone average hearing loss;decibel pure tone average hearing loss; after six months of use, continued toafter six months of use, continued to wear their hearing instruments on a dailywear their hearing instruments on a daily basis and considered them a worthwhilebasis and considered them a worthwhile investment.investment.
  7. 7. Hearing InstrumentHearing Instrument CandidacyCandidacy  TTests have been developed for thoseests have been developed for those hearing impaired who are still in denial.hearing impaired who are still in denial.  A few of these self assessment tools areA few of these self assessment tools are the APHAB, HHIE, COSI.the APHAB, HHIE, COSI.
  8. 8. Hearing InstrumentHearing Instrument CandidacyCandidacy These same assessment tools may also beThese same assessment tools may also be used to determine variousused to determine various hearing/communication challenges of thehearing/communication challenges of the patient/client.patient/client. This will also assist in allowing the patient/clientThis will also assist in allowing the patient/client to “participate” in the assessment process.to “participate” in the assessment process. Hopefully, in taking ownership of their situation.Hopefully, in taking ownership of their situation. (ref. Dillon pgs #216 & 218)(ref. Dillon pgs #216 & 218)
  9. 9. Hearing InstrumentHearing Instrument CandidacyCandidacy  Understanding the patient/client’sUnderstanding the patient/client’s perception can many times assist inperception can many times assist in getting past the denial stage of hearinggetting past the denial stage of hearing loss.loss.  Become aware of their “required”Become aware of their “required” listening environment and needs.listening environment and needs.
  10. 10. Hearing InstrumentHearing Instrument CandidacyCandidacy A well designed case history will greatlyA well designed case history will greatly assist the Hearing Instrument Specialistassist the Hearing Instrument Specialist in determining the self image, expectedin determining the self image, expected benefit, current circumstances regardingbenefit, current circumstances regarding hearing loss, and reveal any coercionhearing loss, and reveal any coercion which may exist in the decision to visitwhich may exist in the decision to visit the clinic.the clinic.
  11. 11. Hearing InstrumentHearing Instrument CandidacyCandidacy 1.1. Money/costsMoney/costs 2.2. Specific hearing instrumentsSpecific hearing instruments These two items may be betterThese two items may be better discussed post-testing—once morediscussed post-testing—once more detailed residual hearing abilitydetailed residual hearing ability information is obtained.information is obtained.
  12. 12. Hearing InstrumentHearing Instrument CandidacyCandidacy The eight factors regarding hearingThe eight factors regarding hearing instrument candidacy have thusinstrument candidacy have thus been addressed/assessed.been addressed/assessed. Not all dispensing clinics use all ofNot all dispensing clinics use all of these candidacy assessment “tools”.these candidacy assessment “tools”.
  13. 13. Hearing InstrumentHearing Instrument CandidacyCandidacy Most medical dispensing models will useMost medical dispensing models will use a clinical form regarding health issuesa clinical form regarding health issues and perhaps a self assessmentand perhaps a self assessment questionnaire.questionnaire. The hearing loss will then be measuredThe hearing loss will then be measured and quantified using subjective termsand quantified using subjective terms such as mild, moderate, severe, andsuch as mild, moderate, severe, and profound hearing loss.profound hearing loss.
  14. 14. Hearing InstrumentHearing Instrument CandidacyCandidacy Franchise dispensing models often use aFranchise dispensing models often use a pre-fitting questionnaire, measure thepre-fitting questionnaire, measure the hearing loss, dispense the product linehearing loss, dispense the product line they represent on a trial basis, andthey represent on a trial basis, and occasionally use a post-fittingoccasionally use a post-fitting questionnaire. Some will also use a casequestionnaire. Some will also use a case history designed to ascertain patienthistory designed to ascertain patient motivation to purchase.motivation to purchase.
  15. 15. Hearing InstrumentHearing Instrument CandidacyCandidacy Let’s design our clinic format basedLet’s design our clinic format based upon the described eight candidacyupon the described eight candidacy parameters described in Dillon.parameters described in Dillon.
  16. 16. Hearing InstrumentHearing Instrument CandidacyCandidacy The Martin CD also has someThe Martin CD also has some patient/client history forms to assist in thepatient/client history forms to assist in the effort to design a clinic form.effort to design a clinic form.
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