We can likely agree that the last thing that you want as a hearing care professional (HCP) is to fit a client with hearing aids that they proceed to seldomly or never use. The benefit of hearing aids for speech understanding is well established, not to mention the potential further benefits related to other health problems including cognition as well as physical and mental well-being (Rickets et al., 2019; Dawes, 2019; Wells et al., 2020). Despite the value that hearing aids can offer, many people with hearing impairment never acquire hearing aids or do not use the hearing aids that they have. In a study based on responses to an annual health survey in Wales, UK, the percentage of people that never use their hearing aids has gradually decreased over the last 15 years (Dillon et al., 2020). However, the most current percentage cited in the article was still 18 % of people that were fitted with hearing aids and never used them (Dillon et al., 2020). Hearing aid acceptance continues to be an important issue. So let’s think about some ways that we can promote hearing aid use and help clients get the maximum benefit and satisfaction from their hearing aids.
Let’s think about some ways that we can promote hearing aid use and help clients get the maximum benefit and satisfaction from their hearing aids.
Beginning with the selection stage, consider the hearing aids that are the most appropriate for the clients. For speech understanding, technology level does not significantly affect the outcome which is a great finding (Hausladen et al., 2021). This means that the primary function of hearing aids – to amplify sounds and ease communication - is attainable independent of the price category. However, keep in mind that premium devices have demonstrated significant improvements in noise acceptance and in subjective satisfaction ratings especially in large group settings (Hausladen et al., 2021). Therefore, depending on each client’s individual needs and financial details of the purchase, encourage the selection of hearing aids with more advanced features. Choosing the most technologically equipped devices as possible will give the clients an advantage right from the start.
The next consideration, particularly with new users, is to perform a detailed hearing aid orientation. The American Speech-Language Association’s (ASHA) Preferred Practice Patterns suggests training the clients on insertion/removal of the device, battery management, routine maintenance, telephone use, and assistive listening devices as well as counseling to establish realistic expectations from their hearing aids (ASHA, 2006). I’m sure that you already include these basic items in the fitting appointment; therefore, you could ideally expand beyond the minimum requirements to optimize the orientation. Make sure to give the clients time for hands-on practice during the orientation to incorporate multiple methods of instruction – visual and tactile.
A further idea is to suggest that clients bring a significant other to the appointment. With the addition of wireless capability in most hearing aids there is continually new functionality to demonstrate. The clients will receive a lot of information that they might forget; therefore, having a person that can assist later is helpful and reassuring. Reinforce the benefits that all parties receive from the hearing aids – clients and family/friends, alike. The adoption of hearing aids should be perceived as a team effort and give confidence to the user that they’re not alone. Remember to review the orientation items at the client’s follow-up appointments to be sure that they’re getting the hang of their new devices.
And a third recommendation is the use of aural rehabilitation. Aural rehabilitation can mean various things from some words of counseling during the fitting to regular rehabilitation sessions at an external site. An article that reviewed best fitting practices referred to a study that found a significant improvement in consonant and sentence test scores of newly fitted hearing aid users after participating in a 4-week hearing training program compared to those that received a normal fitting with no additional training (Hoppe & Hesse, 2017). Additionally, a benefit was noted in a study in the UK in which hearing aid users participated in a daily video training for 6 weeks compared to those that received no additional therapy (Hoppe & Hesse, 2017). The ASHA Preferred Practice Patterns recommends aural rehabilitation because it “facilitates the adjustment to and enhances benefits from the use of hearing aids…” (ASHA, 2006, p. 41). The guide also considers aural rehabilitation as a factor in the “well-being and quality of life (QoL) of individuals with hearing impairment, their family members, and caregivers” (ASHA, 2006, p. 41).
The success of aural rehabilitation will depend upon each client’s level of motivation. Therefore, during the orientation and follow-up sessions provide them at least with tips for better communication, such as how to best position themselves in a restaurant, looking at people’s faces/lips during conversation and asking others to face them when speaking. The key is to offer multiple options of aural rehabilitation so that clients can decide what is best for them based on their goals and abilities. Check out our roadmap to better hearing online or ask your Bernafon contact to share the printed handout.
It can be difficult to encourage others to do things for themselves if they lack the enthusiasm. By recruiting extra help from family members or caregivers and placing all of the information at the client’s disposal, you will know that you’ve at least prepared them with the necessary tools they need to maximize the benefit of their hearing aids.
References
American Speech-Language Hearing Association. (2006). Preferred Practice Patterns for the Profession of Audiology [Preferred Practice Patterns]. Available from www.asha.org/policy.
Dawes, P. (2019). Hearing interventions to prevent dementia. HNO, 67, 165-171. Doi: 10.1007/s00106-019-0617-7
Dillon, H., Day, J., Bant, S., and Munro, K.J. (2020) Adoption, use and non-use of hearing aids: a robust estimate based on Welsh national survey statistics, International Journal of Audiology, 59(8), 567-573. Doi: 10.1080/14992027.2020.1773550
Hoppe, U. & Hesse, G. (2017). Hearing aids: indications, technology, adaptation, and quality control, GMS Current Topics in Otorhinolaryngology – Head and Neck Surgery, 16, 1-24.doi: 10.3205/cto000147
Rickets, T. A., Picou, E. M., Shehorn, J., and Dittberner, A. B. (2019). Degree of hearing loss affects bilateral hearing aid benefits in ecologically relevant laboratory conditions. Journal of Speech, Language, and Hearing Research, 62, 3834-3850.
Wells, T. S., Nickels, L. D., Rush, S. R., Musich, S. A., Wu, L., Bhattarai, G. R., and Yeh, C. S. (2020). Characteristics and health outcomes associated with hearing loss and hearing aid use among older adults. Journal of Aging and Health, 32(7-8), 724-734. Doi: 10.1177/0898264319848866