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1

Who is the client?

Who is the client?

A daughter accompanies her mother to an appointment for a hearing test. The daughter relates that her mother has had hearing difficulty for at least five years. The daughter is clearly pressuring her mother to try a hearing aid. You test the mother's hearing and find that she has a moderate hearing loss. The mother states that she has no need to improve her hearing. You realize that the mother is not willing to acknowledge her hearing loss or the difficulties it creates for her.

The daughter describes the situation: It is possible that the reason mum feels she does not need better hearing is because everyone tries to accommodate her hearing loss. We all speak to her in loud voices and turn the TV volume up to the highest level - even when it is too loud to be comfortable for others in the room. The mother is not socially active and her conversational situations are presently limited. During your discussion with her, you notice that the mother is somewhat withdrawn and unwilling to talk about her hearing problem. You believe her social isolation and possible depression are related to her hearing loss.

Hvordan klarer du den?

Forslag

  1. Ask the mother if there are any situations she avoids due to hearing difficulties, i.e., does she go to church, visit friends and family or join in social gatherings? Discuss feelings associated with avoidance behaviour
  2. Try to interview the mother without the daughter present so that you can better understand the mother's needs
  3. Explore whether the mother would be willing to participate in seniors' outreach programs
  4. Eller..
2

Which way should I go?

Which way should I go?

A 45-year old woman presents with a diagnosis of Meniere's Disease and progressive hearing loss. In the 1980s, the patient was first seen with tinnitus, fluctuating hearing loss and vertigo attacks. In 1985, she underwent a saccotomy on her right ear and was fitted with a hearing aid on the left ear. The hearing loss on the left ear is probably due to recurrent otitis media in childhood.

Five years ago, she stopped wearing hearing aids and now requires an interpreter for communication. Due to her deteriorating speech discrimination and difficult hearing loss, she is requesting cochlear implantation. In the late 1990s, her ENT advised her that she was not a candidate for implantation. However, since 2000, she has been offered cochlear implantation at your clinic. The patient has not made up her mind. She always has an excuse for not scheduling the surgery.

Hvordan klarer du den?

Forslag

  1. Engage the patient in a discussion of the pros and cons of implantation
  2. Arrange to have a cochlear implant recipient (i.e., mentor) meet with the patient
  3. Try to motivate the patient to use a hearing aid until she feels sufficiently informed to make a decision about cochlear implants
  4. Eller..

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