Chelsea Twyman, Class of 2016

Kent State University/NOAC

When audiologists and patients discuss amplification, the topic of realistic expectations must be carefully discussed. This discussion lets the patient know that adjusting to amplification will take time, patience and effort, and that struggles might occur along the way.  Some patients have minor challenges that we can readily solve with programming adjustments.  Most patients can also acquire new communication and coping strategies, especially if we remember to provide that support.  However, how can we help patients who still struggle with the following challenges after their month-long hearing aid trial?

• Not advancing to appropriate amplification target/not obtaining enough benefit;
• Not tolerating high frequency input/not improving speech clarity;
• Daily HA maintenance and/or using hearing assistive technology (HAT);
• Psychosocial distress (perceived HA benefit but burdened by cosmetics, stigma, etc.);
• The hard work of adjustment outweighing perceived benefit.

Patients struggling with these challenges could benefit from group support, defined by Katz and Bender (1976) as “voluntary small group structures for mutual aid in the accomplishment of a specific purpose…usually formed by peers who have come together for mutual assistance in satisfying a common need, overcoming a common handicap or life disrupting problem, and bringing about desired social and/or personal change” (cited by Solomon, 2004, p. 393).

Support groups can help not only patients but also their communication partners, since they too are directly affected:

Brooks et al (2001) described frequent misunderstandings and resulting frustrations in couples in whom one member had a hearing loss. Piercy and Piercy (2002) reported that limited communication can negatively affect a couple’s intimate relationship. Most recently, Scarinci et al (2008) noted a broad range of effects that hearing loss had on the SPs [spouses] in their everyday lives. They noted difficulties in carrying out normal conversations, effects on the SPs’ emotions such as frustration or embarrassment, limitations in their social lives, and increased tensions in their marital relationships. (Preminger & Meeks, 2010, p. 316)

These studies highlight the importance of including both patients and their communication partners in a support group, specifically a group aural rehabilitation program.

Recently, I attended a support group for patients with cochlear implants (CI) and their significant others.  The patients at this support group all had difficulty with two or more of the categories discussed above.  Usually, this support group splits into two subgroups — one for CI users and one for their communication partners, to chat separately before coming together near the end of the session.  On the day I visited, attendance was small due to the weather, so the group stayed together the entire meeting.

The evening began as a meet-and-greet with snacks and coffee.  Everyone was asked to introduce themselves and discuss any recent occurrences in their life. Then a guest speaker (an audiologist) shared information about assistive devices for challenging environments and answered questions.  After the presentation, the patients and their significant others were asked to discuss communication difficulties they had experienced since the past meeting.  This is when the meeting really took off.

The CI users and their communication partners began sharing stories about going to dinner or family events within the past month.  One CI user mentioned that he was speaking so loudly in a restaurant (because he could barely hear himself talk) that people at a nearby table asked him to keep it down.  Thankfully, his significant other supported him and added that they had come up with a visual coded signal that means he’s speaking a little too loud.  The same couple shared the use of an “attention phrase” with the group.  The significant other said, “I hate repeating myself, but I know he’s going to miss the first couple words I say.  When I want to talk to him, I start my sentence with ‘I’m going to say something now.’  Then I say what I want to say.  I don’t have to repeat myself and it’s less frustrating for him to listen.”  This couple seemed to inspire everyone else in the meeting.

Inspiration is a common outcome in support group meetings. Attendees draw strength from each other, and find the courage to face the next challenge. Sometimes patients and their communication partners need support from others like themselves because they can relate so well to the challenges of living with hearing loss.  Seeing others succeed with similar struggles, and be happy even though things aren’t perfect, helps all of us understand resilience and courage.

When we think about counseling, we usually think about the dialogue between patent and audiologist. However, let’s also remember that peers (persons with similar life problems) can also provide counseling support, often with more credibility than audiologists can.  The more we understand the positive effects of support groups, the more comfortable we will feel about recommending and even helping with them.

References

Preminger, J.E. & Meeks, S. (2010) Evaluation of an audiological rehabilitation program for spouses of people with hearing loss.  Journal of the American Academy of Audiology, 21(5), 315 – 328

Sollomon, P. (2004).  Peer support/peer provided services underlying processes, benefits, and critical ingredients.  Psychiatric Rehabilitation Journal, 27(4), 392 – 401.