Difficult conversations: talking about cost in audiology consultations with older adults

Abstract

Objective: Financial cost is a barrier for many older adults in their decision to obtain hearing aids (HAs). This study aimed to examine conversations about the cost of HAs in detail within initial audiology appointments. Design: Sixty-two initial audiology appointments were video-recorded. The data were analysed using conversation analysis. Study sample: Participants included 26 audiologists, 62 older adults and 17 companions. Results: Audiologists and clients displayed interactional difficulty during conversations about cost. Clients often had emotional responses to the cost of HAs, which were not attended to by audiologists. It was typical for audiologists to present one HA cost option at a time, which led to multiple rejections from clients which made the interactions difficult. Alternatively, when audiologists offered multiple cost options at once this led to a smoother interaction. Conclusions: Audiologists and clients were observed to have difficulty talking about HA costs. Offering clients multiple HA cost options at the same time can engage clients in the decision-making process and lead to a smoother interaction between audiologist and client in the management phase of appointments.

Key Words:

• Audiology
• hearing rehabilitation
• clinician–client communication
• cost
• shared decision making
• conversation analysis

Acknowledgements

This study was conducted under the HEARing Cooperative Research Centre, established and supported under the Business Australia Cooperative Research Centres Program.

Declaration of interest

The authors report no conflict of interest.

Notes

Supplementary material available online

Notes

1. Where appropriate and necessary for the analysis, aspects of multimodal interaction such as participants’ gaze and body movements were also analysed. For brevity and clarity, these multimodal actions have not been included in the transcripts in the current manuscript unless crucial to the analytic point being made.

2. Emotional valence refers to the underlying ‘tone’ of an expressed emotion, whether it is positive or negative.