Social-emotional well-being and adult hearing loss: clinical recommendations

Figures & data

Table 1. The 5-step plan to ensure inclusion of social-emotional well-being in audiological rehabilitation clinical practice.

Step 1: Identify the client’s social-emotional well-being. Use a range of approaches, such as direct questioning, probing and self-report screening surveys. Refer for psychological support and other health care professionals where necessary. Encourage and support other health care professionals to identify the social-emotional well-being of individuals with hearing loss.

Step 2: Include family members. Integrate family members in all aspects of audiological rehabilitation. Consider the use of online/tele-practice tools if clients and/or family members cannot attend in person.

Step 3: Incorporate social-emotional needs and goals in an individualised management plan. Collaborate with clients and their families and document the client- and family-centered hearing, communication and well-being needs and goals on a written and verbal individualised management plan. Document any agreed actions and interventions on the management plan and include the rationale for choices made. Ensure all interventions and support approaches are related to the individual and family needs, and explain what each intervention is aiming to achieve. Review the goals and actions identified in the personalised management plan during review or follow-up appointments. Ensure that outcomes following intervention are measured. Agree how to address any goals that have not been met.

Step 4: Relate the identified hearing and social-emotional needs and goals to recommendations, including hearing devices and auditory, communication and social training. Recommend hearing devices, if appropriate, and consider all device options such as hearing aids, implantable aids and hearing assistive technologies. Ensure hearing device recommendations are teamed with training on device management. Ensure the care plan extends beyond hearing technology and consider the client’s social-emotional well-being in providing recommendations. Recommend communication training for clients, either individual or group, in-person or, for clients who are competent with using the internet, online. Recommend auditory and speech perception training with familiar and unfamiliar voices, in quiet and in noise. Include counselling approaches such as referral to peer- to-peer support groups or online forums.

Step 5: Use counselling skills and techniques to explore and monitor the client’s social-emotional well-being. Ensure an appropriate balance between counselling skills through information provision and counselling approaches that address emotional adjustment throughout the patient’s hearing care journey.

Table 2. Auditory wellness rating scale and action-oriented recommendations.

HHIE-S Score	Auditory Wellness Rating Scale	Action-oriented Recommendation
0 or 2	Excellent	Health care professionals should encourage their clients to remain active and engaged (a form of social prescription) and to monitor their auditory wellness over time. Persons completing the auditory wellness screen should be advised that if they note a change in scores they should schedule an appointment with their hearing care professional.
4 or 6	Good
8 to 14	Fair	The client may be on the cusp of needing some assistance when communicating with others to maximise encounters and relationships. Selected communication strategies may help, such as face the speaker so that facial expressions and lip movements are visible; sit within three to six feet of others; ask others to take turns when they speak to make it easier to follow the conversation; minimise any noise or distractions in the room when speaking with others; and make sure to let physicians know when a hearing loss exists. Clients should consider seeing a hearing care professional for a baseline hearing test and find out about the range of intervention options available. Seeking advice from a hearing care professional, remaining active, seeing friends and family, and participating in volunteer activities is very important for maintaining auditory wellness.
16 to 22	Poor	Health care professionals should highlight the importance of scheduling an appointment with a hearing care professional for a hearing test and to learn about the variety of hearing care intervention options available. Hearing interventions enable persons with hearing loss to continue to socially engage and interact with family and friends more easily in all listening environments. Clients who are hearing aid users and find auditory wellness diminished should schedule an appointment to discuss the additional options available.
24 to 40	Very Poor