[PDF] 10/25/17 1 Family-Centered Care: Successful Strategies - NMSHA PDF FamilyCentered-Aural-Rehabilitation_2017_Handout

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[PDF] 10/25/17 1 Family-Centered Care: Successful Strategies - NMSHA

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10/25/17

1Family-Centered Care:

Successful Strategies in

Adult Aural Rehabilitation

K. Todd Houston, PhD, CCC-SLP, LSLS Cert. AVT

Professor

The University of AkronLearning Objectives

!Define family-centered aural rehabilitation and related service delivery models; !Identify at least three aural rehabilitation strategies and explain how they can be implemented;

!List three outcomes that positively benefit adults with hearing loss after they've enrolled in family-centered

aural rehabilitation.

PDisclosure Statement

Dr. Houston has no relevant financial or nonfinancial relationship(s) with the products or services described, reviewed, evaluated, or compared in this presentation. Dr. Houston is the author/co-author of Lecetur(5%(e%)R atee(dinr)g1rgeR0r5dAcAgoR(2014), vssess%)gR n%s5e)%)gRr)lRatA e)Rnr)g1rgeR%)R2d%clue)RD%5dR meru%)gRnAss(2015), and Lecetur(5%(e%)Rv1l%AcAgoR (2016), all published by Plural Publishing.3Current Hearing Loss Statistics by Age y

Hearing Loss Statistics

u in s U-S- adults ages uk a over report trouble hearingf od-A million

U-S- adults

Pk-k million

U-S- adults could

benefit from using hearing aids

9nly u in yU-S-

adults ages Pg a over who could benefit from hearing aids has them u in s adults tusri ages Pg to sCu in o adults togri ages dg

5What is Aural Rehabilitation?

3Adult aural rehab is theuel1(%)gRAGRderu%)gR

(Ay7%)r5%A)Rs5ur5eg%es ThR

Boothroyd, 2007

10/25/17

Overall Goal of Aural Rehabilitation

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Status of perceptual training (or auditory

brain training ) in audiological practices ASHA's 2012 survey of 2,000 ASHA-certified audiologists from a variety of work settings:

L17% provide 'auditory training'

L4% provided speech reading/lip reading

"There is much current focus on the instrument and so little on the rehabilitation of the user" ("We Must Return to Our Rehabilitative Roots" Maurice H. Miller, Ph.D, Hearing Review, Mar 2015) 8

TechnocentricModel of Service Delivery

LAudiologists diagnose hearing loss

and prescribe /fit appropriate hearing technology

LTechnology without aural

rehabilitation treatment is not sufficient to produce a successful outcome

LNeed a well-rounded approach

LIndustry isslowlymoving in this

direction ; AR treatmentistaking patient'slife & desired outcomes into consideration and spouses & family members are seen as partners in the process 9

Cognitive Decline

LWithout proper hearing

intervention, cognitive decline can occur

LWhen hearing is difficult,

the brain requires greater cognitive resources to process auditory signals

LCase studies hypothesize

that HL leading to social isolation and decreased quality of life also impacts cognitive decline 10 1112

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10/25/17

Adult Learning Principles

!Like to have choices !Like to participate in the setting of goals and objectives PA

Lectur!!"

Adult Learning Theory

!Have a variety of learning styles & preferences Ps

Lectur(55%

Adult Learning Theory

!Do best in an environment where they feel safe, accepted, & respected Pd

Lectur(55%

Adult Learning Theory

Lectur(55%

!Want and need feedback !Need to have their abilities & achievements honored

Patient/Family-Centered Core Concept

!Patient-and family-centered care is working Telppatients and 29

Patient/Family-Centered Care:

Core Concepts

!People are treated with respectand dignity !Health care providers communicate and share complete and unbiased informationwith patients and families in ways that are affirming and useful !Patients and families are encouraged and supportedfor participation in care and decision-makingat the level they choose !Collaborationamong patients, families, and providers occurs in policy and program development and professional education, as well as in the delivery of care 30

10/25/17

Why Patient/Family-Centered Care?

!Individuals who are most dependent on health care are most dependent on families: !Those with chronic conditions !The very young !The very old !Families are allies for quality and safety by: ►Providing constant support across settings and assisting with transitions of care ►Participating in developing care plans and supporting patients in following plans ou

What is Family-Centered Care?

!Supports the whole family as a unit !Includes spouses, children, close family friends !Empowers family choice and decision-making !Establishes a collaborative relationship between the provider and family members !Encourages support group attendance for all family members A0

The Importance of Family-Centered Care

!The World Health Organization describes the impact of hearing loss on families as a third party disability. !When one person is affected, those around them are affected as well !Spouses report: !Feeling the burden of communication !Frustration !A change in their relationship, loss of intimacy !They avoid socialization and daily activities 33

Benefits of Family-Centered Care

!More effective than patient centered care !Provides more relevant functional therapy activities that address the individual and family needs !Reduction in the impairment !Better communication outcomes !An improvement in family relationships !Greater family engagement !Higher patient satisfaction 34

Creating Family Centered Care

!Arrange the physical environment to accommodate the family !Inform the family that you are seeking and value their input !Obtain case history and questionnaire assessments from both the patient as well as their family !Acknowledge communication challenges for both parties !Develop goals that address the needs of both the individual and their spouse, family or caregiver !Goals should address the needs of both the patient and spouse, family !Encourage spouses or family membersto join therapy sessions !Provide ongoing counseling !Acknowledge emotions, ask open ended questions, re-state concerns, and wait Av

Role of the Family

!Practice good communication !Be patient !Attend audiologist appointments together !Provide your input !Be flexible !Participate in the aural rehabilitation process As

10/25/17

Client/Family Education

!Vital for patient to understand their level of hearing loss and what to expect in the future !Spouse or family member should tag along in the meeting to become educated on the patient's needs !Discuss topics regarding HA or CI with the audiologist !How to work the device !What to do if technology is failing !What will the device do/not do !Rearrange household !Have furniture face each other !Use lighting in conversational areas !Carpet absorbs noise !Background noise !Request table away from kitchen/walk in area in restaurant setting od

Lois' Journey

Adult Aural Rehabilitation

Audiology & Speech Center

School of Speech

-Language Pathology &

Audiology

The University of Akron

Akron, OH

12 Principles of Aural Rehabilitation

1.Treatment should always adjust to the specific needs of

the patient

2.Educate to empower patients to advocate for themselves

3.Model effective communication

4.Work together with the patient to developcommunication

goals& definition of success

5.Provide individual and group therapy options, support

groups

6.Offer opportunities for successful communication in

therapeutic activities as well as "real world" settings

12 Principles of Aural Rehabilitation

7.Promote clinician-patient rapport through counseling

8.Discuss realistic expectations

9.Role-playing for functional communication events

10.Incorporate hearing assistive technology

11.Provide listening strategies for various situations

12.Incorporate active involvement of communication

partners(i.e. spouse, family members) in every step

Assessment and Beginning Therapy

!Determine Strengths and Weaknesses !Formalized tests, checklists, interviews !Determine where they are in the listening hierarchy !Detection, Identification, Discrimination, Comprehension !Discuss needed supports, therapy model for intervention, and counsel the family !Develop family centered goals and determine functional activities for intervention yP

10/25/17

Questionnaires for Assessment of

Listening Difficulties

!Communication Confidence Profile (CCP) !EXAMPLE: If you are having trouble understanding, how likely are you to ask a person you are speaking with to alter his or her speech by slowing down, repeating or rephrasing? (1-5, Extremely-Not at all) !Qualitative Outcomes Assessment for clEAR (QOAC)

!EXAMPLE: We are having dinner at a restaurant. There is background music. I have to ask my partner to repeat something: (1-7, None of the time-All of the Time)

Adult Aural Rehabilitation Strategies

As Boothroyd (2007) describes, the four components of aural rehabilitation include: •Sensory management--to target & enhance auditory function •Instruction-to increase the probability of positive outcome from sensory management •Perceptual training-to target activity, by supplementing the learning opportunities provided by everyday communication •Counseling-to target issues of participation & quality of life that result from residual deficits of function & activity. 44

Sensory Management & Instruction

!Types of hearing technology you may need !Cochlear Implants !Hearing Aids !Behind the Ear Hearing Aids (BTE) !In the canal (ITC) !Completely in the canal (CIC) !Receiver in the Canal (RIC) !Bone Anchored Hearing Aids (BAHA) !Hearing assistive technology yA

Sensory Management & Instruction: Hearing

Assistive Technology

!Assistive technology can help individuals with hearing loss in difficult situations and improve quality of life !Assistive devices may include: !Cell phone adaptations !Personal amplification !Alert systems !Home amplification systems !Hearing loops !Closed captioning !Hearing assistive technology can be used as a support to make communication more effective. ys

Perceptual Training

Goals:

•Enhance auditory perception skills, •Increase conversational confidence and fluency

Patients differ in how they improve in these

skills •Some learn spontaneously •Some need the help of a family member or close friend

•Some need guidance with encouragement to have the confidence to improve their perceptual skills and have the confidence to use these new skills

Many patients can benefit from active perceptual

training Òmdult mural Yehabilitationw What is it and does it workv mrthur boothroydS Rh"-S Trends in mmplificationS Volume uuS 4o-PS 1une PggdS sohdu-

Are hearing and listening the same

thing? !Hearingallows you to receive acoustic information (speech) !Listeningrequires your brain to attend to and interpret speechquotesdbs_dbs9.pdfusesText_15

[PDF] [PDF] 10/25/17 1 Family-Centered Care: Successful Strategies - NMSHA

10/25/17

1Family-Centered Care:

Successful Strategies in

Adult Aural Rehabilitation

K. Todd Houston, PhD, CCC-SLP, LSLS Cert. AVT

Professor

The University of AkronLearning Objectives

PDisclosure Statement

Hearing Loss Statistics

U-S- adults

Pk-k million

U-S- adults could

9nly u in yU-S-

5What is Aural Rehabilitation?

3Adult aural rehab is theuel1(%)gRAGRderu%)gR

Boothroyd, 2007

10/25/17

Overall Goal of Aural Rehabilitation

B"(:""*+&+-"&%)*0

Status of perceptual training (or auditory

L17% provide 'auditory training'

L4% provided speech reading/lip reading

TechnocentricModel of Service Delivery

LAudiologists diagnose hearing loss

LTechnology without aural

LNeed a well-rounded approach

LIndustry isslowlymoving in this

Cognitive Decline

LWithout proper hearing

LWhen hearing is difficult,

LCase studies hypothesize

10/25/17

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10/25/17

Adult Learning Principles

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Adult Learning Theory

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Adult Learning Theory

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Adult Learning Theory

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Patient/Family-Centered Core Concept

Patient/Family-Centered Care:

Core Concepts

10/25/17

Why Patient/Family-Centered Care?

What is Family-Centered Care?

The Importance of Family-Centered Care

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