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Adult Onset Hearing Loss: Effective Counseling Strategies

Adult onset hearing loss affects a significant proportion of the community, one which increases exponentially with the ageing population. The condition may create activity limitations and participation restrictions for the affected person, thus impacting upon their quality of life. From the individual's perspective, counseling as an adjunct to medical intervention has shown some effectiveness in communication strategies, and the possibility of better adjustment to hearing loss.

Hearing loss impacts upon the individual's personal relationships and often leads to communication and adjustment problems even after hearing aids have been fitted. Rehabilitation in the form of listening training has had some success in previous years, however more recent studies focus on counseling to achieve better quality of life. The major focus of such counseling is to achieve a better informed client by providing information and assisting with personal adjustment. Short term results indicate that there were significant improvements in communication and personal adjustment as perceived by the client. Equally, some studies showed significant improvements in cost-effectiveness measured through quality adjusted life years.

QALYs are beneficial in measuring the dollar cost of intervention, however it is more difficult to quantify effectiveness in counseling strategies, particularly over a long period. Lin (2012) claims that the combination of hearing aids, rehabilitative training and adequate counselling is not enough. It must be noted that Lin has declared an interest in Cochlear Corp., and Pfizer. Lin does not expand upon what he perceives to be "adequate" counseling.

"Adequate" counseling is arguably best measured in terms of effectiveness, however literature reviewed has not provided the longitudinal outcomes nor yet the best strategies to gain such a measure. A more recent study in progress is using an internet based "patient journey" approach, in which each stage of the hearing impairment and intervention is documented with the emphasis on client's emotional responses. The theory is that this approach may improve the success rate by decreasing emotional and social problems.

In conclusion, problems attributed to activity limitations and participation restrictions may be decreased and better adjustment to hearing loss may be assisted through counselling which has shown promising, albeit limited results to date. Counseling has been shown to improve quality adjusted life years and reduce health costs. From the client's perspective, acceptance of the results of intervention, including knowledge of their limitations, and the progress of the disorder, may be the best outcome of effective counselling strategies in adult onset hearing loss.