ASSESSMENT = C.O.R.E.

C = Communication status

O = Overall participation variables

R = Related personal factors

E = Environmental factors

MANAGEMENT = C.A.R.E.

C = Counseling/psychosocial

A = Audibility/impairment management

R = Remediate communication activity

E = Environmental/coordination participation improvement

Last week, we learned the components of CORE and the psychosocial aspects encountered during patient/client assessment.

Today, we will reveal and review some current assessment tools and explore the components of patient/client management (CARE).

The reasons for seeking hearing help or communication assistance are many and varied.

Studies have repeatedly found that those seeking help for their condition had encountered a lifestyle activity limitation (disability).

Few sought help based upon their failure of sound audibility.

Many older persons accept hearing loss as a “normal part of ageing” and will tolerate greater hearing impairment than younger persons.

Social pressures are not as motivating as a self-perceived handicap to their lifestyle.

There have been many assessment “tools”/questionnaires designed to assess the patient/client hearing/communication handicap.

Let’s review Schow pages #388--#391 for samples of assessment documents.

Note: APHAB and COSI are the most commonly used formats as described on page #386

These assessment tools are useful in assisting the patient/client in describing their individual communication challenges.

Once the challenges have been identified, communication goals may be established and CARE management may occur.

Let’s review the steps required for effective CARE management.

C.A.R.E.

C = Counseling

This activity involves three fundamental needs and goals must be set for each of them. They are: AUDIBILITY

ACTIVITY

PARTICIPATION

C.A.R.E.

A = Audibility & instrument intervention

Hearing instruments, cochlear implants, and assistive listening devices are discussed. Three goals must be addressed. They are:

INSTRUMENT FIT

INSTRUMENT FUNCTION

INSTRUMDNT ORIENTATION

R = Remediation for communication activity

There are three communication goals to set between the listener and the communication partner. They are: When to use the amplification device

How to use the amplification device effectively

How to use other amplification communication strategies

C.A.R.E.

E = Environmental coordination & participation improvement

Emphasis on the patient/client lifestyle environment to include three primary goals.

Their occupational environment

Their community environment

Their family environment

To assist with accomplishing the CARE management goals, let’s review Schow pages #380—382.

These orientation basics are good to share when working with your patient/client and their family members.

This basic information is also a good resource when advising others during a community communication awareness event.

Let’s discuss more specifics regarding aural rehabilitation and hearing instrument expectation.

The majority of those accessing hearing instruments are over age sixty-five.

This age group has been often surveyed regarding their experience and expectations with hearing instruments.

They continue to identify four primary complaints with hearing instruments.

The four most common complaints of hearing instrument users are:

1. 28% = Background noise

2. 25% = HI sound & physical comfort & product defects/breakdown

3. 18% = HI provides too little benefit

4. 17% = Costs involved with daily HI use are too expensive (Value)

It is interesting that these complaints have transcended the paradigms of HI technology!

Perhaps it is the dispensing professionals’ skills which must now improve?

As you have learned, successful HI dispensing and aural rehabilitation go beyond the HI.

Residual hearing ability must be accurately identified and stimulated.

Consumer must be empowered with knowledge of their communication expectations and limitations.

Additional assistive listening devices and communication learning strategies must be considered for best patient/client outcomes.

Let’s review the summary points listed at the end of Chapter #10.

These points will serve as a basis for our lab study of Chapter #12 case studies.

The Chapter #12 case studies will reveal how to appropriately and consistently use:

C.O.R.E. for assessment purposes

C.A.R.E. for thorough case management