A “Whole Health” approach in hearing healthcare

When Veterans walk into our clinic, one of our first questions is, “What matters most to you?” It is a way for providers and their patients to connect on a common thread and to treat the WHOLE patient, not just their diagnosis. 

In the Whole Health model, we start by taking care of ourselves, and see the benefits of this cascade into other aspect of our life.

“Whole Health” is an approach to care that empowers individuals to take control of their health and well-being (Kligler,2022).  This can be in the form of things like yoga, meditation, work-life balance, financial security, and a strong social network.  By cultivating an atmosphere that emphasizes Whole Health, we can promote improved outcome for our Veterans and their families. 

This approach is not just about treating medical diagnoses, but also about recognizing personal values and preferences in patient care plans. When Veterans Health Administration (VHA) providers ask patients, “What matters most to you?” we are opening the door to communication that enhances the trust between patients and providers for an improved healthcare experience. 

Three resources that promote a “Whole Health” approach

1. Integrating patient values: ‘My Hearing Goals’ worksheet in SoundSuccess™
   
   A tool we use in Audiology and Speech Pathology that helps us draw upon the question “What matters most to you?” is the My Hearing Goals worksheet, in SoundSuccess™ Rehabilitation Resource.  It is a patient-centered tool, unique to each patient, to help them identify goals that are meaningful and relevant to them. We use it to develop a therapy plan that allows for incorporation of their communication partners or support system in the process. 
   
   
2. Empowering patients to improve communication: Auditory training tools in HearingSuccess Portal
   
   Other tools in the HearingSuccess portal frequently used by our Veterans are speechreading exercises in SoundSuccess Rehabilitation Resource and music therapy activities such as Musical Atmospheres.  Studies show that hearing loss can lead to social isolation and faster cognitive decline if left untreated (Lin, et al., 2013).  The inability to communicate with others can results in social isolation and loneliness in individuals with hearing loss, and this can significantly impact the individual’s overall quality of life (Mamo et al., 2022).
   
   
3. Building community: Online forums, like HearingJourney and HearingLikeMe
   
   Hearing loss may cause distress, anxiety, and depression (Nordvick et al., 2018). Online forums, such as Hearing Journey™ and HearingLikeMe.com, allow patients to connect with other individuals with hearing loss and share stories and experiences. Patients feeling social isolation can benefit from community-building, therefore connecting with other individuals can prevent negative social consequences from occurring and can reduce these feelings of isolation. For many patients, community-building and connection are distinct and meaningful aspects of their whole health journey.

Set a realistic plan, include family, and follow up

At the Connecticut VHA, we find the strongest predictor for continued practice is through developing a realistic plan that aligns with patient’s interests and values and holds patients accountable.  If it’s interesting and fun, you are more likely to continue to do it!  We also partner with patients and families to promote ownership and accountability in their communication journey. We know that regular practice leads to better outcomes. 

We pride ourselves in completing frequent follow-up appointments to check-in, monitor tools that have been implemented, and introduce new goals. We find this keeps up motivation and ultimately leads to better communication with Veterans and their loved ones. The Listening Room™ in HearingSuccess easily allows providers to track patients progress and add new activities to their treatment plan. 

We find that the sooner we introduce these resources to patients in their hearing journey, the better the outcomes.  The Cochlear Implant Team at Connecticut VHA has a mission to create life-long relationships with our patients through a collaborative, whole health- approach to care. We hope that we can serve as an inspiration for others to do the same.

So, I ask you this, “What matters most to you?”

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*Please Note: All views expressed in this article are that of the author and do not necessarily represent the views of the Department of Veterans Affairs or of the United States.

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References:  

Kligler B. (2022). Whole Health in the Veterans Health Administration. Glob Adv Health Med. Mar 2;11:2164957X221077214. doi: 10.1177/2164957X221077214. PMID: 35273831; PMCID: PMC8902183.

Lin FR, Yaffe K, Xia J, et al. Hearing Loss and Cognitive Decline in Older Adults. JAMA Intern Med.2013;173(4):293–299. doi:10.1001/jamainternmed.2013.1868

Mamo, S. K., Wheeler, K. A., Plano Clark, V. L., & Jacelon, C. S. (2022). A Mixed Methods Study of Hearing Loss, Communication, and Social Engagement in a Group Care Setting for Older Adults. Perspectives of the ASHA Special Interest Groups, 7(2), 592–609. https://doi.org/10.1044/2021_persp-21-00218

Nordvik, Ø., Laugen Heggdal, P. O., Brännström, J., Vassbotn, F., Aarstad, A. K., & Aarstad, H. J. (2018). Generic quality of life in persons with hearing loss: a systematic literature review. BMC Ear, Nose and Throat Disorders, 18(1). https://doi.org/10.1186/s12901-018-0051-6