FOCAS tool: Addressing the well-being of clients and family

The Family Oriented Communication Assessment and Solutions (FOCAS) tool has the potential to address the emotional impact of hearing loss on both clients and their families, removing barriers to hearing aid adoption.

According to the recently published, Social-emotional well-being and adult hearing loss: clinical recommendations, incorporating family into clinical practice allows hearing care professionals to support successful hearing loss management and attend to the social-emotional well-being of clients and their families.1

Recognizing this importance of both family and emotions in managing hearing loss, the FOCAS2 tool was developed for every clinician’s Family-Centered Care (FCC) tool kit.

It addresses the needs of families by providing a clear structure to involve them and looks beyond hearing aids alone to meet those needs. It was developed to assist clinicians in implementing FCC more efficiently in adult audiology appointments, and to address the far-field hearing needs of people with hearing loss more thoroughly.

Additionally, the FOCAS aims to provide a useful way for clinicians to address the emotional impact of their client’s hearing loss on both themselves and their families. Since its creation, the FOCAS has been translated into over 20 languages to support use by hearing healthcare professionals around the world.

An adapted version of the FOCAS – The FOCAS-ME

A new version of this resource was created, the FOCAS-ME (Family Oriented Communication Assessment and Solutions – Motivation and Experience) tool.3 It expands on the original FOCAS tool to include a third section that assess Motivation and Experience regarding hearing loss and rehabilitation interventions.

Specifically, there are 5 questions that address some common barriers to uptake of rehabilitation interventions, such as the client’s prior experience of hearing aids (HAs),  their level of motivation regarding improving their hearing, as well as the cost of HAs, which can be another barrier to hearing aid uptake.4 The questions in this section  support the clinician to address these potential barriers to rehabilitation in a structured and transparent way.

Intentionally engaging the family is key

By targeting this information with specific questions, the FOCAS and FOCAS-ME tools can ensure the dialogue will occur, rather than it being incidental or ancillary. Family members are intended to be involved by default in FOCAS and FOCAS-ME appointments, and are invited to contribute their perspectives, and participate in shared goal setting.

For more information, including instructions and a pdf copy of the FOCAS tool, please visit our Family-Centered Care resources page on the Phonak website.


David Crowhen – David is Commercial and Operations Director at Sonova New Zealand (Wholesale) Ltd, and Director of Audiology ANZ.  at Phonak New Zealand.

 Bettina Turnbull – Bettina is Director of Audiology and Education for Sonova Asia Pacific.


  1. Timmer, B. H. B., Bennett, R. J., Montano, J., Hickson, L., Weinstein, B., Wild, J., Ferguson, M., Holman, J. A., LeBeau, V., & Dyre, L. (2023). Social-emotional well-being and adult hearing loss: clinical recommendations. International Journal of Audiology, 1-12.
  2. Crowhen, D., & Turnbull, B. (2018a). FOCAS: Family Oriented Communication Assessment and Solutions. The Hearing Review  Link
  3. Crowhen, D., & Turnbull, B. (2018b). FOCAS: Family Oriented Communication Assessment and Solutions – Motivation and Experience. A new holistic tool for performing hearing needs assessments. Workshop presented at the Audiology Australia’s National Conference, Sydney
  4. Ekberg, K., Barr, C., & Hickson, L. (2017). Difficult conversations: talking about cost in audiology consultations with older adults. International Journal of Audiology, 56(11), 854-861.

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