Want to improve your hearing services?… Invite a loved one

I recently sat down with Dr. Joseph Montano to talk about the importance of including family in hearing healthcare and how it relates to well-being.

A well-known published author, Dr. Montano has been a long-time advocate of Family-Centered Care (FCC). Here he shares more insights on how hearing care professionals can utilize FCC to improve their hearing services.

Joe, thank you for joining us today. Why is Family-Centered Care an important topic in hearing healthcare?

Well, FCC embraces the patient and the people in their lives. So, it is an important part of everything that we do as audiologists.

A friend of mine, who is a psychologist and has a hearing loss, once said, “It’s not hearing loss; it’s a communication loss”. And if you think of it that way –, and you think of a person with hearing loss coming in to see you — who are the people in that person’s life that they communicate with?

So, if we’re saying it’s a communication loss, why not invite the people who are part of that person’s communication circle? And that’s what makes it so valuable.

Do you believe it helps people reconnect to the loved ones in their communication circle?

Exactly. A person getting hearing aids or assistive hearing technologies is doing that because they’re having difficulty with communication. And who is it that they communicate with but their family and their friends. So, inviting family and friends into that circle makes them a whole part of the entire process.

How does FCC help the hearing care provider?

Well, I can speak for myself because I am the hearing care provider. And to me, it makes the interaction so much more pleasant. I love when families come to the appointments at my office. I get to know them, and I get to involve them in their communication with their partner’s problems and the solutions.

And it just takes away that medicinal part of hearing care, and it makes it more real. I enjoy it. It helps me build relationships not only with the patient, but with the families. And as far as I’m concerned, that relationship-building aspect of what we do is really important to success with hearing aids.

How long have you embraced FCC?

I’ve been working in this field for a long time, so I’ve embraced it for a while. I work primarily with older adults, and they rarely come alone to my sessions. They come with maybe an adult child, or a caregiver, or a spouse. And for as long as I can remember, I would invite them into the session if the patient wanted them and was willing to allow that to happen. But it’s a rare that somebody says no to that.

Are patients receptive to FCC?

I think so. When you invite family or a close friend, and they’ve come to that appointment with them, they are part of their lives. And they’re often openly grateful that they can share this with their spouse or whoever it is. With the complexity of hearing aids nowadays, it’s great to have another person to listen to all the instructions and all the things that people must learn.

Are there things that patients discover about themselves or about their situation when you involve family or friends that may even sway them over to hearing aids or other hearing devices?

Absolutely. I use self-assessment measurements as one part of my protocol. In using self-assessment measurements, I ask the patient questions about how they perceive their own hearing loss.

And often, the family member who’s accompanying them, will turn around and say, “I didn’t realize that you felt this way or that it was bothering you to such an extent.” Or the opposite happens. The person says, “No, no, I have no problem, I have no problem, I have no problem.”

And then the family member says, “But wait a minute, we just had a party, and you were sitting in the corner, and you weren’t engaged with everybody at the party.” So, it really brings up a discussion. That’s why whenever we are involved with FCC, we’re also involved in counseling. Counseling is a major part of what we do and including them allows for discussions around the patient’s well-being.

When you include family in appointments, does it add time to an appointment?

A lot of people think that, “Oh, if I invite the family in, the session’s going to go longer, and longer, and longer.” It’s just not true.

In fact, if anything, many of the sessions are quicker and easier because you’ve got more people learning the information that you’re trying to teach. The initial consultation does not take me any longer if the person is alone or if the person is with someone else. I think that it’s how you prioritize your time. That has always been something that I believed is very important.

The approach you’ve described sounds more comfortable than a traditional doctor’s appointment. It feels more family oriented, and I imagine it breaks the tension in the room.

One of the aspects of practice is that I have tried for a long time not to follow a medical model in our practice. I believe in the biopsychosocial model. And by the biopsychosocial model of practice, it means that it’s on a horizontal plane. Everybody is equal.

They’ll get my input and I’ll get their input. I think that aspect of it makes the interaction a lot more positive. It takes the medicinal, the medicine part out of this and so people aren’t intimidated by it.

When bringing family into an appointment, is there anything else you recommend?

Talk about well-being. I don’t think that we’ve thought in terms of well-being in the past, although we’ve been trying to promote that concept anyway. But when you’re able to discuss the feelings and the thoughts behind living with hearing loss, that contributes to this sense of well-being and finding solutions to improve communication.

That’s the bottom line, improving the way you interact with your family and with your friends, and doing the things that make you feel good. And feeling good is, well, it feels good to feel good.

It’s wonderful to learn that inviting family can contribute to well-being discussions and finding solutions to improve communication. Thank you very much Joe for sharing your expertise.

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Dr. Joseph Montano’s 3 tips for implementing Family-Centered Care

1. Embrace is this idea of an FCC practice philosophy.
   By that, I mean that it’s a buy-in by the entire office, from the front-end people who make the appointments, to the people who take credit cards when they leave, to even the custodians who clean up afterward. To me, the idea of an FCC practice means that everybody invites family members.
   
   So, if somebody comes for a hearing test alone, and they’re going to pursue hearing aids, you say, “Oh, you didn’t bring anybody with you. Would you like to bring somebody with you when we talk about hearing aids next week?”
   
   And that kind of idea begins to connect and then people begin to bring people with them. So, even if we invite them in the very first appointment, you call up, “We’d like to schedule you for a hearing test on such and such a date. The audiologists here believe that it’s great to bring family with you, so feel free to bring whomever you like.”
   
   And it’s inviting, and some people will do it and some people won’t. And if they come alone, then we continue to reinforce that invitation throughout all the services that we provide.
   
   
2. Try not to follow a medical model.
   When someone comes into my office for a hearing aid consultation, I have a round table and people sit around the round table. I’m not behind a desk that’s going to separate me from the patient. I’m not wearing a white lab coat, that’s going to say, “Okay, I’m the doctor and you are the patient.”
   
   I’m just one of the crowd. We’re all around the table, and we all discuss all aspects of the hearing loss.
   
   
3. Don’t spend time going over the audiogram.
   We often spend 10 minutes going over the audiogram; something that most people won’t understand. And, for most people, it’s not going to have a lot of meaning for them.
   
   But if you take that 10 minutes and talk about, “What is it like to live with your hearing loss? What are the issues surrounding your hearing loss,” the information you get from the patient and their family is significantly more important than talking about the audiogram.

We invite you to read a previous article on Family-Centered care and eAudiology by Dr. Joseph Montano.