L&L Therapy Services, LLC

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment means that not only does the person with hearing impairment experience the consequences, but his or her frequent communication partners do also. In this article, the authors discuss the impact of hearing impairment in older people on spouses with normal hearing using the conceptualization of "third-party disability" created by members of the World Health Organization (WHO, 2001, p. 251). Results of a series of studies conducted by the authors demonstrate that spouses experience a range of activity limitations and participation restrictions due to their partner's hearing impairment, including a variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. In this article, the authors highlight the important role of family-centered intervention in audiologic rehabilitation for older adults and emphasize the need to increase inclusion of spouses and significant others in the rehabilitation process.

Stigmatized social identity can create psychological barriers to the effective delivery of hearing services for people with acquired hearing loss. These barriers can lead to denial and inhibit clients from accepting the help they need, even if this denial poses disadvantages to their well-being. To overcome these barriers, services are needed that address identity-related issues along with strategies that specifically address stigma. Acquired hearing loss can disrupt existing interpersonal social relations and threaten social identity and status. Efforts to change group norms within a client's immediate social network can provide the social support and practical solutions needed to minimize distress and help create a pool of people who are capable of mobilizing in the interests of broader destigmatization and social change. From the perspective of social psychology and social identity theory, the outreach strategy in the audiologic rehabilitation program originally described by Raymond Hétu and colleague Louise Getty (Getty & Hétu, 1991; Hétu & Getty, 1991), referred to herein as the Montreal Model, offers clinicians an effective psychosocial strategy for engaging clients and significant others in a useful change process.

In this article, the authors describe a biopsychosocial approach to group audiologic/aural rehabilitation (AR) for late deafened adults with cochlear implants. A detailed account of Cochlear Implant Connections is provided, including the individual components of this innovative program. A qualitative review of written narratives and videotaped AR sessions illustrates the ongoing needs, expectations, challenges, and experiences of this underserved patient population. These challenges underscore the need for ongoing AR, including instruction, counseling, and support, to promote late deafened adults' psychosocial adjustment and to maximize their peripheral and central auditory adaptation to cochlear implant use.