What are the six elements of person-centered care?

By Clint McLean

What is the recipe for person-centered care in an audiological setting? We’ve asked some experts from the Ida community to explain the essential ingredients. We call them the six elements of person-centered care.

Empathy

By Kris English, PhD, Professor Emeritus, Audiology, The University of Akron

To explain empathy, I often turn to this definition by Madeleine Van Hecke: “The capacity to so clearly understand how others experience the world that their reactions make sense to us, and we begin to share their emotional response”.

The concept of sharing an emotional response can be illustrated with an analogy of a wooden sounding board in a piano or violin. Certain types of wood panels have properties that enhance the sound quality of the strings, but they don’t add new sound. They merely resonate the original sound. Merely resonating is not an easy or natural response for most people; the tendency is to insert ourselves into the moment, offering advice or sharing our own experiences. However, in addition to possessing some degree of innate ability, everyone can also develop empathy.

Active listening

By Kris English, PhD, Professor Emeritus, Audiology, The University of Akron

Empathy is directly related to a skill called active listening. This term is sometimes limited to observable behaviors like using eye contact, full-body posture, nonverbal responses and clearly giving one’s full attention (no multi-tasking or interruptions). However, when Carl Rogers coined the term in 1951, he had a more profound goal in mind: to help speakers help themselves. 

Active listening is based on the premise that people have the capacity to work through a problem when they talk about it with a non-judgmental listener. Active listening requires minimal input on our part. Head nods and neutral comments such as “I see,” and encouragement like, “Could you give an example?” give the speaker permission to continue talking, and work through the particular difficulty. 

Open-ended questions and reflective conversations

By Hans Henrik Philipsen, Chief Anthropologist, Ida Institute

Open-ended questions are intended to avoid “yes” and “no” answers. Asking questions that encourage clients to tell their story helps to build empathy and trust, and allows you to uncover what really matters to them. 

Open-ended questions trigger reflective conversations which prompt clients to think more deeply about their experiences and actions, while letting them know that you care. These conversations prepare the ground for your clients to help themselves and create an atmosphere for self-management, rather than one where hearing care professionals drive the agenda.

Involving family and friends

Nerina Scarinci, Assoc. Professor, BSpPath (Hons), PhD, Head of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland

In order to successfully involve family and friends in hearing care you need to first identify the important people in the patient’s life and acknowledge the crucial role they play. Involving them means inviting them along to appointments and encouraging them to contribute to any assessment, diagnosis, and treatment for the hearing loss because they play a key role in this process and can contribute to the success of any rehabilitation program. 

In the appointment, you can involve communication partners by asking them questions, including them in the process in a structured way, and giving information to them as well as to the patient. You can ask them for their input on the patient’s communication and how the hearing loss affects them. It’s important that they understand you value these contributions. 

Shared decision-making

Dr. Helen Pryce-Cazalet, Senior Lecturer Audiology, Life and Health Sciences, Aston University

In the shared decision-making process, health professionals and people with health needs make decisions together to determine a course of action. There’s almost always more than one course of action available—including doing nothing. 

Shared decision-making requires information to be accessible and shared in meaningful ways between people with hearing loss and their hearing care providers. The hearing care providers bring experience and knowledge to the partnership about what works on average and in typical ways. The patient brings expert knowledge on their life, circumstances, and what matters most to them. Good communication and a good relationship are required to enable both parties to talk freely about the choices and to weigh the pros and cons of a course of action. 

Understanding needs and preferences

Bridgitte Harley, Director and Audiologist, The Hearing Clinic

Understanding a client’s needs and preferences is essential to delivering hearing care in a meaningful way. This requires both the clinician and the client to participate in a process of, first discovering what the hearing and communication challenges are, and then defining what the person would like to address and improve on.  

Everyone experiences their hearing journey in a unique and personal way, so being acknowledged and treated as an individual is important. Many clients will see having their needs and preferences assessed as an important, motivating factor for participating in their care and may feel more inspired to embark on their journey to better hearing health. Understanding needs and preferences helps you provide better care which leads to a better quality of life for your client and those close to them.