Person-centered care films

Stage: Contemplation

Recommended tools: Motivation Tools, Goal Sharing for Partners, Tinnitus Thermometer

In this video, we see Jo’s first appointment with audiologist Laura. She has struggled to hear her whole life after her eardrum was perforated as a girl, but she hasn’t seen a professional since the 1980s, when a doctor recommended hearing aids or surgery and she never went back.

Jo and her partner Paul are very open about her hearing loss, her nighttime tinnitus, and the specific situations that have become difficult. They are keen to hear about the different treatment options, and Jo decides to first explore meditation and sleep strategies, then look at hearing aids.

As you watch the video, you will see six bars grow and shrink on the screen – these represent the six elements of person-centered care (PCC), each of which is implemented by the audiologist at different points during the appointment. The video is an excellent example of what PCC looks like in reality and how audiologists can respond to the patient’s (and partner’s) needs using this approach.  

Stage: Pre-contemplation

Recommended Tools: The Line, the Box

Morag has hearing loss in her right ear, which she is convinced is due to years of working in a factory with loud machinery. With this impression in mind, her motivation to improve her hearing is very high. She speaks openly with her audiologist, Emily, about other health conditions she has, as well as prior, unsuccessful encounters with another audiologist. Emily helps Morag identify ways in which she is more successful communicating with people, and ways she has already begun adapting to help herself hear better.

When Emily tells Morag that the hearing loss is a result of fluid behind the ear, and is not noise-induced, Morag’s motivation changes dramatically, even though she has options for treatment. Emily addresses Morag’s reluctance to have any kind of operations and tells her there are alternatives, but Morag loses her motivation to take any further action on her hearing loss. Emily wonders if Morag’s reluctance to see an ENT is related to how much time she spends at the hospital because of her other health conditions.

Stage: Contemplation/Action

Recommended Tools: The Line, the Box

Venus has gone to see her audiologist, Jodi, at her daughter’s encouragement. Venus doesn’t believe that she has a hearing loss, claiming that she only has difficulty understanding specific people. She readily admits that she has tinnitus, and has gone so far as to address her difficulties with the people she has  trouble understanding, but is reluctant about trying the hearing aids she is given.

The clinic where Jodi works was not yet using Ida tools, but she is still trying to be person-centered in her practice. She is sensitive to Venus’ resistance, and wants to strike a balance between encouraging her and pushing too far. Jodi is hoping that Venus will open up more about her personal life in future sessions, and that if Venus is more open about other situations in her life aside from her hearing loss, they will be able to work together to improve her hearing.

Stage: Contemplation/Action

Recommended Tools: Reflective Journal, A Patient Journey, Change Guide

A day after learning how to use the Motivation Tools, a clinic in Nottingham tries using them with their clients. While getting information from their clients, the clinicians are adjusting to the new pattern of their appointments, and how to ask their clients the questions about their motivation in a natural way.

Both the audiologists and the clients are surprised by the answers to the questions. In several cases, clients speak openly about why they are uncertain about their abilities to use hearing aids, or how their intentions will compare to the reality.

As the audiologists become more comfortable with using the tools, they find they are more able to engage their clients and get more details about what is most important in their lives, what situations they need to improve their hearing, and what stumbling blocks would potentially hinder them. The clinic manager can see the new level of engagement in the clients, and is ready to make changes to the system they have in place, in favor of one that brings greater satisfaction to his employees.

Stage: Action

Recommended Tools: The Line, the Box, Goal Sharing for Partners, Living Well, Group AR

Barbara comes in to get fitted for a pair of hearing aids. Her husband Robert, who is already a hearing aid user, comes with her. Robert is a supportive spouse who speaks enthusiastically about his own hearing aids, and helps fill in a few blanks for Jodi where Barbara isn’t as direct.

Jodi offers to set up a special mode so that Barbara can get a boost when talking on the telephone. She is unaware that Barbara has particular difficulty when speaking on the phone, and is surprised by Barbara’s reaction when the new function is offered to her.

Jodi tries to reassure Barbara that though what she is experiencing is overwhelming, her reactions are typical, and she will adjust. The staff reflection cements for Jodi and her colleagues the importance of asking open-ended questions to find out what is important to their clients in their daily lives.