One of the most significant physical stressors is pain.  Sudden confusion or unintelligible speech may be indicative of a stroke.  Angina could be serious for the client as could a respiratory problem.  An individual with a lower stress threshold may be unable to vocalise the exact location of the pain and therefore optimal care requires “…the need for excellent assessment and communication skills” (Minichiello et al, 2005, p. 12).  Again, ensuring an environment conducive to meaningful interaction is paramount in my clinic.  Identification of individual strengths and means of communication, providing meaningful discussion and activities, ensuring appropriate lighting, noise control and privacy and designing a care plan to minimise disability through modification of both physical and social environments will help to ensure the individual maintains a sense of self, dignity, respect, autonomy and empowerment.

We are all guilty of blaming the individual instead of trying to understand the aetiology.  “My partner is deaf and needs a hearing aid” – often the first words I hear from caregivers.  An understanding of hearing loss, its effects, the type of assistive listening device recommended, communication and repair strategies and realistic expectations are key components when formulating a hearing healthcare plan with positive outcomes required for success.  Nobody is at fault.  The goal is to improve quality of life through listening and providing the most appropriate advice and in some cases a device.  Using the right words is relevant – hearing impaired as opposed to deaf.  Rarely are people deaf and hear absolutely nothing.  How much hearing does my client have and what does this mean for others who need to communicate with them?  The hearing loss needs to be related to real life and the identified communication problems of the individual.

By being alert to possible stressors, such as pain, sensory impairments, physical disabilities and polypharmacy, the audiologist is better able to build an open and trustworthy rapport.  This in turn, will have positive effects on meaningful exchanges and eliciting the necessary  information to co-design a hearing healthcare plan with realistic expectations.  No two individuals will have the same plan.  The real life effects of hearing impairment on an individual will differ greatly.  How this is managed will depend on the recognition of and respect for individual differences.


Minichiello, V., Somerville, M., McConaghy, C., McParlane, J & Scott, A.  (2005).  The challenges of ageism.  In Minichiello, V. & Coulson, I. (Eds.),  Contemporary Issues in Gerontology.  Promoting Positive Ageing.  Crows Nest:  Allen & Unwin.