Holistic Aural Rehabilitation: a Challenge

Abstract

Despite more than 40 years of medical and technical rehabilitation having been offered to hearing-impaired people in Norway, there are still considerable barriers to aural rehabilitation. This paper presents the current state of aural rehabilitation in Norway. The need for a change in aural rehabilitation, from being mainly a medical and technical matter into a holistic, cross-professional and multi-disciplinary approach, is argued. Educational audiology, as well as other professional fields, must be included, e.g. there is currently a lack of emphasis on psychosocial factors, acceptance of hearing loss and communication skills training. Reports and articles from other countries support the arguments for change in aural rehabilitation practice, not only in Norway. There is also a need for change in the educational programmes for professionals, to further emphasize scientific skills and research work.

Factors affecting older adults' hearing-aid use

“…Thus, rehabilitation programmes would probably benefit from including a focus on the communicative aspects of hearing loss. Specifically, an emphasis on coping (Hallberg, Hallberg, and Kramer 2008) and communication strategies (lip reading, speech reading and auditory skills) might enhance social participation (Falkenberg 2007;Matonak 1999).…”

“…This waste not only causes problems for the individual suffering from this disability but also results in a considerable cost to society. The cost of unworn fitted hearing aids in Norway has recently been reported to be approximately US$16 million annually (Falkenberg 2007). Various explanations have been suggested: noisy and disturbing situations (Bertoli et al 2009); modest need (Gianopoulos, Stephens, and Davis 2002); and practical problems related to use (Meister et al 2002).…”

“…The need for and benefit of follow-up support, which has been defined as organized check-ups and accessibility to professionals, have been documented (Gianopoulos, Stephens, and Davis 2002;Henrichsen et al 1991;Hickson and Worrall 2003;Takahashi et al 2007), although not specifically for older adults. It has been argued that the medically and technically focused audiological follow-up support that is traditionally practiced should shift to a holistic approach that includes functional assessment, psychosocial aspects, communication skills and educating significant others (Falkenberg 2007).…”

Looking for a ‘cure’: negotiating ‘walking’ in a Turkish rehabilitation hospital

“…The main critique in the latter is that, in spite of recent shifts in the conceptualisation of rehabilitation's main purpose as facilitating participation in daily-life activities rather than promoting a medical understanding of disability (Bekken 2014b), in practice emphasis on functional improvement still prevails. For instance, Arntzen, Hamran, and Borg (2015) focus on this approach's impact on stroke survivors' lives at home after discharge, while Falkenberg (2007) draws attention to the medical and technical character of aural rehabilitation in Norway.…”

“…This literature focuses on social constructions of disability in rehabilitation (Sullivan 2005), disabled people's own experiences in the process (Bekken 2014b;Lingsom 2009), and the role of 'client participation' in planning (Alve et al 2013). One aspect discusses rehabilitation as reproducing notions of 'normality' and 'aesthetics' (Hughes 2000), through its emphasis on functional improvement (for example, Bekken 2014b; Falkenberg 2007). Accordingly, moser (2000, 201) sees the 'principle of normalisation' as 'ideology of rehabilitation'; and Sullivan (2005, 31; original emphasis) refers to the 'normalizing regime of medical power … that operates to impose a totalized identity of paraplegic' .…”