In the last posting I mentioned that according to the Regulated Health Professions Act, 1991, s.31; “No person shall dispense a hearing aid for a hearing impaired person except under a prescription by a member authorized by a health profession Act to prescribe a hearing aid for a hearing impaired person.” Only two professions have the authority to perform the Controlled Act of prescribing a hearing aid in Ontario: audiologists and physicians. This means that in order to prescribe a hearing aid, you need to be either a doctor or an audiologist. Others who recommend and fit hearing aids need the co-signature of a doctor or an audiologist. A Controlled Act is a medical procedure where there may be a high or significant element of risk or harm to an individual.
So then what is involved in prescribing a hearing aid?
To begin with, hearing aids are not a cure for hearing loss; they minimize the consequences of hearing loss, and can lead to an enhanced quality of life. At any one time there are roughly 4500 different hearing aids on the market, each with its own characteristics and function. With so many different hearing aids on the market it is important that an audiologist works closely with their patient to help determine which hearing aid style and aid specific sound characteristics will provide optimal performance and communication benefits. Technological advances have increased the flexibility of hearing aids to accommodate far more patient-specific factors in order to improve performance. They can be used to help treat a broader range of hearing losses than in years past, but it is crucial to remember that they cannot repair any damage to the auditory system; they are designed to allow the impaired system to function more effectively thereby improving communication.
When prescribing a hearing aid many factors come into play. First one must look at the type, degree, and nature of the hearing loss as well as a patient’s speech understanding ability which are obtained from a complete hearing assessment. Consideration must be given to accommodate communication needs, lifestyle and personal factors, as well as a patient’s level of motivation to address the hearing loss. One must determine the barriers to a successful outcome and the potential of a patient to obtain benefit from hearing aids. The audiologist then works with a patient to identify and evaluate factors that determine whether an individual is a candidate for hearing aids. These factors include the following; lifestyle and environmental, activities and participation, current and future cognitive abilities, current and future physical abilities, economic considerations, level of motivation to use hearing aids, health and social factors that would impact use, care, and maintenance of hearing aids, and finally goals for desired outcome through the use of hearing aids.
The prescription of hearing aids requires clinical judgement and involves highly individualized and evidence-based protocols that treat the person – not just the hearing loss. Not all hearing losses require, or can benefit from, hearing aids. Your audiologist can identify other treatments which may be suitable.