Do Your Elderly Patients HEAR What You Have to Say? How to Say It So They Do

2002 Oticon Hearing Solutions Speech at International Conference in Italy
Speaker: Robin Raff, MBA

Hearing loss is one of the top three health impediments of the 50+ market segment, the fastest growing segment of the population. "This target segment is also living longer and their lifestyles are changing," pointed out Robin Raff. "They expect to continue living a vigorous and independent life well past the age of prior generations." In her presentation, Ms. Raff asked participants to "put themselves in the shoes" of their patients to feel how this group feels about hearing loss and aging and to learn what is most important to them in their mature years. "By fully understanding your patients, you can best establish trust and rapport and insure that you truly meet their needs."

Life Issues of Mature Adults

"When we think of old, we have generalizations in our minds and we probably approach the people in our lives who are elderly based on our own experience," stated Ms. Raff. She pointed out that it was very typical to generalize about specific age segments, citing examples such as the characteristics applied to 2-year-old children ("the terrible twos") and the difficult teenage years. "As people get older, the tendency to make these same types of generalizations continues," she noted. "Professionals often unconsciously apply these generalizations to their patients, without realizing that there are extreme differences in the mature age segment."

She noted that today, people are living longer. Unlike previous generations, many mature adults are creating new lives at different stages of their lives. Many are facing the death of parents, spouse or friends. Others are retiring, starting an entirely new career, or taking a part-time job. They may have grandchildren or an adult child moving back home. Some may be re-married. Others are coping with the illness of a spouse. Still others will be experiencing financial worries.

According to Ms. Raff, all of these factors are important for the professional to keep in mind. "When a patient comes into your office to talk about a hearing loss, it may not be the most pressing issue on their minds at that time," she stated. "If you can help uncover some of the other issues they are dealing with then it is easier to get them to focus and talk about their hearing loss and where that fits in their priorities at that point."

The mature market segment has many financial concerns, especially worry over the high cost of health care. Many are planning for retirement and, because so many people are living longer, they are looking at their financial resources for coping with long-term care needs. In addition, many are living on a fixed income.

Not All Mature Adults Are the Same

"We also shape their perceptions of themselves by how we speak with them," Ms. Raff noted. "Advertising targeted to mature adults continually focuses on health, long-term care and retirement." She contrasted these messages to the more "uplifting" messages directed at younger audiences that focus on planning a family, purchasing a home and other positive endeavors.

She shared a sampling of television advertising targeted to the mature market and noted that the impression taken away from these commercials might be that older people spend most of their time worrying about health, finances and planning their funerals. "That is really not the case," she stated. "Not all mature patients are alike. Some of them are pursuing second careers, hobbies, and volunteer work. Many of them enjoy traveling. They are typically involved with grandchildren and family."

Middle & Late Adulthood

Ms. Raff suggested that professionals begin to breakdown preconceived notions about a mature client by distinguishing between patients in "middle adulthood" (ages 50-64 years) and those in "late adulthood" (ages 65-79 years).

In the middle adulthood market segment, approximately 69 percent of the people are working. Hearing solutions for this group will need to allow them to stay in work and be competitive in that environment. Females make up 52 percent of the group and males make up 48 percent. Only 29 percent are single and 34 percent are college graduates.

In the late adulthood segment, only 17 percent of people are working. The group is 56 percent female, 44 percent male. Single adults make up 38 percent of this segment and only 22 percent are college graduates.

From a health standpoint, both groups share similar health issues with the incidence of disease states increasing in the late adulthood group. Most common health issues include: arthritis, hypertension, heart health, sinusitis, eye impairment and diabetes. Hearing health issues are experienced by 143 people per each 1,000 adults in middle adulthood, rising to 344 per 1,000 people in late adulthood.

Ms. Raff pointed out that patients in early adulthood may be adjusting to life issues that they are only recently encountering versus someone in late adulthood. These issues may include retirement planning, care-giving for aging parents or young grandchildren. Many people in the early adulthood segment may be recent empty nesters and still fairly physically active, enjoying sports and travel. They may be just beginning to show signs of health conditions ranging from slight hearing loss and arthritis to diabetes and high cholesterol. Some many be experiencing depression.

The later adulthood segment is further into their retirement years. There are more single adults, either divorced or widowed, and grandchildren are likely to be older. Some will be in advanced stages of health conditions and less physically active. More women will be living alone.

"For both groups, finding ways to simplify their lives is important as is caring for their health," Ms. Raff noted.

She advised keeping the many life issues faced by the mature market segment in mind to establish a good starting point for discussions that will enable hearing care professionals to establish rapport with their patients.

Hearing Loss and Its Significance

Ms. Raff noted that many of the reasons for denial and delay in seeking help for hearing loss can be found in understanding what hearing loss signifies for the mature adult. "First and foremost, it indicates a loss of independence," she said. "It is also a physical indication of their aging." The isolation that comes with loss of hearing is another aspect of health impairment that older adults must to deal with. Hearing loss also brings a sense of vulnerability to adults who are used to being in control and independent.

Against the backdrop of these many implications, the decision to seek a hearing solution is a significant step for many older adults. The unplanned expense associated with obtaining a hearing solution can also be significant for people living on a fixed income. They must also cope with adjusting to the physical and emotional aspects of using a hearing aid.

Overcoming Obstacles to Hearing Solutions

Ms. Raff explained that when a mature adult comes to a hearing care professional seeking a solution, they bring with them their own individual experiences that need to be understood to ensure a successful and satisfying solution. They may have had previous experience with hearing aids, including difficulties with battery life, feedback and other issues. They may have preconceptions based on the negative experiences of their friends. They may also be unaware of the many advances that have occurred in hearing technology in recent years.

There is also a fear of the unknown. They may not know what they will experience as a hearing aid user. There will be vanity issues. Ms. Raff suggested that one way to approach this particular obstacle is to have satisfied clients speak with new users or to create a peer support group.

New users need clear, detailed explanations on what the fitting process will involve and how their hearing instruments work. She advised approaching each patient with the assumption that they know and understand nothing about the process of determining a hearing care solution.

Front office staff should also be educated about the needs of the mature adult patient. "They are often the first contact for many patients, and if the staff is unable to answer these first questions, potential patients may turn away for good," she stated.

Involving the influencer, typically the spouse, is critical to a successful experience with mature adults. Ms. Raff also advised encouraging a test period, so that patients understand they can try out a solution and know that if they are not satisfied, there are other solution options available to them.

Building a Personal Relationship

Establishing a rapport is essential in building a relationship with the mature market adult. "Listening and repeating back what is heard and getting a confirmation from the patient is essential," said Ms. Raff. "You also need to empathize and provide information that is relevant to their lifestyles." She stressed the importance of distinguishing between information and guidance appropriate to the age of the patient (i.e., 52 years versus 72 years). It is also important to acknowledge their life experiences and wisdom.

"Recognizing their desire to remain active and independent will also reassure older adults and help establish a connection," Ms. Raff emphasized. "You need to be sensitive to their generational values, beliefs and preferences."

Older adults tend to have great respect for physicians and they see hearing care professionals as one of their physicians. Hearing care professionals need to be conscious of the esteem with which mature adults view them and how much they appreciate the time that a professional takes with them.

Professionals should clearly outline the ways in which hearing aids will address their patient’s particular needs, avoiding any implication that the patient is "needy." It is also essential to recognize that this generation has not grown up with technology and requires a clear explanation of technology.

"What you are offering to the mature adult is a solution that will make their lives more comfortable, enjoyable and fulfilling," Ms. Raff concluded. "You are not simply selling a hearing aid. If you stay focused on this, you will help you client’s to overcome their obstacles to purchasing a hearing aid. It will be difficult for them to turn away if you continually reinforce that their lives will be improved and more fulfilled. Ultimately, you are offering them a solution that will allow them to keep their dignity and independence. You are giving them connectedness."