For several years hearing loss has been related that come with aging. It is thought that as we age our auditory perception conventionally commences to fail. Health care professionals thought that failure was a product of our individual age, such that as we grow old our auditory perception ability lowers. It defines as “Presbycusis (age-related hearing loss) is the loss of hearing that gradually occurs in most individuals as they grow older. Hearing loss is a common disorder associated with aging and is ranked as the third most prevalent chronic condition in elderly people after hypertension and arthritis.” (Shemesh, 2010) Deafness is a “heterogeneous condition with far-reaching effects on social, emotional, and cognitive development.” (Fellinge,2012). In socio-cultural context, social and medical model both advises that deafness also has cultural and social meaning and that the negative effects of deafness is due to sociocultural problem, such as discrimination and barriers to access, as well as physiological disorders. Alternative ideas of deafness are available and can help the client to change positively to the diagnosis and later therapeutic and educational approaches. Deaf culture has a long history of domination and downgrading; its strength as a social network derives from deaf people having been thoroughly excluded from hearing culture, from education and professions. (Garden, 2010). In my client evidence who are deaf or hard of hearing capability difficulties such as communication stress, and unsupportive supervisors, which isolate them from community.
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The reason for selecting this topic is that being a nursing student, my client has listening problem and this may affect her psychological health so that she is associated with depression, social isolation, poor self-esteem, feelings of loneliness, and frustration . (Dewane, 2010) (American Academy of Audiology). That client also difficulty in explaining and sharing their problems. This paper will clarify ethical issues regarding hearing loss, its impact on patient’s mental health, interventions during hearing loss and alternatives. However, in our culture, nurses are expected to respect patient’s rights and treat them with dignity.
During the clinical at St Vincent Nursing Home, I encountered an 83 year old female patient. She has a comorbid of angina attack, hypertension, and diabetic. She done only inter because her father was an engineer and migrate from place to place. She has 4 children, 2 sons were expired due to medical illness and 1 daughter is an abort and one son is also. She was a teacher in past. She has a problem for hearing (unilateral). When first day I sit with my client so she said to me that I never get socialized because all people talk very softly so I am not able to listen. She also stated that I feel embarrassed when I ask the questions again and again. So it’s better to sit in a room rather than disturbing others. I have also a problem for sharing my feeling to others. I spend more time in reading short story as well as religious books. I play cards and talk my son and daughter once a week.
From the analysis of the scenario, in ethical issue that characterizes the topic is beneficence, nomaleficence, autonomy; fairness, integrity, and respect are found in the ethical codes. While these professional and legal fundamentals can detailed as sometimes to look severe and in practice they do not cover all situations. Nomaleficence (don’t harm) discusses to avoid injuring, distressing, hurting, harming, or causing a negative outcome. The opposite, beneficence (do good) are most possible to be helpful and to lead to a good effect. Autonomy (self-determination) is a really important consideration for clients, including informed consent and lack of pressure. Justice indicates that professionals treat clients fairly and do not engage in. Fidelity (faithfulness concern) is a symbol of the professional relationship. In general, mental health work with deaf people involves the same ethical principles. Ethical problems and possible solutions may affect deaf clients differently than hearing clients. (Gutman, 2005).
The theoretical framework used was Mishel’s theory of uncertainty in illness is a good theory to use in order to prevent uncertainty by using a good communication. These theories is a part of communications and caring and Swanson as well as Kolbaca is discussing important things about comfort and caring which is actually connected to communication. (Mattjus, 2012). In people with specific needs (refer appendices A). Occasionally hearing loss effects on mental health like depression and other disorder can occur. Inability to hear can result in feelings of shame. It is embarrassing to unable to behave according to appropriate social rules. The feeling of shame related to hearing from older adults unconsciously reacting in untimely and socially unacceptable ways, such as answering to a misunderstood question in an incorrect manner. Many elders with hearing loss take responsibility for ineffective communication and blame themselves for misconstructions caused by the hearing loss. Various feel apologetic about perpetually asking for others’ avail to understand what is being verbalized and when they’re unable to participate in convivial events (Dewane, 2010). In my case same point of view of my client misunderstanding creates problem. Persons with hearing loss to have impaired on ADLs. An important aspect of everyday life, can be seriously impaired with hearing loss. These difficulties with communication could lead to a perceived reduction in quality of life. (Dalton & Cruickshank’s, 2003)
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Furthermore, if hearing loss is occur in patient should get high-quality nursing care, first do assessment (refers appendices B). Interview people with disability like hearing loss client (refers appendices C). Ability to communicate well and maintain good eye contact. Reduce the anxiety of a client. It is important that patients with hearing disabilities could express their needs, desires, feelings and opinions in communication with health care professionals. (Hornakova & Hudakova, 2013). Listen the client actively and provide a moral support. When speaking to the client, increase volume of the voice, but don’t increase the pitch and don’t shout in front of client. Speak into the “good” ear, being to stay at a distance of 2 to 3 feet. Articulate words carefully, speak slowly, and rephrase if necessary. (Meiner & Lueckenotte, 2006). Reduce background noise by turning off the radio or television. Write the words in note pad if client is not understanding through verbal. Sign language or speech reading may be used with impaired hearing. (Roach, 2001). People with hearing loss use of hearing devices, such as hearing aids. (WHO, 2014). They can also benefit from speech therapy, aural rehabilitation and other related services. (WHO, 2014). Enhance the client activity as well as sit with client in group and remove the isolation and depression fear towards her problem which I had done my clinical rotation.
In the conclusion hearing loss in older age people is common because of increase in age. Reduce the anxiety fear towards loss of hearing power. Family and society should accept that client. It is recommended that respect and dignity of clients should remain paramount at all times. As a health care professional, we should encourage the client to get socialized. We tried to find out whether the future health care professionals successfully handle the difficulties of professional communication with deaf patients. The focus has been placed on a successful and effective communication with the client.
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