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Adult Case Studies, Hearing Assistive Technology: The Role of the Audiologist after the Fitting

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1.  A patient with an Advanced Bionics Naida cochlear implant wants to update his/her hearing aid on their contralateral ear, what platform of hearing aid technology do you need to pursue to ensure compatibility between the Naida CI and the hearing aid with the Compilot? Spice Quest Naida It does not matter

2.  How can a stroke impact loudness perception? A stroke never impacts loudness perception Increased thresholds Abnormal/steep loudness function The person constantly turn up their devices

3.  What do you do if a patient will not pursue medical follow up when it is recommended? refuse to see them until they do documentation and regular follow up with your clinic call their insurance company and report them Call the physician's office and tell them to schedule the appointment and send a letter to the patient

4.  What aspects encompass an audiologist's professional responsibilities? Device fitting Outcomes & Counseling Knowledge about other medical conditions All of the above

5.  When working with adults, it is good to have a strong knowledge of medications: because many patients obtain different drugs from various sources and the drugs may interact with each other resulting in a decrease in cognitive function because patients expect us to know as part of their healthcare team so we can examine possible side effects All of the above

6.  Baseline screening of cognitive function is a requirement of CMS required by the FDA to determine if a person is a candidate for a cochlear implant recommended to be able to rule in/out cognitive decline as a contributing factor in performance outside of our scope of practice.

7.  What additional measures could you refer/do for a patient who is not meeting expected performance outcomes? Speech and language evaluation Neurological consult Cognitive screening and consult All of the above

8.  How would you counsel a family about expected performance with a cochlear implant when there is evidence of cognitive impairment? establish realistic expectations, performance will likely be poorer than average performance with a cochlear implant ensure they know that neurology should be involved in the case the patients will not qualify for a CI paid for by CMS the outcomes will not be impacted

9.  What do you do when a patient is having significant skin breakdown due to a hearing aid or extrusion of a cochlear implant? freak out! immediately call the ENT/Otologist counsel the patient/family, get a release of information and call the ENT/Otologist tell the patient/family to seek ENT care

10.  How do you approach a situation where the safety of a patient is in question due to them living alone? describe the difficulties of living alone, provide written documentation and hope they seek alternative housing contact the family and tell them of your concern contact your local adult welfare office and report your concern; they will force the person to move into an assisted facility it is beyond your scope of practice