audiology terminally ill patient

The Terminally Ill Patient

One of the sadder aspects of laboring in a profession in which long-term therapeutic and personal relationships are often formed is that we all-too-often experience the passing of patients who have become our friends as well.  On other occasions, patients may come to us for the first time, having recently received a poor prognosis. 

We are in the uncomfortable position of needing to relate to these patients and their families as a friend and confidant as well as a health professional and counselor.  Sometimes the imperatives of these roles seem to collide.  

 

Remembering What’s Important

 

Perhaps not so much as we might think.  It is, after all, our professional responsibility to give the best clinical advice we are able, while at the same time projecting a positive and compassionate outlook.  It may help to remember a few important things:

 

We are here to experience each other! Whatever our core beliefs, I think that we can all agree that among the most important measures of our lives are not where we go, what we have, or how we live, but rather reside in our interactions with others and the quality of our relationships.  Neuroscience shows us that our brains are wired for interaction, sociability and intuiting the emotions of others.   

Hearing is critical to a positive quality-of-life.  We all have heard and often repeated the Helen Keller quote that her blindness cut her off from things, while her deafness cut her off from people.  The sense that most contributes to our social nature is hearing.  As I have explained to patients many times, we don’t hear to hear stuff; we hear to hear each other.  Being able to hear music, waves on a beach, rain on the roof are all beautiful things – but they are the gravy.  Our auditory mechanism and its associated neural processing structures are exquisitely designed to process speech.  Difficulty in the ability to process speech often results in social isolation.  And social isolation is fraught with reduced enjoyment of life, depression, and accelerated decline of cognitive function.  

As hearing professionals, we offer tools to enhance our patients’ ability to continue to be active participants in the lives of their loved ones.  We see every day how appropriately fit hearing instruments can resolve or at least slow the progression of negative psycho-social and cognitive effects of hearing loss.    

We all have positive stories to tell our patients and their communication partners of the importance of hearing as the end of life approaches.  

There are the children of the deceased patient who tell us how important it was for their parent and them that they were able to communicate in their final days.  

There is the man who announced at the outset of an appointment, “Well I don’t know how to say this except to just say it: I was recently told that I am dying!  But there’s no use making my last days miserable by not being able to hear on top of it.”  

These are stories our patients need to hear!  The relationship between hearing and quality-of-life is not intuitive, except to those of us who toil this field.  It is our responsibility, for the sake of our patients, to make this clear to them.  And no less so than to the hale and hearty patient who says jokingly, “Well, I’m going to die soon anyway so why should I get hearing aids?”  This is why……..!  

I offer no hard and fast rules regarding how to deal with patients at the end of their lives.  I do sincerely believe, however, that for people with hearing loss, we offer something extremely valuable – and that is connection.  Hearing aids are simply a means to that end.  

 

 

Paul U. Teie, MS, has been an audiologist since 1991.  He has spent much of his career in direct clinical care but has filled other roles in the hearing care industry as sales representative of a special instrument dealer and a hearing instrument manufacturer.  Since 2007 he has provided sales and clinical training for large hearing care networks and currently trains for HearUSA/HearCanada. 


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