WEBVTT 00:00:11.000 --> 00:00:13.000 This meeting is being recorded. 00:00:13.000 --> 00:00:43.000 Good afternoon. 00:01:06.000 --> 00:01:25.000 Thanks for joining we'll just wait until we have more participants coming in so please wait with us. 00:01:25.000 --> 00:01:39.000 MODERATOR: We'll just give it one more minute and then we'll start, thank you. 00:01:39.000 --> 00:02:03.000 Hello and welcome to the public health and hearing webinar series today is the final webinar, webinar six on codesigning new models of hearing health. 00:02:03.000 --> 00:02:15.000 The webinar series is cohosted by Macquarie centre and the Australian hearing hub and the series is focussed on hearing loss in older adults, the webinar is captioned by Bradley reporting to view the captions click on the closed caption select show subtitles and you should see them. 00:02:15.000 --> 00:02:44.000 Today's webinar will be graphically recorded live by Debbie Wood who will provide us with a visual map of our collective insights and understanding of the topic today. 00:02:44.000 --> 00:02:50.000 To formally start the proceedings I would like to acknowledge the traditional owners of the lands throughout and and acknowledge their collective wisdom that shapes continuing connections to land water and culture, pay my respects to elders past present and emerging here from all over Australia and obviously beyond Australia. 00:02:50.000 --> 00:03:03.000 And today I'm on Darug land at Macquarie university. 00:03:03.000 --> 00:03:33.000 I'm delighted to have you join us for this final panel seminar, the final seminar series one of six that we've had with a long journey with many of you throughout that time. 00:03:57.000 --> 00:04:06.000 Today with a panel of experts from many disciplines we aim to explore the key issue that's underpin challenges in addressing hearing health in older adults, we are interested in key approaches where to from here might inform governments and policy makers how we move forward in addressing the huge burden of unmet need we are interested in implementing a new approach to health care, lived experience and person centred carry, hearing technologies health implementation science, health psychmedicine 00:04:06.000 --> 00:04:25.000 For further information about the panel and the areas of expertise look back over the event website. 00:04:25.000 --> 00:04:26.000 Like many of the other webinar series today's webinar is audiology Australia endorsed and links to accreditation information is posted on the website and emailed to you approximately 24 hours after the event. 00:04:26.000 --> 00:04:33.000 Thank you. 00:04:33.000 --> 00:04:42.000 As we start I wanted to just briefly recap over the five previous webinars. 00:04:42.000 --> 00:05:09.000 The first webinar we aim to explore hearing loss, as a major public health problem and really understand why that was the case. 00:05:09.000 --> 00:05:28.000 It becomes really clear that hearing loss in older adults has a high prevalence, one in three adults over the age of 65 have a measure /RABL loss, breaking social bonds and health impacts and escalating costs not only to the individual but society as a whole. 00:05:28.000 --> 00:05:52.000 Our next webinar asked us to listen to the lived experience because the key values there are in understanding the broad impacts that hearing loss has and provides us with opportunity how we might move forward in addressing some of these. 00:05:52.000 --> 00:06:16.000 What are the challenges, some highlighted is the fact that stigma is pervasive, social and self stigma there is a general lack of awareness in the community about the impacts of hearing loss and often it's considered a natural consequence of aging and not addressed, the solutions are focussed on the individual rather than being much broader. 00:06:16.000 --> 00:06:29.000 What that means is it continues to stigmatise the problem, the third series demonstrated that technologies are expanding to we have great opportunities to leverage solutions with technology, greater options and choice for different types of hearing loss different types of hearing problems. 00:06:29.000 --> 00:06:35.000 It allows us increased reach and flexibility so we have solutions now where we don't have to have people coming in to the clinic in order to provide them with the solutions that meet their need. 00:06:35.000 --> 00:06:55.000 We've got increased capacity to be able to meet their need by using these sorts of technologies. 00:06:55.000 --> 00:07:13.000 Also by reflecting inwards as audiologists within the hearing health clinic, to really start to think about how we use the information that adults will provide to us in sharing what their challenges are, how do we use that to best address their concerns. 00:07:13.000 --> 00:07:17.000 Our next seminar series looks at the human centred design, how might we change things, discussions on a social design approach and importance of really strongly engaging with consumers and also community members. 00:07:17.000 --> 00:07:30.000 There are also great opportunities that we need to start to explore. 00:07:30.000 --> 00:08:00.000 In digital health and community pharmacy which allow in increased reach and touch points in health care. 00:08:08.000 --> 00:08:32.000 I want to introduce the panel we have Margot Albrecht, consumer advocate, Caitlin Barr, the CEO of sound fair, a community and consumer organisation, we have Brent Edwards who is the director of the national acoustic lab orities, Annie Lau, in health informatics, Terry Sherman professor of health psychology and Macquarie university, thank you if you can all reveal yourselves welcome to today. 00:08:32.000 --> 00:08:36.000 Wonderful so we have all of our panelists here and I'm going to start by asking each of them from their lens why is the current hearing health care system in Australia failing all the adults, older adults, I might start with Caitlin? Thank you. 00:08:36.000 --> 00:08:39.000 SPEAKER: Thanks cath and hello everyone listening today. 00:08:39.000 --> 00:08:41.000 I had a feeling you would come to me first. 00:08:41.000 --> 00:09:11.000 It's a big question to ask. 00:09:21.000 --> 00:09:32.000 One that I think you've done a wonderful job tackling across the several seminars, through my lens which at the moment is as consumer service provider organisation, and through my background in researching and teaching person centred care within the hearing sector I see the main problem is that the system doesn't meet the needs of diverse individuals, we have a system that is medical I in its focus, provides hearing aids, a technical solution to a chronic health condition with vast social and p 00:09:32.000 --> 00:09:35.000 Understandably causes a big mismatch, and I've had a consumer recently say to me it's like saying every person who needs transport, needs support to get to work. 00:09:35.000 --> 00:09:38.000 Has to use a car and they have to drive it. 00:09:38.000 --> 00:10:02.000 It's an individual solution and it's got to work for everyone. 00:10:02.000 --> 00:10:06.000 The reality is we know for some people riding a bike or walking or public transport is better suited which means we need different costs, options and approaches we need someone to drive the train and infrastructure infrastructure, there no reason the hearing should be any different 00:10:06.000 --> 00:10:14.000 MODERATOR: Great answer, Margot can you share your thoughts? 00:10:14.000 --> 00:10:29.000 SPEAKER: Hi, can you hear me okay, cool, hello everyone. 00:10:29.000 --> 00:10:39.000 From my lens which is as a deaf person I have sensorineural hearing loss, I'm 54 now have been wearing hearing aids since I 25. 00:10:39.000 --> 00:10:49.000 I think its phrase ignore is more appropriate because I believe on so many levels including health hearing care we ignore our older citizens. 00:10:49.000 --> 00:11:04.000 We do need to understand that fitting someone with hearing aids is just the beginning of their hearing journey and not the end. 00:11:04.000 --> 00:11:22.000 For the purposes of this webinar I canvassed a cross section of people in my social or bit who I know have been or are currently caring for older relatives, there's a common thread in each of the stories. 00:11:22.000 --> 00:11:25.000 That re-affirmed my viewpoints on this matter which is from my previous experiences of working in a commercial hearing provider clinic and my ongoing lived experience of caring for my 90 year old mum who now has age related deafness. 00:11:25.000 --> 00:11:55.000 So it's like the blind leading the blind. 00:12:38.000 --> 00:13:08.000 So everyone I spoke to cited fundamental tech barriers as one of the potent issues facing older citizens, one person told me his grandma couldn't use the TV remote let alone hearing aids, some have the added barrier of English being their second language. The family of one man suffering from age related deafness and dementia are unable to determine whether the unresponsiveness is due to the dementia or deafness or both and his daughter commented to me she would love to see exp. 00:13:09.000 --> 00:13:25.000 My mum in law told me about her aunt, highly intelligent, librarian and teacher whose cochlear implants failed her, she's so deaf they can no longer ring her and talk to her so she write letters, her aunt writes beautiful letters but cannot imagine having words that you cannot verbalise in a conversation. 00:13:25.000 --> 00:13:48.000 I'd like to quote my friend Catherine who is like me, born with deafness, wears hearing aids she's a mum and she said, I remember being horrified when my husband's nanny was left to die in a hospital room. 00:13:48.000 --> 00:13:54.000 After a catastrophic stroke she couldn't move but could still hear, the nurses couldn't be bothered to put the hearing aids in imagine if this was our fate when it was time to die, a really sobering thought. 00:13:54.000 --> 00:14:03.000 I think cross the board ignorance of older people. 00:14:03.000 --> 00:14:11.000 MODERATOR: The things I drew from that are the social, importance of the social bonds and challenges of technology, really important and interesting thank you. 00:14:11.000 --> 00:14:19.000 Can I ask Brent through your lens, why is the current hearing health system failing adults 00:14:19.000 --> 00:14:40.000 SPEAKER: I certainly support everything that Caitlin and Margot said but I think I'll take exception to the premises of your statement. 00:14:40.000 --> 00:14:44.000 Because Australia has the best hearing health care in the world and to suggest that it's failing adults I think is a miss statement, failing some people, aged care facilities, some people for whom they're not getting the right solutions but as a whole, more people are getting hearing aids than ever. 00:14:44.000 --> 00:15:14.000 People are more satisfied with the devices they get than ever according to the data. 00:15:15.000 --> 00:15:22.000 And there's a lot of data that people misuse, and the assumption because you have a measure /RA*BL hearing loss means you need a hearing aid, is also false I think there's lots of opportunities for us to improve the innovative, get better hearing health care, and we've heard a couple of examples in the past few minutes already of how we can do that but I would say we're not failing as a whole system. 00:15:22.000 --> 00:15:44.000 MODERATOR: Can I now ask any thank you. 00:15:44.000 --> 00:15:48.000 SPEAKER: Lovely to be here good afternoon everyone, listening to what's been said so far is verien lightening, my research lies in digital health and I will be looking through the lens of the current state of digital health and whether it is indeed addressing the needs of those with hearing impairment. 00:15:48.000 --> 00:16:18.000 When it comes to accessing health services. 00:16:22.000 --> 00:16:49.000 I remember having a very interesting conversation with Margot and Caitlin I remember asking them with the rapid roll out of telly health in COVID whether this has made it easier for people with hearing impairment to see their GP or health care professionals now telehealth is in place assuming one can stay in the comfort of their home see the professional on the screen and they can type if the hearing or communication gets a bit difficult. 00:16:49.000 --> 00:17:00.000 But what I learned from Margot and Caitlin is that many people with hearing impairment have not had an opportunity to engage in telehealth, consultations so far because COVID has had really major significant impacts on their day-to-day lives and setting up their home for telly consultation facility is not a major priority for them at this stage. 00:17:00.000 --> 00:17:23.000 So how has COVID affected those with hearing impairment for example face masks, in particular, have hidden many of the nonverbal communication gestures. 00:17:23.000 --> 00:17:29.000 Making it difficult to interpret facial expressions or lip patterns, plus those who use hearing aids have a lot of difficulty fitting their face masks, where some have reported lose their hearing aids as a result of putting on their masks and have chosen not to wear the hearing aids when they have their masks on. 00:17:29.000 --> 00:17:40.000 So all this has a major impact on people with hearing impairment. 00:17:40.000 --> 00:17:56.000 So we can really understand why engaging in telehealth at this stage is not a high priority for many of those in the journey. 00:17:56.000 --> 00:18:12.000 If we look at the statistics in telly consultation, according to Medicare benefit schedule released in September this year, almost 92 percent of telly consultations are conducted on the telephone alone and only 8 percent of them are by video. 00:18:12.000 --> 00:18:42.000 So what this means is even for those who wish to engage in telly consultation they would most likely have to do it via the telephone alone as their health care professionals have not set up the online video facility. 00:18:47.000 --> 00:18:50.000 For people with hearing impairment I can only imagine having a medical consultation on the telephone is not going to be easy and it's going to require a lot of listening effort and miss communication so even with the rapid room out of telehealth it's been a win for many of us and health care professionals we need so ensure those with hearing /PAEURPLT are able to use tell heath with ease when required thank you. 00:18:50.000 --> 00:18:54.000 MODERATOR: Thank you. 00:18:54.000 --> 00:19:15.000 Frances 00:19:15.000 --> 00:19:21.000 SPEAKER: Hello every body I'm delighted to be here thank you for inviting me to be part of the panel conversation in answer to your question I feel the lens isn't focussing well enough at the moment, it's not focussing on the context where hearing health care provision is offered or on the adult experience. 00:19:21.000 --> 00:19:40.000 We need to bring those two things context and experience in to alignment. 00:19:40.000 --> 00:19:58.000 We need to both watch and listen very carefully to how adults use and manage their hearing health system and how the use and management can be better supported by health care professionals, in a more fluid and linked way. 00:19:58.000 --> 00:20:27.000 So that professionals work together to ensure that patient pathways are smooth and fluid, and that better care includes better informed health care professionals who have a greater capacity for not only decision making but also decision sharing. 00:20:27.000 --> 00:20:50.000 That sharing needs to take place with patients, but also with patients families and friends, and with a range of health and social and welfare professionals and I think that we need to encourage this and as an implementation scientist, this point is really important we need to encourage this by underpinning the work we do by appropriately evidenced research. 00:20:50.000 --> 00:20:52.000 Evidence that can inform long-term change to health care systems and settings, and that change in turn should be informed by much more patient focussed methods and person focussed data collection, data analysis, and data reporting. 00:20:52.000 --> 00:21:01.000 MODERATOR: Thank you. 00:21:01.000 --> 00:21:15.000 Very interesting about the importance of engaging and engaging broadly not just consumers also those who work in the industry. 00:21:15.000 --> 00:21:21.000 Kerry, can I ask you to say a few words, we've worked together to really explore some of these challenges but this is the first time you have been part of the panelling 00:21:21.000 --> 00:21:51.000 SPEAKER: Thank you, hello everyone and for inviting me torpart of this today. 00:21:58.000 --> 00:22:01.000 What I have to add I think over lays much of what everyone else has said which is that we need to acknowledge that we have a number of contexts to understand hearing loss, and that we have the obvious physical context but it goes far beyond that so that we really need to take in to account the psychology context and the social context, and when I say psychological context I mean our thoughts, beliefs, attitudes, everything we bring to the situation that will be informed by our part experiences. 00:22:01.000 --> 00:22:08.000 By experiences with other people. 00:22:08.000 --> 00:22:13.000 All of those values that we have we bring to that situation and along with that we have emotional responses. 00:22:13.000 --> 00:22:35.000 So you might feel embarrassed, you might feel a bit anxious. 00:22:35.000 --> 00:22:50.000 You may feel somewhat I think stigmatised came up, all of these feelings and emotional responses go to how someone feels about having a hearing loss and over laying that is the social context. 00:22:50.000 --> 00:23:20.000 So we need to acknowledge that it's an inherently social process that we have a listener and also have communicators and so in understanding hearing loss we need to understand that much bigger context. 00:23:20.000 --> 00:23:50.000 It could be that your partner is mumbling all the time which makes it more difficult to hear along with you having impairments to your own hearing so I think what's really important if we are going to provide the right kinds of solutions for people then we need to take this tailored approach and we need to understand not just the physical context but just as importantly the psychological and social. 00:23:58.000 --> 00:24:14.000 MODERATOR: Thanks Kerry, I appreciate that and I think that nicely will lend itself to a discussion about to Brent, I wanted to circle back to Brent because I think its idea we are not failing is an important idea to discussion but it sounds like everyone is in agreement whether the system is failing or not there's a lot we can do to improve it and I think that's where the key question then I have Brent is if he we're not failing what are the sorts of things and initiatives that you think we c 00:24:14.000 --> 00:24:19.000 What are key elements of a new approach that we could use that would really enable us to engage more widely whether it's to enhance hearing health or whether it's to bring people in to hearing health care? 00:24:19.000 --> 00:24:46.000 SPEAKER: If you think about hearing health care it almost hasn't changed in 50 years. 00:24:46.000 --> 00:25:13.000 You see a clinician they measure an audio gram they give you a hearing aid that's what we do today and we did that 50 years ago, if there's a failure it's on our end with diagnose /EUBGSs and treatment strategies, besides hearing aids. 00:25:13.000 --> 00:25:23.000 To me it comes down to understanding the unique unmet needs of different segments of the population, different people have different needs they're not defined by audio gram, whether it's stigma, lifestyle or physiology or psychology and so we need to get better at applying precision health care in the hearing space. 00:25:23.000 --> 00:25:26.000 For understanding the uniqueness of the individuals which will cluster so you can come up with unique character prototypes. 00:25:26.000 --> 00:25:30.000 But then unique solutions to match those. 00:25:30.000 --> 00:25:37.000 It's not just hearing aids as the only solution. 00:25:37.000 --> 00:25:59.000 MODERATOR: Thank you so really look at the possibilities for personalisation of care. 00:25:59.000 --> 00:26:02.000 I wanted to throw it more broadly open to the rest of the panel so let me know if you want to contribute, the idea of the key elements that a new approach should or might include and what are we trying to address, what are the key aims that we are trying to address, Kerry? 00:26:02.000 --> 00:26:22.000 SPEAKER: Thank you Catherine. 00:26:22.000 --> 00:26:30.000 Taking it one step further to think about the psychological and social aspects is we need to acknowledge it's very much a preference sensitive decision that people are making these decisions about what sort of solution they want, but it needs to be the right decision for them. 00:26:30.000 --> 00:26:49.000 So we need to take a step back and say this is largely a decision that's based on their personal preferences. 00:26:49.000 --> 00:26:53.000 So in order to develop a solution that's right for that individual, we have to understand all of these different motivations, these fears, likes and dislikes we need to understand that far more broadly in order to tailor a solution that's right for that individual. 00:26:53.000 --> 00:26:56.000 And to help them make the right decision. 00:26:56.000 --> 00:27:13.000 MODERATOR: Thank you yes Frances. 00:27:13.000 --> 00:27:43.000 SPEAKER: I think at the same time back to what Brent said it's a complex picture out there and what we need to be doing now is we need to be link /-PG the individual, the group experience, the setting the systems and we haven't done that yet. 00:27:43.000 --> 00:28:07.000 We need to map all different elements together to really get a much broader picture as well as a much more detailed picture so we need to be doing those two things at the same time to understand where the problems and the fractures if there are any and Brent raised the question whether there are any if there are clearly I think there must be because we need to drive the whole situation forward to make sure we are offering optimal care. 00:28:07.000 --> 00:28:19.000 Find out where the fractures gaps and delays might be happening, where miss understanding or miss interpretations of patient need and experience might be happening but the same time to understand that within a system framework it's not enough to concentrate on an individual we need to put that in the context of the systems and the services that we're offering. 00:28:19.000 --> 00:28:21.000 So I think the time is right to create a model a new hearing health care model that actually maps all those different integrated elements together. 00:28:21.000 --> 00:28:25.000 MODERATOR: Thank you Caitlin then Margot. 00:28:25.000 --> 00:28:35.000 SPEAKER: Thanks cath. 00:28:35.000 --> 00:28:46.000 I have been really interested by the use of the word patient through this conversation and Kerry I think you are the exception in that you used people. 00:28:46.000 --> 00:28:53.000 That says a lot about the lens that we are looking at this through, we see hearing loss as a sickness or illness, something that needs to be fixed rather than something that someone lives with. 00:28:53.000 --> 00:29:17.000 That can be overcome supported, managed by that person by the people around them or by society. 00:29:17.000 --> 00:29:29.000 It's quite a different lens and I think if you have a child with hearing loss or you are a 30 year old with hearing loss it's just something about of you might have hearing loss or tinnitus and I think shifting the lens away from the experts putting the system together and the sick patients who consume that is actually problematic and I would say that's a failure Brent. 00:29:29.000 --> 00:29:49.000 That in fact in equality that presents makes it difficult to come up with any solutions because people aren't part of the conversation and it's so important that Margot is here today. 00:29:49.000 --> 00:29:51.000 But absolutely a key element going forward is you have to acknowledge these are people, capable people given the right circumstances are very able to contribute and absolutely need to be at the centre of any design going forward, nothing for me without me thinking 00:29:51.000 --> 00:29:52.000 MODERATOR: Thanks Caitlin. 00:29:52.000 --> 00:30:01.000 Margot? 00:30:01.000 --> 00:30:31.000 SPEAKER: Solutions, only through my lens. 00:30:42.000 --> 00:30:48.000 From when I went to the hearing care provider one of the big failings that I witnessed was after care service and I saw a real need, an elderly person gets fitted with hearing aids off you go come back in a week how are you going we'll tweak this and that off you go and that's it, what I saw was a need for a really comprehensive and ongoing after care which I know is probably a bit pie in the sky. 00:30:48.000 --> 00:31:01.000 Because of the financial implications of that but I can see home visits being incredibly important. 00:31:01.000 --> 00:31:11.000 Going in to somebody's home, and not just once because it needs reinforcing and often I know with my mum you need to show her over and over again. 00:31:11.000 --> 00:31:18.000 You need to reiterate about cleaning hearing aids, also show them how to put the captioning on. 00:31:18.000 --> 00:31:21.000 Because that's a massive thing, captioning the television. 00:31:21.000 --> 00:31:41.000 Yes Brent is completely right of course he is. 00:31:41.000 --> 00:31:58.000 There is a lot of tech out there but someone that can't even use the remote, my mum can't use her remote for a her smart TV how is she going to work out bluetooth or speech to text. 00:31:58.000 --> 00:32:03.000 I think that gap is there and also a lot of older people are dealing with so many other things, like my mum in law said to me, it's really hard when you are nursing someone and he's older and you're older, and it's all too hard. 00:32:03.000 --> 00:32:09.000 I think that that is a common thing, it's just too hard. 00:32:09.000 --> 00:32:13.000 So after care I think is a huge area that could be looked at. 00:32:13.000 --> 00:32:22.000 MODERATOR: Thanks Margot, interesting, Kerry then Annie. 00:32:22.000 --> 00:32:33.000 SPEAKER: I'd like to add to what Margot said because we are talking about something that's a chronic situation, behaviour change is part of that. 00:32:33.000 --> 00:32:54.000 So whether it be that you need change the way you communicate, it might be that you are wearing a device that all entails someone changing behaviours. 00:32:54.000 --> 00:33:18.000 And we know the whole of psychology is based on behaviour change and we know it's not easy to do and it's not easy to maintain so I think that after care is a really important part of ensuring the long-term and ongoing proper support. 00:33:18.000 --> 00:33:34.000 MODERATOR: Thanks, I wanted to note, I think after care is obviously very important but also how do we work with people to help them to address hearing, what's that behaviour change where people recognise there's a problem and there are solutions that they can address, Annie, these are some burning questions that I have. 00:33:34.000 --> 00:33:51.000 SPEAKER: So I really like what Margot just said about the importance of multiple home visits for after care services to ensure that people are actually looked after and they know what to do. 00:33:51.000 --> 00:34:06.000 I think in order to achieve that service model we can see whether there are elements of digital services that can actually complement that multiple home visits, not replace it but complement it. 00:34:06.000 --> 00:34:21.000 For example, these digital services may not actually be designed for the people with the user of the hearing aids they have been designed for say for families or carers around that individual. 00:34:21.000 --> 00:34:42.000 For example, we can maybe put up some video, YouTube videos, to show them how to put the hearing aids on or to show them how to turn on the captioning on the TV. 00:34:42.000 --> 00:34:55.000 But at the same time, one size fits all is not going to be the right modes and what's important is identifying elements of this whether it's after care service or help seeking pathway where digital may be able to supplement some of that work 00:34:55.000 --> 00:35:25.000 MODERATOR: Thank you and Brent? 00:35:30.000 --> 00:35:43.000 SPEAKER: First of all the comment on agreement, the partly medical and consumer, if you believe health care is a health care issue it's not just about consumer choice and what the consumer wants anymore than if I saw a heart specialist you could have a stent pace maker or drugs, reality is most don't want hearing aids, thank you and good-bye so part of the clinicians role is to convince people of the value of treating their hearing loss. 00:35:43.000 --> 00:36:00.000 Because it has benefits in other ways, psychological, cognitive, getting them to wear the hearing aids all day every day which people don't want to do. 00:36:00.000 --> 00:36:02.000 So there's a weird balance between the doing what the patient of the client wants, letting them choose then having the professional make recommendations because ultimately they know it's a health care issue and there are certainly things that the professional is aware of that the client is not 00:36:02.000 --> 00:36:29.000 MODERATOR: Thanks Brent. 00:36:29.000 --> 00:36:30.000 We had a question, because we've got such a short amount of time we weren't going to take any questions from the audience but we had a question I think it's worth given the experts on the panel, exploring more which is what is after care and how might be achieve it, what might that involve? Kerry do you want to take this on? 00:36:30.000 --> 00:37:00.000 SPEAKER: Sure. 00:37:14.000 --> 00:37:40.000 So I see any kind of health issue that requires a change in behaviour which is pretty much anything whether it be taking medication, wearing a hearing aid, changing your exercise habits, anything like that requires a constant reminder, almost nudging we could call it, and that's often done very effectively by regularly seeing someone like a health psychologist, or a clinician whose trained in aspects of helping to keep you motivated and just checking in to say. 00:37:40.000 --> 00:37:51.000 So we gave you these hearing aids two months ago how are they going, are they working for you are there times you find it's difficult and problem solving and working through how to overcome the barriers, acknowledging it's not always going to be plain sailing when you're trying adopt the changes to your life. 00:37:51.000 --> 00:37:56.000 In some situations it works well and it's others in not there yet in being able to adjust if you want to use the word prescription of the solution. 00:37:56.000 --> 00:38:11.000 Over time as each of these different situations unfold. 00:38:11.000 --> 00:38:22.000 MODERATOR: Thanks Kerry, there's been lovely research in the area looking at the relationships between self advocacy and compliance with using a device, Margot then Frances thank you. 00:38:22.000 --> 00:38:27.000 SPEAKER: On the back of what Kerry said I totally agree with what she said and I think there needs to be an honesty with the client. 00:38:27.000 --> 00:38:56.000 The older person, about the limitations of the hearing aids. 00:38:56.000 --> 00:39:01.000 There's a lot of lovely advertising out there with people with perfect hair and clothing and smiling and there needs to be more honesty, when my mum started wearing hearing aids, I can't understand the TV I can't understand someone can be in front of me and I still can't understand them yeah because I've lived with it all my life. 00:39:01.000 --> 00:39:11.000 It's time and money but if we can be creative with our suggestions. 00:39:11.000 --> 00:39:21.000 For how they could adapt to their new life and how to get the most out of their hearing aids, big ask I think 00:39:21.000 --> 00:39:25.000 MODERATOR: I like that concept of adapting, technology plus adapting and I think they go hand in hand nicely Frances thank you. 00:39:25.000 --> 00:39:52.000 SPEAKER: Interesting what people have said about after care so far. 00:39:52.000 --> 00:40:02.000 I think it is not only about giving specific advice and guidance but also about offering a space for people to be able to come in to contact with somebody else often a health care or social care professional to be able to ask questions, to put themselves forward and to put their needs out there. 00:40:02.000 --> 00:40:05.000 So it's as much about recognising the individuals need continuity. 00:40:05.000 --> 00:40:12.000 Need somebody they can turn to. 00:40:12.000 --> 00:40:20.000 Need to be able to voice their experience as it is about getting the right answers to specific questions. 00:40:20.000 --> 00:40:40.000 It's a privileged space that recognises that we have ongoing needs. 00:40:40.000 --> 00:41:05.000 That we need to address as a community of health care professionals and also researchers who are there to listen, to what people want from us on an ongoing basis towards a specific end point which is support and guidance. 00:41:05.000 --> 00:41:35.000 MODERATOR: I just wanted to let people know if they have a comment from the audience please put it in to the chat it's the easiest way, or in the Q & A Caitlin this is a nice space for to you discuss the role of consumer organisations I think we don't capital ice on working with them to the extent we should. 00:41:37.000 --> 00:41:48.000 SPEAKER: Interesting point and I agree with the importance of after care or ongoing therapeutic relationship, all these different terms and I can see Jan put a comment I'm going to talk about the dollars and who is involved in providing that and I think it's important to acknowledge that the current funding mechanism which is currently under review, doesn't set up business models that are encouraged to embrace after care. 00:41:48.000 --> 00:42:18.000 That's the audiology business model and I think it's time to acknowledge there are more organisations and people who can be involved in the support and enablement of people with hearing loss. 00:42:23.000 --> 00:42:40.000 So be that consumer organisations and we are very fortunate to have several across Australia from deafness forum of Australia our peak body in terms of amplifying voices and charities who provide support services and their business models are more set up with the time and space that was mentioned and that requires acknowledging there are other health professionals, health psychologists, mental health workers are and welcome that inter professional and cross sector collaboration. 00:42:40.000 --> 00:42:44.000 Because we want the best for people who live with hearing loss rather than this is my person and I need to do everything in their whole life span, how can we bring those different contributions together to make it the most flexible and best set up for any given person 00:42:44.000 --> 00:43:08.000 MODERATOR: That's a great question. 00:43:08.000 --> 00:43:11.000 So my final question with just over 15 minutes remaining is what are the challenges and opportunities in implementing a new model of hearing health for adults and Caitlin you've talked about the possibilities, the already existing organisations that provide different supports to adults with hearing loss. 00:43:11.000 --> 00:43:24.000 How do we bring that together? 00:43:24.000 --> 00:43:30.000 SPEAKER: Margot? 00:43:30.000 --> 00:43:38.000 SPEAKER: Well from my perspective on the other end of being a client. 00:43:38.000 --> 00:43:51.000 I don't know about any of these organisations, I just don't know about them. 00:43:51.000 --> 00:44:17.000 And for example I happened to be driving one day and saw there's an employment agency that helps people with hearing loss to get work and I was driving and went I didn't know that existed. 00:44:17.000 --> 00:44:23.000 So perhaps at the point of sale as it were where you have your clinician who is helping you with your hearing aid perhaps there needs to be some kind of expanded care package if you wants some help with this you can contact this and if you want help with that this person can come in and help you with the just to have more information. 00:44:23.000 --> 00:44:43.000 That's not too technical, is not too wordy. 00:44:43.000 --> 00:45:00.000 Easy to understand and a lot of - I don't mean to generalise, I can only talk from my experience a lot of older people don't use the internet or do searchs, that's one way. 00:45:00.000 --> 00:45:10.000 Perhaps a public awareness campaign that destigmatsiesand offers help that's one idea 00:45:10.000 --> 00:45:12.000 MODERATOR: Thanks certainly the federal government is looking at developing an awareness campaign and it's really important, piece of work that we can all get behind, Kerry. 00:45:12.000 --> 00:45:39.000 SPEAKER: Thanks Catherine. 00:45:39.000 --> 00:46:09.000 I think what's really important to remember is that it is a shared decision making so any kind of solution that's developed is based on sharing decision making so it's the clinician informing the individual but also the individual enabling to say to the clinician these are the things I like, these are the things I don't like these are the things I'm worried about. 00:46:17.000 --> 00:46:20.000 So having the opportunity to create a supportive decision environment, so part of that could be developing things like decision aids that will add to the actual in person clinical appointments, something that people could take home, and just take the time to digest all of this information and then to come back to the clinician and say well I've thought about all of these options and this is what I think would work for me and then coming to a point that is really that tailored solution. 00:46:20.000 --> 00:46:50.000 MODERATOR: Thanks Kerry, Frances? 00:47:00.000 --> 00:47:05.000 SPEAKER: Just going back to what I said before I think the big challenge for many of us, putting my research hat on for a moment, is being able to map the macro and micro pictures one to the other so we need to understand people's need and experience but we need to contextualise that in a system based piece of research that's a challenge but it's a complex picture that we want to examine and then we want to be able to use our understanding of that complex picture to ensure that the services. 00:47:05.000 --> 00:47:35.000 That we're offering are the best that they could be for people. 00:47:44.000 --> 00:48:07.000 I think we've got our work cut out for us, all of us in the panel group with our different expertise, how we come together bringing that expertise together to do this large mapping exercise so we have a very strong base line from which to move forward and everyone has a slightly different angle to that but I think at the end of the day that's really where we need to be starting from now with an all of the knowledge behind us about the systems and settings and the way they're running at the mome 00:48:07.000 --> 00:48:08.000 Hearing aids or implants or offering advice about how to manage one's hearing loss or hearing experience we need to bring that together to show the complex picture and where we need to move forward to improve health care services for people who have hearing loss so we can improve people's quality of life. 00:48:08.000 --> 00:48:38.000 MODERATOR: Thanks Frances. 00:48:43.000 --> 00:49:03.000 Some of the research that I have been involved in some with you Frances and some with colleagues overseas has really looked at the barriers entering the health care pathway and the point of care and what we can potentially do but stigma is one barrier another is trust and a sense of the system itself being fractured or frag meanted there's lot a lot of information or not a strong representative for hearing health care. 00:49:03.000 --> 00:49:33.000 And in fact if you look at it from a health and pathway perspective, there have been a number of reports of - because health is not hearing embedded in health and not well supported from the strong point of care from a GP perspective. 00:49:51.000 --> 00:49:54.000 How can we have a strongly aligned pathway and I certainly agree with what Brent says it's a health perspective and social, so there might be different points of entry to addressing in terms of the trust and social identity shifts, Kerry this is right in your area, and expertise, how do we do that? Public awareness campaign is one thing but I think there's quite a lot to consider about how do we work with people to ensure that it's clear that hearing is strongly associated with aging but actua 00:49:54.000 --> 00:50:14.000 To improve outcomes 00:50:14.000 --> 00:50:19.000 SPEAKER: So I think what's really important to ensure that level of trust is to engage individual consumers in all of the processes that we undertake. 00:50:19.000 --> 00:50:45.000 So the label codesigning is really important way forward. 00:50:45.000 --> 00:51:02.000 So that any attempts that we have to redesign the care process needs to be codesigned so that consumers are involved in helping inform where we go with this and particularly as researchers, we're bringing the science to understanding the situation but consumers are bringing their lived experience which is so important. 00:51:02.000 --> 00:51:07.000 So I think that in order to ensure that we have the trust that we need to be going forward side by side with consumer groups to really give the message that we are working together. 00:51:07.000 --> 00:51:34.000 MODERATOR: Thank you very important point. 00:51:34.000 --> 00:51:48.000 So are there any - we've got only a small amount of time left so wanted to wrap up, are there any burning points that the panel wanted to bring up in this journey of really identifying what the key challenges might be and how it enables, understanding the key challenges how it enables us to move forward in a codesign approach to addressing some of these challenges, Frances? 00:51:48.000 --> 00:52:08.000 SPEAKER: I suppose just to help you wrap this up I think the fact that we are having this conversation today suggests that we're in a very positive and optimistic space. 00:52:08.000 --> 00:52:38.000 We are having this conversation to ensure that what we offer to consumers and to families and to carers, and to people interested in this topic is really the very best quality care and support, not only care but to improve people's health and wellbeing. 00:52:44.000 --> 00:52:50.000 And those two things need to go hands in hand and I think that we are in a positive space here and we just need to be sensitive to what needs to change and how it needs to change if it needs to change and the fact we are having this discussion means we are setting off on that pathway right now and I feel very excited about working with consumers and with the people here on the panel to ensure that we can meet that agenda together. 00:52:50.000 --> 00:53:07.000 SPEAKER: I also wanted to add that we don't necessarily need to reinvent the wheel. 00:53:07.000 --> 00:53:34.000 We can actually look at other models of care that having used in overseas or other countries and adapt for our own needs for example in the case of whether the digital health has evolved to serve the needs for the hearing community. 00:53:34.000 --> 00:53:52.000 I think there's a lot of potential and yes there is the issue of digital literacy but we can see the next generation of people coming through will be growing up with technology and they expect technologies, digital pathways to be available to the part of the help seeking journeys or after care service. 00:53:52.000 --> 00:54:00.000 So we don't necessarily need to reinvent the wheel we can definitely look overseas and other places to see what are the working digital models of care that we can adapt for Australia's use 00:54:00.000 --> 00:54:30.000 SPEAKER: I agree entirely with what you just said Annie, you are quite right. 00:54:33.000 --> 00:54:45.000 In my 50s I have been dragged in to the 21st century now I engage a lot with tech and I expand as a consumer I'm expecting more than what the current tech is delivering and so the next generation, my generation and the one just above me, the 60s I think definitely more tech savvy our kids will have something implanted in their head I'm sure. 00:54:45.000 --> 00:54:46.000 I feel really, to be really elderly, just pushed in a corner and it's like it's too late for them. 00:54:46.000 --> 00:55:03.000 It feels like. 00:55:03.000 --> 00:55:07.000 And I find that incredibly sad and I wish that there was something we could do to just capture those people and their end of life and give them the best quality that we can, Annie you are right, I will be okay. 00:55:07.000 --> 00:55:37.000 I can adapt, I can learn. 00:55:47.000 --> 00:55:50.000 MODERATOR: Margot can I ask, when you talk about older people and we did set this up as older adults we were considering it to be, it's very open as to what that might be, we should say adults, you are talking about end of life I think its question becomes how might we develop a holistic care model, not just let's get your hearing fixed and eyeses fixed we embrace as a whole of person approach. 00:55:50.000 --> 00:55:52.000 SPEAKER: How do we do that. 00:55:52.000 --> 00:55:54.000 MODERATOR: I guess I was commenting on that. 00:55:54.000 --> 00:56:09.000 SPEAKER: Yes, absolutely. 00:56:09.000 --> 00:56:26.000 One of the things that we are guilty of is as people age almost like their position in society they revert back to children as the way we consider them and do I it myself. 00:56:26.000 --> 00:56:33.000 I talk over the top of my mum when we are appointments I talk for her, the roles have reversed and it's insulting but it's easier just to do it. 00:56:33.000 --> 00:56:36.000 Things like that I wish I don't know how to change it but I wish we could change it 00:56:36.000 --> 00:57:06.000 MODERATOR: That's a very nice way to start to wrap up. 00:57:10.000 --> 00:57:21.000 There's a lot we can do and it's lovely to be able to start the journey with everyone on the panel, I just wanted to note a couple of nice comments that have come in the chat, around in inclusion, communities and families, and also one of our health colleagues talks about the variations, the racial variations in trust given the disparities in hearing health outcomes. 00:57:21.000 --> 00:57:46.000 To capture diversity and certainly the Australian government is looking at some of the vulnerable populations in addressing hearing health care in future. 00:57:46.000 --> 00:58:16.000 It's been a really nice opportunity to have all of our participants here today, we are really fortunate to have such great experts on the panelling and diversity of opinions and understandings and expertise which I think provides the valuable input and collaboration.gain that's important in moving forward in looking at the challenges. 00:58:30.000 --> 00:58:37.000 I had a note from one of my colleagues professor Adrian Davis a former research director of public health England He's a strong proponent of codesign, bringing it together to address the continuum, I think that's a great idea and look at codesign for a basic foundation, how we work with consumers and to address this. 00:58:37.000 --> 00:58:59.000 I want to thank not only participantsened panelists and the wonderful people that brought this to us. 00:58:59.000 --> 00:59:01.000 People working behind the scenes, Debbie for her fantastic diagrams, today graphic art which is really going to help us to reflect on what the outcomes of the panel have been so we appreciate it as you have been doing it Debbie, looks like a great representation of the discussion today 00:59:01.000 --> 00:59:04.000 SPEAKER: Thank you. 00:59:04.000 --> 00:59:24.000 MODERATOR: So wonderful and wonderful to have you with us. 00:59:24.000 --> 00:59:54.000 I wanted to thank Bradley reporting for the captioning it's been great to have you with us, the entire six series and I think the idea of accessibility is very important, so that we're not looking at solutions for the individual but in fact we have solutions and accessibility for all. 00:59:56.000 --> 01:00:08.000 If you are seeking audiology Australia accreditation, don't forget the information will be sent to you to get CPD points for that and the webinar recording will be on the website, next year the world health organisation is launching the first ever report on hearing so we hope all of you have participated today's can you night with us for the world report. 01:00:08.000 --> 01:00:38.000 There's a lot in the hearing space at the moment I think this is a great time to be looking at some of these challenges and opportunities to collectively work together and collaborate and drive this forward. 01:00:38.000 --> 01:00:44.000 Certainly the people who have been on the panel today and I have been discussing some of these issues for quite some time and we will be continuing to have this conversation and look at how we can collaborate in the future to address hearing health care for older adults with a collective impact perspective and very much engaging with consumers and community and if you are interested get in touch we would be very happy to work with you as well from now on in. 01:00:44.000 --> 01:00:46.000 Thanks very much it's been great to participate or to be part of this webinar series. 01:00:46.000 --> 01:00:59.000 I found it very insightful.