The role of the optometrist in providing hearing care
OT speaks to the new clinical and commercial lead at Leightons Opticians and The Hearing Care Partnership, Melanie Gregory, about the synergies between optometry and audiology, and fitting Nelson Mandela’s hearing aids
What is your professional background?
I am a qualified audiologist and speech/language therapist. My dual qualification gave me insight into the real impact of hearing loss – when you talk about hearing loss, you’re really talking about a communication loss. This is what underpins my interest in rehabilitative audiology and a person-centred or holistic approach to hearing care.
Life started out in South Africa, I got my qualification from the University of Witwatersrand, then ran my own private practice, which was enormously interesting. During that time, I met Nelson Mandela and assisted him with his hearing aids. That was quite a defining moment in my professional life. He was an amazing, humble and very wise man. He received his first hearing aids shortly before his first United Nations address, so there was a bit of pressure there. I thought, ‘My goodness, what if they don’t work or don’t do exactly what they need to do at such an important point in his life and in the history of South Africa?’ It was wonderful experience to meet him and it certainly highlighted the importance of the patient’s daily life perspective in clinical care. We are not working with eyes or ears, but a person who needs to be able to grow, contribute and participate.
I met Nelson Mandela and assisted him with his hearing aids. That was quite a defining moment in my professional life. He was an amazing, humble and very wise man
I had the opportunity to develop this person-centred perspective even further during my time at The Ida Institute, where I developed global collaborative and innovation processes to enhance person-centred counselling methods and tools, together with colleagues from the international audiology community and The Ida Institute. One of the most important principles I learned is that all good innovation begins with empathy and this is particularly true when we talk about innovating clinical practice.
What areas of the job in your new role at Leightons are you excited to get started on?
There is real opportunity and synergy within vision and hearing care. I am looking forward to developing those synergies even further at Leightons. We know that if you have vision loss, you are one and a half times more likely to have a hearing problem. For every level down the vision chart you go, you are 18% more likely to have a hearing problem. It is very clear that there is a strong link between our hearing and vision, and overall health and wellbeing. What I’m looking forward to doing at Leightons is looking for those synergies from a patient journey and a business point of view. I will be looking at how we can develop person-centred, multidisciplinary teamwork further to deliver better outcomes for patients. Our goal is to promote healthy ageing and wellbeing in later years.
We know that if you have vision loss, you are one and a half times more likely to have a hearing problem. For every level down the vision chart you go, you are 18% more likely to have a hearing problem
How will you be developing Leightons’ learning and development programmes?
The main aims will be to develop that multidisciplinary and holistic approach both in vision and hearing. I’ll be working with Leightons professionals, as well as The Hearing Care Partnership professionals. We’ll be introducing two new professional development programmes – the Rising Stars Programme for students and new graduates, and the Clinical Excellence and Leadership programme to enhance the 16 module Leighton’s Academy. The Clinical Excellence and Leadership programme will include advanced hearing aid fitting and management, advanced counselling skills, business management and clinical leadership.
Leightons has an excellent induction programme into the company, but we’re looking to build the programme of clinical excellence even further and to promote continued professional development on an ongoing basis so that professionals are not only up-to-date with new developments, but in touch with what is new, exciting and innovative in the field. We want to ensure that we encompass the latest developments on every level so that professionals remain at the cutting edge of technology and clinical practice.
What are the most exciting innovations in audiology and optometry at the moment?
Some of the most exciting developments in terms of hearing technology includes the increasing connectedness of hearing devices to the internet and increasing processing power. With these developments, sound quality and the ability to manage background noise improves. In addition, patients will have more autonomy in assessing their hearing, monitoring how their hearing devices are working and adjusting their own hearing aids, indicating that we might be moving into a whole new era of patient-driven care.
We want to ensure that we encompass the latest developments on every level so that professionals remain at the cutting edge of technology and clinical practice
Why is it important for optometrists to consider introducing audiology services at their practice?
If you are an optometrist, managing hearing and vision under the same roof offers a huge opportunity form a health and wellbeing point of view for patients and also a business point of view.
Hearing is often described as an unseen and unrecognised problem. However, we know that both hearing and vision impairment can contribute to social isolation and impact memory, cognitive decline and mental health problems. Optometrists are in an excellent position to raise awareness of the importance of hearing for wellbeing and healthy ageing and provide a one-stop holistic service.
People tend to seek help for their vision a little earlier than they do for their hearing, so that puts optometrists in a prime position for early detection of hearing loss. If you consider that 70% of people over the age of 70 have hearing loss there is an enormous opportunity to provide ongoing assessments and promote hearing help-seeking and ongoing care for people who choose that route through optometry. There is a lot of potential in the sector and room for growth, especially if you think about older people wanting to live independently for longer and the later age of retirement and therefore people staying in work longer.
If you are an optometrist, managing hearing and vision under the same roof offers a huge opportunity form a health and wellbeing point of view for patients and also a business point of view
Hearing care is a rapidly advancing and growing area and showing a number of positive trends. The uptake of hearing aids has never been as high as it is at the moment – around 48% based on the latest EHIMA data, indicating the growing recognition of the problem and a positive shift towards wearing hearing aids. Patient satisfaction ratings have never been higher too, thanks to advances in technology and a growing awareness of the link between hearing and wellbeing. More than 80% of people who get hearing aids are very satisfied and they say it makes an enormous difference to their quality of life. People wear their hearing aids for the vast majority of the day.
There are still a lot more people that could benefit that currently do not and optometrists could make a significant contribution to educating patients about hearing and health, the importance of early hearing screening and the benefits of addressing hearing problems early.
People wait, on average, about seven years before they seek hearing help. That puts optometry practices in a unique position to raise awareness through hearing screening and getting people to seek help sooner.
During my time at the Ear Foundation, I often saw people who had waited too long. As a result, they had lost their job, decided to retire early, had difficulty with their home life and withdrawn from the activities that they enjoy doing. Their sense of wellbeing and quality of life had reduced significantly. Optometrists could play a very big role in getting people to seek help sooner.
People wait, on average, about seven years before they seek hearing help. That puts optometry practices in a unique position to raise awareness through hearing screening and getting people to seek help sooner
Have you seen an increase in demand for audiology services?
We know about the ageing population and what that means in terms of an increase in chronic conditions. Hearing is actually the fourth leading reason for years lived with disability. Hearing represents a very significant burden of disease both for the individual and for society.
In addition, we know there is a strong link between hearing and wellbeing and hearing and depression. If you have mild hearing loss and it goes untreated you have twice as much chance of having depression, if you have moderate loss it’s three times higher and if you have severe loss it’s five times higher. Hearing is also listed as the single highest modifiable risk factor for dementia.
I think that optometrists working hand in hand with audiologists are very well placed for developing a healthy ageing message – after all, hearing and vision are both public health issues.
Managing vision and hearing loss is linked with improved health, reduced rates of cognitive decline and depression. These are important findings and provide a compelling argument for managing hearing and vision jointly under one roof.