**9. Beneficiaries of self-directed care**

Considering the low update of hearing aids, the advent of self-directed care and self-fitting hearing aids has the potential to expand the market for services. Below are four underserved segments of the hearing care market that could benefit from

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*Audiology's Third Pillar: Comprehensive Follow-Up Care and Counseling for Those Who Choose…*

systematic follow-up care that is decoupled from the sale of devices. Audiologist can expect a growing number of these individuals coming to their clinic for guidance,

There are at least four types of individuals, currently underserved by hearing aids that are candidates for these alternative devices. Three of the four categories are commonly encountered in the clinic, while the fourth category are in great abundance, but rarely find their way to a clinic for reasons we will discuss later. **Table 1** is a summary of these four underserved patient categories. Here are some added

1.*The Older Old*. Prone to cognitive decline and physical limitations, this group, which also tends to be socially isolated, is susceptible to losing their hearing aids. Additionally, they are often unlikely have the physical or cognitive capacity to wear hearing aids consistently. Thus, many in this group become non-hearing aid users. Neckband multi-tasker PSAPs or other devices for situ-

2.*The Contemplator*. The Stages of Change model, which describes the behaviors and attitudes of people with chronic conditions over a period of time, suggests that individuals in the early contemplation stages are still working though the burdens their hearing loss places on daily life. Thus, they are not ready to act with respect to addressing their condition. Allowing a patient to dabble in a low-risk way from the comforts of home, has the potential to enable the contemplator to act sooner, on their own terms. In this scenario, the initial use of a non-custom product is a gateway product that culminates in the future with

3.*The Patient with Cochlear Distortion*. The cochlea, for a small number of individuals, fails to carry information to higher regions of the auditory system. Researchers have surmised that these cases can be identified by measuring word recognition at a low intensity level and comparing the results at a higher intensity. (A poor result on the Quick SIN also might be an indicator of this condition.) Unlike the typical performance-intensity function that shows improvement in word recognition ability as audibility of speech is increased, patients with cochlear distortion issues fail to show improvement in word recognition ability. Because the patient with cochlear distortion fails to experience the same improvement in speech understanding when audibility is restored with hearing aids, it is presumed non-custom devices might be a more costeffective choice for these cases, as a fully featured set of hearing aids could be

The three previously mentioned groups of patients are likely to seek the services

*Tech Savvy Overshoots*: There are many adults, often between the ages of 50 and 65, that experience occasional difficulty with their hearing, but do not think they have a problem that warrants a visit with an audiologist. Because they are younger,

of an audiologist for testing or guidance. The final category, because they often have normal or near-normal hearing aid and do not consider their hearing to be a "problem," are unlikely to seek help from an audiologist. Therefore, this group must

*DOI: http://dx.doi.org/10.5772/intechopen.88224*

**10. Four underserved patient categories**

details on each one.

full time hearing aid use.

considered technological overkill.

be reached in other ways.

support or service *after* hearing aids have been purchased.

ational use may be a viable alternative for this group.

systematic follow-up care that is decoupled from the sale of devices. Audiologist can expect a growing number of these individuals coming to their clinic for guidance, support or service *after* hearing aids have been purchased.
