CI decision making and expectations by older adults.

To document and analyze the cochlear implant (CI) decision-making process of hearing-impaired older adults. The aim of this study is to assess what support could be helpful during this process in order to improve care delivery. 32 older adult CI recipients (≥ 60 years) with severe to profound sensorineural hearing loss were interviewed about their CI decision-making process 3-12 months after obtaining their first CI. Minimal information was provided to CI candidates by hearing aid acousticians or patient associations. High to very high expectations were reported by patients concerning issues beyond hearing improvement per se. Even though not all expectations were fulfilled by the CI, nearly all recipients who used an implant for at least six months would recommend a CI to others. We identified an opportunity for those professionals to play a greater role in supporting older CI candidates during the decision-making process. It is desirable to establish a comprehensive network of hearing care professionals to collaborate with CI clinics. In order to support older patients adequately in deciding about CI, intensive training should be offered to hearing care professionals in order to provide realistic expectations and reduce fear and uncertainty about the implantation process. These topics need to be communicated in a professional manner and adapted to the candidate's age and personality.