Let’s talk about lifetime care for CI: how can this be achieved?
Let’s talk about lifetime care
Robert Mandara: VP EURO-CIU, Web group of CIICA
In my eyes, the Consensus Guidelines on Adult Cochlear Implantation and the published paper resemble the taxi which transports you to the airport for your holiday. The taxi driver’s job is to get you safely to the airport, not to be interested in whether you will enjoy your trip of a lifetime. However, for you, your real journey and excitement starts at the airport. Today there is a great deal of focus on enabling future users to get implants, but little attention is paid to helping existing users fly on their long journeys post-implantation or post-taxi.
Everyone with cochlear implants needs lifetime care. Without it, CI users could potentially become more isolated and deaf than if they had not been implanted. Although babies implanted today may need over 100 years of care, this is not nearly as daunting, frightening or impossible as it first sounds. After all, CI users do not need direct minute-by-minute support, but require support at intervals of months or years.
CI users’ needs include:
- processors repaired and upgraded
- implants replaced when they fail
- regular hearing tests and maps to get the best results from the implants
- rehabilitation, especially after implant activation
In theory, it is easy to estimate the lifetime costs but ring-fencing funds to ensure that CI users really will be supported through their lifetimes is much more challenging. Unfortunately, governments and health-services rarely plan for even a few years ahead, never mind 100 years. As we have learned, even the best-laid plans can come undone depending on future governments, wars, pandemics, ideals or natural disasters. In my view, it is irresponsible to implant without also committing to providing lifetime care.
We should also realise that CI technology most probably has a lifetime of its own. If or when biological solutions succeed, CI as we know it may cease to be a treatment. At that point, someone will be the youngest CI user in the world – let’s call her Cilla. Who is going to provide lifetime care to Cilla, 100 years after the technology has become redundant and unprofitable? Without CI companies or CI expertise in clinics, Cilla’s future looks scary. For that reason, we need to prepare and plan ahead to keep Cilla connected.
Cochlear implant users of all ages need to be confident that their implants will function until the end of their lives. How will this be achieved?
2 June 2021