Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

The aims of this thesis were to describe the experiences of persons with aphasia and their significant others of their conversations and use of communication strategies, examine current practice of family-oriented speech-language pathology (SLP) services, and test a family-oriented intervention in the early phase of rehabilitation. The persons with aphasia valued having conversations despite perceiving their aphasia as a serious social disability. They acknowledged the importance of the communication partners’ knowledge and understanding of aphasia and their use of supporting conversation strategies. Their own use of communication strategies varied considerably. The persons with aphasia longed to regain language ability and to be active participants in society. A majority of the significant others perceived their conversations with the person with aphasia as being less stimulating and enjoyable than conversations before stroke onset. Aphasia was considered a serious problem. The significant others took on increased communicative responsibility, where two thirds had changed their communicative behaviour to facilitate conversations. Type and severity of aphasia were especially related to the communicative experiences of the significant others and their motivation to be involved in SLP services. Thirty percent of the speech-language pathologists worked with people with aphasia and typically met with their families. They considered the involvement of significant others in SLP services as very important, especially in providing information about aphasia and communication partner training (CPT). However, involvement of significant others was restricted because of a time shortage and perceived limited skills and knowledge. In addition, there were national differences regarding aphasia rehabilitation services. The intervention consisted of three sessions directed to significant others (primarily emotional support and information) and three directed to the dyads (a person with aphasia and a significant other) (primarily CPT). All six participants (three dyads) felt that their knowledge and understanding of aphasia had increased and that their conversations had improved. These improvements were also evident to some extent with formal assessments. These results suggest the following: CPT should be an integral part of SLP services, national clinical guidelines are needed, and further education of speech-language pathologists and implementation of new knowledge into clinical practice requires consideration.

För att anhöriga och personer med afasi ska kunna etablera en fungerande vardag harkunskap om och förståelse för afasi visat sig viktig. I tidigare studier har anhöriga tillpersoner med afasi visat sig sakna relevant kunskap om och förståelse för afasi som debehöver för att etablera en fungerande vardag. Logopediska insatser som är riktadedirekt till anhöriga är relativt ovanliga i Sverige. Syftet med denna studie är att utifråndata från litteratur och intervjuer utforma frågor, så kallade item, som på ett tillförlitligtsätt kan mäta kunskap om och förståelse för afasi hos anhöriga till personer med afasi.Tre fokusgrupper bestående av anhöriga till personer med afasi, personer med afasi ochlogopeder användes för insamlande av intervjudata. Intervjudatan analyserades genomkvalitativ innehållsanalys. Från analysen framställdes sju kategorier med tillhörandeunderkategorier. Kategorierna låg till grund för utformningen av item. Sammanlagt har140 stycken item utformats. Dessa item var av två typer; item bestående av en 6-gradigLikert-skala och item av typen Multiple Choice. Vidare indelades item beroende påvilka svar som kan erhållas . Item med önskvärda svar( typ A) och situations- ochindividberoende item (typ B) som syftar till att ligga till grund för samtal mellananhörig till person med afasi och logoped.. De kategorier och item som studienresulterat i uppvisar samstämmighet med tidigare studier som fokuserat på anhöriga tillpersoner med afasi. Samstämmigheten tyder på att de item som inkluderas i ett framtidaformulär har möjlighet att kunna mäta av kunskap och förståelse hos anhöriga tillpersoner med afasi. För att framtagna item ska kunna resultera i det tilltänkta formuläretkrävs ytterligare validering, reliabilitetstestning och urval. / Previous studies have shown that significant others to persons with aphasia are in needof increased knowledge and understanding of aphasia. The knowledge andunderstanding for aphasia has shown to be crucial to significant others in terms ofpsychosocial well-being and to be able to establish a satisfying everyday life. PresentSpeech-language pathologist services in Sweden tend to have limited involvement ofsignificant others to persons with aphasia. This study aims to design a number ofquestions, items, which will be able to measure the knowledge and understanding ofaphasia for significant others of persons with aphasia. The items result from literaturestudies and semi-structured interviews with significant others to persons with aphasia,persons with aphasia and speech-language pathologists. Transcripts from interviews areanalyzed through content analysis. The study results in 140 items presented in sevencategories, each with a number of sub-categories. Two types of items are designed:items in the form of a 6-point Likert Scale and items in the form of Multiple Choice.The items are also divided depending on whether the answer is knowledgde-based (typeA) or to be used as material for discussion (type B). The categories and items from thisstudy are consistent with previous research. To transform the items into a completequestionnaire, further validation, testing of reliability and selection is needed.

No description available.

Syfte: Att undersöka vilket stöd närstående haft behov av från sjuksköterskor inom akutsjukvård och intensivvård vid anhörigs sjukdom och vilket stöd sjuksköterskor trodde att närstående hade behov av. Metod: Studien genomfördes som en litteraturöversikt. Artiklar söktes i databaserna PubMed och Cinahl. I studiens resultat ingick 13 artiklar med både kvalitativ(n=7) och kvantitativ(n=6) ansats som sammanställdes under olika teman. Resultat: Redovisades i fyra teman; CCFNI, Information, Delaktighet och Bemötande. Närstående och sjuksköterskor ansåg att de mest centrala behoven innefattade information, delaktighet och bemötande. Att få rak och ärlig information och att närstående var delaktiga samt att de blev bemötta med respekt och empati visade sig vara det viktigaste från både närstående och sjuksköterskors perspektiv. Slutsats: Vid anhörigs sjukdom behöver närstående stöd framför allt i form av information, bra bemötande och att få känna sig delaktiga i vården av den anhörige. Denna uppfattning delas av sjuksköterskor inom akutsjukvård och intensivvård. Som sjuksköterska bör man tänka på att ge rak och ärlig information, låta närstående vara delaktiga i den mån de själva vill samt att alltid ge så bra bemötande som möjligt.

Prevalence studies around the world show that men are the largest group at risk of becoming problem gamblers and that men gamble more than women. However, gambling research has long been gender blind. The gambling market is rapidly changing, with the Internet making gambling more accessible. Further, despite the well-documented presence of health, social and financial problems among the concerned significant others (CSOs) of someone close with gambling problems in clinical and help-seeking samples, there is little research investigating on this population. This thesis aims to examine the relation between gender and problem gambling among regular gamblers and CSOs, and to determine whether there was a convergence of men’s and women’s gambling behavior between 1997/98 and 2009/10 in Sweden. A further aim is to examine health problems associated with Internet gambling and CSOs. The data collections were taken from three different but linked gambling and health representative national population based studies in Sweden, all using the same methods: telephone interviews supplemented by questionnaires. The studies are as follows: 1) prevalence study 1997/98, age 15-74 years, n = 10,000, response rate 72% (n = 7,139) 2) prevalence study 2008/09, age 16-84 years, n = 15,000, response rate 63% (n = 8,165); and 3) incident study 2009/10, the 8,165 participants from the 2008/09 prevalence study were contacted again, response rate 74% (n = 6,021). Gambling was generally merged into domains based on the axis chance-strategy and public-domestic. The dichotomy of public and private spheres is relevant in since there is a link between the public sphere and notions of masculinity and a link between the private and femininity. Further, the literature suggests that men are attracted to gambling that involves features of strategy, whereas women generally prefer game of chance. Problem gambling was measured using SOGS-R and PGSI. Health variables included measures such as self-reported health, psychological stress, social support, alcohol consumption, and financial situation as a determinant of health. There were very few indications of a convergence between men’s and women’s gambling behavior. Men and women generally gambled in different domains. Men gambled more than women and dominated all domains except the domain of chance-domestic, a domain associated with less risk and Internet gambling. However, men and women who gambled regularly were just as likely to be problem gamblers. No gender differences were found in the score from separate PGSI analyses in the chance-public domain (games of chance in public spaces, such as gambling machines and bingo in halls). This domain was also the only domain associated with problem gambling for women who gambled regularly. Men and women were just as likely to report that they were CSOs and they constituted a large proportion of the Swedish population (18%). CSOs experienced a range of social, economic and health related problems including psychological stress, risky alcohol consumption, exposure to violence, and separations. For women who were CSOs, no relation with own problem gambling was found. This thesis suggests that the presence of gambling machines must be addressed to prevent problem gambling and that separate analyses for men and women are required to identify important differences between genders. The findings indicate that gambling domains produce and reinforce gender. Further, to be able to prevent problem gambling we require further knowledge about these gendered processes. However, it is also important to see the overall similarities between men and women to avoid reinforcing stereotypical images of gender which would have an negative impact on the preventive work. Male and female gamblers are both very heterogeneous categories where the specific gambling site, context and life circumstances must be acknowledged. Prevention, research and interventions should also target CSOs if a public health approach is applied because they require help and support in their own right. CSOs also play an important to the problem gambler. More qualitative research is required to understand gendered processes in gambling, as well as further research on interventions that go beyond the individual and address gambling and problem gambling at various levels. When addressing the harmful effects of gambling from a public health perspective, it is imperative to recognize the ethical principles of justice, autonomy, doing no harm and beneficence. / -

Bakgrund: Idag är alkohol- och drogmissbruk ett av våra största samhällsproblem. Ett missbruk är en sjukdom med överväldigande konsekvenser för missbrukaren men även dess närstående. Socialt stöd från närstående kan minska risken för återfall och gynna behandlingskontinuitet hos personer med missbruk eller beroendeproblem. Syfte: Att belysa hur sjuksköterskan involverar närstående i omvårdnaden av missbrukare. Design: Fyra semistrukturerade intervjuer med sjuksköterskor verksamma inom beroendevården utfördes för att belysa deras upplevelser av hur närstående involveras i vården av missbrukare. Resultat: Tre teman kunde utläsas varav ett av dessa fick tre underteman. Dessa var Hinder för involvering (underteman: Besöksförbud, Sekretess och Brist på resurser), Relationer och närstående och Fungerande involvering. Resultatet visade att involvering av närstående fungerade till viss del men att de flesta fynden fanns under temat Hinder för involvering. Samtidigt som viljan att involvera närstående fanns så begränsades sjuksköterskorna av olika hinder. Slutsats: Samtliga sjuksköterskor ansåg att närstående kan ha en viktig del i vården av missbrukare men fann det svårt att involvera dem så ofta som de önskade. De främsta anledningarna till detta var besöksförbudet på avdelningarna, sekretess och brist på resurser. Med bättre förutsättningar och tydligare rutiner på avdelningarna borde sjuksköterskorna på ett bättre sätt kunna involvera närstående i omvårdnaden av missbrukare. / Background: Today, alcohol and drug abuse is one of our biggest social problems. An addiction is a disease with overwhelming consequences for the addict but also its significant others. Social support from people important to the addict can reduce the risk of relapse and promote continuity of treatment in people with substance abuse and dependence problems. Purpose: To illustrate how the nurse involves significant others in the care of addicts. Design: Four semi-structured interviews with nurses working in addiction treatment was performed to illuminate their experience of how significant others are involved in the care of addicts. Results: Three themes could be seen and one of those had three sub-themes. These were Barriers to involvement (sub-themes: Restraining order, Secrecy and Lack of resources), Relationships and significant others and Functional involvement. The results showed that the involvement of significant others was functioning to a certain level but most of the findings could be found under the theme Barriers for involvement. While the desire to involve significant others were there the nurses where limited by various obstacles. Conclusion: All the nurses believed that significant others may have an important part in the care of addicts but found it difficult to involve them as often as they wished. The main reasons for this was the restraining orders of the department, secrecy and lack of resources. With better conditions and clearer routines of the department nurses should be better able to involve significant others in the care of addicts.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.