Beyond the cusp of cochlear implant sound processor obsolescence: what do cochlear implant users and their families think, feel, and do about their ageing sound processors?

Cochlear implants (CIs) provide essential auditory access for people who are deaf or hard-of-hearing. Over time, however, sound processors (SPs) become obsolete. For older adults, technological decline can influence communication, participation, and well-being. Understanding these impacts is important for informing clinical care and upgrade pathways. This qualitative sub-study (within a broader mixed-methods study) as part of a broader evaluation of clinical- and economic outcomes associated with upgrading obsolete processors, which captured the perspectives of CI users and their communication partners. Semi-structured interviews were conducted remotely, transcribed verbatim, and analysed using reflexive thematic analysis. Fifteen CI users and seven communication partners were recruited through purposive sampling. Themes described gradual challenges associated with ageing processors, including reduced reliability, emotional strain, and relational impacts. Following upgrade, participants reported greater communicative ease, renewed participation, and reduced family burden. Findings highlight the functional, psychosocial, and relational implications of SP obsolescence and underscore the importance of integrating lived experience into long-term CI care planning.