Seeing MeGuidance on sight and hearing difficulties for staff who care for older people

This booklet offers information and advice about hearing and sight loss for those working with older people. It explains what dual sensory loss is and how it affects older people. It also describes how older people can be supported in residential care and in their own homes.

Increasing numbers of older people are developing hearing and vision problems. Some older people have significant hearing and vision difficulties – known as deafblindness.

Often this hearing and vision loss comes on very gradually. Older people themselves, and others around them, may not recognise or understand what is happening. If you work with older people then you probably work with people with a hearing and sight loss – you just might not realise it.

Combined hearing and sight loss can cause problems with communicating, getting around and accessing information. This can lead to difficulties with many everyday activities and mean that people feel lonely or isolated – even when living in a residential home.

But it doesn’t have to be like this. If the right services and opportunities are available, and the staff supporting them have the right skills and knowledge, older people with hearing and sight loss can continue to live as independently as possible. They will also be able to make choices about their care and the life they live.

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Living with a combined sight and hearing lossLiving with hearing and sight loss is challenging, especially for older people. Understanding the problems people face can help you to learn how best to support them.

What is deafblindness?In 1995, the Department of Health established a definition for deafblindness in the UK: ‘A person is regarded as deafblind if their combined sight and hearing impairment causes difficulties with communication, access to information and mobility. This includes people with a progressive sight and hearing loss.’

This definition makes it clear that deafblindness is characterised by its impact more than its cause. This means that you can identify possible sensory loss by observing its impact on the people you support. See Section 2 for information on signs to look for.

A combination of a visual and a hearing impairment will multiply the difficulties an individual faces. For example: If you have difficulty hearing what someone is saying, you watch their lips and facial expressions for extra clues. But if you also become blind or partially sighted, how will you understand what is being said?

If you don’t see well, you depend on your hearing when travelling to know what is happening around you. But if you become deaf or hard of hearing and can’t hear or see the traffic, how will you know when it’s safe to cross the road?

If you can no longer easily see or hear the television, listen to the radio, read your letters, use the phone or engage in conversation you become isolated from people, events and society. This sensory deprivation can lead to extreme levels of boredom, stress, depression and withdrawal.

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Dual sensory loss is not just a deaf person who cannot see or a blind person who cannot hear. The two impairments impact on each other and multiply the total effect.

One person describes it like this: “If you think of deafness as the colour yellow and blindness as the colour blue, when you mix the two together you don’t get yellow-blue but a completely different colour – green.”

How it affects older peopleDual sensory loss affects different people in different ways. When communication is limited, people become socially and emotionally isolated. When people can’t get around by themselves it affects their confidence, independence and daily living skills. Without access to information, people can’t make informed decisions and this leads to further loss of independence.

These are common experiences for older deafblind people with hearing and sight loss.

For professionals or family trying to support an individual, dual sensory loss can create challenges. If communication is difficult how do you find out what a person wants, explain their options or let them know what is happening? The boredom and frustration of their dual sensory loss can make people withdrawn or irritable.

Providing the right support and finding ways to communicate will make the experience better for everyone concerned.

Don’t miss an opportunity!

If we take the view that loss of sight and hearing are a normal, inevitable part of ageing, we will fail to provide excellent services for a significant number of people.

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How many older people are affected?Sense commissioned independent, expert research on the numbers of deafblind people in 2010. A Centre for Disability Research report found that the deafblind population has been significantly underestimated. 62% of the deafblind population is aged over 70 and the numbers will increase dramatically over the next 20 years as a result of the ageing population.

It’s estimated that by 2030, 418,000 people over the age of 70 will have significant combined visual impairment and hearing loss (Sense/CeDR, 2010)

The figures show how common dual sensory loss is among older people. There are also likely to be a higher percentage of older people with dual sensory loss receiving care.

You are probably already in contact with some older people with dual sensory loss, even if you haven’t already identified them.

Read on to find out how you can make your services accessible to them and promote independence and choice.

Case study

Mary moved into a residential home when she lost all her remaining sight after a brain operation. She’d been almost deaf since the age of 12 but with typical resourcefulness had led a full and rewarding life. She’d married, had two children, enjoyed working at a local shop and always enjoyed a lively social life.

Now the unthinkable had happened and she had been left completely deafblind. At first, her family and the staff in the home where she lived struggled to find a way to reach her. “We started to realise that Mum was changing,” said her son Jim. “She was becoming very disorientated and was increasingly withdrawing into her own mind.”

Fortunately Sense had known Mary for some time and were able to offer guidance and support. They provided a communicator guide, Nikki, for three hours each week funded by the local authority.

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She worked with Mary on a one-to-one basis helping her to develop a new form of communication by using cut-out wooden letters to spell words. Equally importantly, Nikki was able to train and support the other staff working with Mary in how to communicate with and support her.

This was enormously beneficial. “Mum became a lot sharper in herself and was much happier,” said Jim. “She didn’t talk to the voices in her head nearly as much and she really appreciated being able to talk to the other staff in the home.”

Working with older people with dual sensory lossIn this section we look at some of the simple, practical steps you can take to help you identify older people with hearing and sight loss, communicate effectively and provide appropriate support.

Indicators of hearing or vision lossThe following checklists will help you recognise some of the frequent indicators of hearing and vision loss. These are not complete lists; some people may exhibit none of these signs and you may observe others not listed.

A person with hearing difficulties may:

Complain that others mumble or speak too quickly Ask others to repeat what they’ve said Ask others to speak louder Repeat words to verify what’s been said Find it difficult to keep up conversations in noisy environments or

in a group Have difficulty understanding unfamiliar people or accents

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Appear confused because they try to respond but haven’t understood what was said

Get tired in conversations because of the need to concentrate Withdraw from situations where conversation is expected Need TV or radio volume louder than is comfortable for others Find it hard to hear on the telephone or doorbell Use a hearing aid or loop system.

A person with visual difficulties may:

Find it hard to identify objects or familiar faces Need more light for reading and other activities Find it hard to cope with glare, e.g. bright sunlight Sit unusually close to the TV Have unusual reading habits, e.g. holding a book close to the face Give up reading, watching television or other activities Be unable to locate small objects Spill food or knock over cups Stop eating because they can’t see their food Wear mismatched colours or have stained clothing Have difficulty moving around – walking slowly or with less

confidence Bump into things Have difficulties caused by changes in light levels Have difficulties with unfamiliar routes or places.

Problems caused by dual sensory lossa) Communication

Deteriorating hearing and vision can lead to problems in communication. Equipment such as hearing aids may help. When someone can no longer hear speech even with equipment, it has to be replaced by a visual method of communication.

When vision also deteriorates then communication has to become tactile, or ‘hands on’.

b) Mobility

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Moving around safely and confidently with limited hearing and vision is very difficult and is made even more so if there are additional mobility problems. Coping with constantly moving unpredictable ‘objects’, such as people, is a major undertaking.

c) Frustration

When you can’t communicate with people around you, can’t get from place to place and never know what’s going on around you, daily life is very frustrating and stressful. To make matters worse many people lack an effective means of communicating this frustration. This can lead to anger, depression, withdrawal or other behaviour which is out of character.

d) Boredom

If you can’t see the television, can’t hear the radio, can’t see to read a book or newspaper and can’t hold a conversation, how do you fill each day?

e) Isolation and loneliness

From family and friends. From social networks. From information. From opportunities or experiences – for example an impromptu walk in the park or a trip to the pub.

Just imagine a trip to the dining room:

“You don’t hear someone coming along behind you with hot plates, you don’t hear them say ‘excuse me’, you don’t see them pass you on the left and you don’t see the lady who is directly in front of you trying to get by. You know it’s dinner time because you can smell the food, but there seems to be something in the doorway of the dining room, and as the hallway is very dark you can’t work out what it is. Just as you are getting your bearings you’re knocked sideways from the left and collide with a body in front of you. Lots of hands reach out and take hold of you and propel you into a seat at the table. Distressed and confused you’re suddenly not hungry anymore.”

By offering the right support, you can help to make sure that people with dual sensory loss enjoy the same opportunities as everyone else.

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Communicating effectively face to faceOlder people with dual sensory loss often have problems with communication. If we use common sense, clear speech and courtesy we can help an older person to understand what is being said. Simple solutions can improve the environment dramatically.

Before you start:

Make sure you have the person’s attention Always tell a visually impaired person that you are there Ask the person what will make communication effective and do

that Make sure any equipment, including hearing aids, is switched on

and working.

Where to talk:

Between 3 - 6 feet apart at the same level Good lighting is important. Face the light so that your full face can

be seen Avoid background noise. Turn it off or move somewhere quieter.

Clear speech:

Speak clearly Speak a little more slowly than usual, but keep the natural rhythm

of speech Speak a little louder, but don’t shout as this will distort your voice

and lip patterns Try to make your lip patterns clear, but don’t over-exaggerate Keep your face visible. Don’t smoke, eat, chew gum or cover your

mouth with your hand Focus on the person you are talking to. If you are using an

interpreter, always talk directly to the deaf person, not the interpreter.

Help the other person to understand:

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Make the subject clear from the start and if you change the it, make sure the person knows

Use gestures and facial expressions to support what you are saying

If necessary, repeat phrases. If this doesn’t work, try re-phrasing the whole sentence. Some words are easier to lipread than others

Don’t hurry, take your time Be ready to write things down, using an A4 note pad with a black

marker pen Be aware that concentrating on communicating can be hard work

and cannot be maintained for long periods of time Be aware that if a person is smiling and nodding it doesn’t

necessarily mean they have understood you.

Other ways to communicateIf a person can no longer understand speech there are other ways to communicate. Some of these take time to learn. Learning a new communication method can be challenging. Don’t expect it to happen overnight and seek specialist help if needed.

Writing things down

Even if someone has limited vision they may still be able to read large clear letters in thick pen, maybe even with the help of a magnifier. Experiment with different sizes of lettering and different colours of paper and pen.

Block

For some people, drawing block letters on the palm of the hand is the easiest way to communicate. The block alphabet is shown on page 24. This is fairly easy to learn provided the person has sufficient sensitivity in their palm to distinguish the letters.

Deafblind manual

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This is another way to spell out letters onto the hand, shown on page 26. It is easy to pick up but much harder to learn to receive.

Case study

Barbara has been living in a residential home for two years. When she first moved in she got on well with staff and other residents and enjoyed taking part in activities. Although she was quite deaf, she could communicate well provided the person was facing her in a well lit room.

In the last few months she has become more withdrawn. New staff complain that she is difficult and bad tempered.

Staff ask for advice from a specialist in sensory loss who says that Barbara’s sight has deteriorated so that she is finding lipreading difficult. This is frustrating for her. They find that she can still see well enough to read large letters with the help of a magnifier. Staff begin to use an A4 pad and marker pen to communicate with her. She becomes less frustrated, and talks to staff and residents again.

Written information

It is important that information and correspondence is provided in an accessible format. For example, letters, care plans, information about activities, menus, etc. should be available in large print, braille, or audio as appropriate for the individual.

Many visually impaired people are able to read printed information if it is large and bold. No single size is suitable for everyone, but most people prefer their large print in the range of 16 to 22 point. Arial is an example of a clear font.

You can word process simple large print documents yourself.

This is 16 point bold

If a person requires information in braille, or audio formats, you can use any number of transcription services. If in doubt, contact your local sensory team or other specialist sensory agencies such as Sense, Deafblind UK or RNIB.

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Mobility and the environmentOne of the challenges for older people with sensory loss is finding a way to go where they choose, and move around safely. Simple changes to the environment, mobility training and guiding can make a big difference.

The environmentMoving from place to place when you have little or no sight and hearing is a frightening and stressful experience.

Sometimes even the most well-meaning gesture, such as ushering a person across a room that they are unfamiliar with, can be distressing. The ability of a person with hearing and sight loss to move around with or without support should be considered in the context of the wider environment. There are aspects of the environment that can be adapted to aid the individual’s feeling of confidence and improve the chances of independent mobility.

Lighting

Ensure good lighting. Strip lighting or low energy halogen bulbs cast no shadows and illuminate a whole area. Stairways in particular should be well lit. An 11 watt fluorescent task lamp provides a source of good personal lighting.

Noise

Avoid unnecessary background noise. The radio, a television or a vacuum cleaner all create an environment where it is difficult to identify specific sounds or understand speech. Background noise will also cause problems for people using hearing aids, which amplify everything, not just speech.

If the only place to meet people is a room where the TV is on all the time this will cause problems for anyone with a hearing impairment. Having the radio on while you work will make communication harder.

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Contrast

Door handles, door frames, light switches, placemats at meal times in contrasting colours can be useful aids to vision.

The edge of steps should be highlighted either by an edging strip in good strong contrasting colour or by hazard tape.

Ensure internal decor is suitable – no fussy confusing patterns with doorways painted in a blending colour. Instead, have plain or very simple patterned walls with doorways and skirtings picked out in a contrasting colour.

Staff should wear clothing which gives them a strong outline and contrast. No spots, stripes or flowery patterns. Plain un-patterned clothing in strong colours is best.

Dangers

Doors left half open can cause nasty injuries. Buckets, wastepaper bins, handbags, left where they will cause

someone to fall. Things like shelves which jut out from the wall at head height. Low items like coffee tables in the middle of the room. Steps that have no hand-rails or a hand-rail that finishes before the

last step.

OrientationOrientation is the ability to locate ourselves within our environment. Both within the home and outside there are a variety of clues which can help a person identify where they are and therefore move around independently.

Location clues

There are many naturally occurring clues that can provide useful information.

Inside the home one might consider a typical route from the bedroom to the bathroom – the table by the door, the door, the radiator, the corner outside the bathroom, etc. The positioning of furniture can be an

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important orientation clue. For example, chairs and other furniture can be used to divide a large room into a more easily understood smaller area. If furniture is used as a location clue then it is important that it is not moved around regularly.

Outside in the garden there may be different sorts of paving, a lawn, a gate, etc.

Sound can also be a useful location clue for a person who has some hearing. It may not be a good idea to have the radio on all of the time but if it is always located in the kitchen then that is a good guide to where that room is.

Smell: it may be a good idea to use the same pot-pourri in a bedroom and only in that bedroom.

Mobility

The aim should always be to enable the person to move around their environment, either inside or outside the home, as independently as possible.

There are a number of techniques that will help the person to feel confident. It is important to develop a trusting relationship between the person and the carer who is helping to develop mobility skills. Learning how to trail a route is an important step.

Pick a short route and encourage the person to hold one hand ahead while trailing the back of the other hand against a wall. Help them to explore the texture of the wallpaper and any other clues on the route. You might like to use a border strip of wallpaper or, for a more temporary learning period, a strip of Velcro.

More complicated routes can be broken down into easier stages. For example, a walk from the kitchen to the lounge.

Walk the entire route pointing out all of the clues along the way. Divide the route into stages. Support the person in learning the first stage of the route. When they can achieve that part independently, move on to the

subsequent stages.

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GuidingGet into the habit of using the correct technique of guiding.

Offer your arm for the person to hold and allow them to follow you. Don’t grab, push or pull a person – this can cause an accident and be very frightening for them.

Judge the speed the person feels safe walking. If someone has not been guided before they will probably want to go slowly. They may also have other physical problems, such as arthritis, which make walking difficult or painful.

Sudden changes of direction are best avoided. Let them hold the handrail on stairs and walk in front of them,

waiting at the top or bottom to guide them. When you are showing a person to a seat or chair, put their hand

on the arm or back of the chair and let them sit down. Don’t try to push them into the seat.

Case study

Janet is a care worker who supports people in their own homes. She visits Ethel once a week to help with cleaning and shopping. Normally Ethel is very friendly but recently Janet has noticed that Ethel is very confused and even a simple conversation is difficult.

She also notices that Ethel has begun to lose things, especially if she has moved something. She is concerned that the confusion is because Ethel doesn’t see and hear well, not because of dementia. Janet tells her manager that she thinks some specialist help is needed. When she is working, Janet also makes sure that she leaves things exactly where she found them, and that she uses good clear speech when talking to Ethel.

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Best practiceMany of the older people who live in care homes or receive care in their own homes have hearing and sight loss. Providing good quality care means identifying the people you support who have hearing and sight loss, and recognising their needs.

Identifying dual sensory lossIdentifying and responding to the needs of people with sensory loss has been recognised as good practice by NICE in their Mental Wellbeing of Older People in Care Homes Quality Standard and Homecare guidelines.

All care staff working with older people should know how to recognise indicators of sensory loss and understand how to respond appropriately.

Regulation and inspection

Addressing single and dual sensory impairment among the people who use your services will assist you in meeting all five of the key areas against which the CQC inspect. It is not possible to deliver a service that is safe, effective, caring or responsive if people’s sensory needs have not been met. Evidence of this will help demonstrate your service is well-led.

Safe

Good communication and mobility is essential in order to manage risk, while at the same time supporting people’s freedoms. Good communication is also crucial when supporting people to take their medication.

Effective

It is vital that staff have the skills and training to communicate with the people they support. Seeking consent to care and for treatment is not possible without good communication.

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Responsive

Supporting people to develop care plans that reflect their preferences requires excellent communication.

Caring

Good communication is essential to both positive, caring relationships, and to support people to take an active role in decision-making.

Well-led

Support and training for staff to identify and address sensory impairments will help you to demonstrate that your service provides high quality care and promotes a positive person centred culture. By encouraging staff to meet identified sensory needs you can demonstrate that you are encouraging innovation.

Example: After attending dual sensory awareness training, staff in a care home identified a number of residents with a visual impairment. They showed them writing in different sizes and recorded the size they preferred in their care plans. Subsequently, all written information was provided in the appropriate size. This simple, inexpensive change gave the residents greater choice and control.

Care homes for older peopleSocial contact and activities

Keeping active is vital to keeping healthy as we get older. One of the greatest challenges for older people with hearing and sight loss is to fill the time as reading, watching television and other activities may be difficult or impossible. However, it is possible to adapt activities, for example creating large print knitting patterns and audio books.

RNIB sells a number of tactile games, such as dominoes and playing cards, which can be played with sighted and hearing people too. Some museums, galleries and cathedrals offer ‘touch tours’ for people who cannot see exhibits.

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Don’t assume a person has to give up activities they once enjoyed. Look for ways to make them accessible, and ask for specialist help if necessary. Look for new activities that they may enjoy. There may be social clubs for people with sight or hearing loss.

Think about the social activities available to your residents or service users. Do they all assume the ability to hear in a noisy environment? Have you provided communication support such as a loop or communicator guide where appropriate?

Food, meals and mealtimes

For people with sight loss, eating can be difficult. Dining rooms can be noisy, making speech difficult to understand. If a person always sits in the same place this can make it easier for them.

Imagine being served white fish with mashed potato and cauliflower on a white plate if you can’t see well. Think about making the most of people’s remaining vision by serving attractive food on a contrasting plate and place mat in a well-lit environment.

If a person’s hearing and sight loss is severe, make sure they know the food is there and don’t take the plate away until you are sure they have eaten enough.

Specialist equipment

The people you support should have the specialist equipment they require to maximise their independence. For people with a dual sensory loss this will include a range of high and low tech equipment. Loop systems can help anyone who uses a hearing aid to hear speech or the TV. Magnifiers can help with reading. Tactile markers, vibrating alarm clocks, task lighting, the list is endless. A specialist assessment may be necessary to identify the best solutions.

Domiciliary careIf you provide domiciliary care to older people then you are almost certainly providing care to those with a hearing and sight loss. It is possible that this will not have already been identified by those arranging

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the care. For people with hearing and sight loss, having someone come into their home who they don’t know, moving things around and not explaining what they are doing is disturbing and potentially frightening.

Good practice

Ensure you can communicate with people with a hearing loss. The information on page 11 will be useful for communicating with deaf people as well as those with a hearing and sight loss.

Make sure that the person knows you are there, who you are and what you have come to do.

Make sure you work safely. Be careful about where you leave bags while you work.

A half open door can be a hazard. Leave every door as you found it.

Specialist servicesAnyone who meets the definition of deafblind (see page 5) is entitled to an assessment carried out by a person who has specific training in dual sensory loss, its impact, and how to address specific needs. This is true of both people in care homes and those in their own homes.

If you are supporting someone who has a dual sensory impairment and you think that they might not have had a specialist assessment, you may find that they are entitled to additional support. This may make providing high quality support to them easier. For example, a vibrating pager for the doorbell could make it quicker for staff to get into the home to provide the service.

This is a brief overview of the services that may be available for older people with a dual sensory loss. Many are available from social services for those who are eligible. Others can be purchased from suppliers or local voluntary agencies.

Specialist assessment and care planning – assessing the effects of hearing and vision difficulties and their impact on maintaining independence. This must be carried out by a person appropriately

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trained and qualified in the issues faced by people who are deafblind.

Advice, information and advocacy – accessing health and social services, welfare rights, national deafblind organisations, local agencies.

Equipment – assessment and provision of equipment to assist with everyday activities, e.g. easy-to-see amplified phones; large screen textphones; personal TV listeners; loop systems; tactile markers; vibrating pager systems for doorbell, telephone or smoke alarm alerting.

Mobility training – including advice on making the home safer to move around in or training in travelling outdoors independently and safely.

Communication – including support to develop appropriate communication skills for both the person themselves and family members or carers, and information about using interpreters.

Other skills training – including safety in the kitchen and home environment.

One-to-one support – e.g. communicator guide services. Communicator guides are people trained to help with communication and mobility to enable people’s involvement in everyday activities and relieve isolation. The tasks carried out will vary depending on the individual and their needs, but may include: attending appointments; escorting to the shops; reading correspondence; taking exercise; and leisure activities.

What to do when you’ve read this…For managers

1. Think about some of these questions: Do we recognise that combined hearing and vision loss interact to

create a separate and unique disability? Do we know of people who use our services who have a hearing

and sight loss? Could there be more that we haven’t recognised?

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Do our staff know how to communicate with a person with hearing and sight problems?

Should any of our staff have specialist training? Do we know when and where to refer on for specialist assessment

or support?

2. Download and print copies of the Sense checklist for all your staff at www.sense.org.uk/fillinthegaps. Ask them to identify anyone who may have a dual sensory loss.

3. Think about the service you provide for the people you support. Is there anything that needs to change?

4. Think about the training you provide for staff. Does it include information about dual sensory loss?

For staff

1. Look at the checklist on page 9. Think about the people you work with. Do any of them have a dual sensory loss? Should you tell anyone about this?

2. If you identify people with a dual sensory loss, do you need to change the way you work with them? Think about:

Communication Mobility Orientation Safety Access to information.

3. Talk to your manager about the content of this pack.

Case study

Piera came to England from Italy in 1948. She is 85 and wears two hearing aids, without which she is unable to hear at all. Sometimes her hearing loss means that she feels isolated and cut off.

Piera recently took part in Sense’s creative arts project, ‘Material Memories’, which was designed to encourage older people to express

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themselves through art, and increase their wellbeing. “In the group we each made something based on our life story,” she says. “I made pieces about my city Piacenza, where I grew up. I stitched a map of all the roads I used to walk along when I was a girl.”

Many older people can become isolated and lonely when their sight and hearing deteriorate. Without the right support and opportunities, their physical and mental health may decline, and remaining independent becomes a struggle. Arts and crafts activities and groups can prevent this from happening – giving people the chance to socialise, learn new skills and rebuild their confidence.

“As you get older, it’s nice to think of the things you did when you were younger,” says Piera. “I got the satisfaction of thinking, well, I’m still good at doing something. And I met people with the same problem as me, so we could understand one another.”

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ResourcesThere are a range of organisations, publications and resources which can help you improve services to older people with dual sensory loss.

Sense’s Information and Advice Service

Sense’s Information and Advice Service offers accurate, comprehensive and up-to-date impartial information and advice for deafblind people, their families, professionals working with deafblind people and anyone who has a general enquiry about Sense or any aspect of deafblindness. The service covers England, Wales and Northern Ireland.

Contact the Information and Advice Service:

Tel: 0300 330 9256 (voice and textphone)

Fax: 0300 330 9251

Useful organisationsSense, 101 Pentonville Road, London, N1 9LG

Tel: 0300 330 9256

(voice and textphone)

info@sense.org.uk

www.sense.org.uk

Deafblind UK

National Centre for Deafblindness, John and Lucille van Geest Place, Cygnet Road, Hampton, Peterborough, Cambridgeshire, PE7 8FD

Helpline tel/text: 0800 132 320

www.deafblind.org.uk

Action on Hearing Loss22

19-23 Featherstone Street, London, EC1Y 8SL

Telephone: 0808 808 0123

Textphone: 0808 808 9000

SMS: 0780 0000 360

informationline@hearingloss.org.uk

www.actiononhearingloss.org.uk

RNIB

105 Judd Street, London, WC1H 9NE

Tel: 0303 123 9999

helpline@rnib.org.uk

www.rnib.org.uk

Deafblind Awareness Training

Sense provides a range of deafblind awareness and skills training.

Visit: www.sense.org.uk/content/sense-training

References 23

Butler, S J (2004) Hearing and Sight Loss – A handbook for professional carers, Age Concern England

Hodges, L and Douglas, G (2005) Short Study on hearing and sight loss – Preliminary Report for The Thomas Pocklington Trust University of Birmingham

Robertson, J & Emerson, E Estimating the Number of People with Co-occurring Vision and Hearing Impairments in the UK CeDR Lancaster (2010)

Third European Conference of Deafblind International’s Acquired Deafblindness Network proceedings (1998) Elderly Deafblindness

Web based resourcesTo make information accessible – see RNIB’s ‘See it Right’ pack – available at www.rnib.org.uk

This booklet offers information and advice about hearing and sight loss for those working with older people. It explains what dual sensory loss is and how it affects older people. It also describes how older people can be supported in residential care and in their own homes.

Sense

101 Pentonville Road, London, N1 9LG

Tel: 0300 330 9256 (voice and textphone)

Fax: 0300 330 9251

Email: info@sense.org.uk

Website: www.sense.org.uk/fillinthegaps

Registered charity number 289868

Updated: October 2016

Design: www.fabrikbrands.com

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