SEEING ME Guidance on sight and hearing difficulties for staff who care for older people Fill in the Gaps > 2 FILL IN THE GAPS >

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.

You may work with people with a hearing and sight loss, but not realise it

Increasing numbers of older people are Combined hearing and sight loss can cause developing hearing and vision problems. problems with communicating, getting around Some older people have significant hearing and accessing information. This can lead and vision difficulties – known as deafblindness. to difficulties with many everyday activities and mean that people feel lonely or isolated – Often this hearing and vision loss comes on even when living in a residential home. very gradually. Older people themselves, and others around them, may not recognise or But it doesn’t have to be like this. understand what is happening. If you work If the right services and opportunities are with older people then you probably work available, and the staff supporting them with people with a hearing and sight loss – have the right skills and knowledge, older you just might not realise it. 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. 2 CONTENTS 14 Mobility and the environment The environment 4 LIving with a combined Orientation SIGht and hearing loss Mobility What is deafblindness? Guiding How it affects older people H ow many older people are affected? 18 bEST Practice Identifying dual sensory loss 8 Working with older people Care homes for older people with a dual sensory loss Domiciliary care Indicators of hearing and vision loss Specialist services Problems caused by dual sensory loss Questions for managers Communicating effectively face to face Questions for frontline staff Other ways to communicate 24 Resources Useful organisations References The deafblind manual alphabet The block alphabet

3 LIVING WITH A COMBINED 1 SIGHT AND HEARING LOSS

Living 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.

4 WHAT IS DEAFBLINDNESS?

In 1995, the Department of Health hear or see the traffic, how will you know established a definition for deafblindness when it’s safe to cross the road? in the UK: ‘A person is regarded as deafblind if their combined sight and If you can no longer easily see or hear hearing impairment causes difficulties the television, listen to the radio, read with communication, access to your letters, use the phone or engage in information and mobility. This includes conversation you become isolated from people with a progressive sight and people, events and society. This sensory hearing loss.’ deprivation can lead to extreme levels of boredom, stress, depression and withdrawal. This definition makes it clear that deafblindness is characterised by its Dual sensory loss is not just a deaf person impact more than its cause. This means who cannot see or a blind person who that you can identify possible sensory loss cannot hear. The two impairments impact by observing its impact on the people you on each other and multiply the total effect. support. See Section 2 for information on One person describes it like this: signs to look for. “If you think of deafness as the colour A combination of a visual and a hearing yellow and blindness as the colour blue, impairment will multiply the difficulties an when you mix the two together you individual faces. For example: don’t get yellow-blue but a completely different colour – green.” If you have difficulty hearing what someone is saying, you watch their lips and facial expressions for extra clues. But if deaf you also become blind or partially sighted, how will you understand what is being said? deafblind

If you don’t see well, you depend on your hearing when travelling to know blind what is happening around you. But if you become deaf or hard of hearing and can’t

SUPPOSE YOU HAVE DIFFICULTY HEARING BUT THEN BECOME BLIND. HOW WOULD YOU COMMUNICATE?

5 How it affects older people Dual sensory loss affects different people For professionals or family trying to support in different ways. When communication an individual, dual sensory loss can create is limited, people become socially and challenges. If communication is difficult emotionally isolated. When people can’t how do you find out what a person get around by themselves it affects their wants, explain their options or let them confidence, independence and daily know what is happening? The boredom living skills. Without access to information, and frustration of their dual sensory loss people can’t make informed decisions and can make people withdrawn or irritable. this leads to further loss of independence. Providing the right support and finding These are common experiences for older ways to communicate will make the deafblind people with hearing and experience better for everyone concerned. sight loss.

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.

How many older people are affected? Sense commissioned independent, expert The figures show how common dual sensory research on the numbers of deafblind loss is among older people. There are also people in 2010. A Centre for Disability likely to be a higher percentage of older Research report found that the deafblind people with dual sensory loss receiving care. population has been significantly You are probably already in contact with underestimated. 62% of the deafblind some older people with dual sensory loss, population is aged over 70 and the even if you haven’t already identified them. numbers will increase dramatically over Read on to find out how you can make your the next 20 years as a result of the services accessible to them and promote ageing population. independence and choice.

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) 6 mary Mary moved into a residential home Fortunately Sense had known Mary when she lost all her remaining sight for some time and were able to offer after a brain operation. She’d been guidance and support. They provided a almost deaf since the age of 12 but with communicator guide, Nikki, for three hours typical resourcefulness had led a full and each week funded by the local authority. rewarding life. She’d married, had two She worked with Mary on a one-to-one children, enjoyed working at a local shop basis helping her to develop a new form of and always enjoyed a lively social life. communication by using cut-out wooden

letters to spell words. Equally importantly, Now the unthinkable had happened and Nikki was able to train and support the she had been left completely deafblind. other staff working with Mary in how to At first, her family and the staff in the communicate with and support her. home where she lived struggled to find a way to reach her. “We started to This was enormously beneficial. “Mum realise that Mum was changing,” said became a lot sharper in herself and was her son Jim. “She was becoming very much happier,” said Jim. “She didn’t talk to disorientated and was increasingly the voices in her head nearly as much and withdrawing into her own mind.” she really appreciated being able to talk to the other staff in the home.”

7 Working with older people 2 with dual sensory loss

In 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.

8 Working with older people with dual sensory loss

Indicators of hearing and vision loss

The 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: A person with visual difficulties may: Complain that others mumble or speak Find it hard to identify objects too quickly or familiar faces Ask others to repeat what they’ve said Need more light for reading Ask others to speak louder and other activities Repeat words to verify what’s been said Find it hard to cope with glare, Find it difficult to keep up conversations e.g. bright sunlight in noisy environments Sit unusually close to the TV or in a group Have unusual reading habits, Have difficulty understanding unfamiliar e.g. holding a book close to the face people or accents Give up reading, watching television or Appear confused because they try other activities to respond but haven’t understood what Be unable to locate small objects was said Spill food or knock over cups Get tired in conversations because Stop eating because they can’t see their of the need to concentrate food Withdraw from situations where Wear mismatched colours or have conversation is expected stained clothing Need TV or radio volume louder Have difficulty moving around – walking than is comfortable for others slowly or with less confidence Find it hard to hear on the telephone or Bump into things doorbell Have difficulties caused by changes Use a hearing aid or loop system. in light levels Have difficulties with unfamiliar routes or places.

Think about it. Do you recognise any of these signs in people you work with?

9 Problems caused by dual sensory loss a) Communication e) Isolation and loneliness Deteriorating hearing and vision can lead From family and friends. From social to problems in communication. Equipment networks. From information. From such as hearing aids may help. When opportunities or experiences – for example someone can no longer hear speech even an impromptu walk in the with equipment, it has to be replaced park or a trip to the pub. by a visual method of communication. When vision also deteriorates then Just imagine a trip to the dining room: communication has to become tactile, or ‘hands on’. “You don’t hear someone coming along behind you with hot plates, you don’t b) Mobility hear them say ‘excuse me’, you don’t Moving around safely and confidently with see them pass you on the left and limited hearing and vision is very difficult you don’t see the lady who is directly and is made even more so if there are in front of you trying to get by. You additional mobility problems. Coping with know it’s dinner time because you can constantly moving unpredictable ‘objects’, smell the food, but there seems to be such as people, is a major undertaking. something in the doorway of the dining room, and as the hallway is very dark c) Frustration you can’t work out what it is. Just as When you can’t communicate with people you are getting your bearings you’re around you, can’t get from place to place knocked sideways from the left and and never know what’s going on around collide with a body in front of you. you, daily life is very frustrating and stressful. Lots of hands reach out and take hold To make matters worse many people lack of you and propel you into a seat at an effective means of communicating the table. this frustration. This can lead to anger, depression, withdrawal or other behaviour Distressed and confused you’re which is out of character. suddenly not hungry anymore.” d) Boredom By offering the right support, you can If you can’t see the television, can’t help to make sure that people with dual hear the radio, can’t see to read a sensory loss enjoy the same opportunities book or newspaper and can’t hold as everyone else. a conversation, how do you fill each day?

10 COMMUNICATING EFFECTIVELY FACE TO FACE Older people with dual sensory loss Try to make your lip patterns clear, often have problems with communication. but don’t over-exaggerate If we use common sense, clear speech Keep your face visible. Don’t smoke, eat, and courtesy we can help an older person chew gum or cover your mouth with to understand what is being said. Simple your hand solutions can improve the environment Focus on the person you are talking to. dramatically. If you are using an interpreter, always talk directly to the deaf person, not the Before you start: interpreter. Make sure you have the person’s attention Help the other person to understand: Always tell a visually impaired person Make the subject clear from the start that you are there and if you change the it, make sure the Ask the person what will make person knows communication effective and do that Use gestures and facial expressions to Make sure any equipment, including support what you are saying hearing aids, is switched on and working. If necessary, repeat phrases. If this doesn’t work, try re-phrasing the whole Where to talk: sentence. Some words are easier to Between 3 – 6 feet apart at the lipread than others same level Don’t hurry, take your time Good lighting is important. Face the Be ready to write things down, using an light so that your full face can be seen A4 note pad with a black marker pen Avoid background noise. Turn it off Be aware that concentrating on or move somewhere quieter. communicating can be hard work and cannot be maintained for long periods Clear speech: of time Speak clearly Be aware that if a person is smiling and Speak a little more slowly than usual, but nodding it doesn’t necessarily mean keep the natural rhythm of speech they have understood you. Speak a little louder, but don’t shout as this will distort your voice and lip patterns

Simple solutions can dramatically improve someone’s life

11 Other ways to communicate If a person can no longer understand Block speech there are other ways to For some people, drawing block letters on communicate. Some of these take time the palm of the hand is the easiest way to learn. Learning a new communication to communicate. The block alphabet is method can be challenging. Don’t expect shown on page 24. This is fairly easy to it to happen overnight and seek specialist learn provided the person has sufficient help if needed. sensitivity in their palm to distinguish the letters. Writing things down Even if someone has limited vision they Deafblind manual may still be able to read large clear letters This is another way to spell out letters onto in thick pen, maybe even with the help of a the hand, shown on page 26. It is easy to magnifier. Experiment with different sizes pick up but much harder to learn to receive. of lettering and different colours of paper and pen.

Barbara

Barbara has been living in a residential Staff ask for advice from a specialist in home for two years. When she first sensory loss who says that Barbara’s sight moved in she got on well with staff and has deteriorated so that she is finding other residents and enjoyed taking part lipreading difficult. This is frustrating for in activities. Although she was quite her. They find that she can still see well deaf, she could communicate well enough to read large letters with the help provided the person was facing her in of a magnifier. Staff begin to use an A4 a well lit room. pad and marker pen to communicate with

her. She becomes less frustrated, and talks In the last few months she has become to staff and residents again. more withdrawn. New staff complain that she is difficult and bad tempered.

If a person can no longer understand speech there are other ways to communicate

12 Written information Arial is an example of a clear font. It is important that information and You can word process simple large print correspondence is provided in an documents yourself. accessible format. For example, letters, care plans, information about activities, This is 16 point bold menus, etc. should be available in large print, braille, or audio as appropriate for If a person requires information in braille, the individual. or audio formats, you can use any number of transcription services. Many visually impaired people are able to read printed information if it is large If in doubt, contact your local sensory team and bold. No single size is suitable for or other specialist sensory agencies such as everyone, but most people prefer their Sense, Deafblind UK or RNIB. large print in the range of 16 to 22 point.

13 mobility and 3 the environment

One 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.

Moving from place to place when you have little or no sight and hearing is very frightening

14 mobility and the environment

THE ENVIRONMENT

Moving from place to place when you Contrast have little or no sight and hearing is Door handles, door frames, light a frightening and stressful experience. switches, placemats at meal times in Sometimes even the most well meaning contrasting colours can be useful aids gesture, such as ushering a person across to vision. a room that they are unfamiliar with, can The edge of steps should be highlighted be distressing. either by an edging strip in good strong contrasting colour or by hazard tape. The ability of a person with hearing and Ensure internal decor is suitable – no sight loss to move around with or without fussy confusing patterns with doorways support should be considered in the painted in a blending colour. Instead, context of the wider environment. There have plain or very simple patterned are aspects of the environment that can walls with doorways and skirtings picked be adapted to aid the individual’s feeling out in a contrasting colour. of confidence and improve the chances Staff should wear clothing which gives of independent mobility. them a strong outline and contrast. No spots, stripes or flowery patterns. Plain Lighting un-patterned clothing in strong colours Ensure good lighting. Strip lighting or low is best. energy halogen bulbs cast no shadows and illuminate a whole area. Stairways in Dangers particular should be well lit. An 11 watt Doors left half open can cause fluorescent task lamp provides a source nasty injuries. of good personal lighting. Buckets, wastepaper bins, handbags, left where they will cause someone Noise to fall. Avoid unnecessary background noise. The Things like shelves which jut out radio, a television or a vacuum cleaner all from the wall at head height. create an environment where it is difficult Low items like coffee tables in the to identify specific sounds or understand middle of the room. speech. Background noise will also cause Steps that have no hand-rails or problems for people using hearing aids, a hand-rail that finishes before the which amplify everything, not just speech. last step. 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.

15 Orientation Orientation is the ability to locate ourselves used as a location clue then it within our environment. Both within the is important that it is not moved home and outside there are a variety of around regularly. clues which can help a person identify where they are and therefore move Outside in the garden there may around independently. be different sorts of paving, a lawn, a gate, etc. Location clues There are many naturally occurring clues Sound can also be a useful location clue that can provide useful information. for a person who has some hearing. It may not be a good idea to have the radio on all Inside the home one might consider of the time but if it is always located in the a typical route from the bedroom kitchen then that is a good guide to where to the bathroom – the table by the that room is. door, the door, the radiator, the corner outside the bathroom, etc. Smell: it may be a good idea to use the The positioning of furniture can be an same pot-pourri in a bedroom and only in important orientation clue. For example, that bedroom. chairs and other furniture can be used to divide a large room into a more easily understood smaller area. If furniture is

Mobility The aim should always be to enable the clues on the route. You might like to use person to move around their environment, a border strip of wallpaper or, for a more either inside or outside the home, as temporary learning period, independently as possible. a strip of Velcro.

There are a number of techniques that More complicated routes can be broken will help the person to feel confident. down into easier stages. For example, It is important to develop a trusting a walk from the kitchen to the lounge. relationship between the person and the Walk the entire route pointing out all carer who is helping to develop mobility of the clues along the way. skills. Learning how to trail a route is an Divide the route into stages. important step. Pick a short route and Support the person in learning the first encourage the person to hold one hand stage of the route. ahead while trailing the back of the other When they can achieve that part hand against a wall. Help them to explore independently, move onto the the texture of the wallpaper and any other subsequent stages.

16 Guiding

Get into the habit of using the correct Sudden changes of direction are technique of guiding. best avoided.

Offer your arm for the person to Let them hold the handrail on stairs hold and allow them to follow you. and walk in front of them, waiting at Don’t grab, push or pull a person – the top or bottom to guide them. this can cause an accident and be very frightening for them. When you are showing a person to a seat or chair, put their hand on the Judge the speed the person feels arm or back of the chair and let them safe walking. If someone has not been sit down. Don’t try to push them into guided before they will probably want the seat. to go slowly. They may also have other physical problems, such as arthritis, which make walking difficult or painful.

ethel Janet is a care worker who supports She is concerned that the confusion is people in their own homes. She visits because Ethel doesn’t see and hear well, Ethel once a week to help with cleaning not because of dementia. Janet tells her and shopping. Normally Ethel is very manager that she thinks some specialist friendly but recently Janet has noticed help is needed. When she is working, that Ethel is very confused and even Janet also makes sure that she leaves a simple conversation is difficult. things exactly where she found them, She also notices that Ethel has begun and that she uses good clear speech to lose things, especially if she has when talking to Ethel. moved something.

offer your arm for the person to hold onto and allow them to follow you

17 Best 4 practice

Many 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.

Don’t assume a person has to give up activities they once enjoyed

18 Best practice IDENTIFYING DUAL SENSORY LOSS

Identifying and responding to the needs Caring of people with sensory loss has been Good communication is essential to recognised as good practice by NICE in both positive, caring relationships, and their Mental Wellbeing of Older People to support people to take an active role in Care Homes Quality Standard and in decision-making. Homecare guidelines. All care staff working with older people should know how to Well-led recognise indicators of sensory loss and Support and training for staff to identify understand how to respond appropriately. and address sensory impairments will help you to demonstrate that your service Regulation and inspection provides high quality care and promotes Addressing single and dual sensory a positive person centred culture. By impairment among the people who use encouraging staff to meet identified your services will assist you in meeting all sensory needs you can demonstrate five of the key areas against which the CQC that you are encouraging innovation. inspect. It is not possible to deliver a service that is safe, effective, caring or responsive if Example: After attending dual sensory people’s sensory needs have not been met. awareness training, staff in a care home Evidence of this will help demonstrate your identified a number of residents with a service is well-led. visual impairment. They showed them writing in different sizes and recorded Safe the size they preferred in their care plans. Good communication and mobility is Subsequently, all written information essential in order to manage risk, while was provided in the appropriate size. at the same time supporting people’s This simple, inexpensive change gave the freedoms. Good communication is also residents greater choice and control. crucial when supporting people to take their medication. Care homes for older people

Effective Social contact and activities It is vital that staff have the skills and Keeping active is vital to keeping healthy training to communicate with the people as we get older. One of the greatest they support. Seeking consent to care challenges for older people with hearing and for treatment is not possible without and sight loss is to fill the time as reading, good communication. watching television and other activities may be difficult or impossible. However, it Responsive is possible to adapt activities, for example Supporting people to develop care plans creating large print knitting patterns and that reflect their preferences requires audio books. excellent communication.

19 RNIB sells a number of tactile games, such the specialist equipment they require to as dominoes and playing cards, which maximise their independence. For people can be played with sighted and hearing with a dual sensory loss this will include a people too. Some museums, galleries and range of high and low tech equipment. Loop cathedrals offer ‘touch tours’ for people systems can help anyone who uses a hearing who cannot see exhibits. aid to hear speech or the TV. Magnifiers can help with reading. Tactile markers, vibrating Don’t assume a person has to give up alarm clocks, task lighting, the list is endless. activities they once enjoyed. Look for A specialist assessment may be necessary to ways to make them accessible, and ask for identify the best solutions. specialist help if necessary. Look for new activities that they may enjoy. There may be social clubs for people with sight or Domiciliary care hearing loss. If you provide domiciliary care to older Think about the social activities available people then you are almost certainly to your residents or service users. Do providing care to those with a hearing they all assume the ability to hear in a and sight loss. It is possible that this will noisy environment? Have you provided not have already been identified by those communication support such as a loop arranging the care. For people with hearing or communicator guide where appropriate? and sight loss, having someone come into their home who they don’t know, moving Food, meals and mealtimes things around and not explaining what For people with sight loss, eating can be they are doing is disturbing and potentially difficult. Dining rooms can be noisy, making frightening. speech difficult to understand. If a person always sits in the same place this can make Good practice it easier for them. Ensure you can communicate with people with a hearing loss. The information on Imagine being served white fish with page 11 will be useful for communicating mashed potato and cauliflower on a white with deaf people as well as those with a plate if you can’t see well. Think about hearing and sight loss. making the most of people’s remaining vision by serving attractive food on a Make sure that the person knows you contrasting plate and place mat in a are there, who you are and what you have well-lit environment. come to do.

If a person’s hearing and sight loss is severe, Make sure you work safely. Be careful make sure they know the food is there and about where you leave bags while you work. don’t take the plate away until you are sure they have eaten enough. A half open door can be a hazard. Leave every door as you found it. Specialist equipment The people you support should have

20 Specialist services Anyone who meets the definition of Equipment – assessment and provision deafblind (see page 5) is entitled to an of equipment to assist with everyday assessment carried out by a person who activities, e.g. easy-to-see amplified has specific training in dual sensory loss, phones; large screen textphones; personal its impact, and how to address specific TV listeners; loop systems; tactile markers; needs. This is true of both people in care vibrating pager systems for doorbell, homes and those in their own homes. telephone or smoke alarm alerting. If you are supporting someone who has a dual sensory impairment and you think Mobility training – including advice that they might not have had a specialist on making the home safer to move assessment, you may find that they are around in or training in travelling outdoors entitled to additional support. This may independently and safely. make providing high quality support to them easier. For example, a vibrating Communication – including support to pager for the doorbell could make it develop appropriate communication skills quicker for staff to get into the home for both the person themselves and family to provide the service. members or carers, and information about using interpreters. This is a brief overview of the services that may be available for older people Other skills training – including safety with a dual sensory loss. Many are in the kitchen and home environment. available from social services for those who are eligible. Others can One-to-one support be purchased from suppliers or local – e.g. communicator guide services. voluntary agencies. Communicator guides are people trained to help with communication Specialist assessment and care and mobility to enable people’s planning – assessing the effects of involvement in everyday activities and hearing and vision difficulties and their relieve isolation. The tasks carried out will impact on maintaining independence. vary depending on the individual and This must be carried out by a person their needs, but may include: attending appropriately trained and qualified in the appointments; escorting to the shops; issues faced by people who are deafblind. reading correspondence; taking exercise; and leisure activities. Advice, information and advocacy – accessing health and social services, welfare rights, national deafblind organisations, local agencies.

21 What to do when you’ve read this…

For managers

1. Think about some of these questions: 2. Download and print copies of the Sense

checklist for all your staff at www.sense.org. Do we recognise that combined uk/fillinthegaps. Ask them to identify anyone hearing and vision loss interact to create who may have a dual sensory loss. a separate and unique disability?

3. Think about the service you provide for Do we know of people who use our the people you support. Is there anything services who have a hearing and sight that needs to change? loss? Could there be more that we haven’t recognised? 4. Think about the training you provide for

staff. Does it include information about Do our staff know how to dual sensory loss? 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?

FOR STAFF

1. Look at the checklist on page 9. 2. If you identify people with a dual Think about the people you work sensory loss, do you need to change the with. Do any of them have a dual way you work with them? Think about: sensory loss? Should you tell anyone Communication about this? Mobility Orientation Safety Access to information.

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

22 PIERA Piera came to England from Italy in 1948. Many older people can become isolated She is 85 and wears two hearing aids, and lonely when their sight and hearing without which she is unable to hear at all. deteriorate. Without the right support Sometimes her hearing loss means that and opportunities, their physical she feels isolated and cut off. and mental health may decline, and remaining independent becomes a Piera recently took part in Sense’s struggle. Arts and crafts activities and creative arts project, ‘Material Memories’, groups can prevent this from happening which was designed to encourage older – giving people the chance to socialise, people to express themselves through learn new skills and rebuild their art, and increase their wellbeing. “In the confidence. group we each made something based on our life story,” she says. “I made pieces “As you get older, it’s nice to think of the about my city Piacenza, where I grew up. things you did when you were younger,” I stitched a map of all the roads I used to says Piera. “I got the satisfaction of walk along when I was a girl.” 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.”

23 5 Resources

There 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

24 Resources

Useful organisations:

Sense Action on Hearing Loss 101 Pentonville Road 19-23 Featherstone Street London N1 9LG London EC1Y 8SL Tel: 0300 330 9256 Telephone: 0808 808 0123 (voice and textphone) Textphone: 0808 808 9000 [email protected] SMS: 0780 0000 360 www.sense.org.uk [email protected] www.actiononhearingloss.org.uk Deafblind UK National Centre for Deafblindness RNIB John and Lucille van Geest Place 105 Judd Street Cygnet Road London WC1H 9NE Hampton, Peterborough Tel: 0303 123 9999 Cambridgeshire PE7 8FD [email protected] Helpline tel/text: 0800 132 320 www.rnib.org.uk www.deafblind.org.uk Deafblind Awareness Training Sense provides a range of deafblind awareness and skills training. Visit: www.sense.org.uk/content/sense-training

References:

Butler, S J (2004) Hearing and Sight Third European Conference of Deafblind Loss – A handbook for professional International’s Acquired Deafblindness carers, Age Concern England Network proceedings (1998) Elderly Deafblindness Hodges, L and Douglas, G (2005) Short Study on hearing and sight Web based resources: loss – Preliminary Report for The To make information accessible – Thomas Pocklington Trust see RNIB’s ‘See it Right’ pack – available University of Birmingham at www.rnib.org.uk Sense website www.sense.org.uk Robertson, J & Emerson, E Estimating the Number of People with Co-occurring Vision and Hearing Impairments in the UK CeDR Lancaster (2010)

25 Deafblind manual alphabet

A B C D E

F G H I J

K L M N O

P Q R T

U V W X Y

Z

26

Block manual alphabet

Sense, for people with deafblindness and associated disabilities

27 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: [email protected] Website: www.sense.org.uk/fillinthegaps

Registered charity number 289868 Updated: October 2016 Design: www.fabrikbrands.com

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