1. A Perspective on Ageing People with Sensory Disabilities Jeign Craig Vice President HIPEN

3. Hearing Loss Hearing loss affects more than 10 million people in the UK ( 1 in 6 of the population) The most common type of hearing loss is called ‘presbyacusis’ or ‘age-related hearing loss’. (70% of people aged over 70 more than 90% of people aged over 80 have a hearing loss. ) Many people living in sheltered housing, residential and nursing homes for older people will have a hearing loss. They may not have recognised it or sought help. It is vital that these people are supported to manage their hearing loss and minimise the impact on their quality of life.

4. Care Providers Staff in the care homes should be trained, so they can: 1 Intervene early in hearing loss. 2 Meet communication needs. 3 Improve hearing aid use and management.

5. Hearing loss Hearing loss is usually described in terms of severity: mild moderate severe profound mild hearing loss will mean some difficulty following speech, especially in noisy environments. They may wear hearing aids – if their hearing loss has been diagnosed – and find lipreading useful. They will nearly always use speech to communicate.

6. moderate hearing loss means the person will find it difficult to follow speech, especially in noisy environments. They will probably wear hearing aids and/or lipread severe hearing loss means the person may have difficulty following speech, even with hearing aids. They may lipread and/or use British Sign Language (BSL) and communication support

7. profound hearing loss means a person may use BSL as their first or preferred language. People who use BSL often consider themselves to be part of the Deaf community. 23,000 people in the UK are deafblind – they have a combined hearing and sight loss. Many people who are deafblind have some hearing and vision. Others will be totally deaf and/or totally blind.

8. The Impact of Hearing loss If people are not supported to manage their hearing loss effectively, it can lead to: communication difficulties social isolation anger and frustration low confidence, especially in social settings depression stress and anxiety. For many people with age-related hearing loss their life will lead to a life without active participation. Others may want help but may not be sure of what they can do.

9. Dementia Recent research has shown that there is a link between hearing loss and dementia. People with mild hearing loss have nearly twice the chance of developing dementia. The risk increases – three times for people with moderate hearing loss, and five times for people with severe hearing loss.

10. Hearing and sight loss As people get older, their sight, as well as their hearing, begins to worsen. People with a combined hearing and sight loss will find: Communicating effectively will be very challenging Problems with reading Problems getting around Problems carrying out simple tasks without help they may not answer questions appropriately – this can be misinterpreted as an early sign of dementia Older people with hearing and sight loss may easily become withdrawn and depressed. Their isolation may have a negative effect on their relationships with family and friends.

11. Communication - lipreading Find a suitable environment with good lighting, away from noise and distractions Sit or stand at the same level about 1m away from the lipreader Face the light, or your face will be in shadow Make sure the lipreader is looking at you before you speak Introduce the topic of conversation Speak clearly at a moderate pace, without raising your voice Use natural body language. Keep your face visible. Check that the lipreader is following you. Be patient and take time to communicate.

12. Communication – Write key words If you can’t make yourself understood, write down key words (not everything) and then continue the conversation. If the person has sight problems, use a thicker pen or a different colour pen or paper, and make your writing bigger. Work together to find out what will help the most. Don’t use CAPITAL LETTERS. It’s the written equivalent of shouting and doesn’t actually make things clearer.

13. Communication – body language Point to objects, pictures or people that you are talking about. Use facial expressions to show how you feel. Use objects to represent people, things or activities. Put the object in the person’s hand so they can feel or smell it. This is often a good method for communicating with deafblind people, or people with learning disabilities or dementia. [e.g. you could put a cup in their hand for “Would you like some tea?”]

14. Communication – professional support Sign language interpreters Lipspeakers Notetakers Speech-to-text reporters also (although mainly used in educational environments) Communication Support Workers Cued Speech Transliterators

15. Communication - the environment Flooring - carpet helps to absorb noise. Soft furnishings help to reduce sound reverberation and echo. Walls and curtains - busy or bold patterns on can be distracting. Good lighting - without any glare or shadows. Thick tablecloths reduce the noise of cutlery and crockery. Round dining tables - so everyone can see each other.

16. Recognising the signs of age-related hearing loss A person who is losing their hearing will: complain about others mumbling need to have things repeated several times complain that they cannot hear as well as they used to will not react to you struggle to hear on the telephone have the TV or radio very loud cannot follow conversation in noisy places. change in behaviour - be more withdrawn or stop taking part in conversation and activities.

17. Hearing aids Many people with hearing loss find hearing aids very helpful. It can take some time for people to adjust to their hearing aids and it’s important that they get support. Digital hearing aids (UK provide these free on NHS, they can also be bought privately.) Digital means that the audiologist can fine-tune them to match a person’s hearing loss and needs.

18. Behind-the-ear (BTE) hearing aid

19. In-the-ear (ITE) hearing aid

20. Body worn hearing aid

21. Managing a hearing aid Daily check to see if it is working Adjusting the settings Cleaning the earmould and tube Re-tubing Changing the batteries All of the above may be difficult for elderly people (using fine manual skills/ understanding)

22. Aids to hearing telephones fitted with a hearing loop or are specially designed for people with hearing loss textphones a hearing loop or infrared system for the TV, radio, music system flashing smoke alarms accessible entry systems (vibrating or flashing doorbell) good lighting in all areas TV with digital subtitles quiet environment (minimise background noise) seating arrangement that is helpful for communication

23. UK organisations Age UK www.ageuk.org.uk Action on Hearing Loss www.actiononhearlingloss.org.uk Association of Teachers of Lipreading to Adults (ATLA) www.lipreading.org.uk British Deaf Association (BDA) www.bda.org.uk British Tinnitus Association (BTA) www.tinnitus.org.uk Hearing Link www.hearinglink.org

24. Hearing Dogs for Deaf People www.hearing-dogs.org.uk Deafblind UK www.deafblind.org.uk National Association for Deafened People (NADP) www.nadp.org.uk Sign Health www.signhealth.org.uk Text Relay www.textrelay.org.uk RNIB www.rnib.org.uk Sense www.sense.org.uk Signature www.signature.org.uk

25. Key points – a summary Age of onset of deafness Type of deafness Other disabilities Communication needs Worsening sight, mobility etc Other health issues Varying situations – home, care home, hospital Achieving Independence – support needed

26. Give information of what is available to people suffering from hearing loss Give information of what is available to people caring for elderly people Give training to people who have a hearing loss Give training for people who are caring for elderly people with a hearing loss – ProDeafToolKit How can we help?