Fill in the Gaps > Too many older people who are deafblind ... - Sense

Too many older peoplewho are deafblindmiss out on thesupport they needA toolkit for professionals workingwith older deafblind peopleFill in the Gaps >

This booklet offers information and advice for thoseworking with older deafblind people. It explains whatdeafblindness is and how it affects people. It sets out thelegal responsibilities that social services have and explainshow deafblind people can be supported and helped.Increasing numbers of older people are developing hearing and visionproblems. Some older people have substantial hearing and vision difficulties– known as deafblindness.Often this hearing and vision loss comes on very gradually. Older peoplethemselves, and others around them, may not recognise or understandwhat is happening.Because of this combined hearing and vision loss, they may have problemswith communicating, getting around and accessing information. This cancause difficulties with many everyday activities and can make them feelexcluded from society.But it doesn’t have to be like this. If the right services and opportunities areavailable, older deafblind people can live independently and make choicesabout how they wish to live. If appropriate services are provided at the righttime, the need for greater health and social care provision at a later stagecan be reduced.Local authorities have statutory responsibilities towards older people withcombined hearing and vision loss – arising from the guidance ‘Social Carefor Deafblind Children and Adults’ LAC(DH) (2009)6.They are required to provide specialist assessments, appropriate informationand services designed to meet the needs of deafblind people. We will referto the Deafblind Guidance throughout this booklet.In many cases, older deafblind people are seen by a social work team forolder people – rather than a team which specialises in sensory impairment.This booklet explains how you can help to make sure that older deafblindpeople get the support they are entitled to.3

Fill in the Gaps >1 > Deafblindness and older people3 What is deafblindness?3 How it affects older people4 Talking about sensory loss5 How many older people are affected?12 > Legal requirements7 What does the Deafblind Guidance say?8 The Single Assessment Process10 Fair Access to Care Services11 Recognising deafblindness13 The National Service Framework23 > Working with older deafblind people15 How can your team work effectively witholder deafblind people?16 Indicators of hearing and vision loss17 Communicating effectively – face to face18 Communicating effectively – at a distance21 Checklist34 > Resources23 Useful organisations24 References24 Web based resources41

1 > Deafblindness and older peopleThe term ‘deafblind’ describes people of all ages who have acombined hearing and vision impairment. These individuals maybe deaf or hard of hearing as well as blind or partially sighted.They do not have to be completely deaf and blind. In fact, mostdeafblind people have some useful hearing or vision.Deafblindness is aunique disabilityunique2

deafdeafblindblindWhat is deafblindness?Definitions of deafblindness tend not to focus on the degree ofdeafness or blindness a person has, but rather on the effect ofthe combined loss on everyday life – how it affects their ability tocommunicate, to get around and to access all kinds of information.Deafblindness is not just a deaf person who cannot see or a blindperson who cannot hear. The two impairments impact on eachother and multiply the total effect.One deafblind person describes it like this:“If you think of deafness as the colour yellow and blindnessas the colour blue, when you mix the two together you don’tget yellow-blue but a completely different colour – green.”How it affects older peopleDeafblindness affects different people in different ways. Whencommunication is limited, people become socially and emotionallyisolated. When people can’t get around by themselves it affectstheir confidence, independence and daily living skills. Withoutaccess to information, people can’t make informed decisions andthis leads to further loss of independence. These are commonexperiences for older deafblind people.Older People’s social work teams can do a great deal to help olderdeafblind people. See page 15 for information on how to makethis happen.A combination ofvisual and hearingimpairment willmultiply the difficultiesan individual faces.For example…• If you are deaf or hard ofhearing and can’t hear whatsomeone is saying, youwatch their lips and facialexpressions for extra clues.But if you also become blindor partially sighted, howwill you understand what isbeing said?• If you are a blind orpartially sighted personwho is used to travellingindependently, you dependon your hearing. But if youbecome deaf or hard ofhearing and can’t hear orsee the traffic, how will youknow when it’s safe to crossthe road?• If you can no longereasily see or hear thetelevision, listen tothe radio, read yourletters, use the phone orengage in conversationyou become isolatedfrom people, eventsand society. Thissensory deprivationcan lead to extremelevels of boredom,stress, depression andwithdrawal.3

1 > Deafblindness and older peopleDon’t miss anopportunityIf we take the view thatloss of sight and hearingare a normal, acceptablepart of ageing, we missthe opportunity to helppeople make best useof their remaining visionand hearing.Talking about sensory lossMany older people with a hearing and vision loss don’t think ofthemselves as deafblind. They may think that sensory loss is just one moreeffect of old age along with mobility problems, memory loss, illness ordepression – and it often is.But that doesn’t mean we can’t do anything about it. Their hearing andvision loss may have crept up on them slowly so they only gradually realisethat something is wrong. They may see some things, but not others. Theymay hear in some situations, but not others. They may use phrases suchas: “I don’t hear too well” or “I’m having problems with my eyes”. Andyet the everyday difficulties they describe are not just to do with ageingbut are the typical effects of deafblindness.Professionals are likely to use terms such as deafblind or dual sensory loss.The Deafblind Guidance uses these interchangeably to acknowledge thatthe combined loss of hearing and vision is significant for anyone, even ifhe or she still has some useful hearing and vision.Even if a person doesn’tuse the term deafblindabout themselves, we needto recognise the effects ofdeafblindness and offersupport and services to meetthose needs. Be aware ofthe language a person usesabout themselves and adaptyour own to reflect whatthey are comfortable with.4

How many older people are affected?Sense commissioned independent, expert research on the numbersof deafblind people in 2010. The Centre for Disability Researchreport found that the deafblind population has been significantlyunderestimated. 62% of the deafblind population is aged over70 and the numbers will increase dramatically over the next20 years as a result of the ageing population.• 356,000 deafblind people in the UK• Of which,• 220,000 people over the age of 70 have significantcombined visual impairment and hearing lossFuture explosion in numbers by 2030• 569,000 deafblind people in the UK, a 60% increase• Of which,• 418,000 will be people over the age of 70 have significantcombined visual impairment and hearing loss(Sense/CeDR, 2010)• Older people with vision and hearing loss from minoritycommunities are poorly represented in statistics but it is likelythat the incidence is similar to that of white British communities.These figures show how common dual sensory loss is amongolder people. You are probably already in contact with some olderpeople with dual sensory loss. Read on to find out how you canmake your services accessible to them and promote independenceand choice.You are probably alreadyin contact with someolder people with dualsensory loss5

What does the Deafblind Guidance say?The statutory guidance, ‘Social Care for Deafblind Children andAdults’ LAC(DH) (2009)6, provides a framework for all socialservices. It outlines the rights of deafblind people and the dutiesplaced on local authorities. Local authorities are asked to takethe following action:• identify, make contact with, and keep a record of deafblindpeople in their catchment area – including those who havemultiple disabilities that include dual sensory impairment;• ensure that when an assessment is requested or required,it is carried out by a specifically trained person/team, equippedto assess the needs of a deafblind person – in particular toassess the need for one-to-one human support, assistivetechnology and rehabilitation;• ensure that appropriate services are provided todeafblind people – who are not necessarily able to benefit frommainstream services or those services aimed primarily at blindpeople or deaf people who are able to rely on their other senses;• to provide or commission specifically trained one-to-onesupport workers for people assessed as requiring one;• provide information about services in formats, and usingmethods, that are accessible to deafblind people;• ensure that one member of senior managementincludes overall responsibility for deafblind services within hisor her responsibilities.The guidance and itsduties are mandatory.Authorities that failto comply could bechallenged throughjudicial review.7

2 > Legal requirementsHow the Deafblind Guidance fits with:A) The Single Assessment ProcessThe Department of Health states that the purpose of the SingleAssessment Process (SAP) is to make sure that all older peoplereceive appropriate, effective and timely responses to their healthand social care needs. A key value of SAP is to make sure thatindividuals are at the heart of assessment and care planning. Theolder deafblind person’s account of their needs and their viewsand wishes should be kept at the centre of the process.The aim is that information about a person’s needs should onlybe given once, although the assessment, care planning and servicedelivery may involve a number of professionals and agencies.The assessment systems include the following broad types:• contact assessment• overview assessment, and• specialist assessment.To make sure that older deafblind people are properly included,it is important that their specific needs are recognised in thegeneric contact or overview assessments. If vital information aboutthe impact of deafblindness is missed at this stage, referral forspecialist assessment may not happen and the assessment will beincomplete and care planning inadequate.The Deafblind Guidancestates that assessment of adeafblind person should becarried out by a specificallytrained person or team sothat their particular needscan be explored in detail.This has the potential towork effectively withinSAP but requires genericassessors to be able torecognise deafblindnessand its effects and refer onappropriately.How to use SAP with older deafblind peopleThink dual sensory!• Every time you are assessing an older person, ask yourself whether theirneeds could be related to deafblindness.• Make sure you are trained to recognise deafblindness and its effects. At aminimum, everyone carrying out a contact or overview assessment shouldhave the Fill in the Gaps checklist for assessing older deafblind people.• Make sure you use good communication tactics which are useful with allolder people. (For information on communication tactics, see page 17).Make the link• As soon as an assessment identifies that there may be a dual sensoryloss, arrange a specialist assessment via the sensory team or otherspecialist agency such as Sense or Deafblind UK. Assessment and skillstraining by a specialist worker can lead to increased independence andenhanced quality of life.• Develop effective links with the sensory specialists in your localauthority and other specialist agencies.• Take training to develop your own skills in identifying the potentialindependent living skills of an older deafblind person.8

Information• Make sure you have good information about both national andlocal services.• Make sure information, letters and care plans are in accessibleformats (e.g. large print, Braille, tape or disk). For informationabout transcription services, see the Resources section. If yourSAP systems don’t record this information talk to your SAPco-ordinator about adding this.Communication needs• Be aware that some people may need a human aid withthem during assessment – an interpreter, communicator-guideor advocate.• Managers need to be aware of the cost and time implications.Extra time may be required to arrange interpreters. With orwithout interpreters, the assessment itself is likely to takeextra time because of the specific communication needs of adeafblind individual.The effort of concentrating on communicating for a prolongedperiod can be exhausting and may require more than one visit.For older deafblind people to be at the heart of assessment,managers must ensure there is some flexibility in meeting targets.Case Study: George, 73George is 73and visuallyimpaired withlittle usefulcentral vision.He is alsoseverely deaf, relying on twohearing aids to amplify speechand other environmentalsounds. But he struggles tofollow speech even in a quietenvironment.George and his wife hada supportive relationship andmanaged life well withoutsupport. However he appearsto have become depressedsince his wife’s death.His GP requests an assessmentbecause she is concernedabout his ability to cope on hisown. The overview assessmentis carried out and because theassessor has some awarenessof the particular difficultiescaused by combined hearingand vision loss, she is ableto focus some questionsspecifically on these issues.She realises that a specialistassessment is necessary andmakes the appropriate referral.Specialist assessmentidentifies key areas of provisionwhich promote independenceand choice for George.These include:• a vibrating pager systemto alert George to callers atthe door• a loop system to providesome access to the TV• skills training around safetyin the kitchen and homeenvironment• mobility training whichgives him the confidenceto go out alone in the localarea, and• weekly attendanceat a group for visuallyimpaired people where hiscommunication needs arecatered for.9

2 > Legal requirementsB) EligibilityThe eligibility framework for socialcare is set out in Department of Healthguidance Prioritising Need in theContext of Putting People First. Thisguidance and the Deafblind Guidanceare of equal status under the law.Both are statutory guidance issuedunder Section 7 of the Local AuthoritySocial Services Act 1970. Together theypromote better access, assessmentand services for deafblind adults .When a decision is being made about who is eligible for social care services,it’s important to recognise the effect of dual sensory loss on the following keyfactors in maintaining independence:• autonomy and freedom to make choices• health and safety, including freedom from harm, abuse and neglect• personal and daily living activities• involvement in family and wider community life.The risks relating to each of these factors are considered equal. So risksrelating to health and safety are not considered more important than risksrelating to involvement. Older people with a dual sensory loss can experiencerisk in each of these areas and they may be at particular risk in relation toautonomy and involvement.Case Study: Jim, 82A woman reports that her82 year old father who isdeaf seemsto havebecomedepressed.Jim doesn’t seem to wantto communicate with hisfamily and isn’t eating themeals provided by socialservices. He has also lostinterest in his jigsaw puzzles,favourite films and regularpints at the pub nearby. Heseems to be withdrawing intohis own world. What will theassessment uncover?Because Jim is still managingto carry out his own personalcare and is supported with dailyliving tasks by his daughterwho visits twice a week, ageneric overview assessmentconcludes that the risks to hisindependence are moderate(and outside the bandingthat would make him eligiblefor services in many localauthorities).If a deafblind person is screened out at this initial stage, this will notmeet the requirements of the Deafblind Guidance. This states that allassessments of deafblind people (including eligibility assessments) shouldbe carried out by someone specifically trained to do so. This is an importantmessage of the Guidance.10

More about Jim, 82A specialistassessmentdiscovers thathis sight isdeterioratingand is affectinghis ability to lipread people,access leisure activities inthe home, and get out in thelocal area. His autonomy andinvolvement are substantiallythreatened and he is eligiblefor services.Simple services will make adifference: communication tipsfor both him and his familycan improve his involvementin conversation; task lightingcan help him see his meal andfeel more like eating it; simplemobility training means he canget back out to the local pub.An assessor with specialist understanding of the needs of olderdeafblind people will emphasise the effects of hearing and visiondifficulties as well as assessing the effects of ageing, vulnerabilityor other disabling conditions. Specific support to promoteindependence in relation to deafblindness can include:• simple communication strategies• equipment• help to find new ways of carrying out daily tasks• mobility training, or• one-to-one support.Recognising deafblindnessAs the team most likely to come into contact with older peoplewith dual sensory loss, it’s important to make sure that all staff aretrained to recognise deafblindness and its effect on independence(see Resources section for information about training – page 23).Learn to recognise the disability and how people can be supported– rather than accepting it as simply part of the ageing processwhich can’t be helped. Why not develop a ‘champion’ for sensoryissues within your team?The eligibility guidancealso requires assessmentsto take account of needswhich could increase.Local authorities shouldnot wait until the needreaches a higher bandbefore providing a service.11

2 > Legal requirementsCase Study: Hyacinth, 79A 79 year oldBUS STOP blind womanwho usesa hearingaid to support herdeteriorating hearinglives independently andcopes well at home ina familiar environment.However outside the homeshe is experiencing increasingdifficulty.She can no longer get thebus to the shops as she can’tsee the bus numbers andrelies on other people to tellher which bus has arrived.Because of the backgroundnoise of traffic, she can’thear what people are sayingand has felt confused andunable to travel. As well asshopping for food, her weeklytrip is a vital link to the ethniccommunity where she isknown. Because of this she isreluctant to use a shoppingservice.If a one-to-onecommunicator-guide isprovided at this stage itwill ensure her continuedinvolvement, enable herto make independentchoices and prevent furtherdeterioration. Without this,Hyacinth is at risk of losingskills and requiring higherlevels of care, includingthe possibility of needingresidential care.12

C) PersonalisationIt is important to ensure thatpersonalisation is carried out in a waywhich delivers appropriate services todeafblind older people. There are somekey points to note when implementinga personalised approach to support forolder deafblind people. The underlyinglaw on social care has not changed solocal authority duties remain the sameand the requirements of the deafblindguidance still apply.• Assessment – Anyone who appears to be in need of acommunity care service is entitled to an assessment. Wherethat person is deafblind they are entitled to an assessmentcarried out by someone who is specifically trained to assess adeafblind person. Asking a person to complete a self-assessmentquestionnaire will not be sufficient to meet this duty.• Direct payments – Everyone has the option to receivea direct payment in place of a service. Many older deafblindpeople do not wish to take up a direct payment, often becauseof the paperwork and responsibility of managing a budget.Sense has information that will help councils ensure their directpayments support services can meet the needs of deafblindpeople. However good the support services, there will be anumber of people who choose not to take up this option andthey must be provided with an appropriate service.• Service provision – Deafblind people have a rightto a service which meets their needs as a deafblind person.A communicator guide, for instance, will usually be moreexpensive per hour than a personal assistant because of theskills and training required. Deafblind people assessed asneeding such a service must be able to receive one. Wherethey have a personal budget, this must be sufficient to meetthese specialist needs.Putting Everyone First, aguide to personalisationfor all groups is availablefrom Sense atwww.sense.org.uk/help_and_advice/social_services/putting_everyone_first• Resource allocation – Resource Allocation Systems(RAS) often fail to take account of deafblind people’s needs.The personal budget will often have to be higher than theindicative budget generated by the RAS to take account of this.A group of organisations have produced Putting Everyone First,a guide to the issues that must be taken into account to makepersonalisation work for everyone.13

3 > Working with older deafblind peopleIn this section we will look at some of the simple, practicalsteps you can take to help you to identify older deafblindpeople, communicate effectively and provide informationin accessible formats.Understandingthe needs of olderdeafblind14

How can your team work effectively witholder deafblind people?As we have seen, older people who can’t see or hear fullywhat is going on around them may find the physical andsocial environment confusing or even hostile. The effortand skills required to go out or engage in social activitycan be very tiring and may lead to increasing withdrawaland isolation.There is also an emotional reaction to dual sensory loss.People are cut off from the world around them as theyused to experience it and this can lead to feelings of loss,frustration, anger and grief.In this section we will look at some of the simple, practicaladjustments that will help you to identify older deafblindpeople, communicate effectively and provide information inaccessible formats.An older deafblind person is likely to needhelp in the following areas:• Communication• Information – includingpublic information• Mobility and transport• Stimulation and relieffrom isolation• Emotional supportand counselling• Equipment• Housing15

3 > Working with older deafblind peopleThe followingchecklists will helpyou recognise some ofthe frequent indicatorsof hearing and visionloss. These are notcomplete lists; somepeople may exhibitnone of these signsand you may observeothers not listed.Finds it hard tofollow speechIndicators of hearing and vision lossA 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 noisyenvironments or in a group• Have difficulty understanding unfamiliar people or accents• Get tired in conversations because of the need toconcentrate• Withdraw from situations where conversation is expected• Need TV or radio volume louder than is comfortable forothers• Find it hard to hear on the telephone• Use a hearing aid or loop system.Sits close to the TVA 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 closeto the face• Give up reading, watching television or other activities• Be unable to locate small objects• Spill food or knock over cups• Wear mismatched colours or have stained clothing• Have difficulty moving around – walking slowly or with lessconfidence• Bump into things• Have difficulties caused by changes in light levels• Have difficulties with unfamiliar routes or places.16

Communicating effectively – face to faceBefore 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 effectiveand do that.Older people withdual sensory lossoften have problemswith communication.If we use commonsense, clear speechand courtesy we canhelp an older personto understandwhat is being said.Simple solutionscan improve theenvironmentdramatically fordeafblind people.Where to talk:• Between 3 – 6 feet apart at the same level• Good light is important. Face the light so that your full face canbe 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 naturalrhythm of speech• Speak a little louder, but don’t shout as this will distort yourvoice and lip patterns• Try to make your lip patterns clear, but don’t over-exaggerate• Keep your face visible and your head still. 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:• Don’t hurry, take your time• If necessary, repeat phrases. If this doesn’t work, tryre-phrasing the whole sentence. Some words are easier tolip-read than others• Make the subject clear from the start and if you change thesubject, make sure the person knows• Use gestures and facial expression to support what you are saying• Be aware that if a person is smiling and nodding it doesn’tnecessarily mean they have understood you• Be aware that the effort of concentration on communicatingcan be hard work for an older deafblind person and cannot bemaintained for long periods of time• Assessments are likely to take more than one visit and extra timewill need to be allocated• Be ready to write things down, using an A4 note pad with ablack marker pen.17

3 > Working with older deafblind peopleInterpretersSome older deafblind people use specialist forms ofcommunication and will require communication supportduring the assessment process. You will need to know whatform of communication the deafblind person uses and bookappropriate interpreters well in advance. Communicationmethods may include:• British Sign Language• Deafblind manual alphabet• Block• Lip-speaking• Speech to text• Community languages.Your local sensoryteam can provideinformation aboutbooking interpretersand there isinformation in theResources sectionat the back of thisbooklet.Communicating effectively – at a distanceTelephoneMany older deafblind peoplehave difficulty using thetelephone but continueto depend on it. Here aresome simple tips to help youcommunicate effectively onthe telephone.• Use the clear speech skillsdescribed earlier• Don’t shout or hold thephone too close to yourmouth, as this causesdistortion• Don’t speak too quietly• When phoning a personwith dual sensory loss,give them time to adjusttheir hearing aid beforestarting the conversation• Keep answer phonemessages short and simple.18

TextphonesTextphones allow deaf and hard of hearing people tocommunicate through the standard telephone network.Textphones have a display screen and keyboard so that the usercan type what they want to say and read the typed reply. Somedeafblind people use textphones with a large display screen.Information about different types of telephones and textphonescan be found on the RNID website: www.rnid.org.ukBT provides services for people with sensory impairments,including free directory enquiries for visually impaired people(call 195) and text-based phone services for deaf or hard ofhearing people.BT Text Relay is a national telephone relay service.Deafblind textphone users can type messages to the Text Relayoperator who then relays the message in speech to a hearingperson on a standard phone. The spoken reply is then relayedby the operator by typing it as text.Textphone users calling a voice phone user dial the prefix18001 and then the phone number they want. Voice phoneusers calling a textphone user dial the prefix 18002 then thetextphone number they want.19

3 > Working with older deafblind peopleWritten informationAll information and correspondence that your team providesshould be available in accessible formats. For example,appointment letters, assessments, care plans, information aboutservices, etc. should be available in large print, braille, tape or disk.Many visually impaired people have enough vision to read printedinformation if it is large and bold. No single size is suitable foreveryone, but most people prefer their large print in the range of16 to 22 point. Arial is an example of a clear font. You can wordprocess simple large print documents yourself.If a person requires information in braille, audio tape or diskformats, you can use any number of transcription services.If in doubt, contact your local sensory team or other specialistsensory agencies such as Sense, Deafblind UK or RNIB.This is anexample ofArial 18 pointin bold.Specialist servicesThis is a brief overview of theservices that may be availablefor older deafblind peoplevia your sensory impairmentteam (or similar):• Specialist assessment andcare planning – assessingthe effects of hearing andvision difficulties and theirimpact on maintainingindependence.• Advice, information andadvocacy – accessinghealth and social services,welfare rights, nationaldeafblind organisations,local agencies.• Equipment – assessmentand provision of equipmentto assist with everydayactivities: e.g. easy-to-seeamplified phones; largescreen textphones; personalTV listeners; loop systems;tactile markers; vibratingpager systems for doorbell,telephone or smoke alarmalerting.• Mobility training – includingadvice on making the homesafer to move around in ortraining in travelling outdoorsindependently and safely.• Communication – includingsupport to developappropriate communicationskills for both the deafblindperson themselves andfamily members or carersand information about usinginterpreters.• Other skills training –including safety in the kitchenand home environment.• One-to-one support – e.g.communicator-guide services.Communicator-guides aretrained to help deafblindpeople with communicationand mobility to enabletheir involvement in everyday activities and relieveisolation. The tasks carriedout will vary dependingon the individual deafblindperson and their needs,but may include: attendingappointments; escortingto the shops; readingcorrespondence; takingexercise; leisure activities.This service is designedto complement otherservices (e.g. Home Care)and should not be used toreplace it.i20

What to dowhen you’veread this…1. Discuss the needs of older deafblind people atone of your team meetings. Think about some ofthese questions:• Do we recognise that combined hearing and vision lossinteract to create a separate and unique disability?• Do we know of local older deafblind people? How many arewe aware of?• How can we develop our skills in identifying deafblindpeople? What training is available? Who should be trained?Could one team member be appointed as a ‘sensorychampion’?• When assessing older people, do we think about thepossibility of dual sensory loss and its effects?• When assessing older people, do we adapt sufficiently totheir communication needs? Do we know how to accessinterpreters or other communication support if necessary?• Is our assessment information accessible to users and carerswho have dual sensory loss?• How can we use the Disability Discrimination Act 1995 topromote the interests of older deafblind people?• What services are provided locally for older deafblind peoplevia statutory or voluntary agencies?• Do we know when and where to refer on for specialistassessment?2. Find out how to contact your local sensory teamand write their phone number here:3. Consider inviting a specialist from the sensoryteam to your team meeting to discuss howyou can work together effectively with olderdeafblind people.4. Consider organising an event during DeafblindAwareness Week.21

4 > ResourcesThere are a range of organisations, publications andresources which can help you improve services todeafblind older people.Re ferences andorganisationsusefulSense’s Information & Advice ServiceSense’s Information & Advice Service offers accurate,comprehensive and up-to-date impartial informationand advice for deafblind people, their families, professionalsworking with deafblind people and anyone who has ageneral enquiry about Sense or any aspect of deafblindness.The service covers England, Wales and Northern Ireland.Contact the Information and Advice Service:Tel: 0845 127 0066Textphone: 0845 127 0062Fax: 0845 127 0061Email: info@sense.org.uk22

Useful organisations:Sense101 Pentonville RoadLondon N1 9LGTel: 0845 127 0066Textphone: 0845 127 0062info@sense.org.ukwww.sense.org.ukRNID19-23 Featherstone StreetLondon EC1Y 8SLTelephone: 0808 808 0123Textphone: 0808 808 9000informationline@rnid.org.ukwww.rnid.org.ukDeafblind AwarenessTrainingFor information abouttraining, contact theSense Information & AdviceService See contact detailson page 22Deafblind UKNational Centre forDeafblindnessJohn and Lucillevan Geest PlaceCygnet RoadHampton, PeterboroughCambridgeshire PE7 8FDHelpline tel/text: 0800 132 320www.deafblind.org.ukRNIB105 Judd StreetLondon WC1H 9NETel: 0303 123 9999helpline@rnib.org.ukwww.rnib.org.ukInterpretingFor information about usinginterpreters, contact yourlocal sensory team or theSense Information andAdvice Service23

4 > ResourcesReferences:Butler, S J (2004) Hearing and Sight Loss – A handbook forprofessional carers, Age Concern EnglandDepartment of Health (1997) Think Dual Sensory – GoodPractice Guidelines for Older People with Dual Sensory LossHodges, L and Douglas, G (2005) Short Study on hearing andsight loss – Preliminary Report for The Thomas PocklingtonTrust University of BirminghamPrioritising need in the context of Putting People First:A whole system approach to eligibility for social care:Guidance on Eligibility Criteria for Adult Social Care, England,Department of Health (2010)Local Authority Social Services Act (1970) – Section 7 Guidance,Social Care for Deafblind Children and Adults LAC(DH)(2009)6Third European Conference of Deafblind International’sAcquired Deafblindness Network proceedings (1998)Elderly DeafblindnessRobertson, J & Emerson, E Estimating the Number of Peoplewith Co-occurring Vision and Hearing Impairments in the UKCeDR Lancaster (2010)Web based resources:To make information accessible –see RNIB’s ‘See it Right’ pack – available at www.rnib.org.ukDepartment of Health website www.dh.gov.ukSense website www.sense.org.uk24

Thank you for takingthe time to read thisbooklet. We hopeyou find it useful, andthat you can help tofill in the gaps in olderdeafblind people’s lives.Fill in the Gaps >

This booklet offersinformation and adviceabout working with olderdeafblind people. It explainswhat deafblindness is andhow it affects people.It sets out the legalresponsibilities that socialservices have and explainshow deafblind people canbe supported and helped.Sense101 Pentonville RoadLondon N1 9LGTel: 0845 127 0066Text: 0845 127 0062Fax: 0845 127 0061March 2011Email: info@sense.org.ukWebsite: www.sense.org.ukReg. charity no.: 289868Design: www.fabrikbrands.com