Are you a professional working with someone over 70? You need to read this!

About Our Guides

Our Hi-VisUK information and guidance series is designed to help those supporting or caring for an older person with Dual Sensory Impairment (DSI) during this COVID-19 emergency, social distancing and socially isolating.

Undetected DSI

It is possible that the older person you care for has undetected DSI. Our guides and our online learning help you to spot those signs quickly and communicate safely whilst ensuring their DSI is on their AIS record.

Who are they for?

The guides are for the family, friends, neighbours, carers and care organisations, professionals, social care and health care providers of the person with DSI.

What do they include?

Each individual guide aims to help you quickly understand the impacts of DSI and the extra challenges brought about by the COVID-19 emergency of keeping them and you safe and still having effective communication.

Our guides cover a range of everyday situations and related challenges facing a DSI person and those who need to see them during the COVID-19 outbreak.

Included in our free guides you will also find a wide range of practical solutions and information on aids and equipment relating to daily living activities that can support independent daily living.

Is English your second language?

Each guide is available as a webpage and a downloadable PDF. Using the webpage version means you can use the translate button (at the top centre of each webpage) to choose the language you prefer.

British Sign Language (BSL) users can access the BSL video version (there are 8 videos for Guide 3) further down this webpage or click on this link:


Following the COVID-19 health and safety guidance is vitally important not just to keep you safe and well but to also ensure you can continue helping others. Face masks (PPE) may make it more difficult for them to understand you. Our guides include ideas about this.

COVID-19 GUIDE #3: Professionals supporting an older person with Dual Sensory Impairment

This third guide in the COVID-19 series from Hi-VisUK is designed to provide professionals with information and guidance on good, safe practice.

Also in this guide is information on types of aids and equipment you need to know about that can make a big difference to an older person struggling with DSI.

Professionals should also read guides 1&2 for a fuller picture of how DSI impacts everyday life, social and health, and some common questions with a range of tried and tested solutions.

Following the COVID-19 health and safety guidance is vitally important not just to keep you safe and well but to also ensure you can continue helping others.

You must follow guidelines set by your organisation and Government. If you are concerned an older person with DSI may have COVID 19 and you don’t have PPE, talk to your Manager or Health and Safety Advisor. Although keeping you safe, PPE covering your face causes communication difficulties for someone with DSI.  See Guide No.1 for things you could use and do to help communication.


If the person is known to the local adult services as having a sensory impairment, whether Health or Social Care, there should be an AIS (Accessible Information Standard) alert on their record or profile providing the person’s chosen means of communication.

If not, try either contacting the person, their carer or family member, to get that information.

During COVID-19 it is essential to have this information. It will save you precious time and significantly reduce risk. It will reduce anxiety for the older person if communication is effective.


When you arrive at the address you may find that the person is not able to hear the doorbell or knocking at the door. Try to attract their attention by knocking at the window nearest to them and moving around to try and catch their attention.


They may not be able to see you clearly, so when possible wear brightly coloured plain clothing


Try to have your conversation in a quiet location if possible. If this at the front door, keeping 2 metres apart might mean, for example,  asking the older person to turn-off their TV or radio to minimise background noise.

Next, ensure that you are facing them with your mouth clearly visible. Speak loudly and clearly but do not shout.

REPEAT – no more than two or three attempts, if they don’t understand you REPHRASE and try that two or three times, if that doesn’t work, WRITE your message on A4 white paper using a large felt-tip, black marker pen.

You will know if they have understood you or not as they will be able to use their voice to answer your question. But, do not assume that a person has understood if they nod and smile as this is a common coping strategy.


A person may have good speech which can lead to you making assumptions regarding their hearing and understanding.


It could be possible that by supplying a few low-cost aids to daily living, the older person can develop coping strategies to keep them living independently for the foreseeable future.

Look at our list below for some of the most useful types of equipment.


If you have recognised that the older person could have DSI and may be struggling to carry out simple tasks, why not carry sealed packs containing some low cost but useful equipment for their use?

For example, a liquid level indicator and a basic magnifying glass. These will help them to make a hot drink safely and read labels on food, dials on microwaves, cookers and washing machines.

Do not forget to request an urgent visit from a ROVI or similar professional trained and qualified to assess their needs.


When and older person’s sight and hearing are BOTH not as good as they used to be, often simple daily things can become difficult or frustrating.

Important things also get affected such as staying mobile and getting out and about, staying in touch with others, or accessing information.

COVID-19 guidance on social isolation increases these impacts when you have DSI. As a professional you need to know what interventions will help.

Many older people with DSI struggle using the telephone, reading, watching TV, listening to a radio, using the internet or having a conversation. During this COVID-19 emergency, it is vital that communication and information is maintained with older people with DSI and that they can look after themselves during social isolation.

Here is some equipment that can help with communication and daily living activities.

    Handy-sized portable amplifiers to help someone with DSI join in the conversation
    Flashing/vibrating doorbell to alert the person with DSI that someone is at the front door. This would also avoid them having to leave their front door open because they are afraid of not hearing the doorbell/knocker.
    Software to help the person with DSI see and or hear and use a computer.
    Loop systems for the home enable someone with DSI to watch the TV with the family – no need for the volume to be high.
    Special adapted spectacles that help someone with DSI watch TV, see the subtitles on screen.
    These are small, raised plastic stickers, sometimes called bump-ons, to help someone with DSI find the settings on their cooker, microwave, radio, washer and so on.
    Such as using rubber bands to know which bottle is shampoo and which is conditioner can often make all the difference. Or attaching a large parcel label to a jar, bottle or tin with the contents written on using a bold, black marker pen. These can be reused many times. Life hacks are quick, easy and usually free to make.
    Visual (flashing) fire and smoke detector alarms.
    Large keyboard/screen and amplified handset telephones. There are flashing/vibrating phones and additional devices to convert an ordinary phone’s sound to light and vibration alerting the person with DSI that their phone is ringing.
  • Alarm Clock
    Vibrating and flashing alarm clocks to ensure the person with DSI wakes up at the right time.
    Subtitle options on your TV or computer/tablet/smartphone. Cinemas usually have screenings with subtitles, ask them about these.
    Magnifiers with and without a light, pocket-size or larger ones for a desk to help the person with DSI read/work. It is best to buy one that matches their spectacle prescription.
    A liquid level indicator that tells you when the hot water and then milk is near the top of the cup.
    Large-print books, puzzles, newspapers.
    Compact folding task lights that help you see fine detail or when doing your word puzzle book on holiday!


If you know that they use hearing aids, check they are wearing them – and if not, use gestures to get them to put them on. Common reasons an older person doesn’t wear their hearing aids can be simple problems such as:

Batteries have run out or are running low – a quick check and replacement can make a difference.

Tubing has become blocked and/or kinked – you can easily replace these if the person has some in their kit.

The hearing aid needs cleaning – usually build up of wax and dirt. If it is just blocked with ear wax they can be cleaned and refitted. If necessary, check with the local Audiology Team.

A visit to the clinic may not be possible but they can send out replacement batteries and tubing in the post.

Ask the older person if they need help with these basic maintenance tasks.


Hearing aids DO NOT correct hearing issues, they amplify all sound.

Some people choose not to use their hearing aids for various reasons.


If it is necessary and is safe to do so – and you follow the COVID-19 social distancing guidance the following checklist will help you determine if they have DSI.

During your visit you should look out for indicators that this person has DSI, such as:

• They didn’t hear or see you at their door
• They wear hearing aids and glasses
• Their TV or Radio is turned up loud
• Their chair is placed very close to the TV
• They may ask you to repeat or give wrong or surprising answers
• Is there unopened mail?
• Is their appearance or hygiene a problem?
• Unexplained injuries, bumps or falls

You can also use the questions in our simple identification toolkit which you’ll find on our COVID-19 webpage.


If you are visiting a client who is recovering from a stroke, it has likely affected their vision. This might not have been noted in their care plan.


All older people are at risk of exploitation, especially at this extraordinary time. This is particularly so for those with combined hearing and sight loss – DSI.

Ensure that there are measures in place to protect.

For example:

A trusted family member managing finances – they may be happy to give a weekly cash amount to a trusted family member if it means support with shopping, etc., and arranging where possible for Direct Debit through the bank.

Look out for potential safeguarding issues. Bruises can be caused by falls, but do not assume, be alert. Sadly, at times of stress, there is evidence to suggest abuse of elders will increase.

If you have safeguarding concerns, first talk to the person. If they agree then make a referral to your local authority’s Safeguarding Team.

Scams, online, by phone, post or on the doorstep are another example of exploitation which may make people with DSI more vulnerable.

Learn more online with us – it’s free

In this most challenging of times, it is even more urgent that we learn how to communicate and protect one of our most vulnerable groups, older people with DSI. It is also vital we identify more people struggling with undetected DSI – our training helps you to do that.

Thanks to the support of the National Lottery Community Fund we are able to provide free, practical online learning to help you get the COVID-19 message across and support someone with DSI.


For further help or advice please email

Download the Guide


If you are worried about someone:
In an emergency, please call: 999
If there is no immediate risk, call the police on: 101

COVID-19 and Dual Sensory Loss Guides in British Sign Language

Our Hi-Vis UK COVID-19 & DSI guides 1 to 4 are also available on video in British Sign Language (BSL). Each video is also subtitled in English.

There is no sound on these videos. Note: Guide 3 is divided into 8 sections/8 separate BSL videos.


Step 1 : Go Prepared

Step:2 At the Front Door

Step:3 Communicating

Step:4 Low Cost Aids

Step:5 Handy Tip

Step:6 Aids and Equipment

Step:7 Hearing Aid Users

Step:8 Assessing if an Older Person has DSI