Understanding Dual Sensory Impairment

At Hi-VisUK, in our training, we talk about the MAC mantra – how DSI significantly affects a person’s Mobility, Access to information and Communication (M-A-C).

DSI has been described as: “a unique and isolating sensory disability…which significantly affects communication, socialisation, mobility and daily living” (Australian Deafblind Council, 2004).

The Pocklington Trust (2009) found: “these (MAC) challenges interact and self-perpetuate…which leads to further loneliness and seclusion”.

This is a problem affecting the health and wellbeing of the most vulnerable members of society – our elderly family members and friends, those we provide care and support to as providers of social and health care services.

The two definitions above are incredibly powerful as they focus on the key impact – isolation. But to begin to understand dual sensory impairment it is helpful to know something about hearing loss and sight loss separately (single sensory impairment). Then we can look again at the signs of dual sensory impairment, when both senses deteriorate significantly, and start to understand the critical differences between single and dual sensory impairment.

Hearing Impairment

To put things into context, consider a child born deaf or becoming deafened at an early age. Nowadays they could be offered a cochlear implant or other surgical intervention, learn sign language or be fitted with hearing aids at a time in their development when they will be able to adapt to get the best possible use from this type of support. They will have received skilled support at school.

For older people, age related DSI is becoming increasingly common as we all live longer and is a particularly cruel condition that can rob older people of their independence, affect their ability to communicate, cause isolation and have a negative effect on their mental health and wellbeing.

Hearing aids – distort and amplify all sounds not just conversation – yet older people are routinely fitted with hearing aids without training or, more importantly, the time needed to adapt to their use.

Through a hearing aid, even the most expensive digital types, the sounds you hear are not as natural as when you were younger. This is one of several adjustments you will have to make. But they are very useful and many people feel more confident wearing a hearing than not.

Sign Language – it is important to be aware that, compared to English, British Sign Language (BSL) is a language in its own right and like most languages can take years to gain fluency.

An older person who acquires DSI because of ageing is unlikely to benefit from learning BSL unless they know someone else who uses that language.

Eyesight is an important factor in visual languages like BSL. But it is also a highly important part of communication for most older people.  Visual clues such as facial expressions, body language and lip reading all play an important role in communication, increasingly so if both your sight and hearing deteriorate.

Visual Impairment

If a child is born with a significant sight impairment or becomes blind early in life, it is likely they will be taught to use a tactile reading system such as Braille or Moon. They will be taught how utilise their hearing more consciously, for navigation for example and for “reading” by audio recording. They will fully utilise their hearing and voice to communicate, to make friends, to be connected.

Unfortunately though, some children are born with or develop a dual sensory impairment. In these cases they can learn to communicate using a fingerspelling alphabet called ‘deafblind manual’ which involves spelling the conversation on the child’s hand and the child responding by spelling words on the other person’s hand.

You can probably imagine that in each of these scenarios, the deaf, blind or DSI person will receive lots of specialist support and resources made available to them and with the luxury of time to enable them to adapt to using them.

Whereas the vast majority of us use our vision and hearing to communicate and do not need to learn any additional specialist skills or worry about noisy pubs and bustling restaurants… until that is, we grow old and our sight and hearing cannot cope with the noise and the .

Now let’s take a look at when the two sensory losses come together forming a new and unique condition, dual sensory impairment.

So how do you know if an elderly person is becoming dual sensory impaired?

What are the signs to look out for? The following paragraphs provide a useful checklist:

Well, perhaps the older person will say something like – ‘my eyes aren’t as good as they used to be’ – or – ‘I don’t seem to hear as well anymore’.

You might notice other potential signs such as:

Is their TV volume really loud? Are there piles of unopened mail? Are the newspapers unread or have they been cancelled: ‘I can’t be bothered with them any more’.

Have they stopped going out as much as they used to? Does the telephone go unanswered? Are the lights left on in the house all of the time? Does the doorbell go unanswered? Are they unsure who is speaking if there are more than two people in the room? Do they have a burnt or sore finger or thumb?”

Any of the above might be the clues you need to encourage them to seek help and advice about their sight and hearing.  Learn how to use our 15minute free ID checklist for signs of DSI. Try our checklist here

If you think you know an older person who may be DSI or may be becoming DSI contact Hi-VisUK.

Some Facts about Ageing and DSI

The Department of Health and Social Care (2009) estimates one in three people aged 75+ have DSI affecting their mobility, access to information, and communication.

By 2030 one in four of the population of England will be aged 65+ (Office for National Statistics).

As we all live longer many of us will lose the ability to see and hear well enough to continue to live our lives the way we used to.

The Centre for Disability Research (2010) predicted by 2030 the number of people aged 60+ with dual sensory impairment will increase by 60%.

According to The Department for Health (2009), from the age of 75 a person who has become DSI is:

  • 3.6 times more likely to have a stroke;
  • 2.2 times more likely to have arthritis;
  • 2.5 times more likely to have heart disease;
  • 1.5 times more likely to have hypertension;
  • 3 times more likely to fall;
  • 2.7 times more likely to have depression.