Summer 2007
The staff who care for older people – whether in residential services or at home – often feel ill-equipped to work with individuals with sensory impairments. But with a little help there’s a great deal that can be done. Jim Lewis explains.
According to government statistics 922,000 people work in social care in the UK - two thirds of them with older people. Many of these staff will be working in residential homes for older people, providing care for a group of elderly people with a range of difficulties. A significant number of these older people will be living with dementia and most will be frail and require physical care and support. Another large group of workers provide domiciliary care – supporting older people in their homes to enable them to keep their independence.
Providing care for older people is challenging work and often does not receive the recognition and status that it deserves. Pay is often low, time is tight, stress high and there is frequently a high turnover of staff in these roles. Traditionally this work has been carried out by women, and there are increasing numbers of people working in this sector who have arrived in this country relatively recently.
Many of the older people who are cared for have difficulties with their sight and hearing, and some will have substantial difficulties which can be described as deafblindness. And yet, because sensory loss is often regarded as a `routine’ part of getting old, an individual’s needs may be overlooked or disregarded – which means that opportunities for improving someone’s quality of life can be missed. Worse still, the disorientation that someone experiences as a result of sensory loss may be misinterpreted as dementia.
Currently, few care workers have received training in how to support people with sight and hearing difficulties. And yet many will be supporting older people with dual-sensory impairments but perhaps not realise this. In order to tackle this, Sense has launched the second stage of its Fill in the Gaps campaign – including producing a booklet called SEEING ME which provides useful tips and guidance for care staff.
Is this person deafblind?
The first challenge for staff is to recognise that someone in their care has poor sight and hearing. For example, it may be that an older resident doesn’t respond to questions because they can’t hear what is being said, or see well enough to lip-read – rather than that they have a cognitive impairment. Without a specialist assessment it’s often impossible to tell how severe an older person’s hearing and sight loss is.
Tips
'SEEING ME' offers hints on how to spot if someone has a dual-sensory impairment. For example, does the older person often ask staff to repeat what they have said, or sit unusually close to the TV? If you work as a carer and think that a client might have sight and hearing problems then your local authority are required by law to carry out a deafblind assessment. This will identify the level of sensory impairment someone has, ways of minimising the impact of this and any additional support they may require.
Talking the talk
For many care staff communicating with deafblind people can be daunting. “Often staff in care homes aren’t given very much training,” says Liz Duncan, Sense’s Head of Acquired Deafblind Services. “They haven’t been taught the skills to communicate effectively with someone with serious sight and hearing loss.”
Tips
As 'SEEING ME' explains, there are a number of strategies which can help you communicate with deafblind people. Some - such as drawing block capitals on the deafblind person’s hand which is relatively easy for both the carer and deafblind person to learn.
Sense provides factsheets which describe various ways of communicating with deafblind people. We can also provide training to care staff on communication techniques. One care home has set up a communication group so that staff can learn techniques for assisting people with poor sight and/or hearing. It might be possible for your care home to do the same, and then get support from social services or Sense with delivering the training.
Time is tight
Studies show that workers in the care sector suffer from high levels of stress because they worry that they cannot give enough time to individual clients. Helga Pile of the trade union Unison, which represents many care workers, says “With more home care being provided by private agencies, staff often don’t get paid for the time it takes them to travel between clients, and are expected to visit more clients on each shift. Staff have told us they worry that they can’t provide enough support to people with highly complex needs.”
Tips
Any deafblind person, whether living in their own home or in residential care, is entitled by law to an appropriate level of support. This does not all have to be provided by care workers. Your client might be entitled to assistance from a communicator-guide who is specially trained to help them inside their home and out and about. Getting support from a communicator-guide could for instance help your client to go through their own correspondence or go shopping. This will give your client greater confidence and mean that you don’t have to help them with everything they need assistance with.
Rewarding
Working with people with dual sensory impairments does present challenges, although there are ways around most issues. But what comes across again and again from professionals in the care sector is that working with sensory impaired people is something they love doing. Kerrie Webster, who co-ordinates communicator-guide services for Sense West, explains why. “You get a lot of love in this kind of job. When we go and support people they’re always glad to see us, and you get a lot of positive feedback. The greatest challenge of the job - helping people who are isolated - is often its greatest reward.”
Support and care workers speak of the rewards of building up close relationships with people and of seeing them grow in confidence as they realise that they can do more than they realised.
“The greatest challenge of the job - helping people who are quite isolated - is often its greatest reward”
'SEEING ME'
Sense have produced a useful hands-on guide for those working with older dual sensory impaired people in their own home or in residential care. For your free copy please do contact Sense or visit www.sense.org.uk/fillinthegaps
Who do carers work for?
Of the 922,000 care workers in the UK:
- 12% work for local authorities
- 18% work in domiciliary care
- 10% provide day care services
- 50% work in care homes
- 3% are agency staff
- 7% are NHS staff
A shining example
One care home in Wiltshire is leading the way in helping its staff to develop a high quality service for deafblind residents. The Woodmeades home in Warminster has pioneered a staff communications group to look at how to help residents with sensory impairments.
Care Leader Barbara Kemo explains why they decided to set up the group: “It wasn’t that we didn’t care, we absolutely did. We knew that we had people here who were deaf and so would use gestures to try and find out their wishes about things. They would respond but we weren’t always sure that we knew exactly what they wanted or they had understood what we were asking.”
Staff asked Wiltshire social services deafblind worker Rosie Stevens to work with them to improve their awareness of deafblindness, and the group was born. “Rosie has worked with us on the importance of things like good lighting, says Barbara. “The meetings give staff the chance to discuss how we can help particular residents and to learn more about deafblindness in general.” In the longer term the group will consider changes to décor and lighting to assist people with limited vision to be as independent as possible.
“Rome wasn’t built in a day but over time we can look at changes which will help people with not very much sight,” says Barbara. “Working with Rosie has made us much aware about things - like where we put furniture.”
As a result of Woodmeade working with Rosie, a resident who is profoundly deaf and has a visual impairment can now hold conversations with staff.
Barbara explains, “We had referred her to an audiologist but he said hearing aids weren’t any good. It was through mentioning it to Rosie at the communications group that we realised she could get a deafblind assessment.” Because of that assessment the resident now uses a minitech device, which amplifies other people’s speech through a pair of headphones.
“This has made a huge difference,” says Barbara. She can now have conversations with us, and as well as telling us her wishes she’s also been able to chat about her past life and is a lot less isolated.” A second resident has now been referred for a deafblind assessment.
Barbara says, “We have a meeting of the communications group whenever Rosie can come and see us, although if staff feel that something can be done to improve the life of a resident in between times we’ll do it and not wait for the next communications group meeting to agree on it.
“The key thing is that we know that services exist and are beginning to understand deafblindness. It’s something which we may be expanding to our other homes in Order of St. John’s Group.”
“This has made a huge difference - she can now have conversations with us and is a lot less isolated.”
