Australia2008 Pleanry

24 June 2008

Something can be done Dual sensory impairment in the elderly

24 June 2008Information Center for Acquired Deafblindness © 2

Prevalence studies


Prevalence – ”care system”

22

18

12,2

4

10

0

5

10

15

20

25

Denmark (avg.93)

Sweden (avg.86)

Australia(avg.82)

Norway (avg.87)

Norway(nursinghomes)


Why aren’t they found?

Slow progression

Lack of awareness

”I am just old”

Overshadowed by other ailments

”On home turf”

Misunderstanding of symptoms

And anyway: Nothing can be done!


Doing something matters

Close link between uncorrected sensory impairments and poor quality of life

Elderly with DSI who receive the right rehabilitation─ Better mood─ Fuller social life─ Easier daily living

Their quality of life leans towards that of others

To act costs less than doing nothing

Appollonio et al. Age Ageing 1996; 25


Action steps

Awareness

Identification

Service provision─ Who?─ What?─ How?─ (Speed!)

Lobbying


Support providers

If ”deafblind system”─ How to deal with the vast numbers?─ How to get called upon?─ Overkill?─ The word ”deafblind”

If ”mainstream system”─ How to give staff in the elderly sector knowledge about deafblind

specific tools and techniques?─ How to motivate them?─ How to coordinate service?


Service providers

Mostly mainstream service providers:

Sweden

Norway

Italy

India

Spain

Belgium

Venezuela

Uganda

Canada

Denmark

UK

Netherlands

Germany

USA

Also deafblind service providers:


Denmark

Approx. 5% of all elderly over the age of 80 have a significant combined hearing and vision impairment

A total of around 10.000 people

Deafblind consultants are in contact with approx. 500

Approx. 4% of the Danish population is over the age of 80

In 2040 this portion will increase to over 9%


The problem in brief

More than 10 times as many as previously estimated

Don’t get the help and support they need and have the right to

Withdrawal, isolation, reduced quality of life, somatic and mental problems

Very good service system


Danish service system

Family doctor

Preventive home visits

Home helpers

Nursing home staff

Home nurses

Family & friends

Deafblind organisatio

n

Vision rehabilitation

Hearingrehabilitation

Deafblind consultant

s

Hospitals etc.

Contact persons (Interpreters)


What do they need

Three things (first and foremost):

Identification

Identification

Identification

The sooner, the better


Then what?

”Contact person”

Advice and counselling

Coordinated approach from vision and hearing rehabilitation system

Correct vision and hearing aids

”Proper” behaviour in family and staff around them

Peer support

Front of line for technical aids, cataract operations and other rehabilitation measures

(Increased medical attention)


Contact person

Danish legislation since 1991

4-10 hours per week

Help with─ Communicate─ Mail, news─ Link to environment (shopping, bank, post office)─ Guide, accompany─ ”Eyes and ears”

Employed by municipality

No formal training, supervised by deafblind consultants


Our activities

2006: Information campaign – Primary aim: awareness

2007 + 2008: Information targeted at professionals – Primary aim: identification (+ coordination)


Media campaign

Press kit─ Press release─ Fact sheets─ Simulation glasses and ear plugs─ Solo story─ Cases!

Direct contact

Well received

Meetings with members of parliament


It doesn’t get any better…

Is everyone included?

Until now Danish hearing and vision specialists have assumed that there were 900 elderly deafblind in Denmark. But according to new calculations the number is closer to 15,000, Berlingeren (Danish newspaper) writes.

- - -

Just to make sure: Did you also count all those in the Parliament?


Question guide

Experiences from earlier projects in Denmark and Norway─ Questions for the person about his/her functioning give valid

answers

Not a questionnaire

Should be possible to use without instructions


Pilot project Hvalsø

214 elderly over the age of 80

5 % of 214 = 11

45 home visits during the project

Question guide was used eight times

Four deafblind elderly identified (= 8.9% of total visits)


Pilot project Langeland

1700 elderly over the age of 75

5 % of 1700 = 85

Question guide used 186 times

10 elderly (5.4 %) with some degree of dual sensory impairment were identified

83 elderly (44.6 %) with some degree of hearing impairment

34 elderly (18.3 %) with some degree of vision impairment


Leg 1: Preventive home visits

Question guide for use in preventive home visits

Mail to the members of the organisation with an article and the question guide

Two half day seminars

Article and question guide in the online tool box of the The Danish Knowledge Center on Ageing

Presentation at the professional annual meeting

Article in their journal


Leg 2: Nursing homes

Poster and information folder for the 1500 nursing homes

Like hearing through a blanket and seeing through fog…


Leg 3: General Practitioners

Article for Monthly Journal of Practical Medicine (together with a GP)

”What can the GP do?”


Leg 4: Vision and hearing rehabilitation

Use of question guide

Coordination of service


Leg 5: Students

Letter for schools for nurses, occupational and physio therapists, social and health assistants

• Information about this topic

• Offer for more information from our center or a visit from the association of the deafblind


Leg 6: Home help system

Introduction for the home help in a district in Copenhagen

Agreement on continuing contact while they use the question guide


Leg 7: Family

Awareness of symptoms

Information campaign


Information material

For home helpers

For nursing home staff

For hospital staff

Collaboration with vision and hearing (and age care)


Next steps

Continue identification work

Better service

Staff training

Obstacles:─ Little time and motivation─ Competition for awareness and interest from professionals


Swedish project

Demographic survey

10 hour module on DSI in the elderly─ Own experience─ Hearing and vision impairment and its functional consequences─ Interaction, ethics, communication─ Rehabilitation (discussion and thoughts)

Spreading to other municipalities

Train the trainer


Outcome of training

Increased knowledge that can be transformed into competence, motivation and increased understanding

Increased will to learn more and to act as a catalysist in age care


What is important

To use the phoneTo be able to use hearing aidsTo have good home lighting and other adaptations for visionThat relatives and staff understand DSITo have access to news and other important informationTo be able to use an interpreterTo know who is at the doorTo know if and who enters or leaves the roomTo move around in the close environment – and know how it looks


Main importance

That someone takes responsibility that you are seen on the basis of your possibilities and rights!


Norwegian project

Online learning tool

Hearing and vision

Target group: Municipal staff

www.sansetap.no


The aim is not to put years to life

…but to put life to years


Variation is not the spice of life;

it is the true essence of it

Woodburn Heron, 1957


The problem is being aware

that this is a separate disability.

And that something can be done.

Else Marie Jensen

Australia2008 Pleanry

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