Caring for older people with hearing loss

Transcription

1 FACTSHEET Caring for older people with hearing loss A factsheet for staff members, volunteers and carers working in sheltered housing, and residential and nursing homes for older people. If people do not have the right support to manage their hearing loss effectively, it can have a significant impact on their life. This information aims to make it easier for you to support residents who have hearing loss, so they can manage their condition, maintain their independence and play an active part in their community. All of the Action on Hearing Loss publications referred to in this factsheet are available to view and download on our website at Alternatively, you can order printed copies from our Information Line (see last page for contact details). To read our report A World of Silence: The case for tackling hearing loss in care homes, which informs the key recommendations in this factsheet, visit If you would like this factsheet in large print, Braille or audio format, please contact our helpline (see last page for contact details).

2 2 Caring for older people with hearing loss Contents The need for action... 3 About hearing loss... 3 How to identify hearing loss... 5 How to improve communication...6 All about hearing aids...8 Equipment to help with everyday living...12 Welfare benefits How to assess your home Where can I get further support?...15

3 Caring for older people with hearing loss 3 The need for action Hearing loss is a major public health issue affecting more than 10 million people in the UK that s one in six of the population. By 2031, the number of people experiencing hearing loss is expected to reach 14.5 million. The most common type of hearing loss is called presbyacusis or age-related hearing loss. It develops gradually with age (see below, right). Around 70% of people aged over 70, and more than 90% of people aged over 80, are living with hearing loss. This means that a large proportion of people living in sheltered housing and residential and nursing homes for older people will have a hearing loss, whether or not they have recognised it or sought help. It is vital that these people are supported to manage their hearing loss effectively, to minimise the impact on their quality of life. By 2031, the number of people experiencing hearing loss is expected to reach 14.5 million As a result of our recent research into how hearing loss is managed in care homes, we have identified three key recommendations for everyone involved, directly or indirectly, in providing care and support to residents: 1 Intervene earlier in hearing loss. 2 Meet communication needs. 3 Improve hearing aid use and management. This factsheet explains how you can take action in these key areas, and others, to support your residents to enjoy a good quality of life. About hearing loss Hearing loss is usually described in terms of severity: mild, moderate, severe or profound. If someone has a mild hearing loss, they will have some difficulty following speech, especially in noisy environments. They may wear hearing aids if their hearing loss has been diagnosed and find lipreading useful. They will nearly always use speech to communicate. Someone with a moderate hearing loss will find it difficult to follow speech, especially in noisy environments. They will probably wear hearing aids and/or lipread (see page 6). A person with a severe hearing loss may have difficulty following speech, even with hearing aids. They may lipread and/or use British Sign Language (BSL) and communication support (see page 7). Someone with a profound hearing loss may use BSL as their first or preferred language, or lipread. People who use BSL often consider themselves to be part of the Deaf community. There are around 23,000 people in the UK who are deafblind that is, they have a combined hearing and sight loss. Many people who are deafblind have some hearing and vision. Others will be totally deaf and/or totally blind. Age-related hearing loss The most common type of hearing loss is linked to the ageing process. To understand it better, it is useful to know what happens in the normal hearing process. The ear is made up of three parts: the outer, middle and inner ear. The outer part of the ear directs sound into the ear canal towards the eardrum, making it vibrate. These vibrations are passed to three small linked bones (the

4 4 Caring for older people with hearing loss ossicles) in the middle ear. These bones in turn send the vibrations into the cochlea (the hearing organ in the inner ear) and the fluid within it. Movement in this fluid bends the tiny hair-like cells within the cochlea, and this generates electric signals in the auditory nerve (hearing nerve). These signals travel along the nerve to the brain, where they are interpreted as sound. Deafness can be caused by problems in any part of this system. Everyone loses hair cells in the cochlea as they get older, and, gradually, their hearing deteriorates and becomes less sharp. People with age-related hearing loss find that others seem to mumble. They often find it difficult to understand what people say, especially in noisy places, or when the TV or radio is on in the background. See our leaflet Understanding your ears for more information. The impact of hearing loss If people are not supported to manage their hearing loss effectively, it can lead to: communication difficulties social isolation anger and frustration low confidence, especially in social settings depression stress and anxiety. Some people with age-related hearing loss feel that it s a normal part of ageing that they just have to put up with. They quietly resign themselves, completely unnecessarily, to a life without active participation, perhaps believing that there s nothing that can be done about it, or because they don t want to make a fuss. Others may want to seek help but may be unsure of what they can do. Recent research has also shown that there is a link between hearing loss and dementia. People with mild hearing loss have nearly Everyone loses hair cells in the cochlea as they get older, and, gradually, their hearing deteriorates and becomes less sharp twice the chance of going on to develop dementia as people without any hearing loss. The risk increases to threefold for those with moderate, and fivefold for those with severe, hearing loss. Hearing and sight loss As people get older, their sight, as well as their hearing, begins to worsen. People with a combined hearing and sight loss will find communicating effectively especially challenging. They may have problems reading, getting around and carrying out simple tasks without help. Sometimes, they may not answer questions appropriately, which could be misinterpreted as an early sign of dementia. Older people with hearing and sight loss may easily become withdrawn and depressed. Their isolation may also have a negative effect on their relationships with family and friends, especially if they don t visit very often. See page 6 to find out how you can communicate more effectively. You may also find our factsheet Deafblindness useful. Tinnitus Tinnitus is a medical term to describe noise that can be heard in one or both ears, or inside the head, which has no external source. It can be continuous or it may come and go. The type and volume of sound can vary greatly; some people experience a ringing, others compare it to the sound of a train or a short piece of music. The impact that tinnitus has on someone s life can also vary greatly and is often underestimated. For some people, tinnitus can lead to depression, anxiety, stress

5 Caring for older people with hearing loss 5 and sleep problems. And, unfortunately, stress and anxiety can make it seem worse. There are several ways that someone with tinnitus can try to minimise the impact that it has on their life. The following may be used alone or in combination: Therapies, including counselling, tinnitus retraining therapy, cognitive behavioural therapy, clinical psychology and/or complementary therapies. Specialist tinnitus products, which generate soothing sounds to distract people from focusing on their tinnitus. Hearing aids these may help people who also have hearing loss, as hearing better may distract them from their tinnitus. Read our leaflet Tuning out tinnitus for more information or visit On average, there is a 10-year delay between people identifying that they may have a hearing loss and seeking help How to identify hearing loss Research shows that, currently, hearing loss diagnosis is opportunistic and ad hoc on average, there is a 10-year delay between people identifying that they may have a hearing loss and seeking help. Age-related hearing loss can often go unnoticed for some time, as its signs can be misunderstood. For example, if a resident is unresponsive or confused, this may be identified as a sign of dementia or a mental health condition, rather than hearing loss. A delayed diagnosis of hearing loss has significant and sad consequences: many people miss out on getting hearing aids who could benefit from them hugely. How to recognise the signs People with age-related hearing loss often: complain about others mumbling need to have things repeated several times complain that they cannot hear as well as they used to don t react to you struggle to hear on the telephone have the TV or radio on very loud fail to follow conversation in noisy places. You might also notice a change in behaviour in residents. They could be more withdrawn or stop taking part in conversation and activities. This might be because of hearing loss. What to do if a resident s behaviour suggests they may have a hearing loss If you notice a resident struggling to hear, it is best to discuss this with them. It could be that they haven t recognised it themselves, or they may be unaware of the easy steps to take to get a hearing loss diagnosed and treated. The Action on Hearing Loss Hearing Check As a first step, our Hearing Check can help you to identify people who have hearing loss and encourage them to take action. It s a quick and simple test that can be taken over the phone or online. It s not a full hearing test, but it can indicate whether someone has a hearing loss and whether they should go to their GP for further tests. To use the Hearing Check, call (calls from a BT landline cost up to 5p per minute. Other providers charges may vary, a connection charge may apply) or visit www. actiononhearingloss.org.uk/hearingcheck

6 6 Caring for older people with hearing loss Hearing loss can have a big impact on a person s ability to communicate and, therefore, their quality of life Diagnosis and treatment If a resident thinks they have, or shows the signs of, hearing loss or tinnitus, you should arrange an appointment with their GP, who will check for any underlying cause for hearing loss, such as infections or wax, which may be treated easily. Good-quality digital hearing aids are free as standard on the NHS and can also be bought privately. If the resident wishes to see an audiologist on the NHS, they will need a referral from their GP. They do not need a referral to see a private audiologist, but they will have to pay for hearing aids. We recommend that the resident visits their GP first, even if they are considering seeing an audiologist privately, to ensure that there is no underlying cause of their hearing loss. The resident and their family need also to be aware of the options available when it comes to hearing aids (see page 8). Whether the resident sees an audiologist on the NHS or privately, they will be asked a series of questions about their hearing loss, and the impact that it is having on their life, and routine hearing tests will be carried out. These tests will provide the audiologist with vital information about whether there is hearing loss and, if so, what type. From this, they can establish what management is needed for example, hearing aids (see page 8). For some types of hearing loss, surgery may be an option. Some people will need to see other specialists, such as an ear, nose and throat doctor, for further investigation into the cause of their hearing loss, tinnitus or balance disorder. Any Qualified Provider (AQP) The government launched the AQP scheme in some areas of England in This means that any healthcare provider, including the NHS, third-sector organisations and private companies, can deliver adult NHS audiology services providing they meet NHS quality requirements, prices and contracts with all services remaining free to the patient. To find out more, see our factsheet Everything you need to know about getting hearing aids. How to improve communication Hearing loss can have a big impact on a person s ability to communicate and, therefore, their quality of life. There are simple things you can do to aid effective communication: Make lipreading easier When we communicate face to face, facial expressions, lip shapes and body language are important. It s likely that people with hearing loss will rely on these visual clues even more to help them follow what someone is saying, even if they don t realise it. Your residents with hearing loss may benefit from attending a local lipreading class, so you could see what s available. When someone is lipreading you: find a suitable environment with good lighting, away from noise and distractions sit or stand at the same level and 3-6ft away from the lipreader face the light, or your face will be in shadow make sure the lipreader is looking at you before you speak introduce the topic of conversation speak clearly at a moderate pace, without raising your voice.

7 Caring for older people with hearing loss 7 Use natural body language. Keep your face visible. Check that the lipreader is following you. Be patient and take time to communicate. See our leaflet Learning to lipread for more information. Write down key words If you can t make yourself understood, write down key words (not everything) and then continue the conversation. If the person has sight problems, use a thicker pen or a different colour pen or paper, and make your writing bigger. Work together to find out what will help the most. Avoid using CAPITAL LETTERS. It s the written equivalent of shouting and doesn t actually make things clearer. Use body language to convey meaning Point to objects, pictures or people that you are talking about. Use facial expressions to show how you feel. Use objects to represent specific people, things or activities. Place the object in the person s hand so they can feel or smell it. This is often a good method for communicating with deafblind people, or people with learning disabilities or dementia. For instance, you could place a tea cup in their hand for Would you like some tea? Help with communication support If a resident s family member is unable to accompany them to a medical appointment to lend support and help with communication, you may need to go along instead. It is, therefore, vital that you understand the individual s communication, or other, needs. During an appointment, you may need to write some things down if it s clear that the resident didn t hear or understand something. Notes are also useful for family members who can t attend. You may need to write some things down if it s clear that the resident didn t hear or understand something The resident may receive written information from their healthcare professional before and after an appointment. They can also ask to be copied into any letters between healthcare professionals, so that they are aware of what was discussed during their appointment and any onward referrals that have been made. Professional communication support for medical appointments can be booked and paid for by the NHS; however, there may be limited availability for some types (see below). The GP should make it clear in new referral letters that someone requires communication support, so it can be booked in advance. However, it s a good idea to call the department or service ahead of the resident s appointment, to check that they are aware of the individual s communication needs. Communication professionals include sign language interpreters, lipspeakers, notetakers and speech-to-text reporters. For more information, see our Communications range of factsheets. Create a comfortable environment The physical environment has a considerable impact on how easy it is for someone with a hearing loss to communicate. There are many simple things you can do to improve the listening environment. Decoration Consider replacing wooden flooring with carpet, as this helps to absorb noise. Use soft furnishings, as these reduce sound reverberation and echo. Avoid busy/bold patterns on walls and curtains, as they can be distracting.

8 A 8 Caring for older people with hearing loss Make sure there is good lighting in all areas, without any glare or shadows. Dining room Use padded tablecloths to reduce the clatter of cutlery and crockery. Introduce round dining tables, so everyone can see each other. Communication Reduce background noise whenever possible. For example, turn off the TV if no-one is watching, or turn on the subtitles. When using notice boards, type up notices using lower-case letters and large print. If there are communal lounges, make sure there are quiet areas so that people can talk without the distraction of background noise. Contact Action on Hearing Loss to see what deaf awareness training we can offer. Consider any additional needs of your residents and consult specialist organisations or charities for advice. Ask residents for feedback on the changes. All about hearing aids Many people with hearing loss find hearing aids very helpful. But it can take some time for people to adjust to their hearing aids and it s important that they get the support to make the most of them. Digital hearing aids are free on the NHS and they can also be bought privately. Digital means that the audiologist can fine-tune them to match a person s hearing loss and needs. Different types of hearing aid There are several different types of digital hearing aid available. The audiologist will advise which type is best according to the individual s hearing loss and lifestyle. Behind-the-ear (BTE) hearing aids These rest behind the ear and send sound into the ear in one of three different ways: 1 a) Through a piece of clear, flexible tubing connected to an earmould, which fits inside the ear. Most people who get NHS hearing aids have this type (see picture 1). b) Through very thin, clear tubing connected to a small, soft earpiece at the tip of the tubing, which sits inside the ear canal (see picture 2). 2 This type is called an open ear fitting and can be less noticeable than an earmould. It can give a very natural sound but is only suitable for people with mild to moderate hearing loss. c) Through a clear tube with a wire inside, which runs from the hearing aid to a tiny loudspeaker held in the ear by a soft earpiece 3 (see picture 3). These are most commonly known as receiver in the ear or loudspeaker in the ear hearing aids and they are now available from some NHS audiology services. In-the-ear (ITE) and in-the-canal (ITC) aids These have their working parts in the earmould so the whole aid fits into the ear (see picture 4). They tend to need repairing more often than 4 BTE aids and can be fiddly. Body-worn hearing aids These have a small box that clips to clothes or can be put in a pocket (see picture 5). This is connected by a lead to an earphone 5 and earmould. Body-worn

9 Caring for older people with hearing loss 9 hearing aids are very powerful and may be more suitable for people who have sight problems and/or problems using their hands. See our factsheet Everything you need to know about getting hearing aids to find out more, and for information on bone-conduction and CROS/BiCROS hearing aids. Hearing aid settings Many digital hearing aids have settings for different listening conditions. Some adjust automatically in response to different sound environments; others will have to be activated manually (by hand). If a resident is going through the process of getting hearing aids, tell the audiologist about any particular difficulties that they may have been experiencing or activities they regularly take part in. A choice of listening programmes may be of benefit to them in these situations. The audiologist will discuss how to use the hearing aids and any particular settings that may be of benefit. The loop setting (formerly the T setting) Most hearing aids have a loop setting. This lets them pick up sound from listening equipment, such as hearing loop systems, which can be found in public places such as cinemas, theatres and banks, and can help people to hear more clearly over background noise. You can also get loops for home use (see What is a hearing loop?, page 12). Ask the resident s audiologist about the loop setting. Fitting a BTE hearing aid with an earmould see guide opposite The earmould is the part of the hearing aid that goes inside the ear. The hearing aid tube then hooks around the top of the ear, sitting snugly behind the ear. If a person has a hearing aid for each ear, there will usually be some marker so you can tell which aid is for each ear for example, a red mark on the aid for the right ear. If in doubt, check with the person who fitted the hearing aids. 1 Hold the earmould at the back with your finger and thumb. Pull it back past the ear. 2 Put the part that goes down the ear canal into position. 3 Then put in place the bit that goes into the crease at the top of the ear. 4 Use your other hand to pull down the earlobe. Push the earmould firmly into position. 5 Correctly fitted hearing aid. 6 Incorrectly fitted hearing aid the top part of the earmould is not properly tucked into the crease at the top of the ear.

10 10 Caring for older people with hearing loss Fitting a BTE hearing aid with an open ear fitting 1 Hold the hearing aid behind the ear with the soft tip facing towards the head. 2 Place the soft tip in the ear with the tail facing backwards. Push the tip in as far as it will comfortably go. Ask the audiologist if you want to find out about fitting other types of hearing aid. Cleaning BTE hearing aids 3 Fold the tail backwards into the bowl of the ear. Sometimes, when it s new, the tail does not stay in place, but after a few days it should mould itself to the shape of the ear. 4 Correctly fitted hearing aid. When someone has their hearing aids fitted, they should be given written instructions about how to look after them. If you are not sure about any of the information, or do not have access to it, ask the resident s audiologist for advice. Cleaning is different depending on whether someone has an earmould, open fitting or receiver-in-the-canal hearing aid. Tips for cleaning BTE hearing aids with an earmould Clean the main part of the hearing aid by wiping it with a soft, dry cloth or tissue. Take care not to get it wet. Wipe the earmould with a soft, dry cloth or tissue every night. Don t use any chemicals as they could damage it. Use a pin or similar item to remove any wax or debris that has got into the channel that goes through the earmould. About once a week, you should separate the earmould from the hearing aid and wash it. However, you should check this with the audiologist first. Follow the instructions below for washing the earmould: 1 Gently pull the soft tubing off the hooked part of the hearing aid by holding onto the tubing with one hand and the hook of the aid with the other and tugging gently. Don t pull the tubing out of the earmould as you won t get it back in. 2 Wash the earmould (with its tubing still in place) in warm, soapy water. Use a nailbrush or a vent cleaner (or both) to remove any wax. Rinse it well, blow down the tubing to get the water out and leave it to dry overnight. Then push the tubing back onto the hearing aid. 3 Make sure the curve of the earmould goes the same way as the curve of the hearing aid, as shown in the picture on the right.

11 Caring for older people with hearing loss 11 Cleaning BTE hearing aids with an open ear fitting The step-by-step guide below shows you how to clean the tubing of an open-ear-fitting hearing aid. You will need a very thin cleaning tube to help you clean the dome and tube this should be issued by the audiologist. The way you take off the tubing for cleaning is a bit different from one model to another. So, before you start, you ll have to check the instructions you have been given Need a little extra help? The Action on Hearing Loss Hear to Help hearing aid support service helps people to manage and maintain their NHS hearing aids through home visits and drop-in services. It is run by Community Support Officers and volunteers, who can: replace hearing aid tubing make minor repairs show you how to clean earmoulds and tubes show you how to replace your hearing aid battery provide basic training and tips on how to get the most from hearing aids provide information on other equipment and services. As yet, the service doesn t cover the whole of the UK but it s growing all the time. Call our Information Line (see bottom of page for contact details) to find out if there is a Hear to Help service in your area. For information about cleaning receiver-inthe-ear hearing aids, and other types, see our leaflet Adjusting to your hearing aids. How to replace hearing aid batteries Hearing aid batteries need to be changed regularly. It s unlikely that they will last much longer than a week to 10 days if someone wears them continuously. Someone with NHS hearing aids can get free batteries from any hospital audiology or ENT department that has a battery service. Some local health centres supply batteries, and pharmacies also sell them. You can also order batteries from local health centres and audiology departments by post. You will usually need to take the resident s hearing aid record book to the hospital department to pick up the batteries, or include the record book in the envelope if you are requesting batteries by post. The record book will help staff at the audiology department find the right type of battery for the hearing aid. To save the batteries, make sure that hearing aids are turned off at night and turned on again in the morning. Most hearing aids will be set to beep when their batteries are about to run out, but this will only be heard by the person wearing the hearing aids. If you care for several people who wear hearing aids, have a set time each week to help them change their batteries (if necessary) and to check their aids for wear and tear. This could be particularly useful if they have sight problems and/or problems with their hands, and find cleaning their hearing aids difficult.

12 12 Caring for older people with hearing loss When supporting people with hearing aids... Check and record every day that your residents hearing aids are working and that they are wearing them correctly. Know how to use the loop setting and different controls on the hearing aids, how to change the batteries and how to clean the hearing aids. Make sure that there are adequate arrangements for hearing aid re-tubing, repairs and battery replacement. Make sure that there are adequate arrangements to minimise the number of lost hearing aids, and to make sure that lost hearing aids are replaced quickly. On the medication checklist, put a reminder to change hearing aid batteries weekly and make sure care plans have information on each resident s hearing aid needs. Understand that other long-term conditions may have an impact on hearing aid use; for instance, people with dementia may forget that they have hearing aids. If someone is having problems with their hearing aid, check that all the parts are fitted correctly, that there aren t any obvious signs of damage (for example, split tubing), and that it s on the right setting. If you re not sure how to fix the problem, contact the audiologist. Know who to consult (for example, a GP or nurse) to examine ears for wax and to arrange ear syringing, where appropriate. For materials to help you support residents with hearing aids, including a care plan that you can use to ensure battery changes are done regularly and logged, and a troubleshooting guide, visit our website at helpingyoucare Equipment to help with everyday living There are three main categories of equipment designed for people with hearing loss: alerting equipment listening equipment telephones. Alerting equipment This includes alarm clocks, smoke alarms, doorbells and other devices. They make a louder noise, flash and/or vibrate to alert a person with a hearing loss. In a residential home they can help people maintain their independence and privacy. We recommend you install hearing loop systems in the TV rooms, communal rooms and reception areas of your home Listening equipment This amplifies sound (makes it louder) and reduces background noise. Most listening equipment can be used to listen to speech and can also be connected to a TV, radio or music system (with cables or through wireless technology). People who do not wear hearing aids can use the equipment with headphones. Those with hearing aids will need to wear either a neckloop or ear hooks and set their aids to the loop setting to listen. What is a hearing loop? Loop systems usually consist of an amplifier and a wire cable (loop) that goes around the listening area and plugs back into the amplifier. The amplifier then plugs into audio equipment, such as a microphone or TV. The electric current in the loop produces

13 Caring for older people with hearing loss 13 a magnetic field that sends sound directly to people s hearing aids when they re on the loop setting, helping them to hear more clearly. People who don t wear hearing aids can benefit from loop systems by using a loop listener, a portable device that has earphones or headphones. We recommend you install hearing loop systems in the TV rooms, communal rooms and reception areas of your home, to let your residents with hearing loss join in social activities. See How to get equipment, right. Social services is responsible for assessing the home equipment needs of people with a disability Telephone equipment If turning up the volume of the ringer on your existing telephone, or changing its pitch, doesn t make it easier for people with hearing loss to hear, and use, the phone, you could try a telephone amplifier (this only works on phones that have the dialling pad on the base unit). Or, you could add an extension bell or flashing light in one or more rooms. You can also buy phones that have a built-in amplifier and/or flashing light, and some phones have a built-in hearing loop, so they can be used with hearing aids set to the loop setting. A textphone has a keyboard and a display screen. Instead of speaking into a telephone mouthpiece, the person types what they want to say using the keyboard. Someone who uses a textphone can use Text Relay, a service that relays conversations between people who use textphones and those who use voice telephones (see page 18 for contact details). See our Equipment range of factsheets for more information. How to get equipment Social services is responsible for assessing the home equipment needs of people with a disability. Sensory support staff are trained to understand the needs of people with hearing loss and will be able to tell you what support is available, so do get in touch with your local social services department. Equipment is supplied on a loan basis and eligibility is based on hearing loss rather than being means tested. Equipment is also available for people with a sight loss. Try before you buy If you think that someone in your care could benefit from equipment, you can also buy products privately. But make sure you try them out first. Many audiology clinics, hearing therapists, hearing resource centres and social services departments have equipment for people to try out. Normally, you have to make an appointment to do this. Contact our Information Line (see bottom of page) to find the resource centre nearest to you. Specialist suppliers There are a number of suppliers that sell equipment for people with hearing loss. Action on Hearing Loss is the only UK charity with a full range of products for people with hearing loss and/or tinnitus, so we are full of impartial advice. Contact us (see Action on Hearing Loss Products, page 16) for our catalogue, Solutions, or shop online at When buying equipment, look out for: a 21-day or 28-day money-back guarantee so you can return goods if they are not helpful. a VAT exemption certificate some products can be bought without having to pay VAT. The certificate is a simple form saying that the person has a hearing loss and is claiming exemption.

14 14 Caring for older people with hearing loss Welfare benefits There are several benefits that people with hearing loss may be entitled to, such as: Attendance Allowance (AA) Adults aged over 65 can claim AA if they have a disability that affects their everyday life. People with hearing loss may qualify if they need help with communication every day, or if they have other disabilities. Disability Living Allowance (DLA) / Personal Independence Payment (PIP) Adults up to the age of 64 can claim DLA if they need support to communicate, or if they have mobility problems as a result of hearing loss or physical limitations. However, the government is replacing DLA with a new benefit called Personal Independence Payment (PIP). From June 2013, no new claims for DLA will be accepted (this is from April 2013 in certain areas). People currently receiving DLA will have to apply for PIP from October Disabled person s railcard People who are registered deaf or use an NHS hearing aid, or who receive benefits such as AA, can qualify for a disabled person s railcard. See page 17 for details of where you can find out more. War-related benefits People whose hearing was affected by service in the armed forces may be able to claim War Disablement Pension or Armed Forces Compensation, but very strict rules apply. Some civilians disabled during wartime are also covered. For more information about the benefits that people with hearing loss, and their carers, may be entitled to, see our Benefits range of factsheets. How to assess your home Please use this checklist to assess how well your home supports residents who have hearing loss, and to work out what action you need to take. Deaf awareness Have all of the staff and volunteers who work in your home had deaf awareness training? Has there been any staff turnover since your last deaf awareness training session? Have you ever invited Action on Hearing Loss to give a talk to your staff? Communication Are staff members aware of communication techniques for people with hearing loss, and do they use them? Do staff members communicate clearly? Do staff members take steps to stimulate conversation among people in your home? Do you know which of your residents have hearing difficulties or have ever been issued with a hearing aid? Have you ever referred anyone for a hearing test? Do staff members know about the communication support, such as a sign language interpreter, that is available to residents who would benefit from it? Do staff members understand how people can use listening equipment, such as hearing loops, in order to manage their hearing loss? Have staff members been trained to look after hearing aids, including cleaning? Do you have procedures to alert everyone to a possible fire in the night?

15 Caring for older people with hearing loss 15 The living environment Does your home have: telephones that are fitted with a hearing loop or are specially designed for people with hearing loss? textphones (if residents can t use amplified telephones)? a hearing loop or infrared system in TV rooms, communal rooms and reception areas? clear procedures for checking that all hearing loop or infrared systems are checked and maintained regularly? flashing smoke alarms? accessible entry systems, or alternative procedures? accessible lifts with visual indicators? good lighting in all areas? TVs with digital subtitles? reserved quiet areas, without TVs, where residents can go to chat? procedures in place to minimise the amount of background noise; for instance, are table cloths are used to dampen the sound of cutlery at meal times? a notice board in a good position? a seating arrangement that is helpful for communication? Information Do you ensure that residents are able to access audiology departments, when appropriate? Are staff members aware of services available, such as our Hear to Help hearing aid support sessions (see box, page 11), and do they facilitate residents use of these services, where appropriate? Do you access and make available external sources of information, such as our factsheets and leaflets about hearing aids, to residents and their families? Do you include relevant information in your prospectus for potential residents with hearing loss and their families? Louder than Words You could work towards the Action on Hearing Loss Louder than Words best practice charter to demonstrate your commitment to providing the best level of service and accessibility to residents with hearing loss and staff. To find out more, contact our Information Line (see bottom of page) or visit louderthanwords Where can I get further support? Action on Hearing Loss We are the largest charity in the UK tackling hearing loss and making hearing matter. We give advice and information. We provide services and develop technologies to improve the lives of people with hearing loss and/or tinnitus. We conduct research and run campaigns to understand and change people s attitudes to hearing loss. Action on Hearing Loss Information Line Our Information Line is a great place to start if you want more information on hearing loss or tinnitus, or about the work we do. Telephone Textphone SMS information@hearingloss.org.uk Featherstone Street, London EC1Y 8SL

16 16 Caring for older people with hearing loss Free support and information We produce a wide range of free publications. Our leaflets give you concise introductions to various aspects of hearing loss and tinnitus, and our factsheets go into more detail. You can order these from our Information Line (see page 15) or download them from our website at factsheets Action on Hearing Loss website Visit our website org.uk for information about hearing loss and tinnitus, the latest news stories, details of our services, campaigns, research, website forums and much more. Action on Hearing Loss Products We sell equipment that can improve the everyday lives of people with hearing loss. Visit our online shop to see our full range of products for people with tinnitus and/or hearing loss at org.uk/shop. Or you can request a copy of our Solutions catalogue by contacting our Customer Services team directly: 1 Haddonbrook Business Centre, Orton Southgate, Peterborough PE2 6YX Telephone Textphone Fax solutions@hearingloss.org.uk Action on Hearing Loss Care Services We provide high-quality residential care and community services. This includes supported housing and outreach for people who have hearing loss and additional special needs. We aim to maximise the quality of life of the people who use our services and help them to reach their highest possible level of independence. Our services are mainly purchased by local authorities and health agencies across the UK. Action on Hearing Loss Care Services Tel/textphone referrals@hearingloss.org.uk Other organisations Age UK The UK s largest organisation working with and for older people. Telephone Association of Teachers of Lipreading to Adults (ATLA) Provides details of local lipreading classes. ATLA c/o Hearing Link The Waterfront Eastbourne East Sussex BN23 5UZ atla@lipreading.org.uk British Deaf Association (BDA) The organisation representing the sign language community. BDA Head Office 18 Leather Lane London EC1N 7SU headoffice@bda.org.uk Benefit Enquiry Line Provides confidential advice and information for people with disabilities, and their carers and representatives, about social security benefits and how to claim them. Telephone Textphone For specific information about Attendance Allowance and Disability Living Allowance, contact the Disability and Carers Service: Telephone Textphone

17 Caring for older people with hearing loss 17 For Carer s Allowance, contact the Carer s Allowance Unit of the Disability and Carers Service: Telephone Textphone For pension credit applications: Telephone Textphone British Tinnitus Association (BTA) Provides support, advice and information about tinnitus. BTA Ground Floor, Unit 5 Acorn Business Park Woodseats Close Sheffield S8 0TB Telephone Textphone Fax info@tinnitus.org.uk Citizens Advice Bureau (CAB) Helps people resolve their legal, money and other problems by providing free, independent and confidential advice. Find details of your local office in the telephone directory or visit Deafblind UK Provides services and support for deafblind people. Deafblind UK Head Office National Centre for Deafblindness John and Lucille van Geest Place Cygnet Road Hampton PE7 8FD Tel/textphone Fax info@deafblind.org.uk Disabled person s railcard Apply online for money off rail travel in Britain. Telephone Textphone Health Care and Professions Council Responsible for the regulation of health, psychological and social work professionals, including hearing aid dispensers. Telephone Fax Hearing Link Provides a variety of services for people who are deafened, their families and the professionals who work with them. Hearing Link Head Office The Waterfront Eastbourne BN23 5UZ Telephone SMS enquiries@hearinglink.org Hearing Dogs for Deaf People Trains dogs to alert severely and profoundly deaf people to specific sounds, whether in the home, the workplace or public buildings. The Grange Wycombe Road Saunderton Princes Risborough HP27 9NS Tel/textphone Fax info@hearingdogs.org.uk

18 18 Caring for older people with hearing loss National Association for Deafened People (NADP) The national representative organisation for deafened people. NADP Dalton House 60 Windsor Avenue London SW19 2RR Telephone (answerphone they will get back to you as soon as possible) SMS RNIB Offers information, support and advice to people with sight problems. RNIB Headquarters 105 Judd Street London WC1H 9NE Telephone Sense The UK s largest organisation for deafblind children and adults. Telephone Fax reception@sense.org.uk Signature Campaigns to improve the standards of communication with deaf and deafblind people. Mersey House Mandale Business Park Belmont Durham DH1 1TH Telephone Textphone Fax enquiries@signature.org.uk Sign Health The national society for mental health and deafness. Sign Health 5 Baring Road Beaconsfield HP9 2NB Telephone SMS Fax info@signhealth.org.uk Text Relay The national telephone relay service for people with hearing loss. Text Relay Team c/o Internal Box 14 Telephone House Moor Lane Preston PR1 1BA Telephone Textphone helpline@textrelay.org.uk We welcome your feedback If you have any comments or suggestions relating to this factsheet, or if you re interested in joining our Readers Review Panel, we d love to hear from you. Your honest feedback will help us to improve our information. To find out more, or to provide us with your comments, please us at reviewpanel@hearingloss.org.uk or write to Information and Publications, Action on Hearing Loss, Featherstone Street, London EC1Y 8SL.

19 We re Action on Hearing Loss, the charity working for a world where hearing loss doesn t limit or label people, where tinnitus is silenced and where people value and look after their hearing. We provide care, support and information; raise awareness of hearing loss issues; campaign and lobby to change public policy; and fund research into a cure for hearing loss and tinnitus. To find out more, visit Our friendly helpline team is waiting to answer your call or Telephone Textphone SMS (standard text message rates apply) information@hearingloss.org.uk Action on Hearing Loss Caring for older people with hearing loss, version 01, published March This information will be updated and reviewed in March Free Action Tinnitus on Hearing Information Loss is the Line: trading 0808 name 808 of 6666 The Royal (telephone) National / Institute for Deaf 9000 People. (textphone) A registered charity in England and Wales (207720) and Scotland (SC038926) A0615/0313