Enhancing Socialization of Older People Experiencing Loss of Both Vision and Hearing

Across an array of studies, age has been implicated as a major predictor of declines in sensory function, both visual (e.g., Tielsch et al., 1990; Rudberg et al., 1993) and auditory (e.g., Blanchfield et al., 2001; Ives et al., 1995). In congruence with this rising incidence of sensory impairment among the population in general will come an increased concern for the communication and socialization needs of those it affects, particularly older people who have begun to experience vision and hearing losses. If left unchecked, age-related decrements in sensory function can lead to any number of negative outcomes, including secondary injuries, loss of skills that can lead to dependence in everyday activities, and psychosocial problems such as general withdrawal from social situations, loneliness, or depression. These concerns have all been documented in other articles in this journal issue. This article provides some practical solutions for gerontologists and service providers concerned with older people who experience hearing and vision loss. The following are steps that can be used to optimize social interactions through good communication skills. The major factor that prevents people with vision and hearing loss from entering into social situations is communication. The combined disabilities magnify the difficulty because people are unable to augment hearing loss with lip reading. An individual may become passive, agitated, or assertive when the combination of vision and hearing loss affects the ability to communicate with family and friends. Family and friends will also be affected by this change. While assistive technology can enhance a person's ability to communicate, other accommodations must be made in order to maximize the use of residual vision and hearing for the purpose of communication. As people with vision and hearing loss are integrated into existing programs for elders, very practical techniques can enhance the quality of their involvement in community-based programs. The techniques suggested below are designed to be used by practitioners, family members, and friends as well as by people who are experiencing vision and hearing loss. ONE-ON-ONE COMMUNICATION The following are steps for practitioners, family members, and others to take to foster good one-on-one communication with an older person who has dual impairment. Step 1: Create the best possible environment * Begin communication by reducing or eliminating as much background noise as possible. Turn off televisions and radios, and if you are in a busy place like a restaurant or senior center, meet in an area that is as quiet as possible. * Try to avoid having windows or bright lights behind you, the speaker, as they will cause your face to appear darker, thus making lip reading more difficult. If possible, be sure that your face is well lighted. * When you are talking, face the other person directly, and look straight at him or her. People who have a central vision loss may look slightly over your shoulder, but you can maximize the sound of your voice by facing them. * Don't be afraid to change the seating arrangement or the furniture. In a group, sit closest to those who find it most difficult to hear. * When in public areas, do not sit close to entrances or in the middle of the room. Walls and corners usually provide the best noise control. * At a restaurant, do not sit close to the kitchen, bar, or bathrooms. * If possible, choose carpeted rooms with low ceilings and long drapes, which will have the best acoustics. Step 2: Adjust your communication style * Speak clearly, in a normal voice, not in an exaggerated fashion. * Avoid yelling and shouting. Move closer to the other person, but be sure to get permission before you invade any personal space. * Try to keep words and sentences relatively short. Pause slightly to allow the other person an opportunity to fill in the blanks in what she or he is hearing or discerning through lip reading. …