The Illinois Department on Aging
2nd Annual CCP Supervisors Conference
March 25-26, 2013
Crowne Plaza
Springfield, IL
Handouts/Resources Provided BY:
Paige Berry, National Coordinator
Senior Adult Services
Helen Keller National Center
Richmond, VA
804-827-0920
www.hknc.org
Presenter: Barbara Chandler
HKNC SE Regional Representative
404-462-0185
Vision and Hearing Loss: Double-Trouble
When you encounter consumers experiencing both a vision and hearing loss, it is critical that their vision and hearing loss be viewed in total and not as separate entities. Appropriate services are needed to help reduce the fear, isolation, helplessness, and loneliness felt by many senior adults. They did not expect their “Golden Years” to be like this. We hope the information below serves as a guide to assist you in getting consumers with combined loss of vision and hearing the appropriate services needed in order to lead meaningful and productive lives.
The term “Deaf-Blind” includes individuals in the following categories:
1. Blind and Hard of Hearing
2. Deaf and Visually Impaired
3. Hard of Hearing and Visually Impaired
4. Deaf and Blind
If the consumer you are working with needs skills in any of the following areas of Activities of Daily Living, please refer them to the appropriate agency listed in the resource section of this handout.
Alerting Devices (tactile, visual, auditory) for the telephone, doorbell, smoke/carbon monoxide detector
Communication aids: writing guides; computer/email access; large button phones; talking caller ID; enhanced volume control; loud ringer
Folding Money
Cooking and Kitchen Safety
Orientation & Mobility (traveling safely in my environment)
Glasses and other Low Vision Reading Aids
Sunwear to reduce glare (inside building and outside)
Budgeting
Leisure Activities
SPECIAL RESOURCE
The American Foundation for the Blind, in conjunction with the Helen Keller National Center Senior Adult Services, produced a series of short videos on different aspects of Vision and Hearing Loss. The videos describe some common aids and devices used by this population. To view the videos go to:
· http://www.visionaware.org/
· Click on “Everyday Living”
· Scroll down to videos on Vision and Hearing Loss
Types of Vision Loss
Acuity Loss:
· Problem with central vision
· Central vision is used to read and write
· It is the vision tested with an eye chart and corrected with glasses.
· Some people have an acuity loss so great that it cannot be corrected with glasses.
Field Restriction:
· Loss of one section of vision.
· Often peripheral or side vision, which is used to spot things near by and to "keep track" of what is going on around us.
Mixed Loss: It is possible to have both a field restriction and acuity loss. (Macular Degeneration and Glaucoma)
Legal Blindness: Visual acuity of 20/200 or worse with the best correction OR a visual field restriction of 20 degrees or less.
20/20 VISION: This means that the person being tested can see at 20 feet what a normal-seeing person can see at 20 feet. 20/200 indicates that the person being tested can see at 20 feet what a normal-seeing person can see at 200 feet.
Questions for My Vision Care Specialist
1. What is my visual acuity?
2. Do I have a field loss?
3. What is the cause of my vision loss?
4. Will I lose more sight?
5. What can I do to protect my remaining vision?
6. Will medications I am taking cause temporary or permanent vision loss
7. Will I benefit from a low vision exam?
· Magnifiers
· CCTV
· Sun wear (inside and outside)
· Telescope
· Direct Lighting
Fonts – which can you read with ease?
12 Point
14 Point
16 Point
18 Point
20 Point
24 Point
30 Point
36 Point
42 Point
48 Point
60 Point
Times Roman 72
Charles Bonnet Syndrome
(Visual Hallucinations)
• Named after the Swiss naturalist and philosopher Charles Bonnet.
• He reported hallucinations of Charles Lullin, his 89-year-old otherwise healthy and cognitively sound grandfather, who was blind owing to cataract and yet vividly saw men, women, birds, and buildings.
• Less frequently diagnosed but rather common cause of complex visual hallucination
• More common in elderly due to prevalence of vision loss later in life. Seen most often in patients with Macular Degeneration.
• No clear level of visual acuity at which CBS occurs has been documented.
• May persist for a few days to many years, changing in frequency and complexity
• The imagery is varied and may include groups of people or children, animals, and panoramic countryside scenes
Is CBS a form of Mental Illness???
• No - that in itself is major relief to an elderly person experiencing failing vision, social isolation, and other medical problems.
• Many don’t admit symptoms –why? fear being labeled with insanity
• Similar to phantom limb; musical auditory hallucinations
• visual cortex exhibits spontaneous activity, giving rise to conscious imagery
Range of Hearing Loss
Level of Loss / Description / Effect / Hearing Aid Need0 to 25 dB HL / Normal / Normal speech is understood / No need
26 to 40 dB HL / Mild / Difficulty understanding normal speech / Needed in specific situations
41 to 55 dB HL / Moderate / Difficulty understanding loud speech / Frequent need
56 to 80 dB HL / Severe / Can understand amplified speech only / Need for all communication
81 dB or more HL / Profound / Difficulty understanding amplified speech / May need supplemental speech-reading, aural rehab, or sign language
Things I need to know about my hearing loss!!
1. What is my decibel loss?
Right ear______Left ear ______
2. In what frequencies do I hear best?
3. In what frequencies do I have more difficultly understanding?
4. Will hearing aids help?
5. Am I a candidate for a Cochlear Implant?
6. Is my hearing loss progressive?
7. Could the combination of medications I am taking cause further hearing loss?
Communication Strategies for Service Providers
· Say the person’s name to get their attention before talking with them.
· Do not cover your face or keep hands near the mouth area.
· Know where to get an interpreter, if the individual’s primary language is sign language.
· Men – (mustaches should be trimmed so the lips are exposed to aid in speech reading )
· Ladies – (careful about dangling and shinny earrings that might distract from your face)
· Wear solid colors that contrast to your skin tone (no prints, polka dots, stripes)
· Kneel or bend to get at eye level with the consumer
· Make sure there is appropriate lighting
· Check to make sure you are in a position where you can be seen, avoid glare behind you
· Avoid background noise
· Speak clearly at a moderate rate
· Don’t exaggerate mouth movements
· Use short sentences and get to the point
Consumer Plan-Ahead Tips for Better Communication
General – Let others know:
· How to get your attention
· Which ear is best
· How to let you know where the speaker is, so I am facing him/her.
· To tell me when they leave the room.
· To let me know if the volume of my voice is too low or too loud. (ask them to draw line up side of my arm if I need to speak louder; or down the side of my arm if I need to speak lower)
· To let me know if there is feedback (squealing) on my hearing aid.
· Reconfirm important points
Restaurants
· Call ahead and ask for booth with high back.
· If there is no booth, ask for a table in the quietest part of the restaurant.
· Ask to be seated away from kitchen and front door.
· Ask if wait staff can assist you:
o Reading menu
o Buffet line
o Cutting meat
Community Events
· Ask if an assistive listening device is available
· If not, ask if you can bring your own ALD and if the speaker will wear it
· Ask if the speaker will be using a microphone
· Ask to be seated near speaker
· Ask speaker to repeat questions from the audience when applicable
· Do not bluff!
· Try to remain patient and positive
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Self-Advocacy
· Know situations you handle well.
· Know difficult hearing situations.
· Coping skills: What do you do when …
· Know your preferred accommodations.
· Be able to state why you prefer one accommodation over another
· Be aware of application laws.
Alerting Devices
Questions to consider:
1. Doorbell or Knock on Door:
a. Can you hear a knock on the door?
b. With/without hearing aid.
c. If you are not in the same room as the bell/door?
2. Smoke alarm/Carbon Monoxide:
a. Do you have a smoke /carbon monoxide detector?
b. Do you change the battery every 6 months?
c. Can you hear it when it is activated?
d. Can you hear it without hearing aid?
e. Can you hear it if you are not in the same room with it?
3. Telephone:
a. Can you hear it ring if not same room with it?
b. If you do not have hearing aid on?
c. Can you understand most speech over the phone?
d. Do you hear better in the high or low frequencies?
HKNC’s Confident Living Program (CLP)
for Senior Adults goes
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· Partner with HKNC to host a CLP in your state
· Length of program 2.5 days
· The program is geared toward consumers, ages 55 and better who are hard of hearing and blind or visually impaired and do not use sign language as their primary means of communication.
· A maximum of 10 participants
Participants will obtain information and an introduction to skills in the following areas:
Ø coping with hearing and vision loss
Ø enhancing independent living skills
Ø enhancing communication skills
Ø experiencing new technology
Ø self advocacy
Ø elder law issues
Ø emergency preparedness
Ø community integration and developing community resources
Ø sharing life experiences with peers
Ø exploring leisure activity options
Ø having FUN
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For more information contact
Helen Keller National Center
North Central Regional Office
485 Avenue of the Cities, Suite 5
East Moline, IL 61244
309.716.3657 VP
309.755.0018 voice
309.755.0025 fax
Laura J. Thomas, Regional Representative
CLP Facilitated by:
Paige Berry, National Coordinator
Senior Adult Services
Helen Keller National Center
c/o Virginia Commonwealth University
Department of Rehabilitation Counseling
PO Box 980330
Richmond, VA 23298
804-827-0920 Voice
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ILLINOIS RESOURCES
For individuals who have combined loss of Vision and Hearing,
their families, service providers and others
Illinois Department of Human Services/Division of Rehabilitation Services
400 W. Lawrence Avenue
Springfield, IL 62794
217.785.9304 voice
217.785.7798 fax
312.957.4881 VP
Ingrid Halvorsen, Manager of D/HH/DB Services
www.dhs.state.il.us
DHS/BBS Illinois Center for Rehabilitation and Education (ICRE-Wood)
1151 South Wood Street
Chicago, IL 60612
312.633.3545 voice
312.633.3479 fax
Brenda Alexander, Program Manager
Janet Sherburne, Program Manager
Independent Living for Older Blind
Department of Human Services
Bureau of Blind Services
Division of Rehabilitation Services
809 Commercial Avenue
Springfield, IL 62703
Phone: (217) 785-3887
Fax: (217) 524-1235
TTY: (217) 785-3887
Relay: (866) 704-2313
E-mail:
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Independent Living Services for Older Blind
Contact: Priscilla Curtis
Department of Human Services
Bureau of Blind Services
Division of Rehabilitation Services
1307 North Mattis Avenue
Champaign, IL 61821
Phone: (217) 278-3500
Fax: (217) 278-3508
Relay: (888) 472-0940
E-mail:
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Helen Keller National Center
North Central Regional Office
485 Avenue of the Cities, Suite 5
East Moline, IL 61244
309.716.3657 VP
309.755.0018 voice
309.755.0025 fax
Laura J. Thomas, Regional Representative
The Chicago Lighthouse (HKNC Affiliate)
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Deaf-Blind Program
1850 W. Roosevelt Rd.
Chicago, IL 60608
312.666.1331, ext. 3415 voice
312.957.4865 VP
312.421.4788 TTY
312.666.8874 TTY
312.243.8539 fax
Joann Rushing, Program Manager
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National Deaf Blind Equipment Distribution Program/iCanConnect (ICC)
The Chicago Lighthouse (HKNC Affiliate)
Deaf-Blind Program
1850 W. Roosevelt Rd.
Chicago, IL 60608
312.666.1331, ext. 3415 voice
312.957.4865 VP
312.421.4788 TTY
312.666.8874 TTY
312.243.8539 fax
Joann Rushing, Program Manager
www.iCanConnect.org
Helen Keller National Center
for Deaf-Blind Youths and Adults (national headquarters)
141 Middle Neck Road
Sands Point, NY 11050
516.944.8900 voice
516.570.3626 VP
516.944.7302 fax
www,hknc.org
Helen Keller National Center Senior Adult Services
Paige Berry, National Coordinator
c/o Virginia Commonwealth University
Department of Rehabilitation Counseling
PO Box 980330
Richmond, VA 23298
804-827-0920 Voice
Le COBDA (a Deaf-Blind social group)
1850 W. Roosevelt Rd.
Chicago, IL 60608
Regularly scheduled on 2nd Saturday of the month (except January, June and August)
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President: Celine Bush
312/421.4788 TTY
312.666.8874 TTY
312.957.4865 VP
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Illinois Association of Deaf-Blind (state consumer organization)
Karyn Campbell, President
Renee Ingalsbe, Vice President
Illinois Telecommunications Access Corporation (ITAC)
3001 Montvale Dr. Suite D
Springfield, IL 62704
217.698.4170 voice
217.698.0942 fax
Braille Phone, Large Visual Display TTY and Deaf-Blind Communicator
www.itactty.org
State of Illinois Deaf and Hard of Hearing Commission (IDHHC)
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528 South 5th St., Suite 209
Springfield, IL 62701
217.303.8010 VP
217.557.4495 voice
217.557.4492 fax
John Miller, Executive Director
www.idhhc.state.il.us
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Center for Sight & Hearing (HKNC Affiliate)
8038 Maclntosh Lane
Rockford, IL 61107
815.332.6800 voice
815.332.6810 Fax
Diane Jones, President
www.rockfordcenter.org
Anixter Center
2032 N. Clybourn Avenue
Chicago, IL 60614
773.929.8200 ext. 283 voice
Anne Westerman-Rivera, Director of Community Resources and Support