Sensory impairment

As sensory impairment can be a significant life-limiting condition, the challenges associated with the condition are likely to grow over the coming decades.

People with sensory impairment are more likely to feel lonely and isolated. Research by RNID in 2000 found that 66% of deaf and hard of hearing people feel isolated due to their condition excluding them from everyday activities.

Sensory impairment is something that cuts across system wide services; it is important that sensory impairment awareness and services are embedded in the whole system of provision.

The combination of two sensory impairments can mean that a deafblind person will have difficulty, or find it impossible, to utilise and benefit fully from services for deaf people or services for blind people. Meeting the needs of deafblind people therefore needs a different approach.

Apart from the day-to-day difficulties, people with sensory impairment also have poorer health outcomes, higher rates of poverty and lower educational achievements than people free from disability.

• Both visual and hearing impairment are projected to increase in West Wales over the coming years
• Accelerating factors for sight loss include diabetes and obesity
• Sensory impairment is associated with increased risk of falls and fear of falling has a major impact on people’s ability to remain independent.

• An estimated 15,671 people in the West Wales region have a visual impairment, with the vast majority aged 60 and over. Projections show this will increase to 21,910 by 2043
• Around 85,864 people in the West Wales region have a hearing impairment, with the majority aged 70 and over. Projections show this will increase to 107,782 by 2043.

The accessible information standard states that patients, service users, carers and parents with a disability, impairment or sensory loss should:

• Be able to contact, and be contacted by services in accessible ways, for example email or text message
• Expect letters and information in formats they can read and understand, for example audio, braille, email or easy read
• Be supported by a communication professional at appointments if this is needed to support conversation, for example a British Sign Language interpreter
• Expect support from health and care staff and organisations to communicate, for example to lip-read.

People with sensory impairment are more likely to feel lonely and isolated. Research by RNID in 2000 found that 66% of deaf and hard of hearing people feel isolated due to their condition excluding them from everyday activities. Sufficient support in the 92 community is needed to address the issues of isolation and loneliness facing those with sensory impairment, along with improvements to identification and diagnosis, so that appropriate and timely support can be implemented. It has been found that 40-50% of older adults with visually impairing eye disease limited their activities due to fear of falling [6]. Evidence suggests that around 10% of falls can be attributed to sight loss [7]. Injuries from falls have detrimental effects on individuals and require costly interventions. Appropriate support and adaptations to help prevent falls and increase confidence of visually impaired people could improve quality of life and avoid further social isolation and loneliness.

The following support services are available in West Wales:

• Eye Clinic Liaison Officers (ECLOs) are in hospitals and provide support to help link visually impaired patients to the correct services and help navigate the complexity of possible treatments and services
• Specialist Rehabilitation Officers are located within social care and help to support people who have lost or are losing their sight. Rehabilitation officers can help patients experiencing visual impairment to maintain independence, regain lost skills or build confidence. They can also assist with mobility training, which can help an individual to regain their confidence in going outdoors safely and independently
• Specialist Services such as mobility and communication equipment and services including braille and lip-reading services where appropriate.

The following third sector organisations also offer support:

• Royal National Institute for Deaf People (RNID) is a charity that operates across the UK and works to make life fully inclusive for deaf people and those with hearing loss or tinnitus.
• The Royal National Institute of Blind People (RNIB) is a charity that operates across the UK and works on behalf of more than 111,000 people in Wales living with sight loss.
• Wales Council of the Blind (WCB) is an umbrella agency that represents vision impairment within Wales, and works to campaign, lobby and support the improvement of services for people with sight loss.
• Wales Council for Deaf People (WCDP) are an umbrella association of both voluntary and statutory organisations providing support for people who deaf, deafened, hard of hearing or deafblind in Wales.
• Deafblind UK currently supports people with dual sensory impairment in England, Wales and Northern Ireland.

To provide an assessment of the current sensory impairment services, and to determine adequacy of these services and identify areas which can be improved, a series of engagements were carried out.

The following are some of the key issues identified:

• Improving awareness and understanding around sensory impairment and the corresponding needs across primary, secondary and social care
• Developing services to meet predicted demand
• Improving identification and diagnosis
• Improving community support to address loneliness and isolation
• Improving accessibility, so that patients are not turned away inappropriately or give up because of the difficulties of navigating the health and social care systems
• Improving audit of the accessible implementation standard to ensure a person’s needs are fully recognised e.g. someone with complex needs also may have sensory impairment, which may be missed
• Considering alternatives for those with sensory impairment to avoid having to use public transport to access services, which can be particularly challenging, especially in rural areas.

Due to the Covid-19 pandemic, services have shifted from face-to-face to virtual delivery, such as video consultations. The pandemic has contributed to communication difficulties for both the hearing and visual impaired, as certain technologies may not be appropriate for communicating with people of differing sensory needs. Although convenient, remote video consultations do not work for blind or visually impaired people, telephone conversations are more appropriate. The pandemic has led to communication challenges for deaf people e.g., face masks making lip reading impossible and information in braille has been more difficult to obtain.

References:

1. [6] Wang, M. Y., Rousseau, J., Boisjoly, H., Schmaltz, H., Kergoat, M. J., Moghadaszadeh, S., Djafari, F. and Freeman, E. E. (2012). Activity limitation due to a fear of falling in older adults with eye disease. Investigative Ophthalmology & Visual Science, 53 (13), pp. 7967 – 7972
2. [7] Boyce, T. (2011). Falls - costs, numbers and links with visual impairment. London: RNIB