Deafblindness: deaf and blind?

May 15, 2011 by Danielle Cloutier

Deafblindness: deaf and blind?

Deafblindness does not necessarily describe persons who are completely blind and deaf; there are varying degrees of severity. For example, a person with a hearing impairment who also has a severe visual impairment may possess very good visual acuity when looking straight ahead but have restricted visual fields that make it difficult to move around and have access to visual communication information, such as speechreading.

Tips for communicating with persons suffering from deafblindness:

  • Find out how they communicate.
  • Eliminate background noise.
  • Ensure there is sufficient lighting. Avoid bright lights.
  • Limit visual distractions.
  • Face the person and ask them to let you know at what distance they are able to recognize visual cues.
  • Get their attention before talking to them. Make sure you are directly in their field of vision.
  • Establish visual contact.
  • Speak in a normal voice.
  • Use short, simple sentences.
  • Take pauses.
  • Make sure the message is understood. Look for signs of incomprehension.

According to Dr. Stanislas Tomkiewicz, deafblindness is not simply a matter of hearing loss (loss of X decibels) plus vision loss (diminished acuity or visual field). The two impairments cannot just be added together: they potentiate and aggravate each other. When both sensory problems are present, this generates a separate condition. The double sensorial deficiency gives rise to specific disabilities, such as the difficulty of performing social roles. These disabilities are different from those experienced by persons living with only one or the other impairment, which is why deafblindness programs have been introduced in some rehabilitation centres.

Unlike a mobility disability, both hearing loss and visual loss are INVISIBLE. Combined, they have a major impact on quality of life and may in turn engender feelings of isolation and loss of autonomy.

In Québec, 14.2% of the population aged 65 and over suffer from a hearing disability, while 5.9% suffer from a visual disability. The prevalence rate for persons aged 75 and over is 22.1% for hearing disabilities and 8% for visual disabilities (Institut de la statistique du Québec, 2001). An Australian study found that the more visual acuity diminishes in older adults, the more likely it is hearing problems will appear. It is therefore highly possible that one of your elderly patients or relatives is suffering from some form of deafblindness.

Let’s pay attention

You might feel that communication is difficult under certain circumstances: the person responds on a completely different subject, says “yes, yes” or nods inappropriately, stares at you blankly or looks puzzled, and so on. These signs of incomprehension are clues. Don’t hesitate to refer this person to a medical specialist or audiologist.

Physical rehabilitation centres are available throughout the province for persons with physical or sensorial disabilities, including deafblindness.

Jeanne’s story

In 2011, life is frantic, communication tools are increasingly sophisticated, people spend a lot of time travelling, many individuals strive to find a work-family balance, and great value is placed on social interactions. Imagine today’s reality but with a double impairment! Jeanne, a mother, suffers from a hearing and visual impairment attributable to Usher syndrome (deafness at birth combined with retinitis pigmentosa). She has to carry out all her day-to-day activities in addition to her professional work. From dawn to dusk, she has to overcome a myriad of obstacles.

Her vision has diminished over the past year. She has to learn to do things differently, as well as develop skills to compensate for the difficulties encountered. For example, preparing meals and doing the laundry require considerable focus and organization. “Everyone has to carefully put things in the right place so that I can function properly and be more efficient. It’s easy to make mistakes, and it’s very confusing when items are not where they should be. Even a simple task like regulating the oven temperature can prove difficult when we are not able to fully depend on our vision.” Family meals give rise to different challenges: serving the meal, seeing what’s on the plate, watching over the children, having a conversation with the noise of the dishwasher in the background, everyone talking at the same time, music and dimmed lighting to create an ambiance—it’s a lot to manage! Supervising homework, reading bedtime stories and even watching the television or talking to a friend on the telephone are all activities that require loads of energy.

For three months now, Jeanne has had help from a team of deafblindness specialists. Rehabilitation services and the use of compensating means help her alleviate the negative impacts while carrying on with her professional and family roles. The multidisciplinary team encourages social interaction in persons with deafblindness. It is important to understand each of these impairments prior to implementing an intervention plan adapted to the deafblind person’s specific needs.

Jeanne’s intervention plan focuses on improved lighting in her surroundings, better use of her tactile skills, a hearing aid in each ear, technical aids, situational simulations with the family to acquire communication strategies and specialized orientation- and mobility-related interventions. Jeanne and her family receive psychological support, aimed at adapting and mobilizing her capacities during the rehabilitation process. She applied to the assistance program for a grant to purchase the required support services with regard to access to communication and information. These support services are offered province-wide.

References available upon request.

Jeanne’s story was inspired by situations experienced by users.