Australia2008 Pleanry


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  • AGENDA How can elderly with dual sensory impairment be helped? How can awareness be created in relevant groups? How can identification of elderly with dual sensory impairment be supported? Which types of support do they need? What are the experiences from Denmark and other countries?
  • Australia2008 Pleanry

    1. 1. Something can be done Dual sensory impairment in the elderly
    2. 2. Prevalence studies
    3. 3. Prevalence – ”care system”
    4. 4. Why aren’t they found? <ul><li>Slow progression </li></ul><ul><li>Lack of awareness </li></ul><ul><li>” I am just old” </li></ul><ul><li>Overshadowed by other ailments </li></ul><ul><li>” On home turf” </li></ul><ul><li>Misunderstanding of symptoms </li></ul><ul><li>And anyway: Nothing can be done! </li></ul>
    5. 5. Doing something matters <ul><li>Close link between uncorrected sensory impairments and poor quality of life </li></ul><ul><li>Elderly with DSI who receive the right rehabilitation </li></ul><ul><ul><li>Better mood </li></ul></ul><ul><ul><li>Fuller social life </li></ul></ul><ul><ul><li>Easier daily living </li></ul></ul><ul><li>Their quality of life leans towards that of others </li></ul><ul><li>To act costs less than doing nothing </li></ul>Appollonio et al. Age Ageing 1996; 25
    6. 6. Action steps <ul><li>Awareness </li></ul><ul><li>Identification </li></ul><ul><li>Service provision </li></ul><ul><ul><li>Who? </li></ul></ul><ul><ul><li>What? </li></ul></ul><ul><ul><li>How? </li></ul></ul><ul><ul><li>(Speed!) </li></ul></ul><ul><li>Lobbying </li></ul>
    7. 7. Support providers <ul><li>If ”deafblind system” </li></ul><ul><ul><li>How to deal with the vast numbers? </li></ul></ul><ul><ul><li>How to get called upon? </li></ul></ul><ul><ul><li>Overkill? </li></ul></ul><ul><ul><li>The word ”deafblind” </li></ul></ul><ul><li>If ”mainstream system” </li></ul><ul><ul><li>How to give staff in the elderly sector knowledge about deafblind specific tools and techniques? </li></ul></ul><ul><ul><li>How to motivate them? </li></ul></ul><ul><ul><li>How to coordinate service? </li></ul></ul>
    8. 8. Service providers <ul><li>Mostly mainstream service providers: </li></ul><ul><li>Also deafblind service providers: </li></ul><ul><ul><li>India </li></ul></ul><ul><ul><li>Spain </li></ul></ul><ul><ul><li>Belgium </li></ul></ul><ul><ul><li>Venezuela </li></ul></ul><ul><ul><li>Uganda </li></ul></ul><ul><ul><li>Canada </li></ul></ul><ul><ul><li>Sweden </li></ul></ul><ul><ul><li>Norway </li></ul></ul><ul><ul><li>Italy </li></ul></ul><ul><ul><li>Germany </li></ul></ul><ul><ul><li>USA </li></ul></ul>Denmark UK Netherlands
    9. 9. Denmark <ul><li>Approx. 5% of all elderly over the age of 80 have a significant combined hearing and vision impairment </li></ul><ul><li>A total of around 10.000 people </li></ul><ul><li>Deafblind consultants are in contact with approx. 500 </li></ul><ul><li>Approx. 4% of the Danish population is over the age of 80 </li></ul><ul><li>In 2040 this portion will increase to over 9% </li></ul>
    10. 10. The problem in brief <ul><li>More than 10 times as many as previously estimated </li></ul><ul><li>Don’t get the help and support they need and have the right to </li></ul><ul><li>Withdrawal, isolation, reduced quality of life, somatic and mental problems </li></ul><ul><li>Very good service system </li></ul>
    11. 11. Danish service system Family doctor Preventive home visits Home helpers Nursing home staff Home nurses Family & friends Deafblind organisation Vision rehabilitation Hearing rehabilitation Deafblind consultants Hospitals etc. Contact persons (Interpreters)
    12. 12. What do they need <ul><li>Three things (first and foremost): </li></ul><ul><li>Identification </li></ul><ul><li>Identification </li></ul><ul><li>Identification </li></ul><ul><li>The sooner, the better </li></ul>
    13. 13. Then what? <ul><li>” Contact person ” </li></ul><ul><li>Advice and counselling </li></ul><ul><li>Coordinated approach from vision and hearing rehabilitation system </li></ul><ul><li>Correct vision and hearing aids </li></ul><ul><li>” Proper” behaviour in family and staff around them </li></ul><ul><li>Peer support </li></ul><ul><li>Front of line for technical aids, cataract operations and other rehabilitation measures </li></ul><ul><li>(Increased medical attention) </li></ul>
    14. 14. Contact person <ul><li>Danish legislation since 1991 </li></ul><ul><li>4-10 hours per week </li></ul><ul><li>Help with </li></ul><ul><ul><li>Communicate </li></ul></ul><ul><ul><li>Mail, news </li></ul></ul><ul><ul><li>Link to environment (shopping, bank, post office) </li></ul></ul><ul><ul><li>Guide, accompany </li></ul></ul><ul><ul><li>” Eyes and ears” </li></ul></ul><ul><li>Employed by municipality </li></ul><ul><li>No formal training, supervised by deafblind consultants </li></ul>
    15. 15. Our activities <ul><li>2006: Information campaign – Primary aim: awareness </li></ul><ul><li>2007 + 2008: Information targeted at professionals – Primary aim: identification (+ coordination) </li></ul>
    16. 16. Media campaign <ul><li>Press kit </li></ul><ul><ul><li>Press release </li></ul></ul><ul><ul><li>Fact sheets </li></ul></ul><ul><ul><li>Simulation glasses and ear plugs </li></ul></ul><ul><ul><li>Solo story </li></ul></ul><ul><ul><li>Cases! </li></ul></ul><ul><li>Direct contact </li></ul><ul><li>Well received </li></ul><ul><li>Meetings with members of parliament </li></ul>
    17. 18. It doesn’t get any better… <ul><li>Is everyone included? </li></ul><ul><li>Until now Danish hearing and vision specialists have assumed that there were 900 elderly deafblind in Denmark. But according to new calculations the number is closer to 15,000, Berlingeren (Danish newspaper) writes. </li></ul><ul><li>- - </li></ul><ul><li>Just to make sure: Did you also count all those in the Parliament? </li></ul>
    18. 19. Question guide <ul><li>Experiences from earlier projects in Denmark and Norway </li></ul><ul><ul><li>Questions for the person about his/her functioning give valid answers </li></ul></ul><ul><li>Not a questionnaire </li></ul><ul><li>Should be possible to use without instructions </li></ul>
    19. 20. Pilot project Hvalsø <ul><li>214 elderly over the age of 80 </li></ul><ul><li>5 % of 214 = 11 </li></ul><ul><li>45 home visits during the project </li></ul><ul><li>Question guide was used eight times </li></ul><ul><li>Four deafblind elderly identified (= 8.9% of total visits) </li></ul>
    20. 21. Pilot project Langeland <ul><li>1700 elderly over the age of 75 </li></ul><ul><li>5 % of 1700 = 85 </li></ul><ul><li>Question guide used 186 times </li></ul><ul><li>10 elderly (5.4 %) with some degree of dual sensory impairment were identified </li></ul><ul><li>83 elderly (44.6 %) with some degree of hearing impairment </li></ul><ul><li>34 elderly (18.3 %) with some degree of vision impairment </li></ul>
    21. 22. Leg 1: Preventive home visits Question guide for use in preventive home visits Mail to the members of the organisation with an article and the question guide Two half day seminars Article and question guide in the online tool box of the The Danish Knowledge Center on Ageing Presentation at the professional annual meeting Article in their journal
    22. 23. Leg 2: Nursing homes Poster and information folder for the 1500 nursing homes Like hearing through a blanket and seeing through fog…
    23. 25. Leg 3: General Practitioners Article for Monthly Journal of Practical Medicine (together with a GP) ” What can the GP do?”
    24. 26. Leg 4: Vision and hearing rehabilitation Use of question guide Coordination of service
    25. 27. Leg 5: Students <ul><li>Letter for schools for nurses, occupational and physio therapists, social and health assistants </li></ul><ul><ul><li>Information about this topic </li></ul></ul><ul><ul><li>Offer for more information from our center or a visit from the association of the deafblind </li></ul></ul>
    26. 28. Leg 6: Home help system Introduction for the home help in a district in Copenhagen Agreement on continuing contact while they use the question guide
    27. 29. Leg 7: Family Awareness of symptoms Information campaign
    28. 30. Information material <ul><li>For home helpers </li></ul><ul><li>For nursing home staff </li></ul><ul><li>For hospital staff </li></ul><ul><li>Collaboration with vision and hearing (and age care) </li></ul>
    29. 31. Next steps <ul><li>Continue identification work </li></ul><ul><li>Better service </li></ul><ul><li>Staff training </li></ul><ul><li>Obstacles: </li></ul><ul><ul><li>Little time and motivation </li></ul></ul><ul><ul><li>Competition for awareness and interest from professionals </li></ul></ul>
    30. 32. Swedish project <ul><li>Demographic survey </li></ul><ul><li>10 hour module on DSI in the elderly </li></ul><ul><ul><li>Own experience </li></ul></ul><ul><ul><li>Hearing and vision impairment and its functional consequences </li></ul></ul><ul><ul><li>Interaction, ethics, communication </li></ul></ul><ul><ul><li>Rehabilitation (discussion and thoughts) </li></ul></ul><ul><li>Spreading to other municipalities </li></ul><ul><li>Train the trainer </li></ul>
    31. 33. Outcome of training <ul><li>Increased knowledge that can be transformed into competence, motivation and increased understanding </li></ul><ul><li>Increased will to learn more and to act as a catalysist in age care </li></ul>
    32. 34. What is important <ul><li>To use the phone </li></ul><ul><li>To be able to use hearing aids </li></ul><ul><li>To have good home lighting and other adaptations for vision </li></ul><ul><li>That relatives and staff understand DSI </li></ul><ul><li>To have access to news and other important information </li></ul><ul><li>To be able to use an interpreter </li></ul><ul><li>To know who is at the door </li></ul><ul><li>To know if and who enters or leaves the room </li></ul><ul><li>To move around in the close environment – and know how it looks </li></ul>
    33. 35. Main importance <ul><li>That someone takes responsibility that you are seen on the basis of your possibilities and rights! </li></ul>
    34. 36. Norwegian project <ul><li>Online learning tool </li></ul><ul><li>Hearing and vision </li></ul><ul><li>Target group: Municipal staff </li></ul><ul><li> </li></ul>
    35. 37. <ul><li>The aim is not to put years to life </li></ul>… but to put life to years
    36. 39. <ul><li>Variation is not the spice of life; </li></ul><ul><li>it is the true essence of it </li></ul><ul><li>Woodburn Heron, 1957 </li></ul>
    37. 40. <ul><li>The problem is being aware </li></ul><ul><li>that this is a separate disability. </li></ul><ul><li>And that something can be done. </li></ul><ul><li>Else Marie Jensen </li></ul>