Is a decline in vision and hearing just a “fact of life” for people as we age?

Dual sensory impairment is an under-explored and little understood type of disability, but one which can have an enormous impact on those living with it and their partners, families, and carers. The number of people who are living with impairments to both sight and hearing is rapidly increasing as the global population ages, yet the challenges faced as a result are largely invisible. The Third Sense explores the experiences of older adults living with multiple or dual sensory loss, the social consequences, barriers, and stigma faced by people and their loved ones.

Drawn from the lived experience of both the authors and their research participants, this book is necessary and urgent reading for medical practitioners, clinicians, health workers, and social care providers in practice and training; higher education students of Disability Studies, Medicine and related courses, Social Work and related courses, Sociology, and Cultural Anthropology.

• Cover
• Half Title
• Title Page
• Copyright Page
• Abstract
• Acknowledgements
• About this book
• Contents
• Learning objectives
• 1 Dual sensory impairment realities
  • Introduction
  • One day (and night) in the life of DSI
    • Morning
    • Afternoon
    • Evening
    • Overnight
  • Conclusion
• 2 Understanding dual sensory impairment: Definitions, prevalence, invisibility
  • Introduction
  • Dual sensory impairment (DSI)
  • Distinct disability
  • Definition
  • Subtypes of DSI
    • Congenital deafness and blindness
    • Congenital deafness and acquired vision loss
    • Congenital blindness and acquired hearing loss
  • DSI data
    • Hearing loss
    • Vision loss
  • DSI
    • Causation
    • Severity
  • An aging population means a growing population living with DSI: An invisible epidemic
    • Invisible populations
      • Unrecognized/unacknowledged DSI
    • Residents of aged-care facilities
    • Veterans
    • Prisoners
    • First Nations peoples
    • Homeless
    • Multiple disability
  • Conclusion
• 3 Dual sensory impairment: Health, well-being, and security
  • Introduction
  • A note on vulnerability
    • Health, well-being, and security
  • Communication
    • Health and poor communication
    • Communication and assistive devices
    • Communication and Covid-19
    • Loss of communication partners and social networks
  • Access to healthcare
    • Few dedicated health and social care services for DSI
  • Experiences of healthcare
  • Physical health threats
    • Threats from the environment
    • Reduced food and medication safety
    • Risks from conditions causing DSI and treatment
    • DSI and functional decline
    • Public health threats
    • Poor inclusion in disaster preparation and response
    • Exclusion
    • Psychological well-being
    • Cognitive health
    • Delirium
    • Visual hallucinations
    • Tinnitus
  • Ontological security and well-being
    • Unpredictable people
    • Unpredictable trust
    • Unpredictable privacy
    • Unpredictable things
    • Unpredictable places
    • Residential aged care and risk
    • Families and carers
  • Conclusion
• 4 Seeing the unseen: Hearing the unheard: Charles Bonnet syndrome and tinnitus
  • Charles Bonnet syndrome
  • Common causes of vision loss
  • Nature and form of visual hallucinations
  • Causal mechanisms
  • How common is the syndrome?
  • Clinical challenges
  • Management
    • Management roadmap for Charles Bonnet syndrome: List 1
  • Tinnitus
    • Hearing the unheard: DSI and tinnitus
    • Risk factors
    • Impacts
    • Family and carers
    • Management
    • Summary
• 5 The effort and art of caring
  • Introduction
  • Caring in Australia
    • Formal versus informal caring
    • Caring in a DSI context
  • The effort of caring in a DSI context
    • Social isolation and effort
    • Changing roles
  • The art of caring: Rethinking caring in a DSI context
    • Empathic understanding
    • Social engagement
    • Social facilitation and protection; enabling and destigmatizing
    • The art of caring for self
    • Active and passive transitions to a caring role
    • Negotiating and maintaining social networks
  • The way forward: Caring in a DSI context.
  • Building social caring capacity in DSI–doing it better
  • Conclusion
• 6 The impact of DSI on building and maintaining social networks
  • Introduction
  • DSI at the intersection of aging and disability
  • Effects of stigma and self-stigma
  • Importance of social networks in older age
  • Loneliness and DSI
  • Social impact of DSI in older age
  • Social networks and interpersonal relationships: Personal and interpersonal tension, connection, and disconnection
  • Integrating health and social support networks
    • Navigating social support
    • Building social network capacity
  • Building social networks and integrating caring capacity in DSI—doing it better
  • Conclusion
• 7 Living better: Communication 1: Basics for health and social care professionals/practitioners
  • Introduction
  • Simple strategies for everyone
  • Basic dual sensory impairment communication supports
    • How do you introduce yourself to a DSI person?
    • Basic communication with a person with DSI
    • Basic guiding to communicate environmental information
  • Low-cost measures and accessibility technologies
    • Hearing loss
    • Hearing impairment communication supports
    • Low vision
    • Vision impairment communication supports
  • Especially for health and social care professionals
  • Super teams
  • Better communication
  • Acquire skills and knowledge
  • Managing specific conditions
    • Communication breakdown
    • Anxiety and depression
    • Increased mortality risk
    • Cognitive decline
    • Delirium
    • Falls
    • Visual hallucinations and Charles Bonnet syndrome
    • Health literacy
  • Useful resources
    • Communication training modules
    • Patient self-advocacy
    • Written resources to support face-to-face communication
  • Conclusion
• 8 Living better: Communication 2: Social-haptic communication
  • Introduction
  • Social-haptic communication
    • Definition
    • A communication arsenal
    • History of social-haptic communication
  • How to use social haptics
    • Establish safe touch zones
    • Haptices and Haptemes
    • Environmental description
    • What’s for dinner?
    • Emotions
    • Name sign or “body name”
    • Entering/leaving a space
    • Guiding
    • Health
      • Haptices for health
  • Documenting systems, signals, messages, and haptices
  • Conclusion
• 9 Living better: Communication 3: Name signs, print on palm, fingerspelling, and personalized systems
  • Introduction
  • Name signs
  • Print on palm
  • Fingerspelling
  • Deafblind manual alphabet (Australian)
    • Links to other countries’ deafblind manual alphabets
  • Personalized, idiosyncratic, and other messaging methods
  • Document all the communication methods used
  • Conclusion
• 10 Being prepared: Hospital admission and emergency planning
  • Introduction
  • Preparing people with DSI for health and hospital encounters
  • Emergency and disaster preparedness
    • A real life example
  • Conclusion
• 11 Living better with DSI: Integration of care: Putting it all together
  • How it all works together
  • Discussion
  • Visits with the audiologist
  • Practical supports
  • Cups of tea
  • Transitions
  • Documenting strategies
  • Emergency sign
  • Fingerspelling
  • The church ladies
  • Risk factors become reality
  • Health haptics and super teams
  • Short cuts
  • Guiding haptics
  • Bridge again?
  • Travel
  • Physical health
  • Name signs
  • Social wins (and exits)
  • Resources
  • BDBD
  • Conclusion
• Bibliography
• Recommended further reading
• Index

Annmaree Watharow MD, PhD is an academic and medical doctor with lived experience of dual sensory impairment. Moira Dunsmore RN, PhD is an academic and registered nurse with first-hand experience caring for older adults with multiple sensory loss. They are co-founders of a dual sensory impairment special interest group, and the dual sensory impairment project (www.dsiproject.org), based at the University of Sydney.