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Activity Director Programming for Deaf and Visually Impaired Residents - by M. Celeste Chase, AC-BC, ACC, CDP, CMDCP ActivityDirector.org

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Programming for Deaf and Visually Impaired Elderly

Vision and hearing loss are particularly prominent in the older adult population. The most common senses that are “lost” are sight and sound. These senses are specifically controlled by the visual and auditory cortex, respectively. It is possible to lose the senses of taste, smell, and touch, but these are much less common. While vision loss can have a profound negative impact on a person's perception of the world, hearing loss diminishes a person's mode of communication and can lead to social isolation.

Leisure pursuits for the deaf and visually impaired aging are paramount to preventing feelings of isolation and lack of independence brought on by physical deficits. Visual and auditory loss can make everyday activities more difficult and significantly contributes to the sense of exclusion from society. Adapted leisure opportunities offer those moments of inclusion that seem to be without disabilities and significantly improves overall quality of life.
Compensating for Sensory Loss
Studies conclude that when you no longer need to use that part of the brain to process images (for example), more energy and processing power is shifted to the senses of hearing and touch. The brain automatically compensates to improve your ability to move through the world. Such is the case for blind individuals who often use a technique called “clicking”, in which they make small clicking sounds and then interpret the echo they hear to determine the environment around them. This echolocation technique can even allow people to determine specific objects and walk normally without bumping into walls or obstacles.

Look for senses that remain intact to help your resident navigate and relate to his/her environment.

Sense of Touch: Using the sense of touch feel the shape, surface texture, weight and size combined to identify the unknown object which cannot be seen.

Sense of Taste: Offer a variety of food items and ask what ingredients can be identified. Often a specific food will be remembered from childhood days – encourage those memories.

Sense of Smell: A particular fragrance can also evoke memories. Perhaps apple or pumpkin pie made with grandma’s love and care. A fragrance distinct to flowers, candles, colognes or spices can be identified and all may elicit memories from days past.

The “Golden Rule”: Focus on the senses that still remain to lead the way to programming success.

Tapping into the remaining senses helps to keep minds active by doing things that require inquisitive thought and intellectual problem solving strategies. Stimulating and success oriented programming allows residents to feel useful again, despite their physical disadvantages.
The Hearing Impaired
The hearing-impaired elderly are often at risk of having social challenges and not being able to fit in with mainstream groups. This is largely because “communication” is primarily language-based. But there are many available types of leisure pursuits for the hearing impaired that help foster communication and contribute to a feeling of community. A little ingenuity will go a long way towards the discovery of hearing impaired leisure pursuits.

These include:
Computer Skills: Computer savvy skills are integral for keeping up with those that are not close by. Studies have shown that older adult with computer skills were less likely to experience mild cognitive decline as they aged.

Art: From drawing and coloring to painting and weaving, art promotes creativity and expression. Hearing-impaired adults can work with clay and ceramics, as well as all types of sewing activities.

Bingo: Options for the hearing impaired are available. Such as large calling cards with a yellow background that can be held up for those who can't hear the numbers being called.
Video Games: Video games are no longer just for children. Studies revealed that video games improve cognitive reflex and help to sustain cognitive processing for adults over 60 years of age.

Board Games: Board games and card games are suitable for hearing impaired seniors. Generally hearing impaired with no visual loss can read game board “how to play rules”.

Sports: Other options for those who are hearing impaired with good mobility include playing pool, foosball, bocce ball, and shuffleboard.

Headset: If the resident is not completely deaf, a good set of headphones can make listening to music or audio books enjoyable again.
The Visually Impaired
Age-related vision loss is common as we grow older and can often be corrected with glasses, eye drops, surgery and other medications. Some eye conditions however, such as macular degeneration, glaucoma, cataracts and other diseases may evolve into blindness or partial-blindness presenting considerable challenges to those affected. There are many game products are available in adaptive versions for blind seniors.     

Some of these games include:
Monopoly: All of the properties and spaces are in large type and accompanied by braille. All of the cards are in braille and large print. The dice and money notes are in braille as well.

Checkers: Each space and piece is marked in a way that the blind and visually impaired can enjoy this game just as much as sighted people. Bonus points for knowledge of braille not being required to play.

Chess: There are bumps on the white pieces to differentiate them from the black ones and the black spaces on the board are slightly raised.

Scrabble: There is an overlay grid that prevents shifting pieces, as well as braille markings on said pieces.

Here are a few topic oriented books that may be of particular interest to the visually impaired:
Touching the Rock: An Experience of Blindness - by John M. Hull
Autobiography; instructive and profoundly touching.

The Country of the Blind - by H. G. Wells
A mountaineer named Nunez slips and falls into a valley cut-off from the rest of the world where inhabitants are all blind.

If You Could See what I Hear - by Tom Sullivan
Blind from birth, Tom tells you stories that will make you laugh out loud.

Stars Come Out Within - by Jean Little
Autobiography of Canadian children's author Jean Little, blind since birth.

A Dolphin in the Bay - by Diana Noonan
A young boy's relationship with a dolphin helps him overcome his fears.

Tips for Communicating with Visually Impaired People
  • In general, observe first -then ask if your resident requires help - ask for instructions on how they want you to help.
  • Don't raise your voice – or be excessively louder than normal volume.
  • Use normal language- there's no need to avoid words such as "look", "see".
  • Don't point or say 'over there'- be specific; "It is on the bed to your left".
  • Identify yourself as you enter- "Hi Mary, it's Linda".
  • It is acceptable to describe colors, patterns and shapes.
  • Never patronize- do not assume that you have to make things 'easy' for them.
  • When walking, describe the terrain- number of steps, texture of walking surface (carpet, grass . . .).
  • Always respect the person's individuality, dignity and independence.
What Is Available?
Reach out to clubs and organizations for those who are deaf to encourage individuals who are deaf-blind to participate in social activities to reduce isolation.
  • Church leagues/synagogue leagues
  • Community leagues
  • Local associations for the blind
  • Ski for Light - https://www.sfl.org/
  • University- or college-affiliated programs
  • Local deaf club
Lastly, but most importantly- Remember that your program must be “interest based” and “person centered”. You will always have a successful program when you ask your residents to guide you.
Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org
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Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network.
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     Thank you for correcting the information that was released. I recently took the test for certification with NAAPCC and it was a very comprehensive and thorough test. It was not a simple easy test to get you certified. You had to know the information in order to complete and pass. I would recommend this avenue to anyone especially if finances are a struggle for MEPAP I & II. I did purchase the book for long-term care seventh edition and without that I would have struggled.
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