Deafblind services at the Sense charity, Epsom, Surrey

Social workers are oftern wary of touching service users. But for practitioners in deafblind services the tactile sense is often the most important. By Anabel Unity Sale

Playing snakes and ladders first thing on a Tuesday morning is not the usual start to a working day. But for Clair Waterman and Sam Bissett this is a typical morning for them in their roles as assistant regional director and outreach worker for deafblind charity Sense.

The pair are based in the organisation’s south east branch in Epsom, Surrey, in a new office with big purple chairs and clean carpets. They have spent the morning visiting a client in his home and playing board games with him. While it may appear to be lighthearted fun rather than proper work, what Waterman and Bissett were doing – and regularly do – has a significant positive impact on the older clients they work with.

Waterman says: “We are creative in how we work with people. We look for opportunities to engage clients, to create chances to communicate with them, and if that means playing games with them then we do.”

She and Bissett use the snakes and ladders game, which has a raised surface, as well as a chunky wooden version of noughts and crosses to help clients feel more comfortable during their visit and to also assess their level of sensory impairment.

Bissett explains: “It’s good to take something with us like a game when we see clients, who are often isolated, as we can see how independent they are while we are ‘playing’ the game.”

Waterman oversees Sense’s outreach, community and day services in the south east. Alison Asufu-Adjaye, the older person’s access worker for London, is the third member of the team. On average the team provides about 68 hours a week of support to deafblind people, some of whom are older, in their own homes. They visit about 30 clients a month who are either referred to them by other professionals, concerned family or self-referrals. The team also trains health and social care practitioners and users alike in alternative forms of communication and advises residential care home providers on how to work with clients.

Dual sensory loss is often regarded as a hidden disability, which can make identifying it and assessing what support people may require a problem (see Assessment Tips). As people age, it is expected that their hearing and sight will deteriorate and they have to put up with it. However, statistics reveal the issue is more serious than it first appears: one in 12 people will become partially sighted or blind by the time they are 60, rising to one in six by the age of 75. And 55% of people over 60 are deaf or hard of hearing.

This means the creative work Waterman and her team do is important in connecting with a hard-to-reach, and often overlooked, client group. Not only does the team act as an advisory service for other professionals to contact with their concerns but they also highlight the existing frameworks that can ensure deafblind people receive the level of services they are entitled to.

In June 2006, Sense launched a toolkit aimed at professionals working with older deafblind people. Fill in the Gaps explains what deafblindness actually is, and Sense wants to see it being used alongside statutory deafblind guidance for social services.

Waterman recommends practitioners use the single assessment process, introduced in the National Service Framework for Older People, which aims to make sure that older people’s care needs are assessed thoroughly and accurately, but without duplication by various agencies.

So what advice do they have for staff who want to improve their practice with this client group? Bissett says communication between different practitioners working with these clients, and with the individual themselves, is key: “It is about finding out what methods of communication works with the person, and teaching staff how to be aware of this.”

She adds that many health and social care practitioners are afraid of being overly tactile with clients but stresses they need to have the confidence to be. “Touch is the first form of communication,” she says.

Assessment Tips
What are the signs older clients who may be experiencing hearing or sight difficulties but are reluctant to admit it

* Clients not answering the door promptly.
* Their television is always on loudly.
* They cannot follow conversations, especially if several people are speaking at once
* They have problems reading facial expressions
* Find it hard to recognise people, particularly in unexpected situations

Contact Clair Waterman: 0845 1270076

Contact the author
 Anabel Unity Sale

This article appeared in the 26 April issue under the headline “A feel for the client”