Managing deafblindness

It's not always possible to treat the underlying causes of deafblindness, but a range of care and support servicesis available to help peoplewith the condition.

Most deafblind people will still have some hearing and/or vision. The level of care and support they need will depend onhow severe their hearing and vision problems are.

Individual care plan

The individual abilities and needs of a deafblind person should be assessed soon after they're diagnosed. This will allow a tailored care plan to be drawn up.

The care plan will aim to:

• preserve and maximise any remaining sensory functions the person has
• teach alternative communication methods such as the deafblind manual alphabet (see below)
• help the person retain as much independence as possible for example, by recommending they receive training to use a long cane or guide dog or through the provision of a communicator guide
• for young children,ensure their educational needs are met

Some of themain services, techniques and treatmentsthat may be recommended as part of a care plan are outlined below.

Want to know more?

• Sense: Legal rights:social care, education and benefits
• Sense: Early support for your child

Communication systems

As deafblindness can make communicating by speech and writing difficult, alternative forms of communication may be necessary.

The main communication systemsused by deafblind people include:

• clear speech speaking clearly is one of the most effective and common ways of communicating with deafblind people who have some remaining vision and hearing
• deafblind manual alphabet a tactile form of communication where words are spelt onto the deafblind person's hand using set positions and movements
• block alphabet a simple tactile form of communication where a word is spelt out in capital letters that are drawn onto the deafblind person's palm
• hands-on signing an adapted version of British Sign Language (BSL) wherethe deafblind person feels what's being signed by placing their hands on top of the signer's hand
• visual frame signing an adapted version of BSL wherethe signs are adapted to be signed in a smaller space to match the position and size of a deafblind person's remaining sight
• braille a system that usesa series of raised dots to represent letters or groups of letters
• moon similar to Braille, but uses raised, adapted capital letters that are simpler to feel

Want to know more?

• Sense: Methods of communicating with people who are deafblind
• Sense: Quick tips for communicating with people who are deafblind

Vision aids

For somedeafblind people, it may be possible to improve vision using low vision aids, such as glasses, magnifying lenses and task lights.

Specially designed items, such as telephones and keyboards, may also help someone who is visually impaired.

The Royal National Institute of Blind People (RNIB) has more information about everyday living with vision loss ,including advice about the technology availableto help with everyday tasks.

Many libraries stock a selection of large-print books and 'talking books', where the text is read aloud and recorded onto a CD. The RNIB also offer a talking book subscription service , where books can be ordered and delivered directly to your home for a small annual fee.

Want to know more?

• Visual impairment
• Sense: Everyday living aids
• RNIB: Using technology

Hearing aids and implants

Some deafblind people may benefit from wearing a hearing aid . There are various hearing aid styles available to suit different types of hearing loss and personal preference.

Hearing aids use microphones to collect the sound from the environment, amplify it and deliver it into the ear canal of the wearer so that it can be processed by the auditory system. An audiologist (hearing specialist) will be able to recommend the most suitable type of aid after testing your hearing.

For some people, hearing aids that deliver the sound into the ear canal are not appropriate. In these cases, hearing may be improved using a surgically implanted hearing system, such as a cochlea implant or bone conducting hearing implant.

While these still use a microphone to collect the sound initially, they then covert that sound into either an electrical signal or vibration, passing it to the inner or middle ear for processing by the auditory system.

Want to know more?

• Treatments for hearing loss
• Sense: Hearing technologies
• Action on Hearing Loss: Hearing aids

One-to-one support

Every deafblind person is entitled to help from aspecially trained one-to-one support worker if they need it.

Depending on the person's situation, this may be a:

• communicator guide someone who works with people who have become deafblind later in life, to offer the support the person needs to live independently
• interpreter someone who acts as a communication link between the deafblind person and other people, using the deafblind person's preferred method of communication
• intervenor someone whoworks withchildren and adults who were born deafblind, to help them experience and join in the world around them as much as possible

Want to know more?

• Sense: Communicator guides
• Sense: Intervenors

Treating underlyingconditions

Some conditions that affect hearing and vision can be treated using medication or surgery. For example:

• cataracts can often be treated by surgically implanting an artificial lens in the eye read more about cataract surgery
• glaucoma can often be treated using eye dropsor laser surgery read more about treating glaucoma
• diabetic retinopathy can be treated in the early stages using laser surgery read more about treating diabetic retinopathy

Somecauses of temporary hearing loss are also treatable, such as a build-up of earwax or middle ear infections .