Sensory Impairment

***This page is currently under construction, and any content published is subject to change***

‘Sensory impairment is the common term used to describe: Deafness, blindness, visual impairment, hearing impairment and Deafblindness. Sensory impairment is when one of your senses; sight, hearing, smell, touch, taste and spatial awareness, is no longer normal. Examples of this include; if you wear glasses you have a sight impairment, and/or if you find it hard to hear or have a hearing aid then you have a hearing impairment. A person does not have to have full loss of a sense to be sensory impaired’.

Source: Reading Borough Council

Sensory impairment can have a significant impact upon the life of an individual and can cause emotional and psychological difficulties, and people living with a sensory impairment are more likely to have depression, isolation and also a loss of confidence and independence. Sensory impairment places strain upon the health, social and the economic needs of both individuals and society in general.

Headlines

  • Low vision, cataracts, macular degeneration and glaucoma are all predicted to rise – substantially so as the population ages.  Numbers are available in the linked document (Ophthalmology HNA, 2010).
  • That trend is also likely in the hard of hearing, although accurately modelled numbers are not available.
  • The majority of people with hearing loss are older people many of whom may already be struggling with daily living/personal care tasks so early intervention can be a key factor in reducing subsequent health and social care dependency. Numbers are increasing.
  • The numbers of people with dual sensory impairment / deafblindness also increase with an ageing population. The Department of Health (DoH) definition clearly describes the functional difficulties arising.

Sensory Impairment- Symbols

Source: www.ecl.org

Hearing impaired or hard of hearing

Terminology such as hearing impaired or hard of hearing is used when a person has mild to moderate hearing loss, but is again down to personal preference. The term deafened is used when a person loses their hearing due to an illness, accident, or age-related hearing loss. The latter is found to be the largest cause of hearing loss in the UK. Other causes of hearing loss can be many and varied such as:
  • difficulties during birth and/or genetic causes,
  • injury or infection,
  • disease(s) such as measles, mumps and rubella (MMR), and
  • exposure to loud noises.

Deafness and hearing loss in general is an issue because it can be very disabling. People with significant hearing loss can certainly feel and often are very isolated because communication becomes increasingly difficult. Tensions within households rise and problems with neighbours increase eg volume of TV leading to complaints and sometimes legal action.

Action on Hearing Loss (RNID) report that “79% of people first receiving hearing aids are given no information regarding services and information that might be useful “ (2008). This is about ‘point of diagnosis’ intervention.

The Population

  • Wakefield has 270 people registered as deaf and 710 as hard of hearing in 2004, but the RNID also states that figures from the registers should be treated with caution due to significant under-reporting (Deaf Community HNA, 2010).
  • Currently 1632 people on the register: 337 deaf, 1108 hard of hearing and 87 deafblind.
  • *** underestimated as it is only people who register with the council ***
  • These figures are notoriously inaccurate because of under reporting and the absence of the kind of recording and informing framework available for Blind and Partially sighted persons.
  • Recent HNAs of the deaf community have suggested that people in that community felt their health was good and did not feel any less healthy than their hearing counterparts – although this is a self-reported and subjective measure (Deaf Community HNA, 2010).

The table below shows the Wakefield population aged 18+ predicted to have some, or severe, hearing loss, by age, projected to 2021.

Source: PANSI and POPPI.

The Burden

Service Provision

  • Review the processes at audiology and test out the Action on Hearing report – evidence based research.
  • Encourage social care assessments to question hearing aid management and include maintenance as part of a care plan.
  • Continue to raise awareness and look to continue interagency work.
  • Make best use of local 3rd sector and ideas from further afield such as SENSE and Action on Hearing.
  • Take the service into the community.

Visual impaired or sight loss

Headlines

  • Wakefield has a population of 1,006 people registered severely sight impaired (Blind) and 1,367 people registered sight impaired (partially sighted).
  • National figures suggest that approximately 29% of all persons registered blind will have an additional disability that may compound their lifestyle; 1.3% will suffer from a mental health problem and 17.6% will have another physical disability; 2.4% will also have a learning disability (Ophthalmology HNA, 2010).

The Population

Royal National Institute of Blind People (RNIB), predict that there are over 2 million people in the UK with sight loss; with 47% of the vision impaired population being over the age of 80. This number is projected to more than double by 2039, and it is estimated that the number of people living with sight loss will rise from 2 million to 4 million by 2050. RNIB suggest that the annual cost of sight loss in the UK amounted to a minimum of £6.5 billion in direct health care and indirect costs, such as reduced employment.

Source: RNIB Annual Report and Accounts 2017/18, unless stated otherwise.

Eye Health Needs Assessment. This document is not specific to Wakefield, but it is a good representation of the districts population etc …

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/707238/Eye_Health_Needs_Assessment.pdf

People who experience sight loss (formerly labelled; ‘blind and partially sighted’), are now referred to as sight impaired and severely sight impaired. There are guidelines about the level of sight loss to define which of these two categories a person is certified. There are many causes of sight loss, which could include one or more of the below examples:

  • injury or infection,
  • genetic or age-related causes, and
  • conditions such as cataracts, obesity and/or diabetes.

The table below shows the Wakefield population aged 18+ predicted to have a serious visual impairment, including people aged 65 and over predicted to have a moderate or severe visual impairment by age, and people aged 75 and over predicted to have registrable eye conditions, projected to 2021.

Source: PANSI and POPPI.

The Burden

Visual impairment disproportionately affects peoples’ quality of life; particularly the elderly who are within a higher age range, as a result of the deterioration in functional ability over time. RNIB predict that the incidence of sight loss will increase in line with an increasing aging population and with an increase in underlying causes of sight loss, such as obesity and diabetes.

Unmet need in visual problems (based on the definition found in the lifestyle survey) increases with age, although the percentages in men of all ages (except post-75) are higher. While there is not sufficient evidence to suggest why this may be the case, there is evidence at a national level that men are often reluctant to enter into treatment – particularly where preventative treatment is concerned. That need is higher in Wakefield North, Wakefield East and Knottingley. (Lifestyle Survey, 2009; Ophthalmology HNA, 2010).

Service Provision

Early intervention has been identified as a key element in preventing vision loss at a local and international level. For those people with vision loss, research has highlighted the need for accessible information, rehabilitation services and equipment, which can maximise independence. These services are critical in ensuring that people with vision loss are able to interact with the built environment, maintain physical and physiological health, and participate in their community.

Sources: Vision 2020 and McLaughlan, 2008

  • The employment of two Eye Clinic Liaison Officers (funded the Local Authority, PCT and Mid Yorks Trust) provides a bridge between Health and Social Care. The role of this post is to provide emotional support, early intervention, information and advice and onward referral.
    • Re-launch of Low Vision Leaflet to facilitate timely referral to social care services for people experiencing difficulty in their daily life because of sight loss.
    • The launch of the Primary Eyecare Acute Referral Scheme (PEARS) enables prompt referral to an optician in the community for people who are experiencing a sudden eye problem. This enables early identification and treatment, to reduce sight loss.
    • The Diabetic Retinopathy Screening programme provides a systematic process for early identification and treatment of retinopathy, to significantly reduce sight loss caused by Diabetes.
    • Joint work between PCT, Third Sector, and Wakefield MDC to raise awareness of the impact of visual impairment and general health. For example – Falls Awareness and Visual Impairment events.
    • Ensuring that people with a visual impairment are able to access healthcare services. Use of the RNIB ‘Losing Patients’ form to enable people with a visual impairment to request appointment information provided in an accessible format.
    • Raising awareness and promotion of inter-agency working to recognise the impact of sensory impairment and additional disabilities. Wakefield MDC funded ‘Ocular Health and Stroke’ course for Local Authority and Health Care professionals. Provided by the Stroke Association and developed in conjunction with Wakefield MDC.
    • Sensory Impairment Team provides assessment of people with sight loss and individualised programmes of rehabilitation training to maximise independence. This includes Orientation and Mobility Training (Long Cane Training), Daily Living Skills Training (Food preparation, medication management, personal care).
    • Communication Training (IT training, Braille, Moon etc. Eccentric Viewing and support to use Magnifiers.). Self-Directed Support provides a mechanism for people who meet Fair Access to Care Services criteria to receive a budget to enable their outcomes to be met creatively and individually.
    • Third Sector partnerships ensure access to a range of services such as Guide Dogs Association, Action for Blind, Wakefield district Sight Aid, Macular Disease Society.
    • Provision of Assistive Technology to people with a sensory impairment to maximise independence. For example, Telecare.
    • To ensure services continue to meet the needs of people with a sight loss, Family Services support a Visual Impairment Forum who critique the services provided by the Visual Impairment Section of the Sensory Impairment Team.

Dual sensory loss or deafblindness

When a person has difficulty seeing or hearing they can be referred to as having a dual sensory loss, also known as deafblind. Usually, a person suffering with deafblindness will have difficulty with communication, mobilising and accessing information. According to the Care and Wellbeing Company (ECL); the largest number of people in the UK with dual sensory loss tends to be the older generation.
There can be various genetic causes which explain a persons’ impairment, but they can also be a result of an injury or infection. However, if someone has sight and hearing loss, it becomes one impairment termed ‘Deafblindness’, as one sense cannot compensate the other. Deafblind people are entitled to a specialist social care assessment under the Care Act which may lead to services and equipment which will support independence.

Comparison to Other Local Authorities

Comparing Wakefield to other LA’s and England.

Comparative data is not available for Wakefield in 2008 (many fields are not available), but there is such data for 2006. Wakefield reports exceptionally low across all additional disability categories in comparison to other Yorkshire & Humber districts. This may be a reporting issue, rather than a genuine difference in associated need (Ophthalmology HNA, 2010).

In comparison to other areas, Wakefield district is not estimated (by the National Eye Health Epidemiology Model (NEHEM) modeller) to have a higher level of ophthalmological need than that of other SHA organisations. While prevalence estimates are relatively close between neighbouring areas, Wakefield is consistently regarded as having a lower level of need on each of the NEHEM outputs. While some of this difference can be perhaps attributed to having a comparatively smaller Black and Minority Ethnic (BME) population, the reliability of the modeller will always be subject to questioning (Ophthalmology HNA, 2010).

The below demonstrates the current position in Wakefield in relation to our Yorkshire and Humber neighbours across several of the key sensory impairment indicators. Wakefield is currently similar than the England average for many indicators (those indicators coloured yellow).

You can click on the “trends” option below to explore the trends in the various measures.

Source: Public Health England

Service Provision

Action on Hearing Loss
Royal National Institute of Blind People

Publications

Visual Impairment in the Elderly: Impact on Functional Ability and Quality of Life
Wakefield Deaf Community Health Needs Assessment Report, 2014

Definitions

Visual Impairment

An impairment of visual function which cannot be improved by the use of corrective lenses to a level that would normally be acceptable for reading.

Hearing Impairment

The United Nations World Health Organisation (WHO)
defines hearing impairment as the complete or partial loss of the ability to hear from one or both ears and can be graded as mild, moderate, severe or profound.

Primary Support Reason

The Primary Support Reason describes why the individual requires social care support; the primary disability / impairment impacting on the individual’s quality of life and creating a need for support and assistive care. The primary support reason should be identified and recorded at the point of assessment, and then any changes recorded during subsequent reviews. Examples and descriptions of the Primary Support Reason categories are provided earlier within this framework.