It’s estimated that 25,000 people use British Sign Language (BSL) as their main language across the UK, although the total number of people who use BSL (not necessarily as their main language) is likely to be much higher.
Deaf Sign Language users in care homes can be incredibly isolated, as they are often the only sign language user. Staff and residents are usually unable to communicate fully with them. This may make it harder for staff to monitor residents’ needs and wellbeing, and without regular contact with other deaf people who use BSL, deaf residents may even start to forget their own language. This has sadly been the case for my own mother whose ability to sign has decreased with lack of use.
Residents with hearing loss can also be at risk of isolation, especially if their hearing aids are not maintained and if staff don’t communicate with them in an accessible way. 70% of people over 70 have hearing loss, so it’s essential that care home staff have a good understanding of how to support people.
Learning BSL
British Sign Language (BSL) is the most common form of sign language in the UK. It was recognised as a language in 2003 and legally as an official language of Britain in 2022.
BSL involves a combination of hand shapes and movements, lip patterns, facial expressions and shoulder movements. It has its own grammar and is structured in a completely different way from English.
If you have residents who are deaf sign language users, some basic BSL training for staff can help make a positive difference. Being able to sign ‘good morning’, ‘can I help you’, or understand if someone is tired, worried or ill can make residents feel less isolated.
RNID offers several remote training options for organisations including a live course delivered by an experienced deaf trainer or an e-learning module for staff to complete at their own pace. Our courses can help your staff have a basic conversation with a deaf resident and learn useful everyday signs such as greetings, fingerspelling and questions. Our Start to Sign course also covers useful contexts like Deaf culture, BSL structure and using facial expressions. For understanding the challenges that deaf residents and residents with hearing loss face and how to help, our Deaf Awareness training is also a great option.
Understanding hearing loss
If you suspect someone has hearing loss, their GP should refer them to audiology for a full hearing test and if appropriate, provide hearing aids. As a first step, you could help them do RNID’s free online hearing check, but this may not be appropriate for residents with diagnosed or suspected dementia who may not be able to complete the check.
Residents with hearing loss may:
- Comment that other people seem to mumble.
- Need things repeated.
- Struggle to follow conversations in noisy places or when in a group.
- Watch your lips when you are talking.
- Turn the television up too loud.
- Shout when in conversation without realising.
- Appear less engaged than others, particularly in group activities.
Hearing loss and dementia can often be confused with each other, so it’s important to ensure residents with diagnosed or suspected dementia are referred for a hearing assessment, and that this is repeated every two years as recommended by NICE.
Hearing aids
Being aware of who is wearing or should be wearing hearing aids and knowing some basics is also important. Carers should:
- Check batteries are inserted correctly and don’t need changing – they should be replaced every seven to ten days.
- Ensure that rechargeable hearing aids have enough battery life and are recharged as often as recommended, for example every night.
- Check that the ear mould or tubing is not blocked with wax, that it’s not hard, twisted or split, and that there is no condensation in the tubing.
- Check that the volume control is not turned down, and that the wrong program is not being used, for example the loop setting if they aren’t using a loop system.
- Check the hearing aid is not whistling in the person’s ear – whistling is good as this means the hearing aid is working but if it whistles in the person’s ear this may suggest that it is not inserted securely, wax is present in the ear, or that the earpiece no longer fits and needs replacing.
If everything has been checked and the aid has been turned on and off to reset it but it’s still not working, it needs to be taken to audiology to be repaired.
RNID can provide support for care homes where there are multiple hearing aid users by running a one-off support session to provide hearing checks and maintenance. Many audiology departments have postal systems for simple repairs or may offer basic training to care home staff.
Aughnacloy House in Lurgan, Northern Ireland received Hearing Health training from the local RNID team. Connie Mitchell, Home Manager, said, ‘The training provided by RNID staff to my teams was professional, useful and informal enough for my staff to feel comfortable to ask questions. Staff feedback has always been positive.‘The training supported newly recruited staff to learn more about communicating with our residents and supported them to be more confident in handling hearing aids and understand how to ensure they are working correctly. ‘We all benefited from the knowledge shared, particularly about changing batteries regularly and regarding preventing falls. Hearing deficiencies are very common in our care home residents and to have the opportunity to have the RNID Hearing Health training and continued support would be an asset to all care homes.’
Like dentures or glasses, hearing aids can easily be misplaced or lost in bed, in a tissue, or on a table in a common area. This can result in having to wait a long time for a replacement and cause significant distress to the wearer.
It’s essential to record if a resident has a hearing aid, if they have one for each ear, and to create a system to keep them safe such as placing them in a named container whenever they are removed.
Communication
RNID’s communication tips are a useful resource for communicating with deaf residents and residents with hearing loss in an accessible way.
Care staff should always ask the person what support they need and record this information in their care plan, in line with NHS England’s Accessible Information Standard.
People who use (BSL) may be at risk of worse care and poor health if they cannot communicate in a meaningful way. To improve the quality of care, you should:
- Provide a fully qualified and registered BSL interpreter if the person needs one, in line with the Accessible Information Standard.
- Make sure there are opportunities for people who use BSL to stay in touch with family and friends, Deaf organisations and other community groups, either face-to-face or remotely.
For more information about supporting people who are deaf or have hearing loss, visit rnid.org.uk, or contact RNID by phone: 0808 808 0123 or email [email protected]