Caregiver Tip Sheet
This guide provides essential tips for caregivers and medical providers supporting individuals with combined vision and hearing loss. DeafBlind individuals often experience unique barriers in communication and accessing their surroundings. By familiarizing yourself with basic techniques, respectful approaches, and effective communication methods, you can help create a more accessible and empowering environment for those you serve.
Please note that these are general tips. For more information and training on best practices for serving DeafBlind individuals, contact HKNC.
Combined hearing and vision loss can significantly impact how individuals navigate their environment and communicate with others. As a caregiver, it’s essential to ensure that those you serve have full access to their surroundings and the ability to engage meaningfully in their daily lives. Being familiar with the social norms related to approaching, communicating, and interacting with DeafBlind individuals will not only make interactions more respectful and enjoyable but also empower the person to participate fully and equally in their community. This tip sheet is designed to guide you in providing the best possible care and support for older adults who are DeafBlind.
Who is DeafBlind?
The term DeafBlind refers to individuals with combined hearing and vision loss. Most people within the DeafBlind community have some residual vision and/or hearing. While individuals who are Deaf or hard of hearing rely on their vision and those who are blind or have low vision rely on their hearing, those who are DeafBlind need unique accommodations, techniques and tools to ensure that they can access information and communicate effectively, these often revolve around touch.
How to Approach a DeafBlind Person
When approaching a DeafBlind person, let them know you are there by placing your hand on their shoulder. Maintain contact with the person until they visually or tactually locate you. Always identify yourself immediately.
Image description: A DeafBlind woman is standing near a kitchen counter. Ayoung woman approaches her from behind.
Narrator: Here we have a young woman named Jade approaching aDeafBlindwoman, Maricar. Notice how Jade taps Maricar on the shoulder andremains in place until Maricar can tactually locate her. Jade immediatelyidentifies herself and lets her know that she’s going to guide her to the nextroom.
Communicating with Individuals who are DeafBlind
Understanding the Individual’s Communication Preferences
People who are DeafBlind use different methods to communicate including sign language, speech, text and ProTactile language. Each DeafBlind person is unique, it is important to check in with the individual to determine what their preferred mode of communication is and then what accommodations they require to access this mode of communication. To learn more about effectively communicating with individuals who are DeafBlind please refer to:
Tips for Communicating with DeafBlind Individuals via Sign
Tips for Communicating with DeafBlind Individuals via Speech
Print on Palm: Learn alternative ways to communicate with individuals who are DeafBlind.
POP Video Resource
Print on Palm. Print on Palm is an alternative method for communication used by individuals who are DeafBlind. It is typically for short interactions with the non signing public. To use this method, you would print out the words on the palm of the DeafBlind individual’s hand with your forefinger.
All capital letters are used except for the letter “i”. One letter is written at a time in the center of the palm. A pause will let the individual know that you’ve finished the word. You can add question marks to indicate that you’re asking a question and you can swipe back and forth to let them know you’ve made a mistake and are starting over.
This method is often used for receptive communication with the public. For example, a DeafBlind person may use a pre-printed communication card to ask a cashier what the total cost of their purchase is. The communication card will explain that they can let them know by printing the amount on the palm of their hand. But, it can also be used as an expressive means of communication for the DeafBlind individual.
The DeafBlind person can write words on the palm of your hand as well. If pen and paper is available, they will probably write the note out. This has also been used in cases where the individual suddenly loses their vision and/or hearing in an accident or a surgery. We use this method to introduce a more effective method, such as sign language or braille.
There are some limitations to this method. First of all, it is not intended for long or complex discussions or interactions. It is not effective for people who are not familiar with the print alphabet. For example, a person who was born fully blind may have no experience with print. They probably rely on braille and/or voice output. So this would not be a helpful method for them.
You also have to consider conditions that may cause problems with tactual discrimination.
This could include neuropathy, from either chemotherapy or diabetes, or other neurological disorders such as MS. And here’s a brief demonstration of a young woman communicating with a DeafBlind woman using Print on Palm. She is printing out: “Hi, do you need help?” on the palm of the woman’s hand. She prints one capital letter at a time. And notice how Maricar, the DeafBlind woman, places her hand on top of the young woman’s hand for additional information.
As the young woman writes out the word, Maricar lets her know that she understands by nodding. Then Maricar responds yes, she does need help, and gestures that it’s cold and she’s about to go to sleep. The young woman understands this means she wants a blanket, so she gives her the thumbs up and tells her one minute.
In this example, they were able to communicate very effectively without using any sign language.
[End of Transcript]
Ensuring Access and Inclusion:
Provide visual and environmental information.
- Check with the individual to determine method for providing this information and type and amount of information wanted
- To learn more, go to: Providing Access to Visual & Environmental Information
Orient individuals to the area they are in.
Let them know what and who is in the area. You can do this in sign language, speech or you can use hand under hand approach to guide them in tactually exploring the area.
- Identify yourself and others when entering or leaving area
- Make sure not to move items in common areas without informing the DeafBlind individual.
Video Demonstration
Video Transcript:
Here we have a young woman orienting a DeafBlind woman to a table and dinner setting. Notice she uses hand-under-hand approach to guide her hand, first to the back of the chair and then the table. The woman then seats herself and the young woman again uses hand-under-hand approach to show her that there’s a plate and utensils on the table in front of her.
Making Materials Accessible:
Make sure that calendars, notices, all print information is provided in accessible formats. Check in with the individual to see what their print access needs are. Some include,
- Large print: determine preferred font size (Use Sans-Serif font or Arial)
- Avoid white paper as often causes glare and impedes vision
- Make sure there is a strong contrast between text and paper (i.e., light yellow or tan paper with black font)
- Braille (check to see if the person is a grade I or grade II user)
- Digital copy: often individuals have software on their computer, tablet or mobile device that allows them to modify the material to meet their needs. This means it may be easiest to send via email.
Emergency
Make sure to have a system in place to inform a DeafBlind individual that there is an emergency. The universal symbol for “Emergency” is an “X” drawn on the back with a person’s finger. This indicates that there is an emergency, and the person should stand up and allow the individual to guide them to safety. They will then receive an explanation.
Conclusion:
This tip sheet offers a brief introduction to working with DeafBlind individuals. For more in-depth information, resources, and professional training opportunities, please contact us to explore how we can support your learning and development.
Please contact us at PLD@HelenKeller.org for more information.
