Project
Background and Introduction
Michael is a seventy year old retired Soldier. He lives with his wife Ann who works as a Teacher in the local secondary school. They have one adult son James who is married to Hannah, they have two young children. They come to visit Michael and Ann on a weekly basis. Michael is physically active and walks a mile every day.
Michael suffers from a moderate hearing impairment. It was caused by both his age and work related (noise induced) hearing loss from years of shooting with little or no hearing protection being used. This means that Michael experiences difficulty hearing others speak especially if when two or more people are talking.
Psychosocial Impact
Michael’s hearing loss deprives him, his family and friends of easy communication. Hearing loss has affected his ability to speak clearly because his own voice sounds distorted and this is an additional impediment to communication. He has a sense that others seem to mumble. This has resulted in him being embarrassed to use the telephone and he shy’s away from socialising. He also has difficulty hearing the TV and radio. Due to a lack of being able to communicate he displays and expresses the following emotions: loneliness, frustration, fear, embarrassment, disappointment and anger.
Michael feels that his relationship with Ann has been negatively affected because they can no longer have long discussions/conversations and debates. This important part of their relationship no longer exists. Michael feels he is under a lot of strain but feels powerless to change because of his lack of communication.
He also feels ignored by his grandchildren because they are still too young to fully understand the full repercussions of his hearing impairment.
Maintaining independence is critical; Michael naturally does not want his lack of hearing to interfere with his day to day living. He could learn to lip read
He could take a bus trip to Dublin to visit Collin’s Army Barracks Museum (he is entitled to a free pass on the bus as he is a pensioner).
He could be encouraged to visit the day care centre where he could meet other people and do activities such as cooking, reading, art, etc.
Improving Interpersonal Relationships
The Home Carer should be encouraged to talk to Michael. She was afraid that if she spent more time talking to him she would be labelled a dosser or lazy. She should be encouraged to talk to him as much as possible and that it is a part of her role as a Carer which is valued by both Michael and the Home Help Company she is employed by.
Michael needs to be looked at as a whole person not just at his disability. From his time as being a Soldier in the Army Michael is used to getting up at 6am daily. He should be encouraged to keep up this routine if he wants to and not have to change it to suit the needs of others. The Home Care Company could be contacted in order to change the Carer’s start time from 9am to 6am to facilitate Michael’s personal requirements. This means his preference and wishes should come first and foremost out of respect.
Michael could be encouraged to physically interact with his grandchildren by taking them along on his daily walks or he could play soccer with them. When these two options are not suitable due to poor weather conditions they could play the wii together. This will help them improve their relationship as it will not be based purely on the ability to communicate. They are also great forms of exercise.
Specific Recommendations
I envisage that this information will assist Michael’s communication with people he comes into contact on a daily basis. Ultimately, it will improve his social interactions. The following are some simple techniques that can be used: (It is important to note that talking should be encouraged first before moving on to other forms of communication).
Ø Direct Communication
· Gain Michael’s attention and let him know that you wish to communicate with him;
· Face him and talk clearly;
· Do not shout;
· Turn down the volume of the television, radio and block the talk of any other person in the area;
· Ask him to point to what he needs or wants; he will develop a repertoire of pointing for such daily items as the television remote, newspaper, eye glasses, radio etc:
· Rephrase a misunderstood sentence;
· Use facial expressions or gestures to give useful cues;
· Move away from background noise;
· Stand in the light facing Michael;
· Do not obscure your mouth with a cigarette or hands and do not chew food while speaking;
· Offer a pencil and paper. While writing a message, do not talk, a hearing-impaired person cannot read a note and your lips at the same time. Prompt cards could be used and he could be given a board;
· Include Michael when talking, talk to him not about him, when you are with others. This helps keep Michael from feeling alone and feeling excluded;
· Ask Michael what you might do to make conversation easier;
· Be patient, understanding, stay positive and relaxed;
Additional recommended Actions
It is also important that Michael knows his rights and ways to access services. His local Public Health Nurse should be the first point of call.
He could use telephone amplifiers or pictorial signage
Could use subtitle for the English version on the television by pressing 888 on the remote.
There are many different types of hearing aids available. Michael’s General Practitioner or an Audiologist will be in a better position to advise the most appropriate one which will be determined after a hearing evaluation. AM and FM and infrared amplification devices transmit sound directly from the speaker or other source to the listener, thus reducing interference caused by background noise.
Effective Implementation of Health and Safety Measures
Health and Safety challenges faced by the hearing impaired can seriously affect personal safety.
1. Position a light/strobe light over his bed in case there is a fire as he will not hear the alarm. Plan and practice the escape route once a month.
2. Amplify phone ringer signaller to alert Michael to the phone ringing.
3. A motion detector/transmitter will notify the resident of unusual motion such as an intruder.
4. For carbon monoxide there is a silent call detector with a visual alert.
5. Keep a telephone next to the bed along with emergency numbers and hearing aid (if necessary).
Summary
First and foremost, Michael wants and needs to feel that he is accepted by his family and the wider community. At this present time he feels cut-off due to his inability to communicate effectively with others. As a result, he has become depressed and is not making any effort to communicate as he feels it is pointless.
The suggested recommendations are primarily to increase his communication levels. This in turn will have a very positive effect on his personal relationships with Ann, his family, friends and others. It will also allow him the freedom to socialise and develop stronger social bonds.
References
Course notes: Care of the Older Person
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