Thursday, November 16, 2017

Living with Dual Sensory Loss

Living with Dual Sensory Loss (DSL) is frustrating for both the individual and for those that provide care to the person.  DSL can be very isolating and if not addressed may lead to other health issues such as depression, cognitive decline and decline in her overall health.  Establishing a communication system (behaviors always communicate an unmet need) is the first step, and this is done with a thorough assessment to determine her true functional ability, (is she using avoidance behaviors), explore any preferred interests in her past (knitting, crochet, canning, gardening), and identify  her grieving process stage for this significant loss and other losses she has such as leaving her home, decline in her independence.... Once this is determine, strategies can be developed. 

Non-pharmacological interventions are always best, but if she/he does have depression, memory loss, or anxiety this would need to be addressed medically.  When someone begins to isolate due to DSL or other reasons, validating their fears of avoidance behaviors such as fear of leaving their room (falling, bathroom concerns, being abandoned...) and building trust is crucial. Supporting those who are lonely, bored, or believe there is no longer a purpose in their life is what we do best. November and December is the perfect time to offer and share opportunities for to smell, touch, and reminisce about memories of family holidays. Note: holidays can also be very difficult for anyone because of losses, so make sure you acknowledge all emotions.  

If the person is reluctant to leave her room, you may check in and see if she there is friend you could invite to her room (serve herbal tea and cookie) then use the old "Columbo approach (a last minute thought as you are leaving the room) and ask for their help to assemble candy bags for a children's party, pull and dry rose petals for making potpourri  bags, sort nuts, or familiar tasks such as breaking beans, cutting up vegetables, stirring cookie dough...  If she is not open to a visitor, then you can set up the task and begin doing it with her. Once she becomes engaged you can exit ("I have to check on something") and this will encourage some self-directed interests. You can also provide her with a lighted high vision magnifying glass that can be attached to a table, and use a microphone with amplification (I have used a karaoke machine). Once she begins to trust that her needs will be met, then she may begin to take some risks and even try recording her legacy.


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