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‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians
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Our ageing population brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss).
Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are living with dual sensory impairment.
Combined vision and hearing loss describes any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is increasingly common as people get older.
The experience can make older people feel isolated and unable to participate in important conversations, including about their health.
![](https://images.theconversation.com/files/602983/original/file-20240626-18-z4sv1y.jpg?ixlib=rb-4.1.0&rect=45%2C5%2C3788%2C2149&q=45&auto=format&w=754&fit=clip)
Causes and conditions
Conditions related to hearing and vision impairment often increase as we age – but many of these changes are subtle.
Hearing loss can start as early as our 50s and often accompany other age-related visual changes, such as age-related macular degeneration.
Other age-related conditions are frequently prioritised by patients, doctors or carers, such as diabetes or heart disease. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our research told us
I don’t see too good or hear too well. It’s just part of old age.
An invisible disability
Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts social activities and communication, making it difficult for older adults to manage.
It is underdiagnosed, underrecognised and sometimes misattributed (for example, to cognitive impairment or decline). However, there is also growing evidence of links between dementia and dual sensory loss. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, feel happy and be safe.
A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us:
There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else.
Isolated yet more dependent on others
Global trends show a worrying conundrum. Older people with dual sensory impairment become more socially isolated, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing.
One aspect of this is how effectively they can comprehend and communicate in a health-care setting. Recent research shows doctors and nurses in hospitals aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, researchers note. It facilitates:
- shorter hospital stays
- fewer re-admissions
- reduced emergency room visits
- better treatment adherence and medical follow up
- less unnecessary diagnostic testing
- improved health-care outcomes.
‘Too hard’
Globally, there is a better understanding of how important it is to maintain active social lives as people age. But this is difficult for older adults with dual sensory loss. One person told us
I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people.
Again, these experiences increase reliance on family. But caring in this context is tough and largely hidden. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring frustration, social isolation and depression for carers too. One spouse told us:
He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair.
![older woman looks down at table while carer looks on](https://images.theconversation.com/files/602986/original/file-20240626-20-z4sv1y.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip)
So, what can we do?
Dual sensory impairment is a growing problem with potentially devastating impacts.
It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers.
We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to navigate health care.
Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.
Moira Dunsmore, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, University of Sydney; Annmaree Watharow, Lived Experience Research Fellow, Centre for Disability Research and Policy, University of Sydney, and Emily Kecman, Postdoctoral research fellow, Department of Linguistics, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Lychees vs Kumquats – Which is Healthier?
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Our Verdict
When comparing lychees to kumquats, we picked the kumquats.
Why?
In terms of macros, everything is comparable except for fiber, of which kumquats have 5–6x as much fiber, which means a very significant win for kumquats in this category.
When it comes to vitamins, lychees have slightly more of vitamins B3, B6, C, and K, while kumquats have a lot more of vitamins A and B1, and moderately more vitamins B2, B9, E, and choline. A fair win for kumquats here.
In the category of minerals, lychees have a little more copper, phosphorus, and selenium, while kumquats have 11x as much calcium, as well as a 2–3x more iron, magnesium, manganese and zinc. An easy win for kumquats.
Both fruits have great phenolic profiles, being both rich in antioxidants.
All in all, enjoy both, but if you’re going to pick one, kumquats easily win the day!
Want to learn more?
You might like to read:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- When Bitter Is Better: Enjoy Bitter Foods For Your Heart & Brain ← kumquats have a bitter citrus taste, while lychees are quite sweet and mellow
Take care!
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Beyond Guarding Against Dementia
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When Age’s Brain-Changes Come Knocking
This is Dr. Amy Friday. She’s a psychologist, specializing in geropsychology and neuropsychological assessments.
In other words, she helps people optimize their aging experience, particularly in the context of brain changes as we get older.
What does she want us to know?
First: be not afraid
Ominous first words, but the fact is, there’s a lot to find scary about the prospect of memory loss, dementia, and death.
However, as she points out:
- Death will come for us all sooner or later, barring technology as yet unknown
- Dementia can be avoided, or at least stalled, or at least worked around
- Memory loss, as per the above, can be avoided/stalled/managed
We’ve written a little on these topics too:
…or if the death is not yours:
As for avoiding dementia, the below-linked feature is about Alzheimer’s in particular (which accounts for more than half of all cases of dementia), but the advice goes for most of the other kinds too:
How To Reduce Your Alzheimer’s Risk
And finally, about memory loss specifically:
How To Boost Your Memory Immediately (Without Supplements)
this one is especially about cementing into one’s brain the kinds of memories that people most fear losing with age. People don’t worry about forgetting their PIN codes; they worry about forgetting their cherished memories with loved ones. So, if that’s important to you, do consider checking out this one!
What is that about managing or working around the symptoms?
If we’re missing a limb, we (usually) get a prosthetic, and/or learn how to operate without that limb.
If we’re missing sight or hearing, partially or fully, there are disability aids for those kinds of things too (glasses are a disability aid! Something being very common does not make it not a disability; you literally have less of an ability—in this case, the ability to see), and/or we learn how to operate with our different (or missing) sense.
Dr. Friday makes the case for this being the same with memory loss, dementia, and other age-related symptoms (reduced focus, increased mental fatigue, etc):
❝We are all screwed up. Here’s my flavor … what’s yours? This is a favorite saying of mine, because we ARE all screwed up in one way or another, and when we acknowledge it we can feel closer in our screwed-up-edness.
We are all experiencing “normal aging,” so that tip-of-the-tongue phenomenon that starts in our thirties and slowly gets worse is REAL. But what if you’re having more problems than normal aging? Is it time to throw in the towel and hide? I’m hoping that there is a group of people who say HELL NO to that idea.
Let’s use lessons from research and clinical practice to help all of us work around our weaknesses, and capitalize on our strengths. ❞
Examples of this might include:
- Writing down the things most important to you (a short list of information and/or statements that you feel define you and what matters most to you), so that you can read it later
- Making sure you have support (partner, family, friends, etc) who are on the same page about this topic—and thus will actually support you and advocate for you, instead of arguing about what is in your best interest without consulting you.
- Labelling stuff around the house, so that you get less confused about what is what and where it is
- Having a named go-to advocate that you can call / ask to be called, if you are in trouble somewhere and need help that you can rely on
- Getting a specialized, simpler bank account; hiring an accountant if relevant and practicable.
The thing is, we all want to keep control. Sometimes we can do that! Sometimes we can’t, and if we’re going to lose some aspect of control, it’ll generally go a lot better if we do it on our own terms, so that we ourselves can look out for future-us in our planning.
Want to know more?
You might enjoy her blog, which includes also links to her many videos on the topic, including such items as:
- Neuroplasticity – #1 Way To Increase Brain Health
- Which Diet PREVENTS Alzheimer’s? | Best Brain Health Diet
- Stop Anxiety About Dementia & Do I Have Dementia?
For the rest, see:
This Beautiful Brain | The Science Of Brain Health
Enjoy!
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Chair Stretch Workout Guide
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝The 3 most important exercises don’t work if you can’t get on the floor. I’m 78, and have knee replacements. What about 3 best chair yoga stretches? Love your articles!❞
Here are six!
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Who you are and where you live shouldn’t determine your ability to survive cancer
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In Canada, nearly everyone has a cancer story to share. It affects one in every two people, and despite improvements in cancer survivorship, one out of every four people affected by cancer still will die from it.
As a scientist dedicated to cancer care, I work directly with patients to reimagine a system that was never designed for them in the first place – a system in which your quality of care depends on social drivers like your appearance, your bank statements and your postal code.
We know that poverty, poor nutrition, housing instability and limited access to education and employment can contribute to both the development and progression of cancer. Quality nutrition and regular exercise reduce cancer risk but are contingent on affordable food options and the ability to stay active in safe, walkable neighbourhoods. Environmental hazards like air pollution and toxic waste elevate the risk of specific cancers, but are contingent on the built environment, laws safeguarding workers and the availability of affordable housing.
On a health-system level, we face implicit biases among care providers, a lack of health workforce competence in addressing the social determinants of health, and services that do not cater to the needs of marginalized individuals.
Indigenous peoples, racialized communities, those with low income and gender diverse individuals face the most discrimination in health care, resulting in inadequate experiences, missed diagnosis and avoidance of care. One patient living in subsidized housing told me, “You get treated like a piece of garbage – you come out and feel twice as bad.”
As Canadians, we benefit from a taxpayer funded health-care system that encompasses cancer care services. The average Canadian enjoys a life expectancy of more than 80 years and Canada boasts high cancer survival rates. While we have made incredible strides in cancer care, we must work together to ensure these benefits are equally shared amongst all people in Canada. We need to redesign systems of care so that they are:
- Anti-oppressive. We must begin by understanding and responding to historical and systemic racism that shapes cancer risk, access to care and quality of life for individuals facing marginalizing conditions. Without tackling the root causes, we will never be able to fully close the cancer care gap. This commitment involves undoing intergenerational trauma and harm through public policies that elevate the living and working conditions of all people.
- Patient-centric. We need to prioritize patient needs, preferences and values in all aspects of their health-care experience. This means tailoring treatments and services to individual patient needs. In policymaking, it involves creating policies that are informed by and responsive to the real-life experiences of patients. In research, it involves engaging patients in the research process and ensuring studies are relevant to and respectful of their unique perspectives and needs. This holistic approach ensures that patients’ perspectives are central to all aspects of health care.
- Socially just. We must strive for a society in which everyone has equal access to resources, opportunities and rights, and systemic inequalities and injustices are actively challenged and addressed. When redesigning the cancer care system, this involves proactive practices that create opportunities for all people, particularly those experiencing the most marginalization, to become involved in systemic health-care decision-making. A system that is responsive to the needs of the most marginalized will ultimately work better for all people.
Who you are, how you look, where you live and how much money you make should never be the difference between life and death. Let us commit to a future in which all people have the resources and support to prevent and treat cancer so that no one is left behind.
This article is republished from HealthyDebate under a Creative Commons license. Read the original article.
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What does it mean to be transgender?
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Transgender media coverage has surged in recent years for a wide range of reasons. While there are more transgender television characters than ever before, hundreds of bills are targeting transgender people’s access to medical care, sports teams, gender-specific public spaces, and other institutions.
Despite the increase in conversation about the transgender community, public confusion around transgender identity remains.
Read on to learn more about what it means to be transgender and understand challenges transgender people may face.
What does it mean to be transgender?
Transgender—or “trans”—is an umbrella term for people whose gender identity or gender expression does not conform to their sex assigned at birth. People can discover they are trans at any age.
Gender identity refers to a person’s inner sense of being a woman, a man, neither, both, or something else entirely. Trans people who don’t feel like women or men might describe themselves as nonbinary, agender, genderqueer, or two-spirit, among other terms.
Gender expression describes the way a person communicates their gender through their appearance—such as their clothing or hairstyle—and behavior.
A person whose gender expression doesn’t conform to the expectations of their assigned sex may not identify as trans. The only way to know for sure if someone is trans is if they tell you.
Cisgender—or “cis”—describes people whose gender identities match the sex they were assigned at birth.
How long have transgender people existed?
Being trans isn’t new. Although the word “transgender” only dates back to the 1960s, people whose identities defy traditional gender expectations have existed across cultures throughout recorded history.
How many people are transgender?
A 2022 Williams Institute study estimates that 1.6 million people over the age of 13 identify as transgender in the United States.
Is being transgender a mental health condition?
No. Conveying and communicating about your gender in a way that feels authentic to you is a normal and necessary part of self-expression.
Social and legal stigma, bullying, discrimination, harassment, negative media messages, and barriers to gender-affirming medical care can cause psychological distress for trans people. This is especially true for trans people of color, who face significantly higher rates of violence, poverty, housing instability, and incarceration—but trans identity itself is not a mental health condition.
What is gender dysphoria?
Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity, or their internal sense of gender. A 2021 study of trans adults pursuing gender-affirming medical care found that most participants started experiencing gender dysphoria by the time they were 7.
When trans people don’t receive the support they need to manage gender dysphoria, they may experience depression, anxiety, social isolation, suicidal ideation, substance use disorder, eating disorders, and self-injury.
How do trans people manage gender dysphoria?
Every trans person’s experience with gender dysphoria is unique. Some trans people may alleviate dysphoria by wearing gender-affirming clothing or by asking others to refer to them by a new name and use pronouns that accurately reflect their gender identity. The 2022 U.S. Trans Survey found that nearly all trans participants who lived as a different gender than the sex they were assigned at birth reported that they were more satisfied with their lives.
Some trans people may also manage dysphoria by pursuing medical transition, which may involve taking hormones and getting gender-affirming surgery.
Access to gender-affirming medical care has been shown to reduce the risk of depression and suicide among trans youth and adults.
To learn more about the trans community, visit resources from the National Center for Transgender Equality, the Trevor Project, PFLAG, and Planned Parenthood.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Aging with Grace – by Dr. David Snowdon
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First, what this book is not: a book about Christianity. Don’t worry, we didn’t suddenly change the theme of 10almonds.
Rather, what this book is: a book about a famous large (n=678) study into the biology of aging, that took a population sample of women who had many factors already controlled-for, e.g. they ate the same food, had the same schedule, did the same activities, etc—for many years on end. In other words, a convent of nuns.
This allowed for a lot more to be learned about other factors that influence aging, such as:
- Heredity / genetics in general
- Speaking more than one language
- Supplementing with vitamins or not
- Key adverse events (e.g. stroke)
- Key chronic conditions (e.g. depression)
The book does also cover (as one might expect) the role that community and faith can play in healthy longevity, but since the subjects were 678 communally-dwelling people of faith (thus: no control group of faithless loners), this aspect is discussed only in anecdote, or in reference to other studies.
The author of this book, by the way, was the lead researcher of the study, and he is a well-recognised expert in the field of Alzheimer’s in particular (and Alzheimer’s does feature quite a bit throughout).
The writing style is largely narrative, and/but with a lot of clinical detail and specific data; this is by no means a wishy-washy book.
Bottom line: if you’d like to know what nuns were doing in the 1980s to disproportionally live into three-figure ages, then this book will answer those questions.
Click here to check out Aging with Grace, and indeed age with grace!
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Learn to Age Gracefully
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