Table 2

Tools and strategies for vision and hearing screening with older adults affected by dementia, as recommended by sensory specialists

Hearing screeningVision screening
  • ‘Hear Mans’ (manikin head with headphones on used for a quick hearing test)

  • Asking simple questions (does the patient wear hearing aids? does the patient have them?)

  • Chart review

  • Five min hearing test

  • Hearing Dependent Daily Activities questionnaire

  • Otoacoustic emissions

  • Picture board

  • Pocket Talker (how the person responds to using it)

  • Pure-tone audiology

  • Questionnaire devised by a former student of the interviewee’s

  • Repeating no

  • Speech testing

  • Whisper test and finger rub

  • Autorefractor

  • Case history

  • Finger counting

  • Health questionnaire

  • Matching game

  • Objective measures (prescription assessment, eye exam)

  • Sentences on a board in different sized font

  • Vision questionnaire

  • Visual charts (letters, numbers, sentences, single words, pictures, tumbling Es)

  • Ensure that cerumen (ear wax) has been removed

  • Alternating between testing the left and right ear until you get an answer if no initial response to pitch testing

  • Applying techniques developed for screening in children

  • Asking basic questions as a form of hearing screening

  • Bowing out of the screening gracefully if it could not be finished

  • Choosing more meaningful stimuli than pure tones

  • Choosing ‘pulsing beeps’ instead of ‘single beeps’ on the audiometer

  • Choosing a quiet room

  • Educating nurses and doctors on the importance of hearing and screening

  • Frequently encouraging the client

  • Gradually reducing the level of stimulus presentation to find their threshold

  • Repeating measurements to ensure reliability of client self-report

  • Rephrasing screening questions to avoid denial of the problem

  • Starting with speech testing

  • Taking breaks as needed

  • Using a headset instead of ear buds

  • Using ear buds instead of a headset

  • Using sound amplification (eg, Pocket Talker) to facilitate communication

  • Bringing the eye chart closer than normal

  • Distributing a vision form for caregiver to request examination or to help staff look at changes that would warrant a screening

  • Emphasising that the purpose of the screening is to monitor the health of the individual

  • Respecting their autonomy during the screening

  • Staying away from the patient and moving around them with portable instruments