Care planning for residents with combined vision and hearing loss

The workshop on creating effective care plans for residents with dual sensory loss formed one of the most discussed sessions at the National Elderly Welfare Facility Conference and Research Meeting held in Tochigi. Practitioners, facility administrators and researchers gathered to explore how assessment frameworks must change when a resident lives with both significant vision impairment and hearing loss at the same time. The session drew on Japanese facility experience while inviting comparison with international approaches to deafblind care.

Dual sensory impairment, often described in the literature as deafblindness or combined vision and hearing loss, reshapes every aspect of daily support. Communication becomes fragmented, orientation inside the building grows hazardous, and even routine reviews of care goals can leave the resident unsure of what is being proposed. In Australia, Vision Australia and Deafblind Australia estimate that a sizeable proportion of older people receiving aged care services experience some degree of combined sensory loss, particularly those over eighty and those living with diabetes-related complications.

Care planning for this group cannot be approached as a simple combination of separate vision and hearing support plans. The workshop facilitators emphasised that the two impairments interact, magnifying confusion in noisy dining rooms, during handovers, or when fire alarms sound. A person who can no longer rely on lip-reading, gestures, written notes or amplified speech needs a plan built around tactile, spatial and relational cues that staff can reliably reproduce shift after shift.

Australian providers attending the session noted parallels with local reform directions. The strengthened Aged Care Quality Standards, alongside recommendations flowing from the Royal Commission into Aged Care Quality and Safety, push facilities towards more individualised planning, especially for residents with complex communication needs. The Tochigi discussions offered a useful reference point for Sydney-based and Melbourne-based teams redesigning their assessment templates.

Communication as the foundation of any personalised plan

The first segment of the workshop focused on communication assessment, a step that practitioners admitted is often abbreviated in busy facilities. Presenters demonstrated how a quick checklist of hearing, vision, preferred language, tactile responsiveness and yes/no reliability produces a much richer baseline than the standard admission form. Residents were encouraged to indicate their preferred communication channel, whether Auslan, tactile fingerspelling, print on palm, object cues or simply a trusted staff member who knows how to pace conversation.

Workshop participants practiced drafting micro-communication plans that travel with the resident between the bedroom, dining area and garden. These plans specified lighting levels, background noise limits, signage preferences and the staff member responsible for ensuring hearing aids or glasses were cleaned and functioning before each interaction. The exercise made clear that communication is not a personal trait but an environmental achievement that the facility must engineer every day.

The Australian delegation found these micro-plans particularly relevant to residential services in Brisbane and Adelaide, where summer humidity can affect hearing aid performance and glare management for low-vision residents. Speakers also pointed to guides produced after the Tochigi gathering, including reflections on dementia-friendly layouts available through https://jstochigi.org/guides/lessons-from-the-js-festival-building-dementia-friendly-facility-layouts-ade, which complement the sensory-loss planning content.

Environmental design and assistive technology choices

The second part of the workshop moved from communication to the physical environment. Facilitators walked through case examples where care plans failed because corridors echoed, contrast between walls and floors was too low, or vibration-based alert systems were missing from bedrooms. Participants learned to map each resident's route through the facility, then test it themselves with eyes closed and ears covered, a method borrowed from deafblind awareness training.

Assistive technology featured prominently, with practical demonstrations of amplified stethoscopes, personal amplifiers, tactile timers and large-print calendars paired with raised-line markers. The group debated when high-tech solutions such as vibrating pager systems or tablet-based video relay added value, and when simpler tools like a consistent knock pattern on the door delivered better outcomes for residents with late-stage combined loss.

Several attendees compared notes with Australian colleagues working with the National Disability Insurance Scheme, where funding pathways for sensory equipment differ from the My Aged Care stream. The session closed by underlining that any technology introduced must be matched to the resident's routine, not the marketing claims of the supplier, a point reinforced in supplier showcases held across the JS Festival exhibition hall.

Building workforce capability and team collaboration

The third workshop stream addressed the workforce. Presenters argued that a beautifully written care plan collapses if the morning shift cannot interpret it. Training was framed as a layered responsibility, ranging from universal induction for every staff member to deeper, ongoing mentoring for key workers assigned to residents with complex sensory profiles. Role-play scenarios, including simulated cataract and earplug experiences, helped participants feel the disorientation their residents face.

Multidisciplinary collaboration was treated as a planning requirement rather than an aspiration. Optometrists, audiologists, physiotherapists, dietitians, social workers and family members each brought a fragment of information that, in isolation, meant little. The workshop proposed a quarterly sensory review meeting, modelled on case conferences used in palliative care, where the team could update goals and respond to small but significant changes in a resident's thresholds.

This approach resonated strongly with providers in Perth and Hobart, where smaller staffing pools make structured handovers especially important. Speakers also encouraged participants to seek peer support beyond their own organisation, pointing to professional networks such as the ChiliChillin community for facility leaders and the CSharpCon platform for care technology specialists.

Translating the Tochigi insights into Australian practice

The closing session brought Japanese and international examples together, inviting each delegate to draft a thirty-day action plan for their own service. Common commitments included reviewing how sensory assessments were recorded, introducing tactile orientation cues in at least one household, and arranging joint training with local deafblind consultants. Participants also discussed the importance of documenting small wins so that boards and funding bodies could see measurable progress.

Australian providers left the workshop with a clearer sense of how the Tochigi content mapped onto local frameworks. The Aged Care Quality Standards' focus on dignity, choice and clinical governance aligned closely with the workshop's emphasis on personalised communication and environmental safety. Several regional managers announced plans to share their action lists through state-based aged care peaks, ensuring that insights from one facility could lift practice across an entire region.

Practical follow-up was encouraged, including booking study tours and registering for the next JS Festival gathering. Delegates needing further information on the event's resources and ongoing research outputs were directed to the secretariat at https://jstochigi.org/contact, where enquiries about workshops, exhibition space and research submissions could be lodged.

Practical recommendations for facility leaders

The workshop facilitators summarised the session with a set of practical recommendations that any service could begin applying within weeks.

• Conduct a sensory audit of every resident on admission, recording vision, hearing, preferred communication channel and yes/no reliability alongside standard clinical data.
• Draft a one-page micro-communication plan for each resident with combined sensory loss and review it at every handover.
• Test internal walkways with simulated sight and hearing impairment at least twice a year, and act on the findings through lighting, contrast and acoustic adjustments.
• Schedule a quarterly sensory case conference that brings together nursing, allied health, lifestyle staff and family members to refine care goals.
• Invest in core assistive items such as personal amplifiers, tactile timers and large-print calendars before purchasing complex technology.
• Pair every new staff member with a mentor experienced in deafblind support during their first three months of work.
• Document progress in language that boards, families and regulators can understand, linking sensory planning to quality and safety outcomes.