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She has macular and hearing loss. Her hearing aids are helping, but they are not ideal. I'm starting to wonder if we need to take some classes or something to learn brail or some kind of alternate communication skills. Suggestions?

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I think first you have to accept that she can't hear and can't see well and there is nothing anyone can do. You can check with the medical people to see if the hearing aide is working and eyeglasses are fine, etc. but do not expect miracles. Let her sense your presence and perhaps hold her hand or put your arm around her. That makes them know you are close but forget the "old normal". I know of no way to do that.
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Imho, my own late mother was a legally blind woman living alone (until almost syncope from extremely low blood pressure). She managed, having the 'worst ever case of wet Macular Degeneration that her RS had ever seen' by helping herself out by accessing the COB (Commissioner of the Blind). Through this organization, she got aids to help her write letters and checks, balance a checkbook, read a newspaper, make hot tea and soup and so much more.
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My dad has gone completely deaf… can’t even hear with hearing aids and sight isn’t great either. The solution for me has been Whiteboards and thick black markers. That is the way we converse. I tried the sign language route but at 95 it didn’t work. Now the Dollar Store 13”by 15” Whiteboard has been perfect. Good luck. It is not easy!!
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My Dad is now considered legally blind & has hearing issues as well.
What I have done is put curly ribbon on jelly jar & a bow say on pickles
That way he can distinguish between two items
I've also put felt dots on the buttons he uses on the microwave 1, 5, & start
On the 1 I have 1 dot, the 5 I have 2 & 3 on the start button.
Also books on CD's are great
Maybe some of these suggestions will help
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As you were advised, skip Braille. Assuming Mom is elderly, she will only be frustrated.
1. Work with a Low Vision optometrist who can tell you what type of lighting, magnifiers and devices will work best for Mom.
2. Mom should be followed by a retina specialist to try to slow down the macular degeneration. Yes, this is two different specialists (one for eye health and one for vision).
3. An occupational therapist who is trained in vision specifically can come to Mom's home and make recommendations to improve overall safety and functionality.
4. Remind everyone who talks to Mom to speak slowly and distinctly, and reduce background noise.
5. If Mom likes to read, get her large print books from the library with audiobooks to match. If what she sees and hears are the same, she is more likely to be able to read fluently and enjoy it.
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My Dad and I worked out our own hand signals for a few things: time ( point to our watch) shower ( fingers down and wiggling) 5 minutes ( hand up five fingers spread). Legs up, I raised my legs...

He forgot stuff so I wrote a brief note, groceries back around 5:30. (Not an exact time).

When he went to respite while I went away for a couple weeks I made a calendar by copying one and marking the days I would be gone and when I'd be back. He could and did check off the days. He was afraid he was being moved permanently. I wrote a note, big letters, I will take you back home, and the date a day after my return. Stapled it together. My brother visited him after work at the AL while I was gone.

Yes, talking normally right into his ear in a low tone was helpful. During his hearing aid test we found he did not hear the higher tones that are usually in women's voices.

He used a hand held larger magnifying 🔎glass to read, and I had a bright gooseneck light ( full spectrum) next to his chair both for reading and mood.
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Check out youreyes.org.

This unaffiliated nonprofit offers regular web-based town halls discussing issues and solution related to low and decreasing vision. They are wonderful. They also run a low vision hotline and may be able to hep answer questions you may have.

If you are ever in the national capital area, you can make an appointment to try out various assistive vision related devices also. (If not, they may be able to help you with resources - anyway - over the phone). There is some amazing technology to help people with extremely low vision! This organization does not take compensation from any manufacturers.

I purchased Mom’s second set of hearing aids at Costco and found the price, quality warranty unbeatable.
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Nncbb57 Jul 2021
I’ve been wondering about the quality of the Costco hearing aids. Have you been pleased?
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Sorry for the issues you are facing. Make sure your Mom is being seen by a good ophthalmologist. Mac degeneration can't be cured at this time but it might be slowed but only a doctor can tell you what can be done after a thorough exam . Getting large print books, an easily erasable whiteboard and some of the other suggestions listed previously will be a good idea. Check in with the Foundation for the Blind for other great ideas.

Have the hearing aids tested and get up with the latest research on hearing aids. Things are developing rapidly in that field.
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You are hoping for something that is impossible - this can't be done due to age and medical conditions. It is called old age. Just try to be kind and loving and let her know you are present. You can't fix this.
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Have you had her ears checked lately,, maybe she needs to update her hearing Aide.

Depending on how old she is and what she is able and wants to learn.

My 97 year old Dad had both plus dementia and all I could do was to speak up closer to him and speak louder and short sentences.

If she is still able to write, that would be easier than to learn brail.

Check with the Blind and they have all sorts of things to help.
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My Mom had macular degeneration and I made sure to put brighter lighting everywhere, whether it was changing out lightbulbs or adding a couple of led floor lamps where she spent the most time. Once it gets later in the day, like after 4pm - I found not much helped - too many shadows. I also bought magnifying devices so she could read better. Larger print magazines and books are readily available.
Hearing is tricky because the elderly are in denial about it. Make sure the batteries are changed frequently. If they are the newer, digital ones - they can be adjusted and re-tuned during a single visit to the hearing doctor. Speaking directly while looking at her will help, as will talking louder. It gets annoying but that's what works.
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how old is your mom? does she have dementia also? i would get a small white board and markers to suit the type (either wet or dry)board and use that to write out questions. You can use a simple thumbs up for yes and thumbs down for no. I don't know if they have some kind of tablet where you can type out what you want to say and she can answer verbally to what you asked. and if her eyesight is really bad........record what you want to ask her and play the volume up loud. wishing you luck
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People who are loosing their hearing do better in quiet rooms. Try to speak to her in a quiet place (no ambient noise). Ask your mother if she would want to take a class. She may not be interested. Also talk to her to find out whether it's worth taking her to an audiologist. A lot depends on how motivated she is to learn new ways of communicating.
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Moxies Jul 2021
Are the hearing aids new? Mine have been tuned up at the Costco dept where I got them. They retest you and reset them on the computer. People on this site mention white boards. You can write in larger letters and erase them easily. You might contact the place where she got the hearing aids and discuss it. Also, consider a free evaluation and suggestions at Costco/
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The best thing I found for my 95 yo granny was, instead of raising my voice, repeating, or enunciating so she could read my lips (all stressful and frustrating for us both), I learned to lean in and speak in a low voice directly into her ear, as if whispering a secret. She heard it every time, and obviously enjoyed the close contact.
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Maple3044 Jul 2021
Thats what I have to do with my hubby. He has 40% hearing in his good ear and 25% in his other ear. And $5000 hearing aids he won't wear because they don't do any good.
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Hearing amplifiers can help with hearing loss. I find the ones that hang around the neck and use a headset more useful for seniors who often have challenges managing to get the smaller independent ones in their ears or on chargers. I use an amplifier with a blue tooth headset often when at "home"; it's easy to charge and put in or remove when I want. I usually use the smaller in-ear canal model when leaving my home, but not always.
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I assume she's being treated by a vision specialist for the macular degeneration?   My aunt got shots on a regular basis and even though they were painful, they apparently did help slow the deterioration.

I think learning Braille is a good backup plan;   I got some Braille alphabet cards at an elder expo and keep them, in the event I ever need them.

You can also buy extra large mirrors to magnify letters.  A friend of my father had them as her eyesight deteriorated.    I can't recall the name of the organization, but there is one that addresses vision loss and compensation with various devices.   If I can find it, I'll post back.
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Humama Jul 2021
I am a teacher of the visually impaired and I disagree about your recommending Braille. As one who had to learn it as part of my teacher training, I can assure you that it is much, much more difficult to learn than reading print is. There are many conventions (specialized symbols) and rules that do not exist in print. Proficient readers of braille can read only half as fast as proficient readers of regular print (large print reading speed is between this two). In addition, cognitive or sensory issues, such as neuropathy, can further complicate braille reading.

I would be more likely to look at magnification devices, such as CCTV. I would also look at using Apple products because they have built-in universal design for both visual and hearing impairments. You may wish to speak to someone from your state's vocational rehabilitation office about services to help her adapt to activities of daily living.

I do not have the professional knowledge to address the hearing loss. Best of luck as you navigate this situation.
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You might already know this and I don’t know how cataract loss differs from macular loss. That said..,

You will likely have to adapt your communication. Find out if the pitch of your voice is low enough or high enough for her to have best clarity. Look at her and talk slowly and clearly. Expect to repeat things or get answers that don’t fit the question if she’s guessing at what you’re saying. Ask if she’s wearing her “ears.” Be patient. I read that with hearing loss, the brain starts to forget the distinction between similar words. You might need workarounds (like switching to Mommy if you have a Tom in the house).
Have a good sized whiteboard in the kitchen to leave each other notes.
Get her a headset with volume control for the tv.
If her vision allows and she can manage the technology, get an iPad (or android) and scale up the font. Reading news, emails, books; playing games at 24’ pt font size helps.

By the way, are you familiar with ARED vitamins for macular degeneration?
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I took mom around the assisted living facility and we checked out the wall decorations by touch. We practiced finding all the places in the building she wants to go. All the hallways are painted the same color, so it is easy for her to get lost. She runs her hand along the wall until she reaches a frame or table.

For example, if she touches a wooden frame with metal artwork in it, with her LEFT hand, she is facing the dining room. If she touches it with her RIGHT hand, then she is facing the elevator that she needs to go up to her apartment.

She also has no central vistion, so sometimes I stand behind her with my arms stretched forward on both sides of her head to point in the direction she needs to go. She can see my arms and decide which landmarks work for her to find her way.

Get a speaker phone with a quality speaker. Louder is not better, it needs to be clearer.

Her table top reading machine lets her read cards and see pictures sent by her great grandchildren. It helps her maintain contact with every generation of her family.
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We used to be in the Lion's Club and if there is financial need they often help with sight and hearing related assistance. There are many gadgets available for people with sight deficits. Computer software that can read emails to you and voice to text options. Special closed captioning for TV that explains (in great detail), what's going on in the show. Books on tape, of course. Would she want or qualify for a guide dog?

I agree with someone earlier about keeping up with the hearing aids. New technology and changes in their hearing abilities make it worth following up with regularly. Oh darn was going to suggest some simple signing (like I do with my grandkids) but if her sight is bad that won't be of much help.
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I had a delightful great aunt who took lip reading classes at her senior center in preparation for going deaf, since everyone in the family eventually became stone deaf. Bless her heart, she was the only one who never really had the issue, but she was ready, by golly.

My mother is both stone deaf and has macular degeneration. My dad immediately got in touch with the local Braille Institute and bought oversized calendars, got a phone with gigantic buttons and multiple volume and tone settings (provided for free by the phone company), and he bought her this tabletop reading magnifier --

https://www.enhancedvision.com/shop/low-vision-products/merlin-ultra-desktop-magnifier?utm_medium=ppc&utm_campaign=Shop+Products&utm_term=&utm_source=adwords&hsa_cam=199115341&hsa_tgt=pla-42018899887&hsa_src=g&hsa_ver=3&hsa_net=adwords&hsa_grp=15154347181&hsa_ad=99127700581&hsa_mt=&hsa_kw=&hsa_acc=6486675340&gclid=CjwKCAjwi9-HBhACEiwAPzUhHNTSgfdK2k1uun4N9O35rYWdK4ipZ3woqBuEZpEJ-r-a1yRW1EmfqxoCs-IQAvD_BwE

Don't get too freaked out by the price of this thing. They're frequently available for much less on the secondhand market -- that's how my dad got theirs. It saved my mom's sanity, and she used hers for years to read the newspaper and books.

Most important is to make sure people know your mom's limitations with vision and hearing. Ask people to identify themselves to her any time they see her -- "Hi Janet -- it's Bob." -- even if they're standing right in front of her. She's losing her central vision, and faces are the first thing to go. It's really hard not knowing who is talking to you, so get her friends trained early to identify themselves.

Also look into the American Foundation for the Blind for other resources.

Definitely make sure you get good hearing aids for her. Have her hearing checked annually at least and make sure the aids are adjusted. The technology for them is so much better than they were.
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Firstof5 Jul 2021
My mom has a table-top reading machine and loves it. Definitely worth the money.
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