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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 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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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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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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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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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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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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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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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 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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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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