TYPES OF DISABILITIES

SENSORY IMPAIRMENT
HEARING IMPAIRMENT
• Any type of hearing loss, which may be
related to either conductive or
sensorineural problems.
PEOPLE WITH THIS INCLUDE:

• Deaf
• Hard of hearing
DEAFNESS
deaf – physical condition of hearing loss
• Deaf – special collectives
•

• Prelingually deaf : early

childhood
• Since birth: sign language,
lipreading
• Later life: poor lipreading,
average reading and writing
skills.
 For patient education to be
effective, communciation must
be…

VISIBLE
 DISADVANTAGES OF HEARING LOSS
• Problem in communication

• May be unable to speak

• Limited verbal abilities

• Poor vocabulary
ADVANTAGES
MODES OF COMMUNICATION
SIGN LANGUAGE

• American Sign Language (ASL)

- Professional interpreter
- Section 504 of the Rehab Act of 1973
LIPREADING
All people who are deaf can read lips??

• Do not exaggerate
• lighting
• Remove barriers around your face
• Signing or written materials
WRITTEN MATERIALS

-Most reliable way

-Safest approach
-Time-consuming
-Stressful

• Match readability of client.

• Keep message simple
• Visual Aids
VERBALIZATION BY THE CLIENT
• Rapport/trusting relationship
• Try writing down what you hear
SOUND AUGMENTATION
- Patients not completely deaf

• Hearing Aids
• Cupping of hands
• Stethoscope
• Stand/sit near “good” ear
TELECOMMUNICATION
• Telecommunication devices for the deaf (TDD)
• Television decoders
• Caption films
GUIDELINES IN USING DIFFERENT MODES OF
COMMUNICATION

1. be natural.
2. simple sentences
3. therapeutic touch
4. face and stand < 6 feet
5. be considerate
6. do not turn face away
7. Stand directly at light
NURSING INTERVENTION
• Confirm messages been received and
understood
• Find effective strategies to give intended
message clearly.
• Ask patient what suits them.
VISUAL IMPAIRMENT
• 20/200 VISION

• VISUAL FIELD LIMITS IN BOTH EYES

WITHIN 20 DEGREES DIAMETER
4 LEADING EYE DISEASES ASSOCIATED
WITH AGING PROCESS
MACULAR DEGENERATION

• deterioration of the macula, causing

decrease in central vision
CATARACT
• Opacity of the lens
• vision is hazy
• complication of diabetes is a
leading cause of blindness
among middle-aged Americans.
• leaking blood vessels can cause
blinding areas
GLAUCOMA
This disease increases the fluid
pressure inside the eye, leading to
loss of side vision and eventually
total blindness. The increased
pressure destroys the optic nerve.
 Tips in caring for blind or visually impaired
patients:

Persons who have long standing blindness have learned

to develop a heightened acuity to senses like hearing,
taste, touch, smell
When explaining procedures, be descriptive
as possible

Because blind persons are unable to see shapes, sizes

and placement of objects, tactile learning is an important
technique to use when teaching
 When using printed or handwritten materials,
enlarge the print or handwriting

Proper lighting is of utmost importance in assisting the

legally blind person to read the printed word
Providing contrast is a very helpful technique

Audiotapes and cassette recorders are very useful tools

If you are assisting a person who is blind to ambulate,

always use the “sighted guide technique”
LEARNING DISABILITY
 INPUT DISABILITIES

• TYPES:

1. Visual Perceptual Disorder

• inability to read or difficulty with
reading (dyslexia)

• people with this deficit tend to be

auditory learners.
2. Auditory Perceptual Disorder
• inability to distinguish subtle differences in sounds.
example: blue and blow, ball and bell

3. Integrative Processing Disorder

• inability to sequence visual, auditory or tactile stimuli.
example: dog as god

Abstraction- inability to infer

meaning from words or
phrases.
4. Short-term or Long Term Memory Disorder
• inability to restore or recall what a person
has learned an hour before, but he/she may be
able to recall information at later point in time.
COMMUNICATION DISORDERS
AMPHASIA
• problem with speaking, writing or understanding
• multiple modality loss of language ability

2 TYPES
1. Expressive
• affects the dominant cerebral hemisphere
• caused by injury

1. Receptive
• wernick’s area are affected
• can hear but unable to understand the significance of the spoken word.
Working with an expressive aphasia client:

• Recall word images

• Repeat words spoken by the nurse.

Working with an receptive aphasia client:

• Establish means for non verbal

communication
• Speak appropriately
• Encourage and teach client
• Acknowledge client’s frustration
Blanco suggest the following:

• Don’t use baby talk

• Speak normal tones

• Speak in short, slow, simple sentences

• Allow time to answer

• Be patient, slow the person’s response down and involve

the family
DYSARTHRIA
• problem with the muscle controlling the speech
• cause by a damage
• affects the same muscles used in eating and speaking

Dreher makes the following suggestions to

improve communication:

• Be sure environment is quite

• Repeat unclear parts of the subject
• Do not simplify your message
• Ask questions that need only short answers
• Encourage the person to use more oral movement.
 LARYNGECTOMY
• Cancer of the larynx
• men>women
• >60

SPEAKING AFTER LARYNGECTOMY:

• Esophageal speech
• Tracheoesophageal speech
 CHRONIC ILLNESS
8 KEY PROBLEMS OF A CHRONICALLY ILL PATIENT

• Problem management
• Control of symptoms
• Carrying out prescribed regimens
• Prevention/living with social isolation
• Adjustments to life changes
• Interaction with others and lifestyle
• Funding
• Other problems
MEASURES TO IMPROVE COMMUNICATIONS
WITH A PERSON WITH A LARYNGECTOMY:

• Seek quiet environment

• Watch the speaker’s lips

• Do not alter your message

• If you don’t understand the speaker, repeat what you think

the person said, and ask for more information