Version 1 – January 2018

Looking after the

senses:

Ears, Eyes and

Mouth Care

Information and guidance for care homes

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Index

Older people may have issues with their sensory function especially their ears, eyes

and mouth which could greatly impact on their lives.

The resources below will provide an overview of things to consider whilst supporting

your residents:

The poster provides overview what to consider when support residents.

Each checklist provides prompt questions to identify where there may be a problem

and guidance on what to do.

An individual checklist is provided to document concerns and compliment individual

care plans

The further information links to useful organisations that can support your residents

and staff.

Content Page number

Ears, eyes, and mouth poster

Overview of things to consider 2

Ear care - Checklist (2 pages) 3

Eye care – Checklist (2 pages) 5

Mouth care – Checklist (2 pages) 7

Individual checklist

Assessment form developed for residents 9

Where to find further information (2 pages)

Links to websites and further guidelines 10

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Resources

Go to NHS Choices on www.nhs.uk for information, advice and details of local hearing services. For further information on local services, information and guidance, please visit the Sutton CCG Vanguard website on www.suttonccg.nhs.uk/vanguard.

Eyes, Ears and Mouth Care

Ear Care – Checklist

Does Betty have poor hearing?

Things to look out for:

Is Betty listening to the TV or Radio at a louder than usual volume?

Is she not taking part in conversations as she normally would?

Things to do:

Hearing should be tested every 3 years or when a deterioration is noticed.

Check the residents’ ears for wax regularly.

If Betty is receiving palliative care, does she need a review?

Who to contact:

For ongoing hearing difficulties that are impacting on the resident’s daily life, e.g. difficulty

hearing on the telephone, there may be additional hearing equipment to assist. For a

simple online assessment with links to products and providers visit

http://www.dlf.org.uk/content/asksara

You can also contact Action on Hearing Loss on www.actiononhearingloss.org.uk.

There are local disability shops that sell equipment; these are listed on the London Borough of Sutton website on www.sutton.gov.uk.

Alternatively, you may contact London Borough of Sutton, Vision and Hearing Team to receive guidance on receiving an assessment. Contact 020 8770 6080 to arrange or visit the website on www.sutton.gov.uk.

Supportive Care Home Team (your named lead) for any palliative care needs.

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Eyes, Ears and Mouth Care

Ear Care – Checklist

Does Betty have a hearing aid?

Things to look out for:

Is Betty using her hearing aid?

Is Betty’s hearing aid dirty?

Does it fit?

Where is it being kept? Things to do:

Ensure the hearing aid is kept in a safe place

If Betty is receiving palliative care, does she need a review?

Hearing Aid Checklist

Everyday

At night, turn the hearing aid off by opening the battery drawer; as this will disconnect the battery.

Wipe the hearing aid clean using wipes or a damp cloth.

When not in use, put the hearing aid in the box provided to keep it clean,. Every Week

Clean the hearing aid thoroughly.

If there is a mould, disconnect the mould from the hearing aid by gently pulling the tubing

off the hook (see hearing aid instruction manual) and wash it in warm soapy water. Leave it

to dry overnight. In the morning join the mould back onto the hearing aid.

If it has an open fit, use the cleaning whisker to remove debris from the thin wire (please see the hearing aid instruction manual).

Every 6 Months

Get the hearing aid serviced. Contact the hearing aid supplier. Who to contact:

Private hearing aids; please contact the hearing aid supplier for batteries, repairs,

appointments and information, carers are able to do this.

NHS aids; for batteries, repeat appointments, repairs, information or training about using/managing hearing aids, residents/carers can contact the Audiology team that provided the hearing aids. For St Helier Hospital Audiology, see https://www.epsom-sthelier.nhs.uk/audiology-and-audiovestibular-medicine or phone 0208 296 2000.

Supportive Care Home Team (your named lead) for any palliative care needs.

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Resources

Go to NHS Choices on www.nhs.uk for information, advice and details of local services. For further information on local services, information and guidance, please visit the Sutton CCG Vanguard website on www.suttonccg.nhs.uk/vanguard.

Eyes, Ears and Mouth Care

Eye Care – Checklist

Does Betty wear glasses or contact lenses?

Things to look out for:

If Betty has glasses or lenses; does she wear them?

Do they improve her vision?

Does she bump into things, trip easily, and try to put her cup down just off the table?

Is she hesitant?

Does she have difficulty reading, writing or watching TV?

Where are Betty’s glasses or lenses kept; can they be found easily and are they named?

Has Betty been diagnosed with an eye condition? Does Betty have a known eye condition? Things to do:

If due, or there appears to be a change in vision, arrange for a sight test.

Be aware of when glasses or lenses need to be worn (such as reading, TV or long distances).

Clean glasses or lenses regularly.

Have safe place for glasses or lenses.

Check appropriate lighting and avoid glare.

Remove trip hazards.

Who to contact:

Local opticians (see NHS Choices web link below).

If Betty needs another sight test, and her health means that she can’t get out to the High

Street practice, some optometrists provide sight tests in the home.

Supportive Care Home Team (your named lead) for any palliative care needs.

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Resources

Go to NHS Choices on www.nhs.uk for information, advice and details of local services. For further information on local services, information and guidance, please visit the Sutton CCG Vanguard website on www.suttonccg.nhs.uk/vanguard.

Eyes, Ears and Mouth Care

Eye Care – Checklist

Does Betty need a low vision assessment?

Things to look out for:

Do Betty’s glasses or lenses improve her vision?

Does she have difficulty reading, writing or watching TV with her glasses on? Things to do:

Arrange a low vision assessment.

Have a safe place to keep her low vision aids (such as magnifier). Who to contact:

Sutton Vision (for those with low vision) on www.suttonvision.org.uk Core services include: - Sight Loss Advisor based at St Helier Hospital - Low Vision Clinic held at Sutton Vision every 1st and 3rd Tuesday of the month - Resource Centre to demonstrate equipment - Information & Advice - Information on Social groups

Vision and Hearing Team at London Borough of Sutton on www.sutton.gov.uk / 020 8770 6080. They can arrange an assessment for low vision aids, daily living equipment, mobility training at home and outside, advice on reading and writing, advice on use of lighting and contrast and other information.

Supportive Care Home Team (your named lead) for any palliative care needs.

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Other things to consider:

Do they have any kind of mouth condition, such broken teeth, gum infection, ulcers or any kind of ulceration, oral thrush or swelling?

Do they have a constant dry mouth?

Are they receiving palliative care? Are there mouth care needs?

Eyes, Ears and Mouth Care

Mouth Care – Checklist

Does Betty have any kind of denture?

Things to look for:

Is Betty wearing her dentures?

Is Betty eating as she usually does?

Does she have unexplainable weight loss?

Does Betty have food left in her mouth after meals?

Is Betty’s diet sugary?

Does Betty take sugar based medicine? Things to do:

Regular mouth assessments and a daily mouth routine should be carried out.

Ensure a denture check is carried out regularly.

Check dentures are clean, not broken and fit correctly and encourage Betty to clean her dentures every morning and night and (ideally after food).

Check dentures are kept in a safe place in a named denture pot

Does food need to be modified, so she may eat more comfortably? Check gum health.

Who to contact:

Dentist or Clinical Dental Technician (if Betty has no natural teeth)

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Other things to consider:

Do they have any kind of mouth condition, such broken teeth, gum infection, ulcers or any kind of ulceration, oral thrush, or swelling?

Do they have a constant dry mouth?

Are they receiving palliative care? Are there specific care needs?

Resources

Go to NHS Choices on www.nhs.uk for information, advice and details of local dental services.= For further information on local services, information and guidance, please visit the Sutton CCG Vanguard website on www.suttonccg.nhs.uk/vanguard.

Eyes, Ears and Mouth Care

Mouth Care – Checklist

Does Betty have her own teeth?

Things to look for:

Is Betty eating normally?

Is there a strong odour on Betty’s breath?

Is Betty showing verbal or behavioural signs of dental pain (i.e. crying out or pulling at mouth)?

Does she have any physical indicators of dental pain, such as broken teeth, swelling, redness, or ulceration?

If Betty has dementia, and has difficulty spitting, is she using non-foaming toothpaste? Things to do:

A daily mouth routine should be carried out, encouraging Betty to clean her teeth morning

and night with fluoride toothpaste

Regular mouth assessments to check oral hygiene and gum health.

Ensure a dental review is carried out regularly. Who to contact:

For local dental services, please refer to NHS choices for your nearest NHS dentist (see

NHS Choices web link below).

Alternatively, for residents who are housebound, please contact the Department of

Community Special Care Dentistry on https://www.kch.nhs.uk/service/a-z/community-

special-care-dentistry. Tel; 020 3299 3480

For dental advice, please call NHS 111.

Supportive Care Home Team for any palliative care needs.

Where to find further information

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EA

RS

Poor hearing

Action on Hearing Loss

Caring for older people with hearing loss https://www.actiononhearingloss.org.uk/

NHS Choices

Hearing Impairment https://www.nhs.uk/Livewell/hearing-problems/Pages/hearing-problems.aspx

British Society of Audiologists

http://www.thebsa.org.uk/

Sutton Vision and Hearing services

https://www.sutton.gov.uk/downloads/file/1085/sutton_vision_and_hearing_services

Hearing Aids

Age UK

Age UK Hearing Aids with UK Hearing Care offer a complete hearing care service. For more information go to: http://www.ageukhearingaids.co.uk/

Action on hearing loss

Help with hearing aids https://www.actiononhearingloss.org.uk/hearing-health/hearing-loss-and-deafness/hearing-aids-and-other-treatments/hearing-aids/

NHS Choices

Hearing Aid Services – https://www.nhs.uk/service-search/Hearing-aid-services/sm2/Results/615/-0.205108925700188/51.346923828125/1849/0?distance=25

Where to find further information

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EY

ES

Local opticians – https://www.nhs.uk/Service-Search/Opticians/LocationSearch/9

Royal National Institute of Blind People (RNIB) can advise - 105 Judd Street, London, WC1H 9NE. Helpline 0303 123 9999 http://www.rnib.org.uk/.

o Top 10 tips for supporting residents with sight loss o Avoiding Falls o Older people and Sight Loss

Alzheimer’s Society – Sight, perception and hallucinations in dementia https://www.alzheimers.org.uk/

Sutton Vision http://www.suttonvision.org.uk/

Sutton Vision and Hearing services https://www.sutton.gov.uk/downloads/file/1085/sutton_vision_and_hearing_services

For a simple online assessment with links to products and providers visit http://www.dlf.org.uk/factsheets/vision

Local disability shops may sell low vision aids and other equipment; these are listed on Sutton Council website https://www.sutton.gov.uk/.

Local library large print books.

For information and advice on specific eye conditions (e.g. Macular issues or Glaucoma) contact specialist local and national charities via the internet.

Bedside vision check for falls prevention - RCP London https://www.rcplondon.ac.uk/file/5551/download?token=GtphFxI9

Where to find further information

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MO

UT

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SCIE/NICE

Improving oral health for adults in care homes: A quick guide for care home managers 2016 https://www.scie.org.uk/publications/ataglance/improving-oral-health-for-adults-in-care-homes.asp https://www.nice.org.uk/about/nice-communities/social-care/quick-guides/improving-oral-health-for-adults-in-care-homes

NICE

Oral health for adults in care homes. NICE guideline (2016). https://www.nice.org.uk/guidance/ng48/resources/oral-health-for-adults-in-care-homes-1837459547845

Oral Health Assessment Tool (adapted from Australian version) https://www.nice.org.uk/guidance/ng48/resources/oral-health-assessment-tool-2543183533

PHE

Delivering Better Oral Health https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/605266/Delivering_better_oral_health.pdf

Alzheimer’s Society

Eating and Drinking fact sheet https://www.alzheimers.org.uk/site/scripts/download_info.php?downloadID=1138

Age UK

Dental Care NHS and Private Treatment https://www.ageuk.org.uk/Documents/EN-GB/Factsheets/FS5_Dental_care_NHS_and_private_treatment_fcs.pdf?epslanguage=en-GB?dtrk=true

NHS Education for Scotland

Caring for Smiles Guide for Care Homes nes.scot.nhs.uk/media/2603965/caring_for_smiles_guide_for_care_homes.pdf

Dalhousie University 2011

Brushing Up Care Cards https://cdn.dal.ca/content/dam/dalhousie/pdf/dept/ahprc/BrushingUp-OCManual.pdf