Table 2.

Tools and strategies for vision and hearing screening with older adults affected by dementia, as recommended by sensory specialists

	Hearing screening	Vision screening
Tools	‘Hear Mans’ (manikin head with headphones on used for a quick hearing test) Asking simple questions (does the patient wear hearing aids? does the patient have them?) Chart review Five min hearing test Hearing Dependent Daily Activities questionnaire Otoacoustic emissions Picture board Pocket Talker (how the person responds to using it) Pure-tone audiology Questionnaire devised by a former student of the interviewee’s Repeating no Speech testing Whisper test and finger rub	Autorefractor Case history Finger counting Health questionnaire Matching game Objective measures (prescription assessment, eye exam) Sentences on a board in different sized font Vision questionnaire Visual charts (letters, numbers, sentences, single words, pictures, tumbling Es)
Strategies	Ensure that cerumen (ear wax) has been removed Alternating between testing the left and right ear until you get an answer if no initial response to pitch testing Applying techniques developed for screening in children Asking basic questions as a form of hearing screening Bowing out of the screening gracefully if it could not be finished Choosing more meaningful stimuli than pure tones Choosing ‘pulsing beeps’ instead of ‘single beeps’ on the audiometer Choosing a quiet room Educating nurses and doctors on the importance of hearing and screening Frequently encouraging the client Gradually reducing the level of stimulus presentation to find their threshold Repeating measurements to ensure reliability of client self-report Rephrasing screening questions to avoid denial of the problem Starting with speech testing Taking breaks as needed Using a headset instead of ear buds Using ear buds instead of a headset Using sound amplification (eg, Pocket Talker) to facilitate communication	Bringing the eye chart closer than normal Distributing a vision form for caregiver to request examination or to help staff look at changes that would warrant a screening Emphasising that the purpose of the screening is to monitor the health of the individual Respecting their autonomy during the screening Staying away from the patient and moving around them with portable instruments