Sight and hearing tend to be dealt with separately. There's a person for the eyes and a person for the ears, and the advice for each is sensible on its own terms: make it bigger, make it clearer, turn the captions on, get the aids checked.
What that advice quietly assumes is that the other sense is doing the covering. Poor hearing is manageable partly because you can read the subtitles and watch a face. Poor sight is manageable partly because you can be told, and read to, and hear someone come into the room. When both are going at once, each of those workarounds is being asked to lean on the thing that's also failing — and the difficulty isn't the sum of the two. It's considerably more.
This is common in later life and it has a name in the health and social care system: dual sensory loss. Knowing the term matters more than it sounds, because it's the phrase that unlocks the right sort of help.
What it actually looks like from the outside
It's frequently mistaken for something else, which is the reason it goes unaddressed for so long.
- Answers that don't quite match the question, and a growing habit of agreeing rather than asking again.
- Withdrawal from anything with several people in it — the table at Christmas, the church hall, the family video call — while one-to-one in a quiet room is still fine.
- Being startled by someone arriving, because neither the sound nor the movement registered.
- Growing cautious on stairs, kerbs and unfamiliar rooms.
- Doing less, and calling it not fancying it.
Any of that can be read as memory, or confusion, or low mood, or simply getting older — and sometimes it is. But it's worth ruling the senses in or out first, because they're the part with practical answers.
Get both assessed — and use the phrase
The single most useful thing a family can do here is administrative rather than technical.
- Have each sense checked properly. A GP can refer for hearing, and a sight test is straightforward to arrange; NHS-funded sight tests are available to people aged 60 and over. Aids and glasses that were right three years ago may not be right now, and an aid that whistles or sits in a drawer is doing nothing.
- Ask specifically about dual sensory loss. Say the words. Sensory services are often organised as one or the other, and a person with both can fall between them unless somebody names it.
- Ask the local council for a care needs assessment. This is free, it's a legal right in the UK, and it's the route to a specialist assessment for someone with both. Councils have a duty to consider communication needs — but it's a request, not something that arrives on its own.
- Sense (sense.org.uk) is the UK charity for people with complex disabilities including combined sight and hearing loss, and is the best single starting point for information and for finding what's available locally. RNIB (rnib.org.uk) and RNID (rnid.org.uk) cover the two halves.
Nobody hands you this list. It's the part that families usually discover eighteen months later than they'd have liked.
What helps day to day
Most of what works is about being predictable rather than being clever.
- One sense at a time, deliberately. Don't ask them to listen and read at once. Say the thing, pause, then show the thing.
- Come into view before you speak. Approach from the front, into the light, and let them see you're there. Being spoken to out of nowhere by someone you can't see or hear properly is disorientating, and it makes people wary of company.
- Light on your face, not behind you. Standing with a window at your back turns you into a silhouette, and takes away every visual clue at once. Turn round.
- Keep the room the same. Furniture where it was, the chair at the same angle, the kettle in the same spot. Memory of the layout does the work the senses used to.
- Touch, when it's welcome. A hand on the arm to say "I'm here" and "I'm going now" costs nothing and prevents the small shocks that make a person retreat.
- Quiet is not empty — it's necessary. Turning the television off during a conversation isn't a slight. It removes competition the ears can no longer sort through.
- Say who's speaking. Round a table, names before sentences. It sounds stilted for about a day.
Where a computer fits — and where it honestly doesn't
We build a Windows app, so we'll be direct about this.
My World makes a computer far simpler: large, high-contrast buttons instead of a desktop, the button names read aloud, and photos, radio and a video call to a familiar face all one tap away. For someone whose sight is going but whose hearing is reasonable — or the reverse — that combination does real work, because each channel can cover for the other.
When both are substantially reduced, that logic weakens, and we'd rather say so than sell into it. Large print helps less when the sight has gone further; read-aloud helps less when the hearing has. There is a point where the answer isn't a screen of any kind, and is instead a specialist assessment, the right aids, and people in the room. My World is not an aid for sight or for hearing, and it isn't a medical device. It's a simpler computer.
What does keep working for a long time, and is worth protecting:
- Video calls with one person at a time, close to the camera, well lit, unhurried. A familiar face at a familiar time.
- Photographs, large and slow, of people they know. Recognition survives a long way.
- Radio and audiobooks, while hearing allows — see letting it be read aloud.
- Their own room, their own things, in their own order.
The part that isn't about equipment
The thing that tends to be lost first is not television or email. It's incidental company — the chat at the shop, the conversation that starts because someone happened to sit down next to you. That goes early, because it depends on catching things at the edges of a room, and it doesn't get replaced by anything that arrives in a box.
Which means the most effective thing a family can do is often the least technical: turn up more often, and stay a bit longer, in a quiet room with the light on your face. Ring at a set time so the call is expected rather than startling. Say who you are at the start, every time, without making a thing of it.
Both senses fading at once is a real loss, and there's no version of this article that pretends otherwise. But it's a loss with practical answers attached, and most families find them far later than they needed to — usually because nobody told them the phrase to ask for. Now you have it.
If only one sense is the difficulty for now, start with making the screen easier to see or making the computer easier to hear.