Inclusive Physical Therapy: Best Practices for Treating Patients With Dual Sensory Impairments

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Inclusive Physical Therapy: Communicating Effectively with Patients Experiencing Hearing and Vision Loss

As a physical therapist, you support patients through some of the most important aspects of their daily functioning—mobility, balance, strength, and independence. For many older adults, these areas are significantly impacted not only by physical conditions, but also by progressive hearing and vision loss.

Dual sensory impairment is far more common than most clinicians realize, yet rarely addressed thoroughly in professional training. As sensory abilities decline, patients may struggle to follow instructions, lacking understanding to do exercices, or seem unengaged.

Understanding how to communicate effectively with these patients is essential for providing ethical, culturally competent care—and for helping them achieve the best possible outcomes.

Dual Sensory Loss (DSI): An Overlooked Factor in Mobility & Safety

Many older adults experience both hearing and vision changes, often referred to as dual sensory loss (DSL). Research shows that DSL is associated with:

  • Higher fall rates

  • Inability to follow movement cues

  • Reduced confidence in movement

  • Reacting with anger or frustration to raised voices (it doesn’t help anyway)

  • Difficulty understanding safety instructions

  • Lack of engagement and compliance with therapy

As PTs, recognizing DSL can help us anticipate needs, prevent injuries, and build stronger therapeutic rapport.

A 2022 Frontiers in Oral Health study (applicable across healthcare settings) emphasizes that older adults with sensory loss experience more difficulty accessing care, greater anxiety, and reduced health outcomes overall.
Read the full research summary here:
👉 https://pmc.ncbi.nlm.nih.gov/articles/PMC9615611/

When patients cannot hear instructions clearly or interpret visual cues, they may feel unsafe—especially during exercises involving balance, gait training, or transfer practice.

Practical Communication Strategies for PT Sessions

Even small adjustments can transform a patient's therapy experience:

1. Start With Orientation

Before beginning treatment, describe the room layout, equipment location, and what you’ll be doing.
Clear orientation reduces anxiety and improves trust.

2. Modify Verbal Communication

  • Lower your pitch instead of increasing your volume.

  • Move closer to the better ear.

  • Keep your face visible to support lip-reading.

  • Use different words or tactile cues.

3. Strengthen Visual and Tactile Cueing

  • Demonstrate exercises slowly and repeatedly.

  • Offer safe, consent-based tactile cues when needed to guide movement.

4. Make Home Exercise Programs Accessible

Patients with vision loss may benefit from:

  • Large print

  • High contrast diagrams

  • Recorded audio instructions

  • Apps that read text aloud

The Takeaway

Physical therapists are uniquely positioned to support older adults and individuals with sensory loss. By strengthening communication methods and understanding the lived experience of hearing and vision impairment, you can:

  • Improve patient safety

  • Boost exercise adherence

  • Reduce frustration and anxiety

  • Enhance therapeutic outcomes

  • Build a more inclusive, accessible clinical environment

Compassionate communication is an essential part of high-quality physical therapy. Equipping yourself with the right tools ensures your patients feel understood, safe, and supported.

Continuing the Mission of Access and Understanding

Adaptability for Life’s cultural competence - ethics continuing education courses focus on helping psychologist, nurses, dentists, doctors, chiropractors, therapists, and other healthcare professionals and families better serve individuals with vision or hearing loss, blindness, deafness and combinations of sensor loss through culturally competent, practical, and engaging continuing education. These are approved by Oregon Health Authority (OHA) and the Commission on Rehabilitation Counselor Certification.

For those seeking to enhance their skills in communicating with those who have vision or hearing loss, consider enrolling.

2-Hour Cultural Competence CE: Effective Communication with Clients Who Are Hard of Hearing
4-Hour Cultural Competence and Ethics CE: Understanding the Diversity of Legal Blindness, Impacts & Solutions
6-Hour Cultural Competence and Ethics CE: Providing Culturally Competent Healthcare for Those Aging with Dual Sensory Impairments

Each course blends over 25 years of experience in rehabilitation counseling and disability services with lived insight and real-world examples. You’ll walk away with tools that help prevent social isolation, improve connection and communication, and foster hope—even in the face of progressive sensory loss.

What You’ll Gain

  • Strategies to prevent social isolation and despair

  • Tools to support clients experiencing progressive loss

  • Skills to improve communication and connection

  • Easy, low- or no-cost accessibility techniques

  • Real-world examples you can apply immediately

About the Instructor

Deb Marinos, MS, CRC, LPC, is a Certified Rehabilitation Counselor, Oregon Licensed Professional Counselor, and CMBM Mind-Body Skills Group Facilitator. She brings decades of teaching experience with health care professionals and other working with individuals navigating sensory loss and disability. Her courses are designed to be interactive, helpful, and will give you more comfort in your work.

Take the Next Step

If you’re ready to strengthen your skills, deepen your empathy, and make your practice more inclusive—join Deb and Olaf on this journey.

👉 Explore the Cultural Competence & Ethics accredited continuing education courses and sign up today at Adaptability for Life


Adaptability for Life LLC
21887 SW Sherwood Blvd. STE C
Sherwood, OR 97140
deb@adaptabilityforlife.com