Long-Term Care. Options Counseling. Tool Kit:



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Serving People who are Blind or Visually Impaired: A Guide for Long-Term Care Options Counseling Long-Term Care Options Counseling Tool Kit: A PROFESSIONAL S GUIDE

Webcast: Serving people who are Blind or Visually Impaired: A Guide for Long-Term Care Options Counseling Competency/skill - Provide helpful information, tips and resources to support individuals who are blind or visually impaired. Objectives: 1. Identify different cues to identify people who are visually impaired 2. Describe common diseases of the eye. 3. Provide information on where consumers can locate helpful information and support. 4. Describe common issues and strategies for helping consumers deal with these issues. Sample discussion questions: 1. During the webcast Tom Langham described cues to identifying people who are visually impaired. Please name 5 of these cues. 2. There are several common diseases of the eye. Define three of them. 3. List tips that you can share with consumers about ways they can identify clothing, keep track of phone numbers, mark key items (microwave, medications, shampoo vs. conditioner). 4. What agencies may be helpful for people who are blind or visually impaired?

Serving People who are Blind or Visually Impaired: A Guide for LTC Options Counseling Tom Langham, M.Ed., COMS, CRT Office of the Blind and Visually Impaired / Bureau of Aging & Disability Resources Goals for the Webcast Provide an introduction to Blindness and Low Vision Share key information to help identify people who are blind and visually impaired Discuss common diseases that lead to vision loss Share helpful tips and information about resources

Definitions Legal Blindness is: 20/200 in best eye, with best correction, or a field loss resulting in less than 20 degrees. At a 20 foot distance, (the top number in the fraction, or testing distance), a person with normal vision should be able to read the small 20/20 line on an eye chart. The smallest line that you can read on the chart is your visual acuity. If larger lines than the 20/20 line are all that can be read, the visual acuity may be 20/30, 20/60, etc. The larger the second number is, the worse is the vision. A person with 20/200 vision would have to come up to 20 feet to see a letter that a person with normal vision could see at 200 feet! Definitions continued Visually Impaired: typically we include anyone who's vision is 20/70 or worse in best eye, with best correction. However, other factors impact such as their accommodation time to changing lighting conditions, visual field, etc. Let me share some things to look for that will help identify if your consumer is having a problem seeing:

Clues to identifying people who are Visually Impaired Changes the way he or she reads, watches TV, walks, etc., or stops doing one or more of these activities altogether. Squints or tilts their head to the side to get an object in focus. Has difficulty identifying faces or objects. Has difficulty locating personal objects, even in familiar areas. Reaching out for objects in an uncertain manner. Has difficulty identifying colors and selects clothing in unusual color combinations. Holds reading materials very close to face. Brushes against wall while walking, or has difficulty on irregular walking surfaces. Spills food off plate while eating or pours liquids over top of cup Knocks over liquids while reaching. Common diseases of the eye Presbyopia: is the decreased ability of the eye to focus on near objects, caused by a loss of elasticity" in the eye's lens, associated with aging. As we age, we all experience this. Floaters or Spots: Excessive Tearing or Dry Eyes: Cataracts: opacity, or clouding, of the eye's lens which blocks the passage of light needed for vision.

Common diseases of the eye continued Glaucoma: an eye disease associated with too much fluid pressure within the eye. Diabetic Retinopathy: disease of the retina's blood vessels and usually, but not always, affects those who have been diabetic for many years. Retinal Detachment: When a hole or "rip" in the retina allows the inner retina layer to separate from the back layer. Macular Degeneration: The macula is the small area of the retina, which is responsible for fine, detailed vision, such as is required for reading. Degeneration of the macula usually results in gradual loss of central vision. Common issues Cooking- use of tactual markings, organizational skills, work simplifications techniques. Dressing- simple labeling techniques Help around the house- Be organized!!! Home repairs can be done, but take organization and planning. Transportation- use of para-transportation system / Public transportation / volunteer driver systems Banking- adaptive techniques and large print materials Others- there isn t any activity that can t be adapted, but there may be to few hours in the day to do everything.

Helpful Tips for Consumers Labeling Medications Brushing Teeth Marking Shampoo and Conditioner Keeping Track of Phone Numbers Writing Checks Organizing Money Cleaning House Inserting an Electrical Plug Using Appliances Kitchen Safety Eating and Drinking Sewing Helpful tips for preparing written material Use of Bold Line Paper & Bold line pen. Using Large Print when available. Always encourage use of appropriate lighting. Give them time to process

Helpful Information & Resources In Wisconsin Badger Association of the Blind. http://www.badgerassoc.org/programs/professionals/inde x.html WI Council of the Blind http://www.madison.com/communities/wcblind/about.php NorthCentral Technical collage http://www.ntc.edu/students/studentdisa bilityvisually_tech.htm Talking Books Library http://dpi.wi.gov/rll/wrlbph/ OBVI http://dhfs.wisconsin.gov/blind/stat ewisvcs.htm LV support Groups http://dhfs.wisconsin.gov/blind/visu allyimpdsupport.htm Nationally American Foundation for the Blind http://www.afb.org/ National Federation of the Bind http://www.nfb.org/ Prevent Blindness Association http://www.preventblindness.org/ Light House International http://www.lighthouse.org/ Hadley School for the Blind http://www hadley- In conclusion & Best Practices What you can do The individual is not yet ready for lectures on the need for rehabilitation, or advice about how lucky they are, or for sermons about the many other successful people. Redirect thought patterns onto the good and positive and redirect mental energies toward setting realistic goals, developing social contacts, and other appropriate activities. Providing realistic feedback without patronizing When to refer to office of the Blind & Visually Impaired If the individual needs specialized training Has additional disabilities that impact on their independence In the individual has questions you can t answer How to refer to OBVI: Toll free number 888-879-0017 http://dhfs.wisconsin.gov/blind/stat ewisvcs.htm Instilling a desire to continue to grow in self-understanding and problem-solving skills.

Other Professionals in the field: Orientation & Mobility Specialists: Rehabilitation Teacher of the Blind: Low Vision Specialist: Question & Answer Period:

This document was developed under grant CFDA 93.779 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal government. Wisconsin Department of Health & Family Services Division of Disability & Elder Services Bureau of Aging & Disability Resources PDE-45 (9/06)