vision rehabilitation throughout the lifespan working with older adults with low vision chris nelms,...
TRANSCRIPT
Vision Rehabilitation Throughout the Lifespan
Working with Older Adults with Low Vision
Chris Nelms, OTR/L, MLVRMay 7, 2011
The Goals of Independent Living Skills Training with the Older Adult
• Help them remain in their home safely and independently
• Develop ways to use their remaining vision
• Help then know how and when to use devices and strategies in addition or instead of their vision to do independent living skills
• Safety
PERFECT FIT FOR LOW VISION
OCCUPATIONAL THERAPIST
OCCUPATIONAL THERAPY
• Training in disability and aging
• Ability to address physical, psychological, cognitive and social needs of clients
• Safety assessments
Identifying the Challenges and Goals
• Reading• Medicine Management and Health• Money Management• Home Management• Communications• Home Safety• Food Preparation• Personal care and hygiene
Education
• Clients need to be educated about
–The eye disease they have
–The outlook for their future
–The expectations of vision rehabilitation
Rehabilitation Strategies
• Adapting the Environment–Lighting–Color and Contrast–Eliminate Clutter–Organize–Labeling–Magnification
Lighting
• Appropriate lighting can make all of the difference to a person with Low Vision
• Lighting is preferential you need to look at the glare and quality of light to see what works best for the client
Lighting
• The closer the light is to the object the more intense and brighter it appears
• Light should be directed towards what you are trying to see
Lighting
Lighting• Incandescent bulbs are cheaper to buy,
but use more electricity and are hotter• Fluorescent bulbs use less electricity
and are cooler to use• Halogen bulbs use less electricity but
are very hot• LED bulbs are the most efficient in their
use of electricity and last the longest
Contrast and Color• High contrast
makes it easier to locate objects
• Use of bright colors against white or black background
Color and Contrast
• Pouring coffee into a white cup and milk into a dark cup or glass
• Cutting meat on a white
board and chicken on a black
cutting board
• Using a towel of contrasting color on a light surface to find things
Eliminate Clutter
Organize
Labeling• Use tactile labeling
–Bump dots, Braille, puff paint
–Rubber bands, safety pins
• Use large print labels
• Use auditory labels
RNIB PenFriend
ID Mate Summit Bar Code Reader
Magnification• Use larger print – enlarge on Xerox,
buy large print books, write larger• Bring things closer• Use magnifiers
–Hand held–Stand–Video
Magnification• The higher the magnification the
smaller the field of view - Stronger isn’t always better
• Each magnifier has its own length of focus and it is important to keep the magnifier that distance from what you are reading.
Resources for adaptive equipment
• Maxiaids.com
• Shoplowvision.com
• Independentliving.com
• LSSproducts.com
Maximizing Vision through Eccentric Viewing/ PRL
• What is a PRL?
• Preferred Retinal Locus
• That area of the retina that the best visual acuity can be located on.
• Learning to use another part of the retina to see takes training
Vision is more than 20/20 sight
• 20/20 sight only describes whether a person can read a letter 3/8 of an inch in height from 20 feet
• It does not tell anything about color vision, peripheral vision, depth perception or other visual skills that we use daily
Vision is Understanding
Eccentric Viewing
• Is training the client to point their eye in a different direction to see better
• Is training the brain to understand what it is seeing with a different part of the retina
Maximizing Vision through Eccentric Viewing/ PRL
• Determining near acuity
• Evaluation of the PRL
• Eccentric Viewing Training
• Improving Reading Ability
• Using it in ILS
Determine near acuity
• Single Letter Acuity
• Continuous Text Acuity
Evaluation of the PRL
• Use of the Clock Method
• Use of the Playing Card Method
CAT
Eccentric Viewing Training
• Using PRL to see single letters or short words
• Using PRL to see ILS items
• Using PRL to see Faces
• Using PRL with Optical devices
Improving Reading Ability
• Retraining the brain to understand what it is seeing and how to look with the PRL
• Starting with short words and good spacing and progressing
• Starting at an appropriate size type and working towards their goal
Using PRL in Daily Living
• Using PRL to see markings better rather than feeling for them.
• Practicing using the PRL for watching television or when looking at friends or family
Medications
• Large letter labeling
• Organization strategies
• Pill boxes
• Auto refill through the pharmacy
Diabetic Education
• Research shows that keeping the blood glucose at a stable level, will help reduce the diverse secondary effects of Diabetes
Talking Meters
• Prodigy Voice
• Prodigy Auto Code
• Advocate
• Advocate Redi-Code
Drawing up Insulin
• Safe Shot
• Count-A-Dose
• Syringe Support
• Insulin Pens
Safe Shot
• Safe Shot (#80010)– Can use any syringe– Needs a sighted person to set it at the correct
setting– Good for large doses of insulin
Prodigy Count-A-Dose
• Count-A-Dose (#50166)– Used with 50 unit ½ cc syringes– Counts in 1 unit increments– Can be used with 2 bottles of insulin– Cumbersome to do large doses of insulin
Syringe Support
• Syringe Support (#50113)– Used with 100 Unit 1cc syringes– Each rotation in 2 units of measure– Cumbersome to do large doses of insulin
Insulin Pens
• Available by prescription only
• Not available in all types of insulin
• More expensive than regular insulin and syringes
• Cumbersome to do large doses of insulin
Resources for adaptive equipment
• Maxiaids.com
• Shoplowvision.com
• Independentliving.com
• LSSproducts.com