Vision Rehabilitation—Help and Hope

Now what? Your client has received the difficult news that their vision loss is uncorrectable. In this context, “uncorrectable” is described in a 2016 National Academies of Science, Engineering, and Medicine (NASEM) report as “permanent vision impairment that cannot be improved through the use of existing treatments, but whose impact on functionality, productivity, and independence can be lessened through access to vision rehabilitation services and reasonable accommodations.”

Vision rehabilitation services can assist individuals to maximize their remaining vision or mitigate the loss of all vision by helping them develop skills and use tools to dramatically improve their quality of life. As a professional in the aging field, you can help older people with vision loss explore how vision rehabilitation can help them successfully live with vision loss.

The National Eye Institute provides an introduction to vision rehabilitation, describing what it is, who can benefit, and how to get services, along with links to additional information.

Vision loss affects an individuals’ ability to work, care for themselves or others, and perform other activities such as shopping, driving, managing finances, managing medications, and socializing or hobbies. According to the National Eye Health Education Program (NEHEP) of the National Eye Institute, “Vision rehabilitation helps people adapt to vision loss and maintain their current lifestyle.”

Vision rehabilitation includes services and training in several broad areas, including:

Daily Living Skills

An older person diagnosed with vision loss may become concerned about their ability to age in place. Vision rehabilitation professionals provide training for the skills a person needs to perform daily living activities independently, such as cooking and eating, household organization and cleaning, personal grooming and hygiene, money identification and management, and medication and health management.

Meal preparation can be managed by learning techniques to use utensils, cut food, and the safe use of kitchen appliances. Kitchen management becomes easier with new organization skills employing the age-old saying, “a place for everything and everything in its place.” Tactile markers can be adhered to washing machines and dryers to help with laundry tasks. Clothing organization and identification skills help with attire selection.

Orientation and Mobility

Orientation and mobility instruction helps a person who is blind or has vision loss learn how to travel safely and effectively. VisionAware describes orientation as “the ability to know where you are and where you want to go, whether you’re moving from one room to another or walking downtown for a shopping trip,” and mobility as “the ability to move safely, efficiently, and effectively from one place to another, such as being able to walk without tripping or falling, cross streets, and use public transportation.”

Vision rehabilitation professionals with specialized training in orientation and mobility instruction help individuals regain the skills and confidence to move about their home and community independently.

‘Help from a vision rehabilitation professional is key to successfully selecting and using any assistive device.’

Doug Powell, President of the Alliance on Aging and Vision Loss, knows the value of vision rehabilitation. “I have Retinitis Pigmentosa, a degenerative disease, which, in my case, progressed slowly—slowly enough that I was unaware of when I needed to start using a white cane to travel independently,” he explained.

“One day I was running from the bus to the subway station and ran into someone. When he asked if I was drunk or something, I finally realized that I needed orientation and mobility training. After participating in that training, I was able to continue traveling independently and safely. And just as importantly, seeing the white cane would make others aware of why I might appear to be behaving erratically.”

Assistive Technology

Assistive technology can be “low tech” or “high tech.” Many everyday “low tech” household tools such as magnifiers, clocks, watches, reading and writing aids, calculators, thermometers, and timers that talk or have large, bold markings are specifically designed for people with low or no vision. Other easy-to-use assistive devices help with reading, managing finances, medications, other personal business and enjoying hobbies. However, help from a vision rehabilitation professional is key to successfully selecting and using any assistive device.

High-tech assistive technologies are plentiful. Some, such as smartphones, tablets and computers, have built-in accessibility that many use every day. For instance, how often do you verbally instruct your phone to “call home” or “read text messages”? The major smartphone platforms have built-in screen readers that allow everyone—including those with little to no vision—to use their phone and computers.

There are technologies for reading, entertainment, health and fitness, GPS, accessible identification and more. For the home, there are smart appliances and smart doorbells. For more information about the vast array of assistive technologies, the American Foundation for the Blind website has an in-depth section about Technology Resources for People with Vision Loss.

Some find it daunting to decide which technologies are best for them. Again, selection and training in using smart devices, screen readers and other technology can be made less stressful when working with a vision rehabilitation assistive technology professional.

The broad range of resources outlined above can provide direct vision rehabilitation help for those you support to ensure a bright future. Additionally, the Older Individuals who are Blind Technical Assistance Center (OIB-TAC) provides no-cost resources, training and courses for those serving older adults who are blind or have low vision.

Older people who develop vision loss do not have to accept a loss of independence, social life, hobbies and ability to manage their own affairs. Vision rehabilitation can help people develop new skills, adapt to vision loss, and thrive.

For more information on The Reality of Aging and Vision Loss in America, and how Vision Rehabilitation Can Complete the Continuum of Care read the first two articles in this series by VisionServe Alliance.

Neva Fairchild has more than 30 years’ experience in the vision loss field and a lifetime of experience living with low vision. She co-chairs the Access to Quality Services Committee of the Aging and Vision Loss National Coalition and until her recent retirement, was a vital part of the American Foundation for the Blind's Aging Initiative team, addressing the research and public policy needs of people experiencing vision loss later in life. Neva owns Experts on Blindness, based in Dallas, TX.

Photo credit: Shutterstock/ - Yuri A