Aging and Vision Loss

A Handbook for Families

Alberta L. Orr and Priscilla Rogers

Index

activities, everyday: adaptive techniques for, 94–119; assumptions about abilities and, 59–60; lack of interest in, 11, 53; learning new skills for, 13–14, 52–53, 79–80, 181; loss of self-confidence and, 48; symptoms of vision loss and, 25. See also leisure activities; vision rehabilitation services
adapting to light and dark, difficulty of, 21
adaptive techniques: for everyday activities, 94–119; for hearing loss, 147–148; for the home, 123–137; home survey checklist, 138–143. See also devices, for low vision; home and environment, adapting
adjusting to vision loss, 52–53, 64; adjustments for family members, 61–63; family dynamics and, 65–66, 81
AFB Directory of Services for Blind and Visually Impaired Persons in the United States and Canada (AFB Press), 14, 15, 169
African Americans, 30, 31
agencies for blind and visually impaired persons. See vision rehabilitation services
aggressive communication, 73
aging: Area Agencies on Aging, 15, 16, 17; challenges of, 46–48; normal vision changes and, 19–23; U.S. Administration on Aging, 15; vision loss and, 2–3, 12. See also eye conditions; health, overall
Alzheimer's disease, 146, 149–151. See also cognitive disabilities
American Council of the Blind, 90
American Foundation for the Blind (AFB), 13, 14, 83, 183, 186, 192
anger, 51, 58
apartment buildings, safety and, 138–139
apathy and listlessness, 54
appetite, lack of, 53
appliances: cognitive disabilities and, 149; cooking and, 187; labeling, 97–98, 99–100, 112, 132; safety and, 141
Area Agencies on Aging, 15, 16, 17
art, 178
Art Beyond Sight: A Resource Guide to Art, Creativity, and Visual Impairment (AFB Press), 178
arthritis, 145
assertive communication, 73–74
assistive listening devices, 146, 147, 148, 162
assumptions, about abilities, 59–60, 71
audio description, 178. See also video description
audiologists, 146–147

background noise, 147–148
banking. See finances
bathroom safety, 122, 123, 130, 142–143, 186
blind spots, diabetic retinopathy and, 32
blood pressure, 20, 145
blood sugar control, 31–32
blurry vision, 11, 24, 27; cataracts and, 33; diabetic retinopathy and, 32; glaucoma and, 30; macular degeneration and, 27, 28
books and videos, for learning adaptive techniques, 95–96
books on tape, 170. See also reading; Talking Books
braille, 85, 106, 133, 134, 157
brushing teeth, 110

canes: long white canes, 2, 113, 116, 123, 186; support canes, 151–152
caregiving: emotional reactions and, 54–61; maintaining independence and, 76–77; need for, 4–5, 8–9, 60; self-care for caregivers, 10–11
cars, entering, 115
case managers. See geriatric care managers
cataracts, 3, 12, 26, 32–33; diabetic retinopathy and, 31; glare and, 124, 128; vision simulators, 40, 44
CCTV. See closed-circuit television (CCTV)
central vision, 27
Charles Bonnet Syndrome (CBS), 33, 35–36
check-writing guides, 103–104, 106–107, 189
clock method, 102, 158, 187
clocks and watches, 109–110, 189–190
closed-angle glaucoma, 30
closed-circuit television (CCTV), 63, 85, 170, 172–173
clothing: cooking and, 100; matching, 59, 63, 85, 97, 190; organization of, 133–134, 141, 143
cognitive disabilities, 25, 74–75, 146, 149–151
color: print readability and, 171–172; reduced ability to see, 22, 25. See also color contrast, adaptive techniques and
color contrast, adaptive techniques and, 96, 98; clothing and, 133; cognitive disabilities and, 150; eating and drinking and, 102, 187–188; in the home, 122, 124, 129–131, 140, 151, 186, 191; orienting to the environment and, 113; print readability and, 171–172; writing and, 104
communication: about changes in the home and environment, 191; about vision rehabilitation services, 80; adaptive techniques for, 61–62, 188; describing vision loss, 39, 58–59; emotional reactions and, 51, 53, 54; family dynamics and, 12, 66–74, 77, 182; with health care professionals, 36–38; hearing loss and, 74–75, 146–149
community resources and support, 10, 159–163. See also senior centers; vision rehabilitation services
computers, 85, 92, 104–106, 106–107
confusion, 74–75. See also cognitive disabilities; hearing loss
contrast. See color contrast, adaptive techniques and
contrast sensitivity, reduced, 22, 33
cooking, adaptive techniques for, 99–101, 123, 131, 141, 177, 186–187. See also eating and drinking
counseling: for family members, 10, 55, 61; vision loss and, 15, 54, 74, 81, 90

deaf-blind specialists, 145, 148
deaths, of friends and family members, 46
dementia. See cognitive disabilities
denial, 50, 51, 55, 57
depression, 49, 50, 51, 53, 155; family dynamics and, 81; symptoms of, 53–54
depth perception, 12, 23, 112, 129, 150
devices, for low vision: computers and, 104–105, 105–106; for cooking, 99, 100–101, 187; cost of, 47, 103, 170, 173; for eating and drinking, 102–103, 187–188; everyday activities and, 63, 77, 117–119, 175–176, 179; large-print devices, 117–118, 134–135, 176–177, 184, 188, 189, 190; for reading, 34, 106, 157, 170, 172–174, 183–184; tactile markers and devices, 96, 97–98, 111, 112, 132, 177; talking devices, 105, 107, 109–110, 118, 132, 135, 136, 173, 190; vision rehabilitation services and, 13, 15, 85, 86, 92; for watching television, 63, 85, 170, 172–173, 175, 178, 185; for writing, 103–104, 106–107, 132, 142, 188, 189. See also adaptive techniques
diabetes, 31–32, 136, 190
diabetic retinopathy, 12, 26, 31–32, 40, 44
dimmer switches, 127
dining out, 157–158, 168, 170, 172
disability insurance, 16
doctors. See health care professionals
dog guides, 87–88, 113
doorways, safety of, 139–140, 151
double vision, 11, 24
driving. See transportation
dry eyes, 23
dry type macular degeneration, 27
Dymo tape labelers, 134

eating and drinking: adaptive techniques for, 101–103, 131, 143, 187–188; cognitive disabilities and, 149–150; difficulties with, 53; dining out, 157–158, 168, 170, 172; signs of vision loss and, 25
eccentric viewing, 2, 28–29
Eldercare Locator, 15, 117
electronic publishing, 173–174
embarrassment, feelings of, 48–49, 51, 59, 156, 178
emotional reactions: adjusting to, 52–53; to aging, 46–48; communication and, 66–67, 70; of family members, 54–61; learning about, 164; to vision loss, 45–46, 50–51, 53–54, 64, 191
employment, 8, 47, 153, 191–192. See also vocational services
envelope-addressing guides, 103, 104
environment, adapting. See home and environment, adapting
environmental cues, as adaptive technique, 96, 98, 124, 136–137
everyday activities. See activities, everyday
exercise, 20, 167, 168, 178–179
expectations, realistic, 59–60, 149
eye: normal changes in, 12, 19–23; protection of, tips for, 20
eye care professionals, 12, 20, 23–27, 32, 35, 36–38, 83, 167
eye charts, 13
eye color, changes in, 24
eye conditions: age-related, 12, 19–23; common, 24–33; hereditary, 57; more serious, 27–36; questions for health care professionals, 37; symptoms of, 24–26
eye drops, 3, 23
eye exams, 20, 32

falls, 23, 121, 122, 186
family dynamics, 9–10, 60; adjusting to vision loss, 65–66; aging and, 46–48; communication and, 66–74; emotional reactions and, 45–46, 58
family members: adaptive techniques for, 61–63; emotional reactions of, 51, 54–61; helping from a distance, 16, 17; learning about vision loss, 158–159; leisure activities and, 168; self-care, 53, 56–57; support for, 90–91, 163–165, 182; support from, 52–53, 96; vision rehabilitation services and, 79–81
fear and sadness, 51, 57, 68
fear of failure, vision rehabilitation services and, 9
filing systems, 134, 141–142
finances, adaptive techniques for, 106–108, 134, 189
financial security, aging and, 47
finding lost items, 62, 131. See also organizing, as adaptive technique
fire alarms, 148
fire extinguishers, 139, 141
floaters, 23, 24
floors, safety and, 129, 143
font sizes and styles, 171, 172
food, 97, 134, 170. See also eating and drinking
food stamps, 16
friendships, 48–49, 154–159
furniture: arranging, 122, 134; contrast and color and, 130–131; as landmarks, 62, 113, 150; safety and, 140, 191

games, 167, 176–177, 184
gardening, 167, 177
genetic counselors, 57
geriatric care managers, 16, 17
getting help, 14–16
glare: adaptive techniques for, 124, 128–129, 191; avoiding, 158; gardening and, 177; mobility and, 151, 152; print readability and, 172; safety and, 140; sensitivity to, 22, 24, 33; sunglasses and, 20; television and, 185
glaucoma, 3, 26, 29–30, 31, 40, 43
golf, 2, 92
grief, stages of, 50–51
grocery shopping, 160
guide dogs. See dog guides
guilt, 58

Hadley School for the Blind, 95, 177
hair care, 111
hallucinations, visual, 35
halogen lights, 126
halos, around lights, 11, 24, 30
handwriting aids, 85
headaches, 30
health, overall, 20, 47, 50, 64, 144–153, 190
health care professionals: communication with, 36–38, 57, 68, 167; evaluating qualifications of, 17; exercise and, 178–179; family members and, 61; low vision services and, 12–13; types of, 25; visits to, 20, 24
health insurance, 16
hearing aids, 74, 146, 147, 148
hearing loss, 47, 50, 74–75, 145, 146–149
heart conditions, 145
help: asking for, 161, 163; from a distance, 16–17; finding, 14–16; from your older relative, 71, 78–79, 159
hemianopia, 33, 34
Hi-Marks tactile markers, 98, 99, 112, 132
home and environment, adapting, 8, 14, 80, 120–137, 191; for cognitive disabilities, 150; for hearing loss, 148; home survey checklist, 138–143, 186, 187; orientation to the environment and, 113; reduced contrast sensitivity and, 22
home health care, 8–9
home survey checklist, 138–143, 186, 187
human guides. See sighted guides

independence: driving and, 116; emotional reactions, to loss of, 47–48; family dynamics and, 60; help, from your older relative and, 78–79; leisure activities and, 168; maintaining, 8–9; maintaining friendships and, 156–157, 159; other health concerns and, 153; respecting desire for, 9, 63, 74, 75–78, 96. See also home and environment, adapting
independent living services, 15
independent living skills instruction. See vision rehabilitation services
interdependence, 78–79
Internet, the. See Web sites
isolation, 48–49

keys and small items, organizing, 134
kitchens. See cooking; home and environment, adapting

labeling, as adaptive technique, 96, 97, 124, 131–132; appliances and, 99–100, 112, 141, 187; clothing and, 133; safety and, 123
landmarks, 62, 111, 113, 134, 150
large-print books and magazines, 170, 184
large-print devices, 117–118, 134–135, 188; finances and, 189; for telling time, 190
Latino Americans, 30, 31
laundry, adaptive techniques for, 111–112, 143
legal blindness, 26
leisure activities, 166–179, 181, 184–185
lens, of the eye, 21
libraries, 170. See also Talking Books
light, increased need for, 21, 35
light and dark, difficulty adapting to, 21
light bulbs, 21, 125–126
light flashes, 11, 23, 24
Lighthouse International organization, 41, 90
lighting: adapting the home and environment, 100, 122, 123, 124–127, 191; reading and, 184; safety and, 140, 142
liquid level indicators, 85, 101, 103, 137, 141, 188
Liquid Stitch, 175–176
local services, 15, 16
loneliness, 155
long-distance care, 16–17
low vision, 26
low vision clinics, 15
low vision specialists, 12–13. See also vision rehabilitation services
low vision therapists, 86. See also vision rehabilitation services

macular degeneration, 1, 2, 12, 26, 27–29; nutrition and, 20; print readability and, 172; vision simulators, 40, 42
magazines, large-print versions, 170
magnification aids: computers and, 104–105; for reading, 157, 170, 183–184; for television, 175, 185; vision rehabilitation services and, 85, 86
makeup, 111
Making Life More Livable (AFB Press), 95, 184, 187, 190
Meals on Wheels, 15
Medicaid, 16, 17
Medicare, 47, 88
medications, 37, 54, 85, 135, 143, 190
mental illness, 35
mobility: adaptive techniques for, 79, 112–117, 122; Charles Bonnet Syndrome (CBS) and, 35–36; glaucoma and, 29; landmarks and, 62, 113, 134, 150; orthopedic problems and, 151–153; sense of sound and, 136; sighted guides, 62, 63, 87, 114–115, 151, 159, 186; symptoms of vision loss and, 11, 24; vision rehabilitation services and, 85. See also orientation and mobility specialists
money, identifying, 107–108, 189
movies, 175
moving objects, 62
museums, 178
music, 174

National Association of Geriatric Care Managers, 17
National Eye Institute (NEI), 36, 41
National Federation of the Blind, 90, 174
National Library Service for the Blind and Physically Handicapped, 168, 169, 174, 184
Native Americans, diabetic retinopathy and, 31
natural light, 125
nausea, glaucoma and, 30
needlework and sewing, 167, 175–176
newspapers, 174
NFB-NEWSLINE service, 174
night lights, 127
night vision, 35
nonverbal communication, 62, 147
nutrition, 20

occupational therapists, 88
open angle glaucoma, 30
ophthalmologists, 2, 12–13, 83
optical character recognition (OCR) devices, 106
optical devices, 117
optometrists, 12, 13
organizing, as adaptive technique: cooking and, 99; in the home, 96, 97, 124, 132–135, 191; locating small items and, 140
orientation and mobility specialists, 2, 15, 40, 84, 86–88, 116, 185–186
orientation to the environment, 113
orthopedic problems, 151–153

pain, in the eye, 24
paper, for people with low vision, 22, 98, 103, 104, 142, 172
passive communication, 72–73
patterns, 130–131, 150
peripheral vision, 27, 29, 30
personal care and hygiene, adaptive techniques for, 110–111, 190
personal readers, 106
pessimism, 54
pitch, of voices, 147
presbyopia, 19–20
print readability, 63, 171–172. See also reading
prism lenses, 34
professional help. See health care professionals; services
proliferative retinopathy, 32
protective eye gear, 20
protective techniques. See safety
public, going out in, 156–157
public transportation, 2, 87, 116

questions for health care professionals, 37–38

radio reading services, 174
reactions to vision loss, 46–51, 53–61
reading: adaptive techniques for, 106, 168–174, 183–184; enjoyment of, 2, 166; handwriting and, 59, 63; hemianopia and, 34; magnification aids and, 85; print readability, 63, 171–172; symptoms of vision loss and, 25; Talking Books and, 52
recreation, 2. See also leisure activities
reduced visual acuity, 20–21
referrals, for low vision services, 13, 16, 17, 38
rehabilitation teachers. See vision rehabilitation therapists
religious organizations, 17, 54, 162–163
remote controls, 98, 132, 134, 140, 175, 185
restaurants, 157–158, 170, 172
routines, cognitive disabilities and, 149

safety, 122–123; concerns about, 60; cooking and, 100, 101; eye protection, 20; home survey checklist, 138–143; personal care and hygiene, 111; trailing and protective techniques, 113–114. See also home and environment, adapting
screen reader software, 105
Secondary Audio Program (SAP), 175
self-care, for family members, 10–11, 56–57, 164, 165
self-confidence, 48, 52, 76, 161
senior centers, 15, 17, 116–117, 160
sensitivity to light or glare, 24, 33
service organizations, 17
services, locating, 14–16, 16–17, 56–57, 83. See also support groups; vision rehabilitation services
shadows, 125, 127
Sharing Solutions newsletter, 90
shaving, 111
siblings, communication and, 67–68
side effects, 37, 38
sighted guides, 62, 87, 114–115, 151, 159, 186
signature guides, 103
signs of vision loss, 19–26. See also symptoms
skills, for daily activities. See activities, everyday
smell, sense of, 136
smoke alarms, 123, 141
smoking, 20
social and cultural activities, 163, 164, 167, 178
Social Security Administration, 16
social workers, 16, 89
software, for low vision, 105–106
Solutions for Everyday Living for Older People with Visual Impairments (video; AFB Press), 96
Solutions for Success (AFB Press), 95
sound, sense of, 136. See also hearing loss
sports, participating in, 2, 92, 167, 168
spouse, loss of, 46, 47
squinting, 25
stairs: Charles Bonnet Syndrome (CBS) and, 35–36; difficulties with, 23, 24; safety on, 122, 127, 131, 139
state rehabilitation agencies, 14–15
stereotypes, about vision loss, 49–50, 64
stoves. See appliances; cooking
strokes, visual complications of, 33, 34
success stories, 91–92, 181
sunglasses, 20, 129
sunlight, 125
Supplemental Security Income (SSI), 16
support canes, 151–152
support groups: for family members, 57, 74, 90–91, 164–165; for the visually impaired, 2, 10, 80–81, 89–90, 191
supportiveness, communication and, 70–71
support networks, informal: for family members, 163–165; maintaining independence and, 77; for the visually impaired, 73, 154–165, 182
surgery, for cataracts, 3, 32
symptoms: of cataracts, 32, 33; of depression, 53–54; of diabetic retinopathy, 32; of eye conditions, 24–26; of glaucoma, 29, 30; of hemianopia, 34, 35; of macular degeneration, 1, 27, 28; of normal aging, 12, 19–24; of vision loss, 7–8, 11, 18–19

tactile markers and devices, 96, 97–98, 111, 112, 132, 177
Talking Books, 2, 52, 149, 168–170, 173, 184
talking devices, 118, 136; clocks and watches, 109–110; computers and, 105; electronic publishing and, 173; finances and, 107; labeling and, 132; medications and, 135, 190
telephones, 108–109, 142, 188
television, 167, 175, 185; glare and, 128
telling time, 109–110, 189–190
tests, medical, 37–38
texture and touch, as adaptive technique, 124, 135–136, 176
theaters, 178
thermostats, 141
touch, sense of. See texture and touch, as adaptive technique
trailing and protective techniques, 113–114, 123
transportation, 15, 87, 116–117, 155–156, 159–160, 162–163. See also mobility
20/20 marking pen, 99
20/20 vision, 20–21, 26

understanding vision loss: communication and, 67–68; vision rehabilitation services and, 80; from your relative's perspective, 58–59, 73
United States Blind Golf Association, 2

Veterans Affairs, Department of, 15
video description, 175, 185. See also audio description
vision loss: learning about, 11–14, 164; signs of, 19–26; simulating, 39–44; treatment for, 3
vision rehabilitation services, 84–89, 92–93; adaptive techniques and, 8, 95, 148, 168–169, 170; emotional reactions and, 9, 54, 191; everyday activities and, 60, 190; family members and, 79–81, 90–91; locating, 13–14, 14–15, 38, 83; macular degeneration and, 28–29; maintaining independence and, 77–78; openess to, 10; other health concerns and, 153; success stories, 91–92; vision simulators and, 40
vision rehabilitation therapists, 2, 85–86, 92. See also vision rehabilitation services
vision simulators, 39–44
VISIONS Services for the Blind and Visually Impaired, 95
vision therapy, 84
visual acuity, 26, 33; reduced, 20–21
visual field loss, 26–27, 34, 35
vocational services, 15, 84, 88–89, 92, 192
voice memo recorders, 142
volunteering, 167, 168

walkers, 151
walking. See mobility; sighted guides
Web sites, 14, 36, 40, 56, 105, 169
wet type macular degeneration, 27–28
wheelchairs, 153
writing, 103–104, 132, 142, 188

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