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AFBAmerican Foundation®
for the Blind

Expanding possibilities for people with vision loss

Lesson 11: Personal Management, Grooming and Eating Techniques

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Many adults with new visual impairments may have concerns about their appearance. Shaving, applying make-up, and caring for and styling hair may seem like virtually impossible tasks without the use of sight. Even keeping toothpaste on the toothbrush may be challenging! Adults with new visual impairments may feel embarrassed when they eat in public and might frequently order foods they can eat with their hands in order to avoid having to use silverware. Lack of facility with these daily tasks can play havoc on the newly visually impaired person's confidence.

Many people who enter vision rehabilitation training are embarrassed to let their instructors know they are having difficulties with these very personal tasks. You may feel exactly the same way. This lesson will provide some suggestions to help you regain your confidence in managing your personal appearance and your ability to enjoy dining out.

Diagram of a high contrast bathroom sink - a white sink on a dark red counter top

Lesson Goals

  • Identify four techniques for brushing your teeth;
  • Use spatial orientation and organization to move freely in your bathroom;
  • Shave your face or legs safely using three skills from the Toolbox;
  • Use several low vision techniques and aids to shave your face;
  • Identify three ways to make hair care more manageable;
  • Describe several ways to organize and label skin care products and cosmetics;
  • Apply foundation, mascara, blush, and eyeliner using techniques from the Toolbox;
  • Care for your nails independently with four simple steps;
  • Assess the safety of your bathtub or shower;
  • Develop some techniques for eating at home and in a restaurant.

Click here to review the learning checks before reading the lesson.

Brushing and Flossing Teeth

You have not lost the ability to brush your teeth, but you may have difficulty measuring the right amount of toothpaste or aiming the toothpaste onto the brush. One technique you might try is to place an index finger alongside the bristles of the brush. Without squeezing, drag the tube across the bristles along the side of the finger. Do this several times until you get a sense of how large the bristle head is. Then squeeze the tube gently as you drag it over the bristles beside the finger. You can also place an index finger on one side of the bristles and a thumb on the other and drag the toothpaste over the bristles between the index finger and thumb. If you have difficulty keeping the toothbrush level when applying toothpaste, you can squeeze a little toothpaste onto your index finger instead and then rake it into your mouth with your teeth. It's not recommended that you squirt toothpaste into your mouth; you might squirt too much, which can be a choking hazard.

If you have some usable vision, select a brightly colored toothbrush. The dark, contrasting color around the edge of the white bristles may make it easier to apply toothpaste to the toothbrush. Storing the toothpaste and toothbrush in a container darker or lighter than the bathroom wall and counter will make them easier to locate.

See the VisionAware Resources list at the end of the lesson for more information on applying toothpaste.

If you're having problems measuring enough floss, wrap it three or four times around two fingers on one hand and then two or three times around two fingers on the other. Your non-dominant hand can keep the floss taut while you unwind a little at a time from your dominant hand.

In Lesson 4 several suggestions were given for moving safely within an area of your home or a particular space. This technique is called spatial orientation. In the bathroom, this technique can be used on the counter around the sink. This body-sized space can be divided into several sections. For example, your tooth brushing items can be placed in a corner, shaving equipment in another, and so on. Eventually, you will find yourself reaching for those items just as if you could see them sitting there.

Shaving

Use your free hand to guide the electric razor

From Lesson 3 you know that your body still remembers how to do every task you've ever done repeatedly whether you have vision or not. This is called muscle memory. Lesson 4 covered how shaving for men and women requires only three skills, the same three skills needed to apply make-up and numerous other similar tasks: the use of landmarks, overlapping strokes, and the grid pattern

Some of you may have always shaved in the shower and shaving without vision is not a problem. But, before you lost your vision, you may have been accustomed to standing in front of a mirror when you shave, visually monitoring the finished product. If you have no usable vision, but it helps to stand in front of the mirror while shaving, then do so. Before you begin to shave, visualize your face. Think of the parts of your face as landmarks: each cheek, your nose, upper lip, chin, forehead, ears. Next, move your right hand over your right cheek, then your left hand over your left cheek. This gives you a non-visual sense of the size and shape of your cheeks and will be helpful when you begin using overlapping strokes to remove facial hair. You will use an overlapping circular motion if you use an electric razor. Similarly, explore your upper lip and your chin. Determine the length of your sideburns by comparing their bottom edges to the bottom of your earlobes.

It does not matter which part of your face you shave first, but it is recommended that you always begin with the same area of your face. Consistency helps ensure that you don't miss an area. If you are using an electric razor, you may find the only difference is the need to go over your face more carefully, making smaller circular movements. Remember, it's perfectly all right to go over the same area twice!

If you like using a safety razor, before you apply shaving cream, keep the safety shield on the razor and practice making overlapping strokes on each cheek, upper lip, and chin. This can help you get comfortable with the process before you start to use the razor. It's suggested that you shave around your sideburns first by covering the bottom edges with a finger. After you shave each area, use your fingers to locate places where you still have shaving cream instead of using your vision.

See the VisionAware Resources list at the end of the lesson for more information on shaving your face.

If you still have some usable vision, hang a dark or light towel on a door or towel rack behind your head—which ever will help outline your face the best. You may not be able to see your face clearly in the bathroom mirror, but you might be able to use a magnifying mirror about 12 to 14 inches from your face. Adjusting the light in the bathroom can also make it easier to see what you are doing. Lighting positioned in the middle of a ceiling can cause shadows; lights directed down on the counters are not especially helpful. Bathroom counters and tile walls may create glare, visual distortions, and eye sensitivity. A light that illuminates your face but doesn't point directly into your eyes can help you see where you are shaving.

If you are a woman who has always shaved in the shower without a mirror, this task may not be too difficult to complete with vision loss. You would not have been able to visually monitor shaving under your arms. Shaving your legs requires three steps. Cover your leg with a sufficient amount of shaving cream or body wash to avoid a razor burn. Use overlapping strokes as you shave around the leg. Check with your fingers to see if you removed all of the hair. If not, go over those areas with your razor.

It's best not to shave your legs while standing in the shower. Shower floors can be slippery, and some people get very light headed when they bend over. Sit in a shower chair and prop your foot on a small, waterproof stool.

Hair Care

Hair care begins with a good style and cut for your face. If you are having problems managing your current style, ask your hair care professional to suggest an easier style that still highlights your best features. Also, ask him or her to describe how to style it yourself. This goes for women and men.

Store shampoo, conditioner, body wash, soap, and other products used in the shower in a caddy that hangs over the shower head or over the shower door. Some showers have built-in places for these items. Put the hair care products on one shelf and the bathing products on another. If the shampoo and conditioner are in similar bottles, place a rubber band around one so you can tell them apart.

Applying Make-Up

Begin by organizing and labeling your skin care and make-up products. Skin care products frequently come in jars, tubes, and bottles that are indistinguishable from one another. Braille users can make word labels for their products. If you have usable vision, create labels in large, bold print. Create single letter labels out of materials you can feel tactilely, such as electrical tape, puff paint, or glue. Put a C on the jar of cleanser, M on the moisturizer, and so on. Use a basket or tray to keep everything together: skin care products in one area and make-up in another. You may prefer to use an electronic labeling device/reader.

Label your make-up unless the item is very easy to identify tactilely (i.e. mascara). Label each color of eyeshadow, blush, and lipstick.

Arrange the items you plan to use in the order you will apply them to your face. If you use mascara, consider putting it on first. That way, if you accidentally touch the bridge of your nose or cheek with the applicator, you can remove it before applying foundation and blush. If you have uveitis, glaucoma, iritis, or experience eye infections, it's better for your eyes if you don't wear mascara.

When applying foundation, blush, and eyeshadow, use facial landmarks—your forehead, eyelids, nose, cheeks, and chin. A sponge or make-up brush helps to smoothly blend in foundation. Apply consistent pressure and count the number of strokes you use to load the brush with blush or eyeshadow, and then tap the brush against the side of the sink before applying to your cheeks or eyelids. It may take some practice to consistently apply the same amount to both cheeks and both eyelids.

Do some prep work before you attempt to put on mascara or eyeliner. Use the fingernail of your dominant hand and draw a line just under your lower lashes. Practice this several times for several days in a row. Next, use the eyeliner pencil with the cap on to practice drawing lines under the lower lashes. Repeating these actions will help you develop the muscle memory you need without running the risk of poking your eye with the point of the pencil. Once you can keep the pencil right under the lashes, you are ready to remove the cap of the eyeliner. You may want to place the index finger of your non-dominant hand in the corner of the eye to act as a buffer as you line your lower lid. (If you are right-handed, place your left index finger in the outside corner of your left eye and place the point of the eyeliner pencil next to it before you start to draw the line. You will place the left index finger on the inside corner of your right eye. If you are left-handed, reverse this procedure.)

To prepare to apply mascara, first use your index finger as your mascara wand. Gently stroke your upper lashes. Practice this over and over until you can stroke your lashes without poking your eye. Next, practice stroking your lashes with the cap on the wand. Finally, remove the cap and place the index finger of your non-dominant hand in the corner of the eye to protect it from the point of the wand as you stroke your lashes. (Use the same procedure described above for eyeliner.) Some prefer to hold the wand just beneath their upper lashes and blink to coat their lashes.  

You may prefer to use softer, more subtle shades of cosmetics in order to avoid applying too much. Contact your cosmetic consultant and have a makeover. Ask her to observe you applying the new makeup several times until you feel confident with your new skills.

See the VisionAware Resources list at the end of the lesson for more information on makeup application.

Nail Care

buffing nails

People notice well-manicured nails. Nails that are clean and filed or trimmed make an impression on people you meet. If you have always kept your nails shaped or trimmed, you probably will be able to continue this task with vision loss without much of a problem. If you have diabetes, it is recommended that a professional or podiatrist care for your nails.

Perhaps you are a woman who has prided herself in having beautiful manicured, polished nails. With a few adjustments and practice, you can still perform this task. If you have some usable vision, place a light or dark towel under your hand to provide contrast. This will let the outline of each finger stand out, which will help you see where to apply the polish.

If you have always painted your own nails, try the following steps.

  • Take a dry nail polish brush and stroke across your nails as if you are polishing them. Do this several times feeling the brush as it touches each nail and getting familiar with the muscle memory as it develops.
  • Apply a clear polish. Practice with clear polish until you feel confident with your skill.
  • Keep your polishes in the refrigerator. It is easier to feel the cool polish as you apply it to your nails, and cold polish spreads a little slower.
  • Finally, be brave and use a bright color. Use a manicure stick dipped in polish remover in case you get some polish on the edge of your finger or need to clean around each nail. Don't be embarrassed if you make a mistake. Even the best professionals have to do some clean-up.  

If you don't feel confident in polishing your own nails, pamper yourself with a professional manicure. Throw in a pedicure from time to time!

See the VisionAware Resources list at the end of the lesson for more information on fingernail care.

Bathing

You probably do not have any difficulty bathing with vision loss, but a few safety reminders are called for. Some of the more dangerous places in your home are the shower and tub and the floor immediately surrounding these areas. Always put down a bath mat that is large enough to cover the area where you might drip water getting in and out of your tub or shower. Some shower doors have little troughs along the bottom edge that can collect water from the showerhead. When you open the door to get into the shower, the water in the trough can leak out onto the floor. Make sure your bath mat is wide enough to catch that water.

Regardless of your age and the amount of usable vision you have, grab bars should be installed in all of your showers and tubs. You need something to hold on to as you climb in and out of a bathtub or step in and out of a shower. Similar safety bars should be installed on shower walls so you can hold on as you bathe. Slip proof material should be applied to shower floors and the bottom of bathtubs, or you can use heavy, slip proof mats with holes that let water flow to the drain. Take an inventory of your bathtub and shower and add these safety items before you have an accident.

Do you remember the section in Lesson 5 about the upper protective technique? This technique protects your head, face, and chest from open doors and cabinets, and anything else you might run into at face level. It is important to never bend over without using the upper protective technique. Visually impaired individuals frequently forget this rule and bend over when showering and hit their heads or badly bruise their faces on the bathtub faucets or other hardware protruding from the walls. Stay mindful of the dangers if you do not use this safety technique.

Eating Techniques for Home and Dining Out

Some common problems at mealtime frequently experienced by newly visually impaired people include the following:

  • Locating food on the plate;
  • Pushing food off the plate;
  • Cutting meat and large vegetables such as asparagus and broccoli spears;
  • Using condiments;
  • Buttering rolls and other types of bread;
  • Eating salad with large pieces of lettuce;
  • Locating a beverage without spilling it.

You may have some or all of these problems, plus others not mentioned.

Although all of these problems can occur at home and in a restaurant, it's easier to control the situation when eating at home. For example, if poor lighting is contributing to the problems of locating food on your plate or pushing food off, at home you can increase the light with brighter light bulbs or by setting a lamp on the table. You can probably eliminate the problem of food falling off your plate by using a placemat in a color that contrasts with your plate. For example, a dark placemat under a white plate will help you see the rim of the plate. Solid colored plates make it easier to see most foods. Many foods get lost among the designs on plates with patterns. Pouring coffee into a light-colored cup helps you see the rim when adding cream. Some people with low vision carry a dark placemat when eating out because most restaurant dishes are white.

black plate, cup, and silverware against a white placemat

If you do not have usable vision, there are some techniques you can try. Put fewer items on your plate. After a few bites, go around the edge of your plate and push the food toward the center with your fork. When eating foods that are easy to push off the plate, such as peas and corn, use a piece of bread or your knife blade as a "bumper."

Regardless of how much vision you have, follow this technique to locate a glass of water, tea, coke, or wine. Make a loose fist and place it on the edge of the table. Without lifting your hand, gently move your fist in the direction of the glass. Once you locate the bottom of the glass, uncurl your fingers and grasp the bottom of the glass. You will never turn over a glass if you use this technique. This one works both at home and in a restaurant.

Some newly visually impaired people report that they have stopped eating salad. This is quite understandable in a restaurant where the pieces of lettuce are 3 inches long, and the tomato slices may be 3 inches wide. At home, you can break the lettuce into small pieces, cut tomatoes into small wedges, and slice the other vegetables or fruit into bite-size pieces. One popular restaurant chain offers a salad they call "The Chopped Salad." It's simply a salad that comes already cut up. You might try asking the server to have your salad cut up before bringing it to the table.

Even at home, condiments can sometimes be problematic. Telling salt from pepper may be the number one complaint and easiest to remedy. Salt is heavier than pepper. Unless the pepper shaker is completely full and the salt is almost empty, you can compare the two shakers and quickly identify the salt. Salt will make a little noise if you shake it, and pepper is silent when you shake it.

It's generally easier to control salad dressing, ketchup, mustard, and mayonnaise if you use squeeze bottles at home. The current trend in most restaurants is to bring salad dressing in small cups, giving you the option of pouring it on your salad or dipping one bite at a time in the cup. If you like ketchup and mustard on a burger and the containers on your table are not squeeze bottles, pour some on your plate and then use a spoon to put it on your burger. Again, you can ask the server to bring your burger with the condiments already on it.

Cutting a steak, chicken breast, chop, or fish filet may take a little practice. As you try these techniques, visualize what you are doing. First, use your fork to trail around the outside of the piece of meat. This gives you an idea of the size. Next, cut it approximately in half. Set one half aside. Now you have the choice of cutting up the entire half or cutting one bite at a time. Find one end of the meat with your fork. Place it into the meat about 1 inch from the edge. Place your knife behind the fork tines and cut as you would if you had vision. Remember, you still have the muscle memory to perform this task. Once you've cut through the meat, lift the fork slightly and slide the knife under the bite you've just cut. If it's cut completely through, the knife will slide right under it.

In a restaurant, you may not feel completely comfortable cutting your meat. Ask the server to bring your meal with the meat already cut. It's not uncommon for even the most confident visually impaired person to make this request. Restaurants often bring the plates so full that a slip of the knife or fork could knock something onto the table. The trick is how you make the request. If you speak with confidence, you don't need to feel embarrassed. You can order vegetables that you know will be easy to eat or you can ask for asparagus spears and 3-inch green beans to be cut in half.

See the VisionAware Resources list at the end of the lesson for more information on eating in restaurants.

When you serve yourself at home, you know where you placed the meatloaf, the mashed potatoes, and the mixed veggies. When the server in a restaurant sets the plate in front of you, they may tell you the plate is hot, but they won't say that your meat is at 6:00; your potato is at 12:00, your beans are at 3:00, and your roll at 9:00. (This description is based on the positions of a clock face.) You may want a companion to tell you where each item is located, or you can use your fork and go around your plate to identify each food by texture. Some visually impaired people choose to eat their roll with no butter or only use it as a bumper. Others have mastered the butter trick by practicing at home.

See the VisionAware Resources list at the end of the lesson for more information on eating techniques.

Hopefully, you've found many of the techniques in this lesson to be easier than you anticipated. Hopefully, these techniques will help you regain your self-confidence and encourage you to enjoy socializing around a meal with friends and family at home or in your favorite restaurant.


Learning Checks

If you have difficulty keeping the toothbrush level when applying toothpaste to the brush, what technique should you avoid for safety purposes?

  1. Place an index finger beside the bristles of the toothbrush, then squeeze the tube gently as you drag it over the bristles beside the finger
  2. Place the index finger on one side of the bristles and thumb on the other and drag the toothpaste over the bristles between the fingers and thumb
  3. Squeeze a little toothpaste directly into your mouth
  4. Using a red or another brightly colored toothbrush may make it easier to apply toothpaste for people with some usable vision

Answer: c

Men and women use the same three skills to shave. These same skills are used for applying make-up. What are they?

  1. Landmarks, overlapping strokes, and the grid pattern
  2. Balance for standing, circular movements over face or legs, and landmarks
  3. Shave in a pattern, use overlapping strokes, and then assess the results through your sense of touch
  4. Landmarks, visualization, and overlapping strokes

Answer: a

A woman should avoid wearing mascara if she has which of the following eye conditions?

  1. Diabetic retinopathy or albinism
  2. Uveitis or glaucoma
  3. Retinitis pigmentosa or macular degeneration
  4. Optic nerve atrophy or cataracts

Answer: b

Putting a dark-colored placemat under a white plate or pouring coffee into a light-colored mug describes what low vision technique?

  1. Light/dark adaptation
  2. Color contrast
  3. Accommodation
  4. Visual clutter

Answer: b

What are three techniques you can use to keep from pushing food off your plate, when eating in a restaurant?

  1. Always take your dark placemat with you to put under the white dishes
  2. Continually push your food from the edge of the plate to the center
  3. Use your roll or knife as a bumper to prevent your fork from pushing food off the edge
  4. All of the above

Answer: d

Click here to return to the beginning of the lesson.


VisionAware Resources

The following links will take you to VisionAware online resources that support this lesson. Please be advised that information in these links may go beyond the scope of this lesson or this course.

Personal Self-Care

Applying Toothpaste After Vision Loss

Shaving Your Face After Vision Loss

Makeup Application After Vision Loss

Fingernail Care After Losing Your Sight

Eating in Restaurants

Eating Techniques


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