Problems and Solutions to Vision Loss

Many problems arise when trying to carry out routine daily activities when your older relative experiences vision loss. There are, however, many easy solutions to these problems which can ameliorate the impact of vision loss. Here are the most frequently occurring circumstances.

Reading

Mom can't see to read any more.

There are several solutions depending on your mother's vision:

• First, if she has some vision she should see a low vision specialist who can help her with a magnification system and lighting, both of which are critical to reading. Low vision services are explained in Low Vision and Older Persons.
  
  
• She might enjoy the talking book program and being able to listen to books and current magazines. Talking books are recorded materials—most often books or magazines—on audio disc and audiocassette provided by the National Library Service for the Blind and Physically Handicapped that are available on free loan to people who are blind, visually impaired, or otherwise enable to read or use standard printed materials. To obtain Talking Books, playback equipment, and accessories, you must be registered for the Library of Congress Talking Book Program. Call 1-800-424-8567 or write to the Reference Section, National Library Service for the Blind and Physically Handicapped, Library of Congress, Washington, DC 20542 for an application. In many communities, this application is available from a local public library, the regional Library for the Blind or a state or private organization that serves people who are blind or visually impaired.
  
  
• Many public libraries now have large print books available. Depending on your mother's vision, these might be helpful but remember that good lighting is critical.
  
  

Mom says she can't see well enough to read. I know the lighting in her house is inadequate. Suggestions?

Lighting is often a major key to seeing to read. Check the Adapting Your Home section of AFB's web site for suggestions. Also, the AFB book Making Life More Livable in AFB's online bookstore at www.afb.org/store contains many recommendations on lighting.

Leisure Activities

My parents used to play cards with their friends all the time. With Mom's vision loss, they feel they can no longer continue this activity.

Most card games are now available in large-print and tactile versions. These are available through catalogs that specialize in vision-related products. For information about some of these catalogs check the Independent Living Resources and Products fact sheet.

Also, there are many other games that have been adapted for users who are visually impaired or blind—such as dominoes, checkers, chess, just to mention a few.

My Mom and Dad used to watch TV together all the time. Now Dad can't see the TV.

• One simple solution is for the viewer to move closer to the television or vice-versa.
• Also, there are screen magnifiers available However, these provided limited magnification. Check out the technology section on the AFB web site for more information.
• Sports glasses may help, depending on the type and degree of vision loss.
• Also, make sure that glare is not causing a problem for your dad. You can eliminate glare by positioning the TV away from windows or using shades or mini blinds to minimize the glare.
• Finally you may need to consult a low vision specialist as discussed in the Low Vision and Older Persons section of the web site.

Dad can't find his favorite programs on TV anymore. He says the remote is too complicated.

A number of different types of TV remotes are now available through vision-related specialty catalogs listed in the Independent Living Resources and Products fact sheet. Some reduce the number of keys; others are available in large-print/high-contrast keys or tactile keys. You will need to decide what type is best for your dad by working with him.

Getting Around

Mom gets very disoriented due to her vision loss. She used to go to her outside mailbox but can't find it.

Your mother may be helped by an orientation and mobility specialist who is specially trained to help persons with vision loss to regain their ability to get around in their home and community. Please call AFB's toll-free number, 1-800-232-5463 or check AFB's web site to find services in your state and community.

I am afraid Dad will fall. He trips all the time.

Often people who are experiencing vision loss have problems with their balance. Your Dad might benefit from using a cane, which can help both with his balance and with locating objects in his path. Also, you may want to conduct a home survey to make sure that pathways are clear and that items such as throw rugs are not contributing to the problem. For more information about how to obtain a cane and instruction on how to use it check out the Getting Around section on AFB's web site or find out about services available in your area through AFB's toll-free number or go to AFB's web site and find services in your state and community.

Vision loss is one of the major causes of falling in this country and you need to check this out immediately before he has a serious fall.

When I try to walk with my mother, I don't know how to help her. There must be some way to help a person who can't see.

Sighted guide is a technique that has been developed by the vision rehabilitation field just for this reason. It is covered in our fact sheet Being a Sighted Guide.

Mom has fallen in her bathroom several times. She says she can't tell where things are since everything is white. What can I do to help her?

Read the Adapting Your Home section of the web site and also use the Home Survey Checklist. These should help you in figuring out what to do to eliminate glare and provide needed contrast. Of course, it is essential to use non-skid mats and grab bars in the bathroom.

Cooking

Cooking is a real chore for Mom. She used to enjoy it. Now she says she can't see to do things anymore such as measure ingredients, set the temperature for the stove, or even find the items in the kitchen and be able to identify frozen and canned goods.

Your mother can cook again if she gets some assistance to do so. Some possible solutions include:

• Your mother can benefit from having a rehabilitation teacher visit her home. Call AFB's toll-free number or check the directory online for services in your area.
• Complete the Home Survey Check List to determine some of the things you can do to make your mother's kitchen more accessible.
• AFB Press has several books available in our online bookstore that can give you some tips on what to do to help your mother such as Making Life more Livable and Solutions for Everyday Living for Older People with Visual Impairments.
• Check out the vision-related specialty catalogs in the Independent Living Resources and Products fact sheet for kitchen-related aids and appliances. You can mark your oven temperature and stove burner settings using special products such as "hi marks." Large-print/high-contrast measuring cups and spoons are available, as are high-contrast cutting boards.

Eating

My dad is having a hard time at mealtime. Plus, he absolutely refuses to go to a restaurant any more. He says he creates a mess at the table and can't find his food.

There are some simple techniques that can help your dad get oriented to the table and to help him find his food. The most important aspect of eating is helping the older person know how to locate his food, utensils, and beverages.

• The clock method is an excellent method of locating food and items in the place section. For example, you can tell your relative that his roast beef is at noon and his water glass at 2:00.
• Using contrast for the place setting will help individuals who have some vision as well. This includes using drinking glasses and cups that provide contrast for the beverage that is in them.
• Using a non-skid, contrasting surface on which to put the place setting is recommended, such as cloth shelf liner. This material comes in different colors, can be cut to fit the situation, and is washable.
• Specialized utensils are also available such as rocker knives, bumper guards for plates, and audible liquid level indicators so that your older relative can pour liquids safely and efficiently.

For more information about eating techniques check out some of the publications listed in the Independent Living Resources and Products fact sheet.

Keeping in Touch: Corresponding and Phoning

Mom used to write me letters all the time. Now she says she can't see to write well enough. I miss her letters. Any suggestions?

Writing guides for letter writing, signatures, envelopes, and checks are available through vision rehabilitation agencies and through vision-related specialty catalogs in the Independent Living Resources and Products fact sheet. These make it possible for persons who are visually impaired or blind to continue to write legibly. Your mother may need encouragement and possibly some instruction to use these.

Before experiencing vision loss, Dad called me at least once per week. Now he says he can't see my number or even dial the phone accurately. What is the answer?

Large-print/high-contrast telephones are available through some retail stores or through vision-related specialty catalogs in the Independent Living Resources and Products fact sheet. Also, programmable phones are now readily available in which telephone numbers can be programmed for 1 or 2 button dialing or voice dialing. Some phone companies provide directory assistance and phone dialing free of charge by completing an application signed by a physician. You will need to check with your local phone company for the availability of this service in your area.

Managing Currency

Mother doesn't know how to organize her money when she shops.

Identifying and organizing money can be a major problem for persons who are visually impaired. Wallet organizers are available through catalogs that specialize in vision-related products. Some tips that may help:

• Coins can be identified by touch. Quarters and dimes have rough edges. Nickels and pennies have smooth edges. Also nickels are thicker than other coins.
• Bills can be folded for identification purposes and placed in different sections of a wallet. For example, leave dollar bills unfolded; fold $5 bills lengthwise; fold $10 bills by width; fold $20 bills lengthwise and then by width.
• Ask grocery clerks or shopkeepers to identify each bill as change is given.
• Electronic bill identifiers are available but are expensive and not practical for household use.

Banking

Dad wants to maintain his banking account but he can't write checks legibly anymore, much less keep up with the account.

There are several solutions to this problem:

• Most banks can order raised line checks for their patrons.
• Also, check writing templates are available that make it easier to write and sign checks. These are available through your local vision rehabilitation agency or through vision-related specialty catalogs described in the Independent Living Resources and Products fact sheet.
• large-print check registers are also available from the same sources.
• Many banks allow online banking. This may be an option that your dad may prefer if he is familiar with using a computer or is interested in doing so. Both large print and speech programs are available to make computers accessible for persons who are blind or visually impaired. Check out the technology section on the AFB web site.

Telling Time

Dad can't tell time anymore since he can't see the read the face of his watch.

Low vision, tactile, and talking watches are available through the vision-related specialty catalogs listed in the Independent Living Resources and Products fact sheet. There are many choices available to meet his needs. Low vision and talking clocks are also available.

Maintaining Good Health

Dad has diabetes and says he can't check his blood sugar or give himself shots since he cannot see the insulin gauge.

There are a number of diabetic aids and appliances that can help individuals with diabetes to remain independent such as talking glucometers for checking glucose levels to count-a-dose devices to ensure that insulin dosages are calibrated correctly. These aids can be found in the vision-related specialty catalogs listed in the Independent Living Resources and Products fact sheet.

Mother is on a diet and wants to be able to check her weight daily. However, she can't read a weight scale.

Talking scales are available through the vision-related specialty catalogs listed in the Independent Living Resources and Products fact sheet.

Maintaining Your Appearance

Mother used to take pride in her appearance. Now she wears clothes that don't match. She lost some of vision recently and I think that may have something to do with it.

There are a number of methods that can be used to help your mother distinguish her clothes. First you need to talk to her about the situation and tell her you will be glad to help her. You should stress that you want to work with her to develop a method that makes sense for her—such as putting similarly colored clothes together in one section of a closet or, alternatively, putting outfits together. For more tips on how to organize clothing and drawers and on simple labeling devices, check the Tips for Organizing your Bedroom section on the web site. Also books such as Making Life more Livable and Solutions for Everyday Living in AFB's online bookstore contain many good ideas. Rehabilitation Teachers who are specially trained in vision rehabilitation services can offer the most help to your mother in this and most other areas of personal independence. Read the Help is Available or Special Services to Help Older Persons Experiencing Vision Loss sections on the web or ask AFB's Information Center about this information.

Coping and Adjustment

Dad is really having problems coping since he has developed macular degeneration. Is there any help available for him?

To find out about vision rehabilitation services read the Help is Available or Special Services to Help Older Persons Experiencing Vision Loss sections on the web or ask AFB's Information Center about this information. He may need the help of a low vision specialist and a rehabilitation teacher. Older people with other types of eye conditions such as glaucoma or diabetic retinopathy or hemianopia, caused from stroke, can also benefit from these services.

Modifying the Environment

What are some tips for adapting my mother's home? She has recently been diagnosed with a visual impairment.

Check out the Adapting Your Home section of the web site. Also, you may want to conduct the Home Survey Check List, also on line. Some general rules of thumb are as follows:

• Increase lighting
• Eliminate glare
• Eliminate hazards
• Create color contrasts
• Organize and label items
• Discuss any changes in the home with your older relative

Employment

Dad would like to go back to work.

Believe it or not, the fastest growing segment of workers in this country is individuals 55 years of age and older and people with visual impairments are no exception. Your dad should be encouraged to look into work options. Every state has vocational rehabilitation programs for individuals who are blind or visually impaired. Information about programs in your state can be found by contacting AFB's Information Center at afbinfo@afb.net, toll-free at 1-800-232-5463 or by checking AFB's web site at www.afb.org.

You may want to read AFB's brochure on returning to work entitled Consider Older Workers Who Are Visually Impaired. This can be ordered free of charge through AFB's toll-free number, 1-800-232-5463.

You may find out more information by visiting AFB's web site at www.afb.org. AFB's web site contains valuable information on living with vision loss, information for friends and family members, services available in each state for vision rehabilitation, books and resources, AFB's National Center on Age-Related Vision Loss in Dallas, and many other useful items.

The additional information sheets referenced above can be found on the web site or through AFB's Information Center at afbinfo@afb.net or 1-800-232-5463.