Seven Steps To Independence

by: Jenice D. Heck - Occupational Therapist

When learning how to manage your vision loss, it is important to remember 3 golden rules:

1. Vision loss is specific to each individual.  Having the same cause of vision loss as another person, does not mean that your visual limitations will be the same.
2. Because your visual limitations are specific to you, the adaptations that work best for you may be different than the solutions other people use to stay independent. 
3. There is always more than one way to solve a problem.  You may have to go through a little trial and error to identify the best solution to meet your needs.  Creative problem solving may be the answer, or purchasing a simple device may do the trick.  Either way, if you need help identifying the ideal solution to fit your needs, Contact Us or Ask Roxy.

The following 7 steps are a guide to help you identify the adaptations that will improve your safety and level of function at home. They are a map to point you in the right direction toward independence.  Some steps may be more helpful than others, depending on your degree of vision loss.  But, each step will point you in the direction of getting the most out of your remaining vision, during your daily activities.

1.  Minimize Clutter

Clutter on surfaces and floors can affect your safety and independence.  Throw rugs, lose wires, and excess furniture can become tripping hazards when moving around in your environment.  Likewise, clutter on counter-tops and tables can be a strain on your eyes, causing them to work harder to locate and identify items.  Keeping your floors and surfaces clear and tidy can reduce your chances of injury and enhance your ability to identify what is around you.

Take this cup, for example.  In which of these 2 pictures can you more easily see the cup? 

Eye conditions such as Macular Degeneration, Diabetic Retinopathy, cataracts, and Glaucoma can cause blurry spots that reduce the ability to see details.  Reducing the amount of shapes and colors in an environment makes it easier to understand what your eyes are seeing.

2.  Maximize Lighting

If you have low vision, proper lighting can be the key to your success.  There are 2 types of light sources you should consider in your home and work environments:  overhead lighting and task lighting. 

Overhead lighting should enhance your ability to move around in your environment.  Quite often, this is accomplished through the use of standard incandescent bulbs positioned in the center of the ceiling.  Incandescent bulbs tend to shine with a yellow hue that may be too dim for some people and too glary for others.  Bulbs that cast a clean white light, such as fluorescent, LED, or halogen bulbs, tend to brighten a room with more comfort and clarity.  A variety of bulbs can be purchased for a fixture that supports a standard bulb.  Be sure to check the recommended wattage on a fixture before changing out your bulbs. For more information about lighting options for your home or office click here to visit our store.

Let’s look at our cup on the counter again.  Is it easier to see the cup with or without the task lighting?

Task lighting refers to a light source that shines directly on your work surface.  Having the right task light is an important step toward increasing your safety and level of function. Following this 3 step process can help you to identify the best task light to meet your needs.

1. Identify the areas in which you perform your daily activities.  Common examples include:  kitchen counter, stove, kitchen sink, kitchen table, desk, reading chair, and bathroom vanity.
2. Determine the best type of lighting for you.  Some examples may include:  fluorescent, simulated sunlight, and LED.
3. Choose a light fixture that will accommodate the type of lighting you require.  You may need a portable light that can be moved around your work area.  Or, you may have a favorite spot on the kitchen counter that would be ideal for an under-cabinet fixture.    

3.  Reduce Glare

Sensitivity to glare is a common problem with many types of eye conditions.    When the eye loses its ability to regulate the light entering the retina, you may experience pain, fatigue, or even blurred vision.  It is important to protect your eyes from harsh light, which may be damaging to your retinas.  The good news is there are solar shields available that are designed to filter out certain harmful rays of light, while allowing other rays through to provide necessary brightness and clarity. 

If  you find most overhead lighting to be painful or glary, you have 2 options:

1.  Replace your overhead fixtures that cast direct lighting with a system that casts indirect lighting.  Fixtures that point light to the ceiling instead of the floor can brighten a room comfortably without glare.
2. Wearing yellow or orange solar shields inside your home or office can reduce glare from windows or overhead fixtures, allowing the light you need to improve your vision.   

 Take a look at this cup again.  Do you notice a difference when you look at it with the yellow filter?  Is it more comfortable on your eyes?

Remember, having the right protection over your eyes when traveling outdoors is extremely important to maintain the health of your eyes and to get the most out of your vision.  Wearing darker shields such as amber, plumb, or gray can filter out the harsh brightness of the sun, allowing you to see more details such as cracks in the sidewalk, curbs, or obstacles in your path.

For more information about solar shields Click Here to visit our on-line store. 

4.  Create Contrast

Sensitivity to contrast is often overlooked as a component of vision loss.  However, it can be one of the most limiting factors during your daily activities.

Contrast sensitivity refers to our ability to distinguish between various shades of color.  Pure black and white are the highest form of contrast at 100 %.    Small changes in our ability to see contrast can make a big difference in our ability to function.  For example, a 30 % reduction in contrast sensitivity can make it difficult to see the edges of street curbs or cracks in the sidewalk.  It can make it difficult to walk in areas that fluctuate between shade and sun.  It can even make it difficult to identify faces, money or newspaper print.

Creating contrast in your home and work environment can improve your level of function and safety.  All it takes is a little creativity and problem solving.  For example, if you are having trouble traveling within your home, a contrast adaptation may help.  Painting the trim to contrast your walls and floors can make it easier to maneuver within your environment.  Likewise, if you contrast the color of your kitchen counter tops with your cabinets, your eyes will not have to work so hard to stay oriented.

These techniques can work on a smaller scale, as well.    Take our cup, for example.  Though you may be able to see the white cup on the teal counter-top, it dramatically stands out on the black placemat. 

This technique can be helpful when preparing foods, as well.  If you’re going to cut a white onion, using a black or colored cutting board can make it easier to see what you are doing.  On the flip side, if you’re going to cut a tomato or a green bell pepper, using a white cutting board may be your best choice.

5.  Adapt Your Technique

Adaptations do not have to be big or complicated to make a difference in your level of function.  In fact, simple changes to the way you perform a task will give you the best chance for success.

 For example, if you’re going to pour water into this cup, but you cannot see the water rising, there is a simple adaptation that can help.  Simply place the tip of your index finger over the edge of the cup.  When the water rises to touch your finger tip, you’ll know that it is time to stop pouring.  Of course, this technique is only useful for cold liquids.  It is not appropriate for managing liquids that are hot.

There are an inf inite number of techniques to help you adapt to your vision loss.  Nevertheless, you’ll need to exercise your creativity and problem solving skills. Following these steps can help you to get started:

1. Identify the activity that has become difficult for you, since your vision has declined.
2. Break the activity down into steps.
3. Take each step one at a time to identify alternative methods for performing the same task.
4. Sign up for training classes at your local agency for he blind to learn tricks of the trade for experts in the field.  Click here to learn more about Daily Living Skills classes at The Lighthouse for the Blind.  

Remember, an Occupational Therapist (O.T.) is trained to help people with disabilities to develop adaptive techniques for independence.  Ideally, you would want to work with an Occupational Therapist who is specially trained to work with people with vision impairment.  Click here to learn more about Low Vision Occupational Therapy Services.

6.  Compensate for Your Limitations

Sometimes it’s easier to overcome a problem by using a special device or adapted aid.   There are hundreds of devices available to help you compensate for vision loss in all areas of daily activity.  However, the best solution is not always the most expensive.  And, you will always have choices.

 Let’s go back to our cup, once again.  If you’re going to pour a drink and the strategies we’ve discussed still aren’t enough for you to be fully comfortable to perform the task independently, there is an adapted device that can help.  It’s called a liquid level indicator.  It looks like a small battery pack with two metal prongs.  The prongs hook over the inside edge of the cup.  When the liquid rises to touch the prongs the device begins to make a loud buzzing sound, which is the cue to stop pouring.  This is a perfect example of how you can turn a visual or tactual task into an auditory task.

You may be tempted to avoid using adapted devices.  It’s not uncommon.  However, you need to consider 2 things, while you are learning how to cope with your vision loss.

1. There are hundreds of devices out there to help you to maintain your independence.  Not all of them will be the right fit for your needs.  However, some of them will be ideal to make your life easier.  The frustrations you may be experiencing, while performing your daily activities, are not uncommon.  There are special devices that have been designed to be user friendly and task specific to help you with your particular needs.
2. Adaptive devices do not have to be expensive, but they should be considered an investment in your independence, much like a car.  Sighted individuals invest time and money into the purchase of a vehicle, its maintenance, gas, and even insurance.  This gets pretty expensive and is an ongoing investment for independence.  Depending on your level of vision loss, you may no longer have the expense of a vehicle.  So, you need to invest in other devices for independence, such as an electronic magnifier to help you read or a talking labeler to help you label your environment.  The beauty of these items is that they are a one-time purchase with no maintenance or insurance necessary for your success. 

7.  Know Your Resources

Always remember that you are not alone.  If you are having difficulty performing your daily tasks, adapting your environment or finding the right device to maintain your independence, there are resources available to help you.  Knowing where to find assistance is the key to success.

Don’t let the term “blind” keep you from accessing the help you need.  Though services vary, every state has an agency dedicated to serving the blind, which includes services for people with low vision.  A good start is to research “blind services” in your local Yellow Pages or through an on-line Google search for your area.

If you are a veteran, the Veteran Administration can be an excellent resource for training and equipment.  Contact your local VA to inquire about services for the blind.

If you need help problem solving, our website can serve as a helpful resource for guidance and information, through our “Ask Roxy” blog.  Roxy specializes in providing tips and techniques for independence at home or work. Just ask Roxy a question and she will help you solve your problem with adaptive skills that are commonly used by people with vision loss.   Click here to access Ask Roxy or simply return to our home page.

If you have questions that are specific to your eye condition, please contact your eye care provider.  If you need help finding an eye care provider, or if you have questions that are specific to community resources in Southeast Louisiana, The Lighthouse Information and Referral Center can be a helpful resource at (504) 897-3456, toll free 1-866-222-2229, or email info@lhb.org.

If you’re not sure if there is an adaptive device to meet your needs, Magnifiers & More, the Lighthouse Store, can help.  Call 504-891-7008, toll free1-888-792-0163 ext. 228, or email orders@lhb.org.  Click here to visit our on-line store.

There are national agencies dedicated to serving the blind and visually impaired.  If you are looking for help beyond your local agency, you can check out the links below.

            afb.org

            acb.org

            nfb.org

CONCLUSION:

Just remember that your vision loss is specific to you, but you are not alone.  There are techniques and tools available to help you maintain your independence that has been created by people who have experienced your same frustrations.  The best place to start is to make simple adaptations to your home and work environments.  Sometimes the simplest changes can make the biggest difference in your ability to function.  If adapting your surroundings doesn’t solve the problem, adapt your technique.  Learn to use your other senses to compensate for your vision loss.  Learning how to do this without a device is best, but there are adaptive devices to help you, if you need to make things easier.  Lastly, don’t forget that you have resources.  No one expects you to know everything there is to know about vision loss.  Contact your eye care provider with questions that are specific to your eye condition, or contact your local agency for the blind for training and additional help.  The Lighthouse for the Blind in New Orleans website is a great resource to keep handy.  You can put Ask Roxy in your favorites, when you need to brain storm with someone who is skilled in adapted techniques for independence.

There is always more than one way to solve a problem.  Vision loss means that you can no longer rely on your eyes for all of your information, but, luckily, you have many other SENSES to help you live a normal productive life.