Refer to an ophthalmologist or optometrist.
Meanwhile, OTs can provide interventions to enable the use of the client’s remaining visual acuity.
OT Interventions
Increase background contrast
- Use black on white.
- Or apply bright colors (e.g., markers, tape).
Increase illumination
- Using different types of light sources, color temperature, softness, placement, and wattage (higher is better).
- Without increasing glare.
- Beware of casting shadows.
Reduce background pattern
- Use solid colors instead of background surfaces.
- Reduce clutter in general.
Enlarge objects and features
- Print instructions in larger print.
- Relabel frequently used objects, e.g. medications, calendars.
- Encourage use of magnifiers.
- Change computer and electronics accessibility settings for low vision.
Reorganize
- Store or place frequently used items at a convenient eye level.
- Store less frequently used items lower or higher.
- Encourage clients to keep items organized.
- Put items back where they belong.
- Establish habits and routines to prevent tasks from becoming overwhelming.
- Modify tasks to reduce the number of steps or its complexity.
Other Interventions
- Ensure adaptations such as glasses are used and kept clean.
- Warm water and soap work well to clean glasses.
- Use sunglasses for bright sunlight and light changes between environments.
- Minimize and remove fall hazards, e.g., phone charging cords
- Address psychosocial factors including social isolation, depression, anxiety, substance abuse.
- Address driving if client drives and potential hazards to self and others.
- Enhance other senses (auditory, tactile, olfactory) and use other strategies and assistive technologies to achieve the same function, e.g. Amazon Echo instead of using a light switch.
Referral
- Free library services for low vision, e.g. talking books, magazines, music.
- Lighthouse Information and Resource Center – www.lighthouse.org
- Local telephone companies may offer free directory assistance.
- Pharmacies may provide large-print medication labels.
- Businesses may provide larger-print products.
- Refer to an organization for white cane orientation and mobility (O&M) training BEFORE recommending guide dog training.
- Consider a guide dog for clients with experience using white canes.
Guide Dog Study
First-Time Experience in Owning a Dog Guide by Older Adults with Vision Loss – Li, K., Kou, J., Lam, Y., Lyons, P., & Nguyen, S. (2019). First-Time Experience in Owning a Dog Guide by Older Adults with Vision Loss. Journal of Visual Impairment & Blindness, 113(5), 452-463.
Introduction:
In spite of the vast amount of literature on pet therapy and dog companionship, limited studies exist on older adults with vision loss and the experience of owning a dog guide. The purpose of this study is to explore the facilitators and barriers of first-time ownership and utilization of a dog guide as experienced by older adults with vision loss.
Methods:
Data were gathered among seven participants using open-ended semistructured telephone interviews. Participants described their experiences related to owning a dog guide. Using phenomenological analysis, themes were extracted from verbatim transcriptions.
Results:
Through constant comparison methods, five themes emerged: increased responsibilities for new dog guide owners, changes in habits and routines, quick human–dog guide bonding, increase in community integration, and enhancement of autonomy through dog guide ownership.
Discussion:
The study results suggest that obtaining a dog guide increased the older adults with vision loss everyday engagement in community activities. The increased confidence in independent mobility may have led participants to engage in activities in unfamiliar environments, thus improving their autonomy, self-esteem, and physical abilities. These changes resulted in increased feelings of independence and freedom for the older adults with vision loss. Participants also revealed positive changes in their daily habits. Due to the increased physical ability and motivation needed to complete activities, making adjustments to owning a dog guide became easier. Furthermore, a human–dog guide bond was prevalent among all seven participants.
Implications for practitioners:
Themes extracted provide health practitioners and dog guide organizations insight into how owning dog guides may empower older adults with vision loss.
Resources
- Veterans can receive services and devices free of charge – U.S. Department of Veterans Affairs 844-698-2311
- American Diabetes Association: 800-342-2383
- American Foundation for the Blind 212-502-7633
- American Macular Degeneration Foundation 888-622-8527
- American Printing House for the Blind 800-223-1839
- Association for Macular Diseases/Ophthalmic Edge
- Glaucoma Research Foundation 800-826-6693
- Macular Degeneration Foundation 888-633-3937
- Macular Degeneration Partnership 888-430-9898
- Macular Degeneration Association 855-962-2852
- MD Support 888-866-6148
- National Eye Health Education Program
- National Federation of the Blind 410-659-9314
- National Institutes of Health database
- Vision AwareTM – Find Services for People Who Are Blind or Visually Impaired
