Wednesday, March 16, 2011

Impact of Low Vision on General Daily Activities

Extent of the problem, when the low vision substantially affects the daily lives of the senior citizens, is quite significant. According to the National Center for Health Statistics (NCHS), there are approximately 6.2 million seniors (65 years of age and over) that are visually impaired. There are approximately 9 million Americans 45 to 64 years of age, who are visually impaired. As the 9 million baby boomers with vision loss continue to age, the number of seniors who have impaired vision will continue to grow substantially. But even for those, who are not considered as visually impaired, the certain vision degradation might cause significant difficulties in fulfilling daily life activities. Most of the limitations are manageable, so if you know what they are and why they are happening, you will be better equipped for the adaptation, changing home environment accordingly and getting equipped with technical devices to leverage your disadvantage while out of home.

With the correct approach, encouragement, and medical assistance seniors with vision loss can, and do, continue to enjoy full and independent lives.  The three keys are:
                - Accepting the reality of your situation.
                - Developing a positive, “I can do this” attitude.
                - Adopting the use of alternative methods.

As mentioned in one of the previous posts, the aging eye receives significantly lower amount of light in comparison with younger, healthier eyes. This means that senior citizens require environments with more lighting than younger people may require. What may seem like bright lighting to younger people may seem like very dim lighting to the elderly. This need for additional lighting makes it very difficult for the elderly to function in environments with low illumination, which limits the places in which they can function. For example, theaters, parking lots at night, and dark restaurants are often difficult for senior citizens' to function in because of inadequate lighting.

Along with the need for increased illumination, the elderly struggle with the impacts of glare in the performance of everyday activities. Each of the three major types of glare, dazzling glare, veiling glare, and scotomatic glare, results from a different lighting situation and causes a different visual effect. One of the biggest problem sources of light is a large amount of natural light. Large amounts of natural light can interfere with the elderly person's vision when spending time outdoors or when driving during the daylight. It can also impair vision indoors when large windows face the sun or when there are very bright artificial light sources. Examples include sun entering the front windows of large grocery markets and everyday situations, such extra light reflecting from the bathroom mirror, which would cause scotomatic glare. These large amounts of light have a partial blinding effect on the individual. To complicate the problem, the older eye has a more difficult time recovering from glare than younger eyes. This means the blinding effects are long lasting.

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The decreased ability to distinguish between different colors and intensities of color impacts the elderly eye in a number of ways. Senior citizens may have trouble dressing themselves in clothes that society will find acceptable. This is because it is difficult to match clothing when many colors are indistinguishable and look alike. Other grooming activities may be difficult to do with impaired color discrimination also. For example, low-vision women may not realize the intensity of the cosmetics they apply. This means they may wear more make-up than expected. Both of these situations will influence the way people treat low-vision senior citizens.

Poor color discrimination also affects senior citizens' perceptions of their environments. Because softer colors and colors of similar intensities are very difficult for the aging eye to discriminate, rooms and facilities decorated in pastels will appear very dull and sometimes gray to senior citizens. Often, facilities and products designed specifically for the elderly utilize pastel shades of colors. Elderly persons who spend significant amounts of time in these environments may find themselves feeling depressed by the constant drabness of the colors they perceive.

The same is true for objects within the environments of elderly persons. Greeting cards, artwork, craft supplies, wrapping papers, flowers, and other objects of pastel colors are often given to senior citizens. High-detail objects can compound the problem, such as thin, scrolling scripts on greeting cards. While these gifts may be very attractive to younger eyes that can distinguish the colors, to the elderly they can appear dull and gray. This inability can leave senior citizens feeling frustrated. Family, friends, and caregivers can help by giving gifts, cards, and other objects that use high contrast, long wavelength colors, such as reds, yellows, and oranges.

Senior citizens are at a disadvantage when it comes to their medical care because of their inability to discriminate colors. Medications come in a wide variety of shapes and colors, but still there are many different pills that have similar shapes. These similarities, combined with an inability to discriminate colors, make it especially difficult for senior citizens to distinguish one medication from another. Obviously, the risk of misusing medications implies a wide range of dangers.

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Lowered acuity influences the elderly person's ability to perform a number of everyday activities. Difficulty reading is the most obvious impact when living with lowered acuity. Senior citizens begin to require larger size fonts when reading and find it hard to read writing with little contrast at any size font. Reading problems can impact several aspects of senior citizens' daily lives. Recreational reading is impaired, such as books, magazines, newspapers, menus, and personal letters. Phonebooks and advertisements are often printed in small fonts, making it difficult for senior citizens to find needed information. Labels on products, such as food and medicines, use very small fonts, making meal planning and medicine organization a challenge. Other impacts of poor acuity on daily life include difficulties reading clocks, watches, telephones, computer screens, and television remote controls.

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Reading is not the only task that is impaired by lowered acuity in the elderly. All tasks that involve resolving fine details become difficult. Writing also becomes harder as acuity decreases. Tasks such as mending clothes or sewing buttons also require the resolution of fine details.

Other age-related factors impact the daily lives of senior citizens. For the elderly, age-related changes introduce visual challenges, such as recognizing faces at long distances or at low contrasts. Visual-motor coordination, often referred to as eye-hand coordination, decreases with age and adds to the problems caused by low acuity, poor contrast sensitivity, and poor color discrimination to further impair tasks such as writing and sewing.

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