Tuesday, April 26, 2011

Low Vision Impact on Social Activities for Older Adults

Quality of Life

Vision impairment is associated with a diminished quality of life. Older adults with impaired vision are less able to perform routine activities of daily living, are less mobile, are more isolated, suffer higher rates of depression, and consequently, have a substantially reduced overall quality of life when compared to their normal-sighted counterparts. Impaired vision is a significant independent risk factor for falls and fractures in older people. The ability to travel independently, often linked with issues of quality life, becomes challenging and daunting in the presence of vision loss. Older individuals, especially those with vision impairment, face greater safety risks when crossing busy intersections and when driving. Visually impaired older adults find it difficult, if not impossible, to read for pleasure, watch television, movies and sports for recreation with friends and family, barring them from the most common forms of social engagement, which can further add to a sense of isolation and depression. They confront formidable challenges in using computers and harnessing the internet to access information, to communicate, and to pursue lifelong education through increasingly available online courses. With the aging of the population, the growing number of visually impaired older Americans who are losing the ability to care for themselves further contributes to this major public health concern.

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Social Life Effects

Low vision affects the social activities of older persons in a number of ways. Psychologically, low vision limits senior citizens because they are often afraid to leave their homes. Studies have shown that low vision adults have a much harder time moving about in unfamiliar places than in their more familiar homes. Senior citizens who know they are more likely to fall in an unfamiliar area may be likely to leave the home. This can add to the social isolation that the elderly already face.

Low vision also plays a more direct role in limiting the social activities of low-vision senior citizens. Interacting with other people can be challenging for the elderly because many features within human faces tend to be low contrast. Examples of low contrast features include the nose and sometimes the lips. Inability to easily see the lips may impact individuals' ability to communicate, especially if they are also hard of hearing and rely on lip movements to help them understand spoken language. Senior citizens often have a difficult time recognizing even the most familiar people by visual cues alone.

Social activities are also limited by transportation issues. We already discussed the impact of low vision on driving for senior citizens. Many elderly will not leave their homes unless absolutely necessary because driving can be extremely hazardous. This inability to get from one place to another severely impacts the ability to socialize outside the home.

Finally, poor acuity contributes to the lack of social activities by limiting senior citizens' ability to read. Menus, bibles, sheet music, playing cards, dominoes and other common items used during social functions are often printed in small print, making them difficult to read. Rather than deal with the frustration of being unable to function normally in a social setting, the elderly often choose to avoid these situations altogether.

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Recommendations

Each situation is special and requires individual approach. We will offer basic generic recommendations on how diminish negative effects of low vision on your social life.

  1. Magnification Devices

Many of the difficulties associated with loss of vision are due to reduced reading ability, and most people with low vision find magnifiers helpful for short daily tasks – such as reading mail or expiry dates on food.

A wide range of magnifiers are available, and they differ in strength and how they are used. Some magnify close work tasks and others are used for objects further away.

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Types of magnifiers for close work:
  • Hand held: cheap and widely available in a good range of magnifying powers X1.5 to X15. They can be held in one hand, and they are often available with a light in them. It can be difficult to use a hand-held magnifier if there's a hand tremor.
  • Stand: slightly more bulky than a hand held magnifier, but they are fitted with a stand that rests against the page, making it easier to keep the object in focus. Stand magnifiers can be available in powers of 2x to 20x magnification and are often fitted with a light.
  • Spectacle mounted: the magnifier lens is fitted into a spectacle frame. This is not the same as ordinary spectacles. It does allow both hands free but requires the book to be held very close to the spectacles.
  • Electronic magnifiers: spectacle mounted, hand held and stand magnifiers are limited to about 20x magnification, whereas some electronic aids can achieve 70x. Most electronic aids use a camera to create an enlarged image on a viewing screen. Other features can be incorporated, such as improved contrast between the object and the background and often object size can be changed using a zoom function. Electronic magnifiers are not currently available through most NHS low vision clinics, but can be bought privately.

There are also different distance magnifiers available mostly for employment and educational purposes:
    • Telescopes: telescopic systems can achieve a magnified image, but it's difficult to use due to the small field of vision. Training is often needed before a person can use the telescope well.
    • Binoculars: you can use both eyes to view far off objects. This can useful if you have nystagmus (shaky eyes).

The stronger the magnifier, the bigger it makes the object appear. Unfortunately, the stronger magnifiers become the smaller the amount of print they can view. It is not possible for a really strong magnifier to cover the whole page of a book.

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  1. Large Print
It is understandable that there are special books, printed in large print for vision impacted readers. But the same approach should be taken for all other devices you use. Choose mobile phone with easy distinguishable buttons and large onscreen fonts, adjust your computer settings to accommodate your needs for screen resolution and large fonts in display settings, seek for GPS with good and easy to use zooming capabilities.

  1. Planning your Social Activities
Being retired is having some substantial advantages, and having more available time to plan better your activities, including social life, is one of them. First of all, do elaborated research and choose the activities and entertainment events, where your vision impairment impact will be minimized and will not affect much your participation. Plan carefully, and do not forget your optical devices. If you need to walk or to drive to the unfamiliar area, review the address and driving/walking directions carefully to avoid surprises, mostly unpleasant. Use online services and handheld/car GPS devices to get the best directions.

Keep your mobile phone handy to call for assistance if needed.

  1. Night Activities
Whenever possible, restrict your outings to the day time, when impact of your low vision is minimal. If you need to attend evening entertainment activities, consider to ask for designated driver or call a taxi. You will not have to deal than with driving complication at the night time and difficulties to locate the right address.

Handling social situations for a person with low vision (Dr. Bill Takeshita)

If you have 45 minutes now, and you want to get better perception on how to deal better in social life while affected with low vision, I would recommend downloading and reviewing the audio lecture on how to handle social situations for a person with low vision. Dr. Bill Takeshita discusses ways and approaches on how to improve your social life when you have low vision. Link for downloading: http://www.ziddu.com/download/14760918/SocialSituations.mp3.html


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