5 Elements of Accessible Web Design

A common misconception is that all you need to have a successful blog or website is good content. While content people want to read is important, if you can’t see it, or it is difficult to read, very few people are going to take the time to try. There is lots of good content to choose from.

Making your content easy to scan and read and using great graphics that can tell a story are just as important. Especially if you want to reach the millions of potential readers that are blind or visually impaired.

While a person with low vision (due to age-related macular degeneration, cataracts,glaucoma or other eye diseases that are related to aging) can increase font size or graphics by enlarging them with a pinch of the fingers or scroll of the mouse, the result is often blurry and still difficult to see.

If a person is blind and using a screen reader, what they hear may not match what is written or displayed. A picture without underlying descriptive text is worthless. And when a blind person is using a screen reader to read a web site, they will often tab from link to link to scan your article, skipping over your text, to get a sense of what the options are. “Click here” says doesn’t tell the reader anything.

Here are 5 essential elements of accessible web design.

5 elements of accessible web design

12/15/15

Susan DeRemerSusan DeRenmer, CFRE
Vice President of Development
Discovery Eye Foundation

6 Tips to Help With Holiday Stress

We all know that the holidays can be stressful with the many demands of shopping, baking, parties and the expectation that you should be filled with cheer and goodwill. This is all daunting under the best circumstances, but if you are also losing your vision to eye diseases such as glaucoma, age-related macular degeneration or diabetic retinopathy, the depression can increase.

6 Tips to Help With Holiday Stress

holiday stress
Being realistic, planning ahead and asking for help will let you deal with the stress and depression that may come with the holidays. Here are six tips that will help you deal with the pressures of the holidays, with additional tips for those with vision loss.

  1. Begin by realizing you don’t have to be happy just because the holidays are here. You may have experienced a loss of someone close to you that makes celebrating the holidays hard.
     
    With vision loss: You may miss seeing or putting up decorations; baking for friends and family; or seeing the joy and smiles of loved ones. You can’t force yourself to be cheerful because of the time of year.

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  2. While the common reaction to depression is stay home and isolate yourself, don’t, it will only make you feel worse and dwell on things you cannot change. Join friends when they ask you out, find community events to attend or volunteer. Sharing time with others can provide a welcome distraction and lift your spirits.
     
    With vision loss: It is common to be uncomfortable with asking friends and family for a ride, but if they are attending the same party of community event, ask them if you can get a ride. They won’t mind a will be glad you are there. Worst case, call a taxi or use Uber.

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  3. Don’t expect perfection. You need to define for yourself what would make a great holiday and not let the media and retail stores tell you what the holidays should be. Also remember that your traditions will change as your family changes and grows. Look at this as an opportunity to be creative and start new traditions.
     
    With vision loss: Scale your holiday to what is comfortable to you. If fewer decorations make it safer and easier for you to navigate around your home, then reduce the number of things that go up to a few larger items you can enjoy more easily – you can even “decorate” with holiday music.

    Even traditions may need to change. Allow someone else to host the family or neighborhood celebrations. It is nice to pass the honor on and you won’t be so stressed and tired you can’t enjoy the festivities.

  4. Plan ahead so you don’t feel the pressure. This refers to budgeting both time and money.
         • Plan extra time for decorating, shopping, baking, wrapping presents, or any other activity you want to include. Rarely do things run smoothly, especially at holiday time.
        • Decide how much money you can spend, and stick to it. To make money go further, give homemade gifts, start a gift exchange instead of shopping for everyone in your family or office, or make a donation to a charity in someone’s name.

    With vision loss: The same concepts apply – you need to budget your time and money.

  5. Don’t over extend yourself and learn to say no. If you don’t you may become resentful and overwhelmed. Friends and family will understand if you can’t do everything. If your guilt gets the better of you, ask the person making the request to help with the tasks. They will gain a new appreciation of what you do.
     
    With vision loss: Don’t be afraid to let people know that you may not be able to do things as easily as you could in the past. No one, except you, know the limitations you have with your vision. It can be very uncomfortable for others if they think they are asking too much of you, and you could become resentful for being asked to do something beyond your capabilities.

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  6. Stay healthy. The best way to do this is to watch what you eat and drink, get plenty of sleep, continue any exercise routine you have and take time to relax.
         • You will be tempted with lots of sweets and snacks. Try eating something healthy like cut veggies before you go to the party to curb your appetite. Remember to limit your alcohol because of the calories and the fact that it is a depressant.
         • Sleep will keep you alert and better able to focus what you want to get done and will help keep you more positive.
         • Exercise is a great way to help relieve the stress you feel, give you an extra burst of energy and help you clear your head.
         • Taking 15-20 minutes to just listen to music, take a bath, go for a walk or read book can help you think more clearly and relax. You will actually get more done when you can “re-charge” yourself.

    With vision loss: Everything listed above is good for good eye health. A good diet of brightly colored fruits and vegetables and exercise are very important. Being tired can affect how well you see, and stress has been known to have an adverse effect on a person’s vision.

Because of the busy holiday season, this month we will only be publishing once a week, on Tuesdays.

12/8/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Low Vision Aging Adults at Higher Risk for Falls

Low vision in aging adults varies as do the occupational therapy techniques that might help older adults in becoming more independent. Mr. P has glaucoma resulting in a narrowed field of view. He is light sensitive, and keeps his blinds closed, darkening the house. He is responsible for doing his laundry, yet his washer and dryer are in the basement, causing a safety concern. Mrs. K has macular degeneration with 20/400 visual acuity. She has severely reduced contrast sensitivity, and can no longer drive or recognize faces easily. She no longer gets to the senior center for regular exercise sessions, which is concerning to her and her OT. Ms. T was diagnosed with diabetic retinopathy. She has struggled for years to accurately see her glucometer and insulin. She has recently developed peripheral neuropathy, leading to wheelchair dependency. Each of these patients is likely to leave their home less often because of their low vision, eventually leading to a decline in lower extremity weakness, balance, endurance and confidence. The fear of falling leads to more isolation, which can cause even more lower extremity weakness, problems with balance, decreased endurance, and even depression. The irony is that this cycle, which began with caution and a fear of falling, lends itself to exactly that. . .a fall.

Why are low-vision aging adults at higher risk for falls?

According to the CDC, “Each year, millions of older people-those 65 and older-fall. In fact, one out of three older people fall each year, but less than half tell their doctor. Falling once doubles your chances of falling again.” The typical aging adult with low vision faces challenges that others do not. Difficulty seeing details combined with reduced contrast sensitivity leads to a decline in mobility and socialization.
risk for falls
risk for falls
So how do we help older adults with low vision lower their risk for falling? When considering safety within the home, persons with low vision must make it a priority to add lighting & contrast whenever possible. Consider all rooms of the house, including entrances, hallways and stairways.

  • Placement of night lights in hallways, stairway, etc.

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  • Keep flashlights in accessible places throughout the home where night lights are not possible.

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  • Instead of closing blinds, keep them open & wear appropriate colored filters to manage glare/light sensitivity.

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  • Small battery operated stick-on lights or rope lighting is inexpensive, and easy to place on steps to light up a stairwell.

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  • Line edge of steps, or stairway railing with brightly colored duct tape to increase visibility.

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  • Make sure grab bars, tub benches, shower chair are high contrast, to be most visible.

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  • Remove throw rugs, with the exception of those providing function, such as the one at the entrance and bathtub. Their purpose is for providing dry shoes and feet, but they should have a non-skid back and a high contrast color to “stand out.”

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  • Reduce clutter in rooms to increase safety by removing items from floors, walkways and stairwells.

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  • Consider investing in a Medical Alert System to provide added piece of mind, confidence, especially when living alone.

Persons with low vision can decrease their frequency of falls by staying social and walking in the community. Unfortunately, many low vision adults become more house bound when they can no longer drive. Locating sources of alternative transportation may be helpful. Seeing faces is difficult, making socializing a challenge, which can lead to depression. The following recommendations take into consideration the challenges of not seeing details or across the visual field normally, while improving lower body strength, endurance, coordination, confidence, and hopefully reducing the risk of a fall.

  • Encourage regular trips to the grocery stores and the mall to keep physically fit. Malls are safe environments to walk around because of wide, straight hallways. Use magnifiers to see price tag/label details, or take advantage of personal shoppers who assist with locating items.

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  • Participate in regularly scheduled exercise sessions (videos, groups, etc). Sit/stand in the front row, ask instructor to provide clear verbal instruction, instead of only demonstration. Consider hiring a personal trainer in order to get 1:1 instructions for how to use exercise equipment. If watching a video, move closer to your largest TV screen. Home exercise equipment can be labeled with high contrast markings to increase visibility of its details.

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  • Consider joining a senior center in the community. Some have low vision support groups.

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  • Access driving alternatives, such as the Smart Bus, Senior Centers, Local Volunteer or Church groups. Consider using money previously spent for a car and its expenses to hire a private driver.

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  • Use appropriate colored filters in bright outside conditions or darker inside environments (i.e. Amber outside in the sun; Yellow inside a dark restaurant or outside with overcast weather).

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  • Consider using a walker or support cane when walking longer distances in the community or neighborhood. Many individuals decline using an assistive device, not realizing how active and fit it can make them. Rolling walkers are even available with seats, allowing for rest breaks wherever necessary.

While the fear of falling is great amongst all seniors, those with low vision need to consider adding strategies that specifically benefit them. Making changes within the home may be as simple as improving lighting and contrast. Remaining physically fit outside of the home may be done with shopping or exercise equipment, but either way staying active will improve confidence, the fear of falling, and hopefully decrease the chance of a fall. If you are unsure of what approach is best for you, consult with your ophthalmologist about scheduling a low vision eye exam and occupational therapy.

Reference:
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control-CDC 24/7: Saving Lives, Protecting People

12/3/15

Annette Babinski's headshot thumbnailAnnette M. Babinski, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center
 
 
 
 
 

Michelle Buck's headshot thumbnailMichelle Buck, MS, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center

Business Opportunity for Blind Adults

Food for Thought – Business Opportunity for Blind Adults

For those not in the know, the acronym sounds like a popular sandwich. However, for Louisville, KY resident, George Bouquet, The Hadley School for the Blind’s and the National Association of Blind Merchants’ joint“BEPLT” program (Business Enterprise Program Licensee Training) is more like a dream come true.

George Bouquet - Business Opportunity for Blind
George Bouquet

Hadley is the largest provider of distance education for people who are blind and visually impaired worldwide and the BEPLT program is part of the school’s Forsythe Center for Employment (FCE) and Entrepreneurship. Under the Randolph-Sheppard Act, legally blind adults are given first right of refusal on operating state and federal government vending facilities including cafeterias, snack bars, convenience stores, micro markets, and vending machines and rest stop vending areas nationwide. In February 2014, Hadley’s FCE partnered with the National Association of Blind Merchants (NABM) and the National Federation of the Blind Entrepreneurs’ Initiative (NFBEI) to bring the academic portion of training to would-be blind vendors. Individual state Business Enterprise Programs provide the hands-on component of the blind vendor training. Bouquet is Hadley’s first graduate from the school’s new BEPLT program.

Born with both Pierre Robin Syndrome, which often results in a smaller-than-normal lower jaw, a cleft palate, a tongue that falls back in the throat, and difficulty breathing, as well as Stickler Syndrome, which causes hearing loss, eye abnormalities and joint problems, Bouquet has struggled with health issues throughout his 54 years. Although he was born without eye lenses, he was not born blind. Rather, his vision worsened over time. Bouquet worked in several food service positions since high school and had wanted to become a Randolph-Sheppard vendor even before he would have qualified as legally blind!

There are only so many blind vendor licensee training slots available and many more people compete for them than such programs can accommodate. The first time Bouquet applied to receive the training was in February 2014. Unfortunately, he was not accepted into a program. However, he was fortunate to gain some blind vendor experience by working under friends who already held the license. In early 2015, Bouquet’s counselor told him of another opportunity to apply for vendor training. This time he was accepted and Bouquet began Hadley’s BEPLT program in April 2015. Bouquet was so motivated to graduate from the program that he completed approximately two modules (one-lesson online courses) per week. Hadley’s BEPLT students complete a 10-module program and then take their state’s physical training component. After passing both elements, graduates are eligible to bid for the opportunity to become a blind vendor in their community.
George Bouquet - Business Opportunity for Blind
“The [Hadley BEPLT] program offers a lot of useful information. It will really help anyone wanting to undertake vending,” he said. Bouquet then acknowledged that the material about food borne illnesses helped him to realize the tremendous responsibility he would be accepting by running a government food service area. “As a manager, you need to decide what you are willing to delegate to other people,” he added.

For Bouquet, becoming a blind vendor allows him to hire and train his 25 year-old unemployed son, who inherited most of his visual and hearing problems. This training is Bouquet’s first step toward creating a legacy of financial independence.

10/13/15

Sheryl BassSheryl Bass, MA, MSW
The Hadley School for the Blind

Vision Loss and Depression

On Tuesday, September 29, 2015, the National Eye Institute (NEI) hosted a Twitter chat on vision loss and depression. Here are some highlights of that discussion, along with some great resources to learn more about dealing with vision loss and depression.
vision loss and depression

  • Many studies show that people with vision loss or low vision are at risk for depression, although not everyone with vision loss gets depressed.

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  • A person with low vision is defined as someone who finds it difficult to do daily tasks even with regular glasses, contacts, medications or surgery.

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  • The number of Americans with low vision will increase over 70% by 2030. Broken down by ethnicity, African Americans with low vision will increase 93% and Hispanics with low vision will increase 190% during the same period. This is due to the rapidly aging Boomer population. 88% of Americans with low vision are age 65 and older.

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  • Symptoms of depression include persistent feelings of sadness, anxiety, irritability and fatigue. It is a common and serious illness that interferes with daily life. Each year, about 6.7% of American adults experience major depressive disorder. Women and men experience depression differently, with women 70% more likely to experience depression than men.

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  • People 65 and older are at particular risk for developing serious depression related to vision loss and yet it is often underdiagnosed and undertreated. Older adults may have other, less obvious symptoms of depression or they may not be willing to talk about their feelings. Many overlooked because sadness is not their main symptom. It is important to remember that while depression is a common problem among older adults, it is not a normal part of aging.

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  • An estimated 29-58% of those who suffer significant vision loss have major depressive disorder one year later. People with vision loss are 2x more likely to be depressed than someone without vision loss. Depression can be very disabling and may reduce the effectiveness of low vision rehabilitation interventions.

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  • A recent study confirmed age-related macular degeneration (AMD) is a big contributor to depression risk, as it accounts for about 45% of low vision cases.

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  • Older adults w/ vision loss are also 3X more likely to report difficulty in 1) walking, 2) managing medications, and 3) preparing meals. In fact about 39% of people with severe vision loss experience activities of daily living ADL limitations, compared to 7% of those with better vision. ADLs include eating, bathing, dressing, toileting, walking and continence.

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  • A link between depression and vision loss was also found in people as young as 20 according to a recent study. It looked at over 10,000 adults in the US and found they were approximately 2x more likely to be depressed.

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  • A decline in vision can also be associated with lower emotional, physical, and social functioning. To help those with low vision avoid depression it is important that they remain active and engaged in the world around them. And while people may become depressed because of vision loss, other causes of depression may also be present.

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  • An integrated approach to depression management in older adults with impaired vision may be the best course of action. Behavioral activation helps people recognize that loss of the activities they enjoyed that have led to depression and encourages them to find ways to re-engage with these activities. After 4 months, behavioral activation reduced the risk of depression by 50% compared to the control group. Behavioral activation can be used alone, or as part of psychotherapy called cognitive-behavioral therapy (CBT).

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  • Cognitive behavioral therapy (CBT) helps people with depression restructure negative thought patterns and to correct distorted thinking that is often part of depression. But it is important to remember that the best approach to treating depression is to personalize it for each individual.

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  • Often, the combination of pharmacotherapy and psychotherapy is a very effective option for depression treatment. Other time-limited psychotherapies, including interpersonal therapy (IPT) are effective in treating depression in people of all ages.

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  • Collaboration between eye care and mental health professionals can help people with vision loss improve their quality of life.

Resources
Understanding depression

How to live with low vision

Living with Low vision – How you can help webinar

Update on depression and AMD

Association of vison loss and depression in those over 20

Sadness impairs color perception

Rehab helps prevent depression from age-related vision loss

10/6/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Listen Up: Free Low-Vision Audio Recordings

Three million people in the U.S. age 40 and older have low vision. According to 2010 research by the National Eye Institute, the number of Americans with low vision will continue to grow dramatically, from 2.9 million in 2010, to 5 million in 2030, to 8.9 million in 2050, as our population ages. In response, The Hadley School for the Blind, the largest provider of distance education for people who are blind or visually impaired worldwide, has launched a series of 10 free audio recordings designed to help those living with low vision maintain their independence. Available through the new Low Vision Focus @ Hadley program the recordings share practical ways to address daily living skills made difficult by vision loss.

Low-Vision Audio Recordings

The recordings are available on CD, NLS (National Library Service) cartridge and as free mp3 audio downloads from the Low Vision Focus @ Hadley (LVF) website at www.lowvisionfocus.org. Individuals are required to register online to receive access to the free audio recordings or they should call 1-855-830-5355 for the CDs or NLS cartridges. low vision audio recordingsEach recording is approximately 30 minutes long and covers a different aspect of living independently with low vision. This series helps people move forward using step-by-step tips and techniques, along with information and resources to help maximize the vision they have.

Following are the 10 audio lesson topics and a sample tip from each:

  1. Making the Kitchen User Friendly
    It’s a good idea to have two different cutting boards – a light colored one and another that’s darker. This will allow you to choose a background color that contrasts with the color of the food you’re working with. So, slice white onion or mozzarella cheese on the dark surface, and carrots or green peppers on the light colored board.
  2. Low Vision Cooking
    When putting a pan on a burner, make it a habit to move the panhandle over the counter. It’s also a good idea to point it in a consistent direction.
  3. Doing Simple Kitchen Tasks
    When you’re cooking with spices, don’t add spices by shaking them over the mixed ingredients, because once you add too much, they can’t be removed. Instead, shake spices into your palm and pinch the amount that you want. You can always add more.
  4. Basic Tactile Marking
    When marking a microwave keypad with tactile dots, put one dot on each number – but add an extra dot on the number five. Since the five button is in the middle, the double dot will let you identify it, so you can use it to figure out where the other numbers are around it.
  5. Simple Home Modifications
    The direction that the light is coming from is just as important as the source. A lamp with a gooseneck or an adjustable swing arm will help you to position it right where you need the light. Remember, whatever you use, make sure it’s completely shaded, so no light is directed in your eyes making it difficult to see the object.
  6. Getting Around the House
    Every place in your home where sound can be heard is a great landmark for the room. Constant sounds like a ticking clock are a great way to tell where you are. Other less dependable sounds like the traffic on the street can tell you where the windows are, your neighbor’s television can let you know where the living room is, and the intermittent motor hum of your refrigerator can always point you towards your kitchen.
  7. Looking Your Best
    To mark your shampoo and conditioner, think about it this way: when you’re washing your hair, you use the shampoo first, and the conditioner second. To mark them, just put one rubber band around the shampoo, and then two rubber bands around the conditioner. It’s a simple concept – the container used first gets one mark, and the second gets two.
  8. Keeping Prescriptions in Order
    Open your pill bottles over a tray or baking sheet lined with dark colored felt. If you drop a pill, it won’t bounce on the floor and it will be easier to see.
  9. Going Out for a Meal
    When reaching for glassware, approach the glass from above, bringing your hand down to the rim, and then to the bottom to pick it up. Putting it down in a consistent place on the table will help you find it more easily.
  10. Going Out with a Friend
    A sighted guide is someone who has enough vision to help you get from one place to another safely. You will hold onto their upper arm with your hand so both of you maintain physical contact as you walk. When you’re approaching obstacles or changes in your path like doorways, stairs, or sidewalk curbs, it’s the sighted guide’s job to give you verbal and physical information to keep you aware of the surroundings.

While the LVF is geared toward older adults, the program is open to any individual who is experiencing sight loss or caring for someone who may be losing his or her vision. Adult children of seniors living with low vision are encouraged to take advantage of the online resources to assist their parents. Caregivers and professionals, especially those working with low vision support groups in local communities, are also encouraged to utilize the resources available through the LVF website.

In addition to downloadable recordings, the Web site offers links to free low vision webinars, Hadley distance education courses that are relevant to those with low vision, tips and resource lists. In the future, Hadley will provide free, “quick tip” videos through the Web site that complement the audio recordings as well as new monthly webinars.

“We are so excited to offer Low Vision Focus @ Hadley and enable this growing population to retain their independence and live with confidence,” says VP of Education and Training and head of Low Vision Focus @ Hadley, Doug Anzlovar.

For more information or questions, call 855-830-5355 or email lowvisionfocus@hadley.edu.

9/22/15


Sheryl BassSheryl Bass, MA, MSW
The Hadley School for the Blind

Vision Rehabilitation Services

The term “vision rehabilitation” covers a wide range of services that can help you learn how to remain active with vision loss while maintaining your independence and quality of life.
sorting meds - vision rehabilitation

Vision Rehabilitation Services

The following are different vision rehabilitation services you can access in addition to the information and help you will receive from your ophthalmologist or optometrist.

  • Communication skills: These help you with reading, writing and assistive computer technology. In some cases you may even want to learn braille.
  • Counseling: This can be beneficial, not only to you, but and family and/or friends that want to better understand or help you with your vision loss.
  • Independent living skills: These skills can be a simple as learning how to cook safely, take care of your personal appearance, manage your finances, keep exercising, or enjoy hobbies. The people that come to your home to help you keep your independent may also suggest home modifications to make life easier and help ensure your safety.
  • Independent movement and travel skills: These skills are important not only to help with your independence, but also to keep you from isolating yourself. Isolation is a common problem with vision loss as you may not want people to know you are losing your vision, or you are afraid of falling or embarrassing yourself. However, isolation can lead to depression.
  • Low vision evaluations and training: There are a variety of hand-held and desktop magnifiers, special reading glasses, lighting sources and other devices that help you make the most of your remaining vision.
  • Vocational rehabilitation: Loss of vision does not necessarily mean you can no longer work. Vocational evaluation and training, along with job modification and restructuring, can keep you enjoying the work you have enjoyed and depend on.


laptop help - vision rehabilitation

Vision Rehabilitation Service Providers

When looking for vision rehabilitation services, what should you know? You are best looking for a specially trained person including low vision therapists, vision rehabilitation therapists, and orientation and mobility specialists. They each have completed a standardized certification process that will let them help guide you as you work toward your vision goals.

  • Certified Low Vision Therapists (CLVTs): These therapists work with you to use your remaining vision with various devices and assistive technology. They also help you determine what modification you might need at home or work to remain independent and safe.
  • Certified Vision Rehabilitation Therapists (CVRTs): These therapists teach special adaptive skills that will allow you to confidently carry out a range of daily activities.
  • Certified Orientation and Mobility Specialists (COMS or O&Ms): These specialists teach skills that help you navigate safely and confidently when you are home, in the community or traveling far from home. This can include the use of a cane, GPS devices or public transportation. They also include guide dog instructors, but this training is more intense and takes place at a guide dog facility for several days.

To remain active and independent may require learning new skills, but it is important to find the right person to help you learn those skills. By finding the best person to suit your needs, the process can be a fun and positive experience.

9/17/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Using Andragogy to Help People with AMD

Adults and children do not learn in the same way. The concept of “andragogy” was widely introduced to the world of educational theory by Malcolm Knowles, PhD, in the latter part of the 20th century. He contrasted “pedagogy,” which is generally used to describe the method or practice of teaching — and comes from the Greek for “child learning” — with the practice of “andragogy,” which applies specifically to adult learning. While Knowles did not invent the term, he advanced the argument that andragogy should be very different from pedagogy.
Andragogy to Help People with AMD
Maureen Duffy, CVRT, LVT, an editor for Journal of Visual Impairment & Blindness, a writer and blog editor for VisionAware, and author of Making Life More Livable: Simple Adaptations for Living at Home After Vision Loss, relies heavily on andragogy in her work with vision-impaired adults. Loved ones — especially adult children of older people — have a tendency to push care and “help” on grown-ups as if they were children, she says. Not surprisingly, this method seldom works.

Using Andragogy to Help People with AMD

From her work as a certified vision-rehabilitation therapist (CVRT) and low-vision therapist (LVT), Duffy calls out three concepts of andragogy to keep in mind when trying to help an adult who is coping with vision loss:

1. Adults have life experience.
Children don’t have a lot of life experience. And while adults have an incredible amount of life experience, we don’t always treat them as if they do. They already know how to problem-solve. If they have been cooking for their entire lives, they don’t need to learn to learn how to cook all over again; they just need to make adaptations.

“We treat adults as if they have to forget everything they’ve learned, and try to teach them something new,” Duffy says. “That doesn’t usually work. I say, ‘Show me how you’ve always done this. There’s probably just a little adaptation you need to make, and you can keep doing things the way you’ve always done them.’ You can’t just go in, and tell someone you’re going to change everything they do. Just figure out an adaptation.”

2. Adults are reactive learners.
Children are ready to learn when they are told they are ready to learn: We send them to school, and they know it’s time to learn. Adults are ready to learn when they decide they need to know or do something to improve their daily lives — not before. You cannot make an adult learn until they are ready to learn. That’s a big difference.

“Adults tend not to say, ‘I’m going to learn this now because I might need it later.’ They say, ‘I have this problem right now; I need to learn this thing right now,’” Duffy says. “It’s common for family members to tell a person with macular degeneration, ‘You need to learn braille in preparation for when you go blind in the future.’ That’s not true. They can read larger and larger print for as long as they are able to do so. It creates additional anxiety to tell an adult they have to start now to prepare for when they can’t see. You can’t prepare for that. It’s a process, and you make changes as you go.”

Andragogy to Help People with AMD
3. Adults are self-directed.
Adults want to be independent and determine, for themselves, what it is they need to learn. And that won’t necessarily match what family members think or want.

“Adults will decide what they want to learn, usually based on a hierarchy of needs and what they really need to know now,” Duffy says. “That hierarchy starts with survival needs: making food, getting food, reading medications, etc. And the only way to know what an adult wants and needs to learn is to ask them.”

At the heart of andragogy, it seems, is respect for the fact that an adult is an adult — and should be treated as such. “Andragogy is more focused on teaching problem-solving skills, which can be used over and over again by the adult in a variety of situations,” Duffy says.

Another difference between the way children and adults learn is the need for adults to maintain a sense of autonomy, points out Judi Delgado, director of the Macular Degeneration Partnership (MDP). “People with AMD may need to adjust the way they do some things, but they can still do them,” she says. “It doesn’t help them if others try to take over or do things for them. It’s important to understand that the person is already losing so much; if loved ones try to take over their lives, it just adds to the loss of independence.”

9/10/15

 

Maureen Duffy, CVRTMaureen A. Duffy, CVRT, LVT
Social Media Specialist, visionaware.org
Associate Editor, Journal of Visual Impairment & Blindness
Adjunct Faculty, Salus University/College of Education and Rehabilitation

3 Tips for Caregivers Helping People With Low Vision

Receiving a diagnosis of age-related macular degeneration (AMD), diabetic retinopathy or glaucoma can be a shock. Loved ones naturally want to help, but they don’t always know what to do or how to do it. Here are 3 tips for caregivers helping people with low vision.

We asked vision-rehabilitation expert Maureen Duffy, CVRT, for advice. She suggests turning to local low-vision agencies, trained low-vision professionals and online resources, such as the Macular Degeneration Partnership and the VisionAware services guide. Perhaps most importantly, she says, look for a support group.
3 tips for caregivers
“I have found that most adults with whom I’ve worked turn to their peers, and they get the most guidance and help in vision-loss support groups,” says Duffy, an editor for Journal of Visual Impairment & Blindness, a writer and blog editor for VisionAware, and author of Making Life More Livable: Simple Adaptations for Living at Home After Vision Loss.

Duffy shared the three most important things to ask a loved one after they find out they have AMD:

1. What do you understand about what the doctor said and about what’s going on with your vision? What don’t you understand? What do we need to clear up?
If they don’t understand completely, ask if you can go to doctor with them to be a note-taker and information-gatherer. Ask the doctor for explanations. Be clear and concrete about the information you need — and ask the doctor for next steps.

The Macular Degeneration Partnership website has a downloadable list of questions to take along, as well as suggestions on how to be an advocate during a visit to the doctor on its “Be an Advocate” page.

2. What is the one thing you are most afraid of RIGHT NOW?
At first, their biggest fear is of going totally blind: “I won’t be able to do anything; I’ll be all alone; I’ll be totally helpless.” With AMD, they won’t go totally blind, and they can learn to make the most of their peripheral vision. There are services that can help, but it’s tough in the beginning: Go slowly.

Vision-rehabilitation services can help teach them to function safely and independently in critical day-today activities, such as:

• Independent movement and travel:

  • getting around indoors
  • walking with a guide
  • using a long white cane
  • crossing streets
  • using public transportation
  • using electronic travel devices

• Independent living and personal management:

  • preparing meals
  • managing money
  • labeling medications
  • making home repairs
  • enjoying crafts and hobbies
  • shopping

• Communication and technology:

  • telling time with an adapted clock or watch
  • signing their name
  • using tablets and smartphones
  • using computers with speech or screen magnification
  • learning braille

3. What is the ONE thing you are most afraid you can’t do?
Don’t start talking about everything that may need to go on; it’s just too much and is overwhelming. Start with the one thing. “I can’t aim for the toilet”; “I can’t keep food on the fork”; “I can’t make my coffee in the morning.” Help them find solutions for simple things. Figure out alternatives. That little bit of accomplishment encourages self-analysis.

“Many people have difficulty telling currency bills apart,” Duffy says. She shares a simple, effective way to do this by folding each bill differently:

  • Keep the $1 bill flat and unfolded.
  • Fold the $5 bill in half crosswise (with the short ends together).
  • Fold the $10 bill in half lengthwise (with the long sides together).
  • Fold the $20 bill like a $10 bill lengthwise, and then in half again crosswise, like the $5 bill.

It’s important to remember that no matter how much you may want to help, your loved one may not be ready to accept assistance. Pushing too much too soon isn’t helpful. Once you ascertain that your loved one is ready to be receptive, offer your help gently, slowly and with empathy.

9/8/15


Maureen Duffy, CVRTMaureen A. Duffy, CVRT
Social Media Specialist, visionaware.org
Associate Editor, Journal of Visual Impairment & Blindness
Adjunct Faculty, Salus University/College of Education and Rehabilitation

Print and Web Design for Older Adults

How to Design for Older Adults

Reading the small print can be very challenging as you age. Your eyes lose their elasticity due to a hardening of the lens inside your eye. This condition is called presbyopia and begins to affect many people after the age of 40, continuing to advance as you age. Readers glasses or a single prescription is no longer the best solution. You may find that you need one pair of eyeglasses for reading a book that you hold in your lap, while a different strength may be needed to use a computer at your desk, because it is further away. But it is not just the font size that can affect how easily you can read. Font shape, spacing and color all contribute to readability. Here are some helpful hints if you are producing printed materials for people over 40.
design for older adults
Print Size
Ideal size will vary depending on the font you choose as not all fonts are the same size. A 14 point type size in New Times Roman is smaller than a 14 point Verdana font. Therefore smaller fonts should not be less than 14 points and you may find they are easier to read at 16 points.

Font Type
Decorative fonts are difficult to read and should be used sparingly. For the body of text stick to a regular font that is bolder, with thick lines that are more legible.

Some people prefer a serif font, such as Times New Roman, as they say it is easier to read because of the “tails” at the end of the letters that create an illusionary line, helping to guide the eye along the line. However, others prefer a sans serif font, such as Ariel. It can be easier to read because of the simplicity of the lines. It is a personal choice.

Regardless of the font you select, use both upper and lower case letters in your body text. All capitals letters can be difficult to read. Save them for headlines or to emphasize a word or two.

Avoid using italicized text as the letters appear squeezed together, increasing the reading difficulty.

Presentation Style
Allow for white space as it provides natural places for the eyes to relax and can help you focus on what you are reading.

Align text to the left, as it is easier to read. And don’t wrap text around graphics.

Keep normal spacing between letters, neither expanding nor condensing them which make it more difficult to read the words. Space lines of text at 1.5 instead of single space, to make the lines of text much easier to follow.

Contrast & Color
As you get older, yellow, blue and green become increasing difficult to differentiate from each other if they are used in close proximity to each other, especially if you have cataracts. Yellow can almost disappear.

To make it easier for reading, stick with very dark type on a white background. Avoid patterned backgrounds.

Avoid using very glossy paper as it creates glare that can make reading hard. Also make sure your paper is thick enough so print form the other side of the page cannot be seen.
design for older adults
Websites & Blogs
Most of the rules listed above for printed materials also apply to websites and blogs (expect the glossy paper rule). But here are a few additional suggestions for online communications.

Use design templates that are one column (or one and a sidebar) to make it easier read. This is especially true for viewing on mobile devices, even if your web design is mobile responsive.

Allow enough space around clickable items, such as word links and buttons, so they are easy to target and click separately. Make sure the linked text is clearly defined with a color that is easy to differentiate for the surrounding text. Bright royal blue is the most common color used.

Provide a space between paragraphs.

Online a sans serif font is much easier to read, but keep the size at 12 -14 points. Ariel is common font, but Tahoma and Verdana are often used and were specifically designed for online usage. Verdana is a naturally large font, so a 12 point can work well.

Offer a feature where you can easily change the size of the font directly from the screen. An example is the Discovery Eye Foundation site where the control is located at the top right of the page. You can even offer on-screen contrast settings like on the Macular Degeneration Partnership page, at the top center of the page.

Avoid layering shades of the same color, such as dark blue type on a light blue background. Also avoid layering colors that clash such as red type in a purple block. These make reading the text more difficult.

These are just a few of the ways to make text easier to read, both in print and online. Do you have any other tips to share below in the comments?

7/28/15


Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation