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What happens when a doctor refers a patient to us?

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      By Jonathan Ice
      Independent Living Teacher serving the Cedar Rapids area

      When doctors refer a patient to the Iowa Department for the Blind, what can they expect to get out of it?

      If clients are receptive to having a visit from an independent living teacher – which typically is done in the home at no charge – the following short-term services can be provided:

      1. If it is hard to set appliances visually, we can put raised markings on the controls to restore access and independence
      2. We can instruct them in tactile methods of dialing the phone or direct them to sources of phones with larger buttons
      3. If they have a land-line phone, we can arrange to get directory assistance at no cost
      4. We can offer templates for writing letters, envelopes, checks, or signatures on their own
      5. We can show magnifiers and talking gadgets (such as watches, clocks, scales, calculators, and medical instruments), and if they are interested in purchasing any of these we can order them from our Aids and Devices store, which offers this equipment to Iowans without any retail markup
      6. We offer the services of our Library for the Blind and Physically Handicapped (Braille, large print and talking books)
      7. For access to newspapers, there are two resources to which we have access: NFB Newsline (which gives access to over 300 newspapers and magazines nationwide via a menu system) and radio reading services. In most of Iowa, subscribers to this free service can listen to their newspapers via IRIS radio, but in border areas they may be served better by services in neighboring states, such as APRIS out of Rock Island, IL.
         

      In the longer term, we find if there is any interest in entering or remaining in the active workforce. If so, our vocational rehabilitation program will provide the resources and training to make this possible.

      If a person’s ability to get around safely and independently has been compromised by loss of vision we can provide training in use of the white cane and access to their local public transit options.

      If reading is a problem, we can offer Braille, highly recommended for any who can't read their own handwriting. We also have a loaner pool of equipment, which includes closed circuit TV (CCTV) devices, which magnify print matter by many times allow access to mail and other everyday reading. If they find such devices useful, we can get them in touch with vendors who sell them, or occasionally we will have used equipment which we can donate to clients.

      Computers are an increasingly prevalent aspect of American life, and we can provide training in use of screen-reading software and screen magnifiers that can restore access to computing.

      If cooking or some other aspect of home management has been negatively affected by vision loss, we can provide instruction and tips on how to do these under the new conditions. If people want to work on several skill areas at the same time, and learn them quickly, they can attend our Adult Orientation Center, our full-time residential training facility in Des Moines.

      A not untypical client might be 61-year-old Dorothy, who just has had major loss of vision due to macular degeneration. She acutely misses being able to read, and she can't drive any more. She used to sew a lot, and is considering giving away her sewing machine. She is having a hard time reading recipes, and measuring ingredients has become impossible for her. Her family has banned her from the kitchen, for fear that she might cut herself or set fire to the house. She can't see to dial her telephone or find phone numbers.

      She's getting pretty discouraged because her world seems to be shrinking around her.

      She can see well enough to navigate OK under most circumstances, but she's unsure of herself when she's around steps and curbs.

      She is diabetic, and can't measure her insulin, and it's getting hard for her to read glucometer to monitor her blood sugar levels.

      During my first home visit with Dorothy, after assessing her functional vision, I placed raised markings on her appliances, and she asked to have them put on her microwave, her oven, washer, dryer and thermostat. Now she can set these without having to resort to magnifiers, flashlights, or borrowed eyes.

      We looked at diabetic management, and she likes the Count-a-Dose, which allows her to measure insulin independently. She also gets a talking glucometer, which audibly announces her blood sugar levels, so she has no doubt what they are.

      I signed her up for talking books and IRIS, and now she has restored access to books, magazines, and newspapers. She also signed up for Newsline, which makes it easy to find out TV listings.

      We applied for free directory assistance from Qwest, her local phone service provider. I pointed out the raised mark on the “5” on her phone, which helps her dial numbers by touch.

      She likes the plastic templates for writing checks and her signature, so accepted these items from me. I taught her non-visual ways of threading her needles, and suddenly she's back in business with sewing, as the needle was the big obstacle to her doing this beloved craft.

      When I first offered her a white cane, she rejects the offer because "I'm not that bad yet." Later, when she finds that, in addition to giving tactile information about what's a few steps ahead of her, it also helps communicate to others why she isn't recognizing others or has to ask the questions she's asking, she decides to take a cane, and gets instruction in its use for getting around her neighborhood.

      To give her more control in the area of cooking, we recorded her favorite recipes, and she learned alternative techniques of chopping vegetables, measuring dry and wet ingredients, and telling when meat and baked goods are done. She attended one of our periodic senior orientation weeks in Des Moines, where she met other blind people from around the state and learns more ways of doing things she once did only with sight.

      In Dorothy's case she never decided to enroll full-time at our residential training center in Des Moines, the Orientation Center, nor did she decide to return to the job that she once enjoyed, but she knows that, if she wanted to choose those paths they would be open to her.

      Read a doctor's story about referring a patient to IDB.

      Learn more about living with vision loss and how the IDB can help.