Low Vision Intervention: Decision Making for Acquiring and Integrating Assistive Technology

Abstract

Occupational-therapy intervention can enable strong, independent decision making primarily related to assistive device acquisition and use for clients with low vision. In developed nations, occupational therapists (OTs) provide interventions for older adults with acquired vision impairments more frequently than for any other population. Therefore, the information here will be applicable mostly to that age group. This chapter explores two main topics: (1) the decision-making process involved in acquiring and integrating low-vision assistive technology for clients with low vision and (2) the types of assistive technologies available to clients with low vision.

The occupational therapist and optometrist were very helpful and introduced me to a lot of technology. The OT had a pretty good grasp of the technology and was fairly abreast of what was available. I take my hat off to her.Client

Appendices

Case Study of Darius: Use of Assistive Devices to Overcome Low-Vision Impairment

Keywords

Assistive technology, Macular degeneration, Vision impairment

Introduction

The theme of this case study is use of assistive technology with a client with vision impairment from macular degeneration .

The student’s tasks include:

• Reviewing the wide range of options available for magnification, lighting, home adaptation, and computer app technologies for use by the client.

• Reviewing the challenges of acquiring and learning to use assistive technologies for people with low vision.

Overview of the Content

Major Goals of the Intervention

The goal of the intervention for Darius is to assist him to find and use assistive technology that allows him to function independently in his home and remain active in his community.

Learning Objectives

By the end of this chapter, student will be able to:

• 1. Identify likely candidates for use of assistive devices,

• 2. Discuss the process of service provision and the variety of low-vision services, and

• 3. Identify the variety of low-vision technologies available to people with low vision.

Background

Personal Information

Darius is a 60-year-old man, formerly employed as an electrical engineer. He lives alone in a three-level townhouse in a suburb of a mid-sized city. About 1.5 years ago, Darius began to experience problems with reading. The lines were wavy and his vision seemed blurred in spots. As his vision deteriorated, Darius began having problems completing projects on time at work. He eventually was dismissed with early retirement from his position. His supervisor assured him that the dismissal was not related to his vision loss, but Darius felt uncertain about it. He also began to have serious problems in his marriage of 8 years which eventually might be ended in divorce. He has no relatives living in the area. He continues to drive in the daytime.

Pertinent Medical History

Darius was diagnosed with macular degeneration , wet type. His vision continued to deteriorate over several months and then, following ophthalmologic treatment, stabilized at 20/180 acuity in the best eye. He has been diagnosed with clinical depression for which he takes medication and sees a psychotherapist once a week.

Occupational Therapy Interventions

Evaluation in Darius’s home by an OT revealed the following :

• Darius loves good food. He likes to prepare meals when at home but also loves dining out. He especially likes trying new restaurants.

• Money management is a challenge for him. He uses a computer software program for online bill paying and account reconciling but still has difficulty reading the computer monitor.

• He plays golf but is dependent on friends to take him to the course. Friends are hesitant to golf with him because he requires several attempts to hit the ball and needs someone to help him find the ball.

• Darius uses a telescopic lens to assist him with driving. He only drives in the daytime and only very short distances.

The Students Report

The following guiding questions have been identified in developing possible solutions to Darius:

• 1. What added information is needed to sufficiently determine Darius’s assistive device needs in the home and community?

• 2. What client-centered goals should the OT develop with Darius to move him toward safe, independent living?

• 3. What assistive technology devices should the OT recommend for Darius?

• 4. What additional therapeutic services might the OT recommend to Darius?