By Larry Johnson
The U.S. population continues to age, and the prevalence of visual impairment also continues to increase. America faces a growing number of older adults for whom visual impairment presents daily challenges to their ability to live independently. Approximately 5 million Americans over the age of 65 are classified as legally blind, and this number is expected to increase by 60 percent over the next 15 years.
There is shockingly a woeful lack of funding and specialized services available for older adults experiencing vision loss, and the preponderance of existing programs and services for people with visual impairments are focused on employment, not on the broader needs of older Americans with vision loss, who are trying to navigate the community and seek social engagement and independent living outside of employment-related settings.
Many state agencies can admit that there are serious gaps in education and training related to vision loss for service providers and agencies across the aging network. These include a lack of information about access points for available supports and services for older Americans experiencing vision loss.
According to the AARP, nearly 90% of older adults say that they want to age in place. However, for those with vision loss there are often major obstacles that make this extremely difficult.
There is much that the federal government, and the U.S. Department on Aging, in particular, could do to ensure that older Americans who experience vision loss would be able to age in place and age with dignity.
There are two key focus areas to be spotlighted: Public Awareness and Education Outreach and Upskill Training of Area Agencies on Aging Staff.
Public Awareness and Education Outreach
The Department on Aging, through the states’ Departments of Health and Human Services, provides a wide range of services for older Americans, including all types of health and human services, such as health care, home care, personal care and long-term care to help ensure their well-being, dignity and independent living choices. Programs also are in place to support family caregivers. Experienced state agencies staff and paid contractors help eligible older Americans access services that:
- Create opportunities to live independently in their own homes.
- Provide information about state and federal benefits and legal rights.
- Give family caregivers the tools to do their job.
- Provide access to meals at home or in group settings.
- Identify assisted living facility care, daytime programs or nursing home services that they may qualify for.
- Advocate for people who live in assisted living facilities or nursing homes.
- Guide people to the right long-term care services.
Lamentably, many of these programs and services such as those provided by local area agencies on aging, in-home care and the Aging and Disability Resource Centers are not well known, especially among older Americans who may be experiencing vision loss or their families. This represents a major challenge in the provision of services to this population if individuals do not know where to go or what resources are available in their community.
What is needed is a broad-based, multipronged awareness campaigns aimed at:
- older adults with visual impairment and their families;
- healthcare providers across the continuum, in-home, and facility-based;
- aging network partners (AAA, ADRC and their community partners); and
- the broader community of stakeholders or “gatekeepers,” such as first responders (EMS) and faith-based communities.
Likewise, state agencies, supported by the federal Department on Aging, should conduct public awareness and education outreach campaigns designed to provide information relating to the programs and resources available to aging adults who are blind or visually impaired in their state. The campaigns must be:
(1) tailored to targeted populations, including:
(A) aging adults with or at risk of blindness or visual impairment and
the families and caregivers of those adults;
(B) health care providers, including home and community-based
services providers, health care facilities, and emergency medical services providers;
(C) community and faith-based organizations; and
(D) the general public; and
(2) disseminated through methods appropriate for each targeted population.
Often, designated websites or information portals are minimally effective, because they are not easily accessible or commonly used by persons with vision loss or their family members.
Upskill Disability Sensitivity and Awareness Training
Clearly there are gaps in education and training related to vision loss for service providers and agencies across the aging network. These include a lack of knowledge and training about appropriate interaction and understanding of individuals experiencing vision loss.
There is a need for training and education across service provider and professional association networks within existing structures for regular education and training. A tiered approach – scalable from base knowledge to task-specific, such as orientation and mobility, independent living skills and politically correct language. The goal should be to help reduce the tendency toward paternalism when helping older Americans with vision loss. One possible approach might be an online training curriculum focused on basic awareness and sensitivity of vision loss targeted to home health care providers, nursing home and assisted living staff and ombudsmen with the AAA’s and ADRC’s.
Such training should include describing the fear, vulnerability, a sense of loss of control, the loss of confidence, the need to learn new ways to live life, and family dynamics, as life changes with loss of vision.
Whatever policies or initiatives instituted by the Department on Aging or the Administration on Community Living should align with these two focus areas outlined above: Public Awareness and Education Outreach and Upskilling Training of area agency staff. The end goal should result in more older Americans who experience vision loss being able to remain in their own homes, if they so choose, and live their golden years with dignity and independence.