Techniques for Completing Activities of Daily Living for Persons with Low Vision or Blindness
Often, eye care and other healthcare professionals address activities of daily living (ADLs) for patients with low vision or blind. While most eye care and healthcare providers can identify ADLs, they often do not understand how people with low vision or blindness complete tasks. This article discusses common categories of ADLs for those with low vision or blindness and techniques for accomplishing them.
To complete ADLs, people with low vision or blindness use numerous strategies. These vary based on an individual’s level of functional vision, independent living skills, and personal preferences. Often, people with low vision or blindness use visual and non-visual methods to complete tasks. These methods may also vary as environmental factors change, and as people’s visual acuity fluctuates.
Organization and Labeling
The most effective and efficient efforts for people with low vision or blindness are to develop a system of organization and labeling. These are important in personal and professional environments and they provide consistency among methods people use when accessing items in specific settings. This is important for efficiency, health, and safety. Using various methods or combinations of methods, labeling methods can be effective. Large print labels, which may also include high-contrast colors can be very helpful. Electronic labels and QR codes enable people to access information with a mobile device. Audio labels can be placed discretely on many home or work items, and then read aloud via a small portable device. Braille labeling may be more appropriate for some people.
Medication Management
Medication management is an important safety consideration for people with low vision or blindness. They must have organization and labeling systems. For example, several methods can be used to manage medications. Talking prescription labels are particularly helpful, because they read aloud prescription details, medication information, and instructions. Large print or braille labels are low-tech options. Pill organizers with braille are also available, and many pill organizers can be easily labeled by other means. Magnifiers may also be beneficial.
Personal Management
Personal management refers to personal hygiene, grooming, clothing care and management, time-telling, money identification, and other personal tasks. Using adaptations and modifications, people can complete these tasks. Typical modifications or techniques that enable personal management include labeling personal hygiene items, using washable labels or other physical labels, and organizing clothing. Tactile or high contrast appliance labeling also helps. Talking, large print, or braille watches and clocks enable people to correctly identify and manage time. Currency readers help to identify U.S. currency denominations. The Bureau of Engraving and Printing provides currency readers, free of charge, to all eligible blind and visually impaired U.S. citizens and national residents.
Reading Tasks
Reading is often among the most challenging and necessary training areas for people with low vision or blindness. Access to printed information enables people with low vision or blindness to regain independence and remain informed. Techniques vary according to each individual’s functional vision, personal preference, access to technology, and environmental considerations (e.g. lighting, glare). Regaining or maintaining access to other print materials addresses people’s personal, social, and employment needs. People can use magnifiers (e.g., portable, handheld, and head borne) and video magnifiers (stationary, desktop, and portable), that allow for changes in print materials’ size, color and contrast. Some of these device models may enable distance viewing. Handheld or head borne telescopes can enhance distance viewing. Proper task lighting can provide adequate but controllable lighting. Reading glasses and other specialized lenses (such as bioptic telescopic lenses) may be appropriate, while large print or braille reading materials may also be helpful.
Computer and Technology Use
Assistive technology (AT) includes computers or mobile devices people use for reading and completing related tasks. AT offers numerous opportunities and enables people to complete activities of daily living. A screen reader reads text aloud; screen magnification or screen readers (or combinations of both) electronically access information. A screen reader allows information that is text based to be read or created using speech output. Screen magnification enlarges text and illustrations. Magnification software can change font colors, background and foreground colors and schemes, increase pointer size, and help users to be more efficient and effective with computers and mobile technology. This includes all typical productivity software, internet use, and mobile applications that assist in activities of daily living and employment considerations. Commonly used assistive technology includes screen readers, screen magnifiers for desktop and mobile devices, video magnifiers with optical character recognition, devices that scan and read printed materials, and refreshable braille displays used to access electronic documents.
Navigation and Travel
Navigating independently, safely and knowing one’s location in space, is known as orientation and mobility. Proper orientation and mobility training is vital. It teaches people to use visual and non-visual techniques, and to use their other senses. This often includes the use of a white cane, support cane, and may include a dog guide. Independent travel may include other devices and techniques. Large print or braille compasses, or electronic compasses (on mobile devices) can help with orientation. Large print or braille maps can help in navigation. Bone conduction headphones enable people to hear audio output on mobile devices, while not disrupting the ability to hear environmental sounds. Mobile GPS applications help travelers to navigate and orient themselves. Transit applications provide access to maps and schedules.
The ability to complete activities of daily living and live independently depend on each individual’s personal preferences, proper training, functional vision, skill development, and access to proper equipment and software. The skills and techniques discussed here are only a few of the methods used by people with low vision or blindness. When referring ADLs for independent living and employment, it is important that eye care and other healthcare providers understand the methods and techniques people with low vision or blindness can use to accomplish activities of daily living.
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