A news item about the NIH award to Maine about their Falls ...



AER Division on Aging Fall 2015 Newsletter Dear Members of Division 15,We hope you will enjoy our Aging Division newsletter. From now on, we will be sending out a newsletter twice a year instead of quarterly and sending shorter Division 15 Mini news more frequently to keep you up to date. We hope you will contribute and help us with disseminating information relevant to issues on aging and vision loss to the field. Division 15 Officers:Pris Rogers, chair Neva Fairchild, chair elect Holly Kaczmarski, secretary/treasurer, serving her second term Alberta Orr, past chair, is serving as Newsletter Editor.From the Chair:As you know, our membership has always been small, and we are mostly a secondary membership for many of our members who are VRT’s or CLV’s. To grow our membership, we suggest that each of us identify one person who is an AER member to join Division 15. In that way we can double our numbers and our strength and reach more people through our information vehicles. So I challenge you to try this. Let us know your results! The Division on Aging provides resources to professionals who are working with or on behalf of older individuals who are experiencing vision loss. We need your input. Division 15 Virtual Water Cooler Discussion Sessions: A Chance to Talk with Other Division Members about Aging IssuesDivision 15 has been hosting water cooler discussions during FY 2015 and inviting members of other Divisions to attend. Starting in January, 2016, due to budget constraints, the notices for the water coolers will go out to Division members only. So please sign up today to become a Div. 15 member and continue to receive our invites and updates. To date we have had 4 water cooler sessions: the White House Conference on Aging and related vision issues, two on cognitive decline and the fourth on falls. See below for summaries.Schedule for Remaining Water Coolers in 2015October 23 at 9 p.m. eastern. “Cognitive Decline” by Colleen O’Donnell, CLVT.November 16 at 10 a.m. eastern. “A Useful Tool for Giving Hope” by Pat Wetmore, COMSDecember 15 at 1:00 p.m. EST topic TBAWater Cooler Summaries:White House Conference on Aging—discussion of issues related to aging and vision loss. See the update on AFB: with Individuals with Cognitive Decline and Vision Loss Water Cooler Discussion Notes—Neva FairchildWe have had two water cooler discussions on cognitive decline. The first was led by Sarita Kimble and was recorded. Here is a link to the recording: second water cooler discussion on cognitive decline, led by Neva Fairchild, brought the following points up for consideration:Dementia often results in visual perception changes. By mid-dementia, usually about the time of diagnosis, the person’s visual field is reduced to about a 12 inch circle of visual perception, whether they have a physical cause of field restriction or not. You can see how this, combined with central vision loss from macular degeneration, is certainly problematic...To simulate the visual perception experience, Use your hands and form binoculars and try to walk around. How has your gait, balance, speed, step length, etc. changed? Combine this with the loss of immediate recall and organized scanning is impossible. They cannot find their glasses even when they are lying on the table nearby. The person who finds their glasses usually points out that they were right there all along.Try sitting at a dining table, put a plate right in front of you and then put on your binoculars again. Look around as if others are at the table with you. You don’t see what is sitting right in front of you, but you see the plate in front of someone else and reach for a bite of their food. This results in a family member or a food service worker admonishing you and you didn’t even realize you had food of your own.An individual with this limited field of perception won’t see people coming at them from the side, so when someone touches their shoulder they are startled. Startle responses cause heightened energy which causes greater confusion and disorientation. A verbal greeting when you are a few feet away, using their name, can avoid frightening the person over a simple request to come to an activity elsewhere.Now, put on binoculars again and look down at your shirt. You can see how not only limited acuity but limited visual perception can result in the fact that they don’t see the food they dripped down their front. Family members and caregivers point out all these errors like they are idiots and really they aren’t seeing well because of visual perception problems as well as vision loss. Understanding these visual perception changes associated with cognitive decline can lessen stress for you as a rehabilitation worker, as well as for family members and other caregivers.Resources where you may learn more are: and Dementia Factsheet and sight loss FAQs Cooler on Falls led by Katherine Clarrage:Katherine discussed the Balancing Act Program, a self-initiated falls prevention program that aims to improve balance and reduce falls was developed for older persons with vision loss. The program, designed at the University of New England College of Osteopathic Medicine Department of Geriatric Medicine, requires only one training session and can then be done at home with no equipment or further instruction. If you are interested in finding out more about the program, you can contact:Marilyn R. Gugliucci, Ph.D., Professor & Director, Geriatrics Education and Research. Office: 207-602-2453; mgugliucci@une.eduA news item about the NIH award to Maine about their Falls Program appears below in the “News from the Field Section”. Discussants at the water cooler also brought up Frat-up, a novel web-based fall-risk assessment tool and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. has a community falls prevention manual: () has exercises in mp3 format with guided directions.A Matter of Balance and Low Vision: has fall prevention videos: a fall prevention plan: News National Conference Related to AgingAER 2015 Conference on Vision Loss in Older Adults and VeteransWe have a wonderful opportunity for our Division to shine at AER’s 2015:?Conference on Vision Loss in Older Adults and Veterans: Leveraging our Collective Wisdom. It will be held November 4-6, 3015 in Norfolk, VA. Here is the website for the conference agenda and other essential details: conference will honor older adults with vision loss and our veterans and service members who have been affected by injury or age-related eye disease resulting in vision loss.??The conference will be a state-of-the art meeting that you won’t want to miss. This conference will be of interest to vision rehabilitation and low vision therapists, occupational therapists, optometrists, ophthalmologists, and others in the vision medical field who work with blinded veterans and older persons with vision loss. The entire program was printed in the October 6, 2015 issue of AER Viewpoint and is available on line at: Session speakers include, B.J. LeJeune, Dr. John Crews and RSA Commissioner Janet LaBreck and Wm. "Bill" Schmitz, Jr. and many exciting topics in breakout sessions. You can still register at the door. Department of Health and Human Services NewsUS Surgeon General Launches National Call to Action on WalkingIn September, the United States?Surgeon General?issued a call to action to address major public health challenges such as heart disease and diabetes.?Step It Up! The?Surgeon General’s Call to Action to?Promote Walking and Walkable Communities?articulates the health benefits of walking while addressing the fact that many communities unacceptably lack safe and convenient places for individuals to walk or wheelchair roll.“Everyone deserves to have a safe place to walk or wheelchair roll. But in too many of our communities, that is not the reality,” said Dr. Vivek H. Murthy, the 19th U.S.?Surgeon General. “We know that an active lifestyle is critical to achieving good overall health. And walking is a simple, effective and affordable way to build physical activity into our lives. That is why we need to step it up as a country ensuring that everyone can choose to walk in their own communities.”Data consistently show there are safety and accessibility issues that make communities less walkable. A 2013 study by the U.S. Department of Transportation, for example, found that 3 out of every 10?Americans?reported that no sidewalks existed along any streets in their neighborhood. In many communities violence – and the perception of violence – may prove a barrier to walking.The?Surgeon General?calls on community planners and local leaders to create more areas for walking and wheelchair rolling and to prioritize the development of safe routes for children to get to and from schools. The call to action suggests that these designs should include sidewalks, curb cuts, crosswalks, safe crossings for the visually impaired and more green spaces. The?Surgeon General?further calls on city managers, law enforcement and community and public health leaders to address safety concerns by better maintaining public spaces, working with residents to promote a shared sense of community ownership, ensuring proper street lighting and fostering neighborhood watch programs.The?Surgeon General’s report discusses the health benefits of walking and calls on individuals to make walking a priority in their lives. Fewer than half of all U.S. adults get enough physical activity to reduce their risk of chronic disease, and only a quarter of high school students get the recommended amount. Physical inactivity contributes to heart and lung disease, diabetes and cancer, which account for 86 percent of our nation’s health care costs.?Building?walking into daily life can reduce disease and save money.“We know that an average of 22 minutes a day of physical activity – such as brisk walking – can significantly reduce the risk of heart disease and diabetes,” added Dr. Murthy. “The key is to get started because even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”To read the?Surgeon General’s Call to Action and learn how to promote walking and walkable communities, please visit?. American Society on Aging Devotes the Summer 2015 Issue of its journal Generations to Issues on MedicareTo mark Medicare’s 50 th anniversary, the American Society on Aging (ASA) devoted the Summer 2015 issue of its quarterly journal, Generations, to this milestone occasion. The issue delivers a timely and insightful exploration of Medicare—past, present and future—and includes articles on a broad range of topics. You can read this issue free of charge. Generations brings together the latest in research, practice, and policy on a single key topic in aging, with the intent to enhance readers’ understanding of the topic and the implications for practice. The issue includes personal reflections on the launch of Medicare, a focus on how well the program serves an aging population (and people with disabilities), the politics of Medicare, and most importantly, key opportunities and challenges facing Medicare’s future. Authors include former Secretary of Health, Education, and Welfare Joseph Califano, former administrators of the Medicare program, Bruce Vladeck and Gail Wilensky, and numerous experts, each offering different perspectives on the program. The issue is posted in its entirety on the ASA website. To access the issue online, go to . On the Home Page a single article will appear. To the right you will see the cover of the journal Generations. You can click on it and read all the articles or scan the table of contents and go to the article(s) that interest you most! It’s a great opportunity to examine the journal. ? ? The issue is also available in print. To order print copies and/or to subscribe to Generations journal, go to . Judy Scott Retires after 46 Years of Service to the field of vision loss and 34 years at the American Foundation for the BlindJudy is one of the founders of Division 15 and has always been a staunch advocate for programs for older persons who are blind or visually impaired. She was very involved in advocacy efforts to increase funding for Chapter 2, the federal program that provides services to this population. This includes helping to spearhead the National Agenda on Aging, a national coalition of service providers involved in advocacy. On the home front, she envisioned, created and led a $2.3 million campaign to fund the?AFB Center on Vision Loss?in Dallas, a national demonstration and training site to help individuals and their families learn how to cope and live successfully with a visual impairment. News from the Field News from Mississippi National Research and Training Center on Blindness and Low Vision, Starkville, MS by B. J. LeJeune, CVRTThe National Research and Training Center on Blindness and Low Vision at Mississippi State University has recently been awarded 2 large 5 year federal grants starting October 1, 2015 – one from the Rehabilitation Services Administration to provide training and technical assistance to the Older Blind Programs, and one from the National Institute of Disability, Independent Living, and Rehabilitation Research on enhancing employment outcomes for persons with blindness and low vision.?Older Blind Technical Assistance and Training GrantThe National Research and Training Center on Blindness and Low Vision (NRTC), at Mississippi State University, has been awarded the Rehabilitation Services Administration (RSA) older blind technical assistance (TA) and training grant. This grant was established under the WIOA legislation to provide assistance to older blind program directors and direct service staff. The guidelines stipulate TA and training in areas of best practice, community outreach, budget management, and completion of the 7OB report. Partnering with the NRTC in this grant are American Foundation for the Blind (AFB), Helen Keller National Center (HKNC), and Vision Serve Alliance. Here are a list of some activities which will be implemented. Please watch for announcements related to these items and plan to participate. More information will follow as details are available.Participation in the RSA project directors meeting October 2015AFB all access pass – this is a training opportunity for direct service staff. Online courses available through the AFB eLearning center will be made available at no cost to service providers who work with older blind consumers served under 7OB funding. These courses provide ACVREP credits. A special track for older blind Program Directors and staff will be planned in conjunction with the AFB leadership conference. The date for the next conference is March 3-5, 2016. Establishment of a Community of Practice websiteIntensive TA and training for 3 designated state agencies per yearDevelopment of new online training modules by the NRTC, HKNC, and AFB eLearning.More about the Grants:As a result of these two grants we will be hiring several new positions?- both for researchers and persons with field experience in working with individuals with blindness and low vision. ?Among others, we will be hiring the following:?Rehabilitation Counselor/Training SpecialistOlder Blind Specialist/ Research Associate ll/lll? Communication Specialist/Research Associate ll/lll? Research ProfessorProgram ManagerAnne Sullivan Macy Fellow (for someone wanting to work on a PhD or as a post-doc) – see more below.Check out details at ???The NRTC at MSU is a great place to work.? With experience and a master’s degree, the salaries are very competitive, and the benefits, including the opportunity to take free classes and get reduced tuition for your children, are excellent.? Why Move to Mississippi? First of all, the work is exciting, interesting and significant and you would work as part of a dynamic team.? But wait, there's more...Starkville MS is in the Northeast part of the state and is a growing community with lots of interesting things to do. We have the exciting MSU Bulldog collegiate sports program including fishing, golf, rodeo and women's volleyball and soccer in addition to football, basketball and baseball. In addition to SEC sports, if you are interested in culture, we are the smallest town in the country with a symphonic orchestra, we have a vivacious and active community theater and a large international community. For those who enjoy the outdoors, the Natchez Trace is 18 miles away, the Noxubee Wildlife Refuge, with its beautiful lakes, lies near the campus and the community is building bike trails and hiking trails to accommodate the growing number of persons interested in being environmentally sensitive. We have an active free bus system which connects the campus and town. We are part of the Blues Trail in Mississippi and have a number of annual festivals in the area that attract musicians and crafts people. As a land grant university, MSU is large and beautifully landscaped with over 10,000 acres of forest, a horse park, a vet school and experimental farms.?? ?We have just opened a new whole food cafeteria and 2 new dorms, with 2 more being erected.? Our enrollment is about 20,000 each year and we are considered a Carnegie research institution.? Wow, if I wasn't already working here, I would have talked myself into applying! Hope to see some applications with your names on them!?Applications Invited for Research Training Program The National Research and Training Center on Blindness and Low Vision (NRTC) at Mississippi State University is seeking a Ph.D. graduate student or post-doctoral candidate as the new Anne Sullivan Macy Scholar beginning in the summer or fall of 2016. This program honors the unique contribution of Anne Sullivan Macy to the extraordinary educational experience of Helen Keller. A candidate who is blind or visually impaired or one who has experience working in the blindness field will be given preference. Candidates must have or be seeking a Ph.D. in the social sciences (e.g., rehabilitation counseling, psychology, sociology, special education). Since 1981, the NRTC’s mission has been to enhance employment and independent living outcomes for individuals who are blind or visually impaired. In keeping with this mission, the goal of this training program is to support development of a scientist-practitioner who is well grounded in applied research methods and practices, focused within the field of blindness and low vision. As a post-doctoral position, the program offers salary with full benefits. A student working as a graduate assistant while completing a Ph.D. program receives a full tuition waiver and monthly stipend. In either case, the recipient will participate in ongoing applied research and knowledge translation activities and will attend regional and national conferences. The Anne Sullivan Macy Research Training Program was established in 1992, supported by funding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). Previous award recipients have gone on to work as researchers, professors, and administrators. The very first Anne Sullivan Macy Scholar, Dr. Brenda Cavenaugh, served as Director of the NRTC from 2007 – 2010. The current research training program will be funded under the NRTC’s new 5-year NIDILRR grant: Rehabilitation Research and Training Center (RRTC) on Employment Outcomes for Individuals with Blindness or other Visual Impairments.To learn more or to apply for the Anne Sullivan Macy Research Training Program, visit the NRTC’s website at and select the “Employment Opportunities” button on the front page. Potential applicants are also encouraged to contact Dr. Michele McDonnall, NRTC Director, at (662) 325-2001 or via email at M.Mcdonnall@msstate.edu JVIB News Related to Aging and Vision Loss Journal of Visual Impairment & Blindness (JVIB) 2016 Special Issue on AgingGuest editors: John E. Crews, D.P.A., Vision Health Initiative, National Center for Chronic Disease Prevention And Health Promotion, Centers For Disease Control And Prevention; And Bernard A. Steinman, Ph.D., Center for Social And Demographic Research On Aging, University Of Massachusetts BostonDeadline for submissions: February 28, 2016Projected publication date: November-December 2016JVIB invites papers addressing a variety of topics related to aging and vision impairment. Topics of interest include, but are not limited to:Innovative application of technologyNovel rehabilitation interventions,Partnerships and collaborations in state- and community-based programs,Access and utilization of vision rehabilitation,Family caregiving,Outcomes measurement,Quality of life,Interventions addressing health promotion and chronic conditions,Public policy,Health policy, andHealth services research.International contributions are welcome. Practice papers as well as conceptual and research papers are invited. This is a great opportunity for graduate students in VRT and O&M programs who want to write and for those of you working within the field who have not published yet to consider a practice report. As a student you may already have an excellent paper which could serve as the basis for an article. Authors should feel free to contact the guest editors to discuss potential ideas. John Crews can be reached at: jcrews@. Bernard Steinman can be reached at: bernard.steinman@umb.edu.Guidelines for contributors are available from: jvib_guidelines.asp; phone: 212-502-7651; e-mail: press@. The maximum length of full manuscripts is 5,000 words. Maximum length of research reports and practice reports is 2,500 words.Submissions should be sent to: jvib@nccu.edu. Submitted manuscripts will undergo standard peer review.Important News about Fall PreventionContributed by Kathy Clarrage, COMS?Certified Orientation & Mobility SpecialistState of Maine, Division for the Blind & Visually ImpairedNational Institutes of Health awards $380,000 to study Fall Prevention Program for Elderly (Bangor Daily News, September 16, 2015)The National Institutes of Health has awarded $380,000 to researchers at the University of Maine Center on Aging, University of New England and The Iris Network to study a falls prevention program for older citizens who have vision impairment. Falls among older adults can lead to serious injury, loss of independence or death. The two-year project aims to inform community programs how to provide the best falls prevention information for older citizens.The study will focus on the effectiveness of the UNECOM Balancing Act Program, a self-initiated falls prevention program that aims to improve balance and reduce falls. The program, designed at the University of New England College of Osteopathic Medicine Department of Geriatric Medicine, requires only one training session and then can be done at home with no equipment or further instruction.“In Maine and throughout the country, aging services are shifting toward community and in-home interventions allowing older adults to age in their homes and communities,” Jennifer Crittenden, fiscal and administrative officer of the UMaine Center on Aging, said in a press release.Among the 65 and older population, 30 to 40 percent experience a fall, with vision-impaired seniors nearly twice as likely to fall, according to information from The Iris Network, an organization that provides services statewide to Maine people who live with blindness and visual impairment.“Accidental falls are the leading cause of fatal and nonfatal injuries for those 65 years of age and older,” said U.S. Sen. Susan Collins, the ranking member on the Senate Special Committee on Aging. “This grant will contribute to the important work being done at UMaine’s Center on Aging and help raise awareness and prevent life-threatening falls in the older adult population.”Through a randomized controlled trial, researchers will be able to test the effectiveness of the UNECOM Balancing Act curriculum among seniors who have visual impairment. The study also will examine the program’s potential for adoption by community-based programs such as Maine Area Agencies on Aging as a convenient, home-based plan that is user-friendly and accessible to older adults living in rural areas.“These funds are welcome news for medical researchers throughout the state as well as those suffering from vision impairment,” U.S. Sen. Angus King said. “The UNECOM Balancing Act Program has the potential to help our elderly population live more safely in their homes and communities. This is especially important in a rural state like Maine, where easy and immediate access to medical facilities and treatment is often dependent upon location.”Co-principal investigators for the study are Lenard Kaye, director of the UMaine Center on Aging and professor in the UMaine School of Social Work, and Marilyn Gugliucci, director of geriatrics education and research at the UNE College of Osteopathic Medicine.“The UNECOM Balancing Act Program was designed specifically for community dwelling older adults,” Gugliucci says. “Maine’s rurality makes it difficult for older adults to get to group programs, so having an opportunity to work on falls prevention in the home is quite important. To have the opportunity to adapt the Balancing Act Program for older adults with visual impairment will aid even more Mainers who want to maintain their independence.”Participants for the study will be recruited from clientele of The Iris Network in York and Cumberland counties who are age 62 and older and who meet additional eligibility requirements. Participants will be randomized into control and treatment groups and will take part in a series of assessments that will help researchers understand the differences in outcomes between groups.“Maine is often referred to as the oldest state in the nation. This grant will give us the opportunity to get out in front of a growing need in our elderly population, for whom a fall often signals the end to independent living,” Ruth Mlotek, director of vision rehabilitation services at The Iris Network, says.The primary outcome measures of the study will be participant balance and frequency of falls. However, several other factors also will be measured, including pain, physical activity, fear of falling, perceived difficulty in performing the exercises, ability, motivation and predisposing factors for falls.An additional aim of the study will be to determine if developing social networks will encourage participants to stick with the balancing exercises.Research findings and the UNECOM Balancing Act Program will be disseminated among human service organizations through networks such as the National Association of Area Agencies on Aging, the Association for Education and Rehabilitation of the Blind and Visually Impaired, and the Maine Gerontological Society.Another Comprehensive Prevention Program Effectively Reduces Falls among Older PeopleHHS-supported study tests falls intervention programSince our September Water Cooler discussion session was devoted to falls for fall prevention month, this program should be interesting to all readers. Families and physicians have a new tool in the fight against falls- a comprehensive prevention program developed by the U.S. Department of Health and Human Services that reduces both falls and resulting use of long-term care such as nursing homes.The prevention program, which includes clinical in-home assessments of health, physical functioning, falls history, home environment, and medications to create customized recommendations, was developed by?HHS-based on the research evidence on risk factors and interventions. Using a randomized control trial, the program was tested among long-term care insurance policy holders age 75 and older to determine whether the intervention was effective and, if so, the impact on long-term care utilization.The study found that the program led to significantly lower rates of falls over a one-year study period. Those who received the intervention had a 13 percent lower rate of falls, and an 11 percent reduction in risk of falling compared to the control group.?Participants?also had a significantly lower rate of injurious falls. Long-term care insurance claims were 33 percent lower over a three-year period. The intervention, which cost $500 per person to administer, saved $838 per person.Falls- which happen to 1 in 3 people age 65 and over every year-- can cause pain, suffering, and death, and cost an estimated $35 billion in health care spending in 2014. They are a leading risk factor for needing long-term care at home or in a nursing facility. Given the impact of falls, findings from the?HHS-funded study give hope for reducing the rate of falls among the growing population of older adults.“While falls are preventable, we need to intervene at the right time in a way that is comprehensive and yet individually tailored,” said?Richard Frank, Ph.D., the assistant secretary for planning and evaluation at?HHS, whose office funded the study. “Preventing falls helps everyone: the older person, their family, and the health and long-term care systems. And this study shows that by investing in falls prevention, we can reduce long-term care use and spending.”The risk factors for a fall include fear of falling, gait and balance problems, certain medications, clutter in the home, and some health conditions. Few interventions have taken a comprehensive approach to address all of the risk factors through one program.Although this study focused on the rate of falls and long-term care utilization and costs, future research will examine the impact of the intervention on health care utilization and costs.“We expect to see a similar or greater return on investment in terms of health care costs,” added?Richard Frank.The 2015?White House Conference?on?Aging, in partnership with the?National Council?on?Aging, recently convened a Falls Prevention Summit to call attention to the critical role of falls prevention in healthy aging and to provide opportunities for older?Americans?and stakeholders to share their views and ideas on this important issue. More information about the intervention and the study design are available at study appears online and in print in the June issue of Health Affairs. (Revised June 8, 2015)Member of LinkedIn? You may want to join one of their Groups—by Alberta OrrThere is an interesting email discussion group called ChangingAging which I joined this summer. You won’t get bombarded with emails about what has just been posted, and it is about aging, not aging and vision loss, but those who post are often thought provoking. You may enjoy it. Please Share Articles and StoriesIf you have a great practice story you would like to share through the division newsletter, or if you see an article on a timely topic, please share it with us when we call for input for our next Aging Division 15 Newsletter in the spring. We welcome feedback so we know how best this newsletter can meet your needs. Please email: Alberta L. Orr, editor: oalber7@ or Pris Rogers, chair: progers@ ................
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