IOWA DEPARTMENT FOR THE BLIND



IOWA DEPARTMENT FOR THE BLIND

Des Moines Register Article on Blindness

By Andie Dominick

Losing vision, finding strength

“You just have to learn to deal with it first. It’s just like anything. You deal with it – then you find help. Look around. There’s always someone worse off than you. I’m not totally blind, and I look around and see those who are totally blind and I think, ‘I’m so lucky.’”

That’s the gist of the advice Janet Kessler of Creston wants to send other Iowa seniors losing their vision. The 75-year-old, lifelong Iowan has lost most of her sight to macular degeneration, a disease that impacts nearly 30,000 Iowans over the age of 50. It’s the leading cause of blindness in older Americans.

Janet lived for several years with one eye she couldn’t see out of, but said her “good eye” compensated. It didn’t stop her from her long career bartending and managing clubs.

Then, about seven years ago, she suddenly lost her vision while tending bar at a party. “It just went – bingo,” she said. The next day, she went to the doctor and found out her vision couldn’t be saved. “At first I sat there and said, ‘I think my life’s over.’”

Actually, she “sat there” for about three weeks. She said she gave up on everything. Finally, she called the Iowa Department for the Blind to ask for a book on tape. The agency sent a caseworker to her house who showed her some tips for performing daily activities without vision. The caseworker suggested Janet spend a week at senior training in Des Moines. She went. “But I told my husband to drive slow on the way back because I might be calling to come home,” she said. She didn’t go home. She lived there for a week, learning how to use a white cane, read a little Braille, use an elevator and measure ingredients to cook. Even though she is able to see a little bit, the training program requires students to wear “sleep shades” (like blindfolds) that prevent them from seeing anything. In fact, computers at the school have no monitors.

This forces people to learn to perform tasks and get around with no vision at all – rather than being distracted by focusing on trying to perform tasks with the little vision they have.

“I combine what they taught me with what I can see, and I live a pretty normal life,” she said. “Iowa is so lucky to have this terrific service and Iowa Blind is terrific. We go south in the winter time, and other states don’t have the same services.”

Janet and other visually-impaired seniors I’ve talked to say the hardest thing about losing their vision was losing their ability to drive. It takes away some of their independence.

Janet says she is lucky – her husband and friends take her where she needs to go. She sometimes uses a white cane and when she goes out in public, but gets around her house without one. And she finds pleasure in many things – including cooking. It’s just a little more work. It now takes her four days to do her Christmas baking, something she used to do in two. And she told of a beautiful, tall meringue she had on the top of a pie – until it fell. She added flour instead of sugar.

“You have little crazy things like that happen all the time,” she said.

VISION LOSS: HELP OLDER IOWANS MAINTAIN INDEPENDENCE

Aging brings a higher risk for many health problems – including blindness. Iowa has the seventh highest percentage of people in the nation age 40 and over with serious sight impairments. That statistic doesn’t refer to people who need reading glasses when they get older; it refers to people with conditions, including glaucoma and age-related macular degeneration, that can seriously compromise vision.

As Iowans age, more will be diagnosed with eye diseases – which can threaten their ability to live independently. From paying bills to getting groceries, the difference between staying at home and moving to a care facility can be learning new ways to perform basic, daily tasks most of us take for granted.

Must of the responsibility for helping these seniors falls to the Iowa Department for the Blind. But Iowa lawmakers need to better support the agency, which has been hit hard by recent state budget shortfalls.

In 2009, the department had a total state appropriation of about $2.6 million. Lawmakers reduced that to just under $2 million this fiscal year. The agency loses approximately four federal dollars for every state dollar appropriated, meaning the state cut results in the department giving up over $2 million from Washington. Director Karen Keninger calls the cut “brutal.” This means it takes the department longer to provide essential services to Iowans.

Such a large reduction in funding is unacceptable.

The services this agency provides are crucial to Iowans of all ages – from helping people stay employed with technological assistance to an intensive training center in Des Moines where students of all ages learn how to work with tools, on computers and with a white cane. The agency’s library in Des Moines sends reading materials – in large print, Braille, and on tape – to Iowans free of charge. It contains more than 88,000 book titles.

But the agency is also a lifeline for older people, who are most at risk of losing vision. A solid infrastructure for services is imperative going forward – particularly when services must reach seniors living in rural areas, who may not have other resources nearby to assist them. Teachers employed by the department help older Iowans do everything from preparing meals to learning Braille to take notes they can read later.

Sylvan Dawson, 79, of Marion, said his teacher helped him set up a computer program that allows him to use the internet and e-mail. “He helped me get familiar with software that reads the screen to me,” Dawson said.

Pat Breckenridge of Des Moines said the agency helped her stay in her job by providing a reader that enlarges print. The 63-year-old also attended a senior orientation run by the agency this summer.

Visual impairment is one of the top reasons people lose their independence – which leads to increased long-term care costs. According to information provided by the National Federation of the Blind, the average cost of care for an older person living independently is $4,800 annually. Compare that to $36,600 for an individual in institutional care. Also, nearly 20 percent of all hip fractures in seniors are attributed to vision loss. Taxpayers frequently end up footing the bills for these higher costs through Medicaid and Medicare health insurance programs.

Skimping on state funding for services that help the visually impaired not only hurts Iowans immediately, it ends up costing all of us more in the long run.

Who is eligible for services?

The Iowa Department for the Blind provides services to those who are legally blind or otherwise visually impaired. A visually impaired person has difficulty performing tasks—even with the best glasses or contact lenses. Being legally blind means having vision no better than 20/200 or a visual field no wider than 20 degrees.

What type of help is available?

The department provides numerous options for help, including a residential training program at its Orientation Center in Des Moines. Students there take classes in cane travel, computers, industrial arts, Braille and cooking. The Vocational Rehabilitation Program helps Iowans prepare for, obtain or retain employment through counseling, technology training and work-site assessment. Teachers who work in the Independent Living program travel throughout the state to help people in their homes learn to cook, travel and maintain independence. The Iowa Library for the Blind and Physically Handicapped has the largest collection of books, magazines and other materials in the country. They are available by mail, free of charge. The library also shipped about 3,000 digital talking book players to readers across Iowa. For more information, contact the agency at (515) 281-1333 or (800) 362-2587. You can find out more online at .

Macular Degeneration

Age-related macular degeneration is the leading cause of vision loss in Americans 60 years of age and older. The disease affects the macula, the part of the eye that allows you to see fine detail. It can gradually destroy central vision in both eyes.

Symptoms

There are two types of macular degeneration – wet and dry. Neither cause pain. Dry AMD is the most common form and an early sign is blurred vision which often goes away in bright light. For wet AMD, the classic early symptom is that straight lines appear crooked.

Who is at risk?

The greatest risk factor is age. People in middle age have about a 2 percent risk of developing the condition, but the risk increases to nearly 30 percent in people over age 75. Other risk factors include: smoking, obesity, a family history of the disease, and gender (women appear to be at greater risk than men).

Treatment

Though there is no cure, AMD can be treated with surgeries and therapies, which can prevent the disease from progressing to advanced stages. Once dry AMD has reached the advanced stage, no form of treatment can prevent vision loss. Also, a National Eye Institute study found taking high doses of antioxidants and zinc reduces the risk of advanced macular degeneration and can slow its progression. Researchers used the following daily supplements: 500 milligrams of vitamin C, 400 International Units of vitamin E, 15 milligrams of beta-carotene, 80 of zinc and two milligrams of copper (cupric oxide). These levels of vitamins and minerals are difficult to achieve from diet alone and higher than the amounts in daily multivitamins. Source: NEI, National Institutes of Health.

Karen Keninger, director of the Iowa Department for the Blind, was diagnosed as a child with retinitis Pigmentosa. She has been completely blind since the age of 20. After working as a rehabilitation consultant and program administrator for the department’s library, she was appointed to the position of director. Keninger will answer readers’ questions about vision loss and services for Iowans who are visually impaired. Send questions to adominick@. We will publish excerpts on the opinion pages later in the week and you will be able to all questions and answers at aginginiowa.

Numerous Eye Problems Afflict Iowans

Iowa ranks high nationally in the percentage of residents with eye disease. According to a 2008 report from Prevent Blindness America and the National Eye Institute:

--12,359 Iowans over age 40 are blind.

--28,346 Iowans over age 50 have age-related macular degeneration.

--Each year, there are an estimated 270,038 cases of cataracts, 44,581 cases of diabetic retinopathy and 23,651 cases of glaucoma.

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