Low Vision Technology in the Home- What Can Be Done to ...



Low Vision Technology in the Home- What Can Be Done to Increase IndependenceSherry Boothby, OTR/L, CLVT, MSOccupational Therapist/Certified Low Vision TherapistCoastal RehabEvolution of Technology in Low Vision OTWhen I started in Low Vision in 2004, technology was an emerging area.Mostly low-tech solutions (magnifiers, talking books on cassette tapes, mini cassette recorders). Video magnifiers with CRT monitors were high tech!Amazon Echo/Alexa (2014) not around yet, nor iPhones (2007), iPads, or smart home technology. Low Vision Occupational Therapy EvaluationReview eye report for history and visual acuity and fields Assess for near and distance VA, scotomas, contrast sensitivityDevelop Occupational Profile: PMH, Background/PLOF, life roles, review patient’s vision goalsLow Vision OT EvaluationAssess Sensorimotor function: ROM, strength, sensation, balance, mobility/history of fallsAssess cognitive functionAssess Occupational Performance: Self-care (feeding, grooming, bathing, dressing, medication management, toileting)Low Vision OT EvaluationMeal Preparation (setting appliances, cooking, reading recipes, pouring, hot/sharp safety)Home Management (laundry, cleaning, shopping, sewing, setting thermostat)Financial Management (Reading bills, writing checks, money ID, online banking)Low Vision OT EvaluationCommunication (using telephone, time telling, writing, computer use, reading mail)Vocational (employment or volunteer position)Leisure (television, reading, crafts, etc.)Education (for student age- HS through college)Social ParticipationMedicare/Insurance CoverageMedicare covers outpatient OT services for low vision rehabilitationMust have acuity 20/70 or worse in better eye or visual field 20 degrees or less. If scotomas are documented but acuity better than 20/70, can code for that to cover OT servicesIf patient is receiving home health services under Medicare Part A, then OT cannot bill for outpatient servicesEnvironmental ModificationsHome assessment for fall risk hazards, ambient and safe pathway lighting, glare control, contrast enhancementAssess need for tactile/visual markings on household appliances (microwave, stove/oven, washer/dryer, thermostat) with bump dots or fabric paintAssess reading or computer station/area for positioning and ergonomicsTactile markingsLighting and Glare ControlAssess task lighting needs and instruct patient/family in lighting principlesConsider cost when presenting task lighting solutionsSun lens assessment outdoors and indoors for controlling glare/enhancing contrastEnvironmental modifications to reduce glare Task LightingDevice Training-Low Tech OptionsTraining on use of recommended optical devices, incorporating into functional daily tasks identified during evaluationOptical devices include hand/stand magnifiers, glasses, video magnifiers, wearable technology Non-optical aids useful for ADL/IADL tasks (i.e. LP checks/registers, LP address book and calendar, felt tip marker, bold lined paper)Device Training- Low Tech OptionsTalking devices, including talking clocks, calculators, telephone keys/caller ID, scales, BP cuff, glucose meterContrasting cutting board, measuring cups, long oven mitts, large button timer, other adaptive aids for cookingLarge button remote control, telephonesNon-Optical AidsFour slides showing these devices…See LS&S website for more information about purchasing Non-optical aid Technology Advances in Low Vision Video magnification- Desktop models with flat screen HD monitors, portable HD units, 3-in-1 units with 3 viewing modes, wearable technology, text to speechWork in conjunction with AT vendors to keep up with latest technologySmart phones, iPad/tablets with built in accessibility features for low vision; Kindle for book readingSmart home technology- Amazon Alexa, Google HomeText to Speech Video MagnifierVideo Magnifier with OCRus.products/cvc-hd-ocr-24-g3-us-a-13m-clearview-c-full-hd-speech.html Other options include portable video magnifier with OCR (Compact 6HD Speech) or ClearReader+ OCR onlyMany other brands available (i.e. Zoomax Snow 7HD plus text to speech, Smart Reader HD Portable Electronic Video Magnifier and Text Reader with Console)Head-Mounted Technology - Enhanced Vision low-vision-product-line/jordy.htmlHead-Mounted Technology - Iris benefits/ Iris Vision Demonstration of Iris Vision:youtu.be/UUT7q2YSrig Low Vision Patient with Iris Vision Demo at HomeHead-Mounted Technology: discover-acesight/ OrCam (OCR/text to speech only)Wearable assistive technology device for the blind and visually impaired that reads text, recognizes faces, identifies products and more.watch?v=F2dVDHa421k Smart Home DevicesAmazon Alexa can be used as a personal assistant and for environmental controls.home/what-is-amazons-alexa-and-what-can-it-do/ Google smart-home/news/google/137665-what-is-google-home-what-can-it-do-and-how-does-it-work watch?v=MAn6oH08WgQ Siri as Personal Assistant and Home siri/ ios/home/ Can use Siri to set reminders, schedule appointments, set a timer, and other functions like with AlexaAlso, environmental controls using the Home appUniversal AT use vs. Low Vision OTSmart home technology is becoming mainstream, and any practitioner knowledgeable in this area working with someone with low vision could provide training.Home safety recommendations are part of a general OT’s tool kit, and lighting should be addressed as part of it.Incorporating contrast and addressing glare control with environmental modifications could be done with some training in low vision rehab.When it comes to magnification, video magnification, or AT that is vision-specific, best practice would be to refer to a low vision specialist.Also, adaptive techniques and devices for low vision would need additional training and could benefit from referral to LV munity ResourcesTalking or large print book program through Maine State Library; also, local libraries for ebooksVA patients may get assistance with purchasing devices- refer to VIST CoordinatorDisability Rights Center for patients with hearing loss also- for assistance with large button/amplified phone or related assistive technologyCommunity ResourcesFinancial assistance/cash loans for AT: mPower Loans from Alpha One Maine AT inventory for demonstration and loansLocal support groupsOnline resources and 211 for general assistance inquiries (i.e. transportation and other services)Thank you for attending! ................
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