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Low Vision Assessment and Rehabilitation

Residential Vocational Training

Activities of Daily Living

His wife undertook many of the domestic responsibilities. His level of visual functioning, enhanced by his developing orientation and mobility skills, was generally safe and sufficiently functional to support his activities of daily living. This was assessed by a supervised program of residential self-care using a specifically-designed apartment of his own within the unit.

Assessment and training was established in the following areas, cognizant of the potential for future visual deterioration.

• Telling time: Upon admission, he used a large print watch; he was introduced to reading a braille pocket watch.
• Using the phone: Conventional usage required a system for recording phone numbers; he was also enrolled in the free phone service for visually-impaired people.
• Care of clothing: Can perform laundry tasks.
• Labeling: Using large print; tactile markings for appliances; could benefit from labeling personal items in braille.
• Sewing / ironing: Can thread a needle; wears wrinkle-free clothes.
• Personal care: Satisfactory except for nail care - advised about the importance of regular care from a podiatrist because of potential for serious foot problems in patients with diabetes.
• Budgeting: Bills read with CCTV; two-compartment wallet for separate bills.
• Housekeeping: Satisfactory.
• Eating: Satisfactory; concern over safety with hot liquids because of reduced sensation in his hands.
• Meal preparation: Adequate skills using residual vision. With vision occluded (sleepshade) he was slow but was safe and cautious in handling sharp knives and hot oven.
• Shopping: Large print grocery lists/hand magnifier.
• First aid / safety: Knowledgeable.

Dr. Cole has mild peripheral neuropathy of both hands with moderate losses of pain discrimination (protection) and two-point discrimination (impairing braille interpretation), and moderate to severe diabetic peripheral neuropathy of both feet and lower legs. The importance of preventive foot care was emphasized. Initiation of a regular exercise program wearing comfortable, well-fitting shoes was also recommended.

Owing to the possibly progressive nature of his diabetic retinopathy, sleep-shaded training was performed to develop his skills in laundry, sewing, housekeeping, eating and cooking without visual clues.