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Posted March 26, 2009 | Copyright © The Northern Virginia Daily
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Vision-impaired seniors gain back their independence

Massanutten Manor resident Elizabeth Wyatt uses special glasses to watch television in her apartment. Rich Cooley/Daily

Vision specialist Phoebe Burgess, right, assists Massanutten Manor resident Elizabeth Wyatt in using this electronic magnification device to read inside her Strasburg apartment. Rich Cooley/Daily

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Specialist makes changes in the home that improve safety and mobility

By Elizabeth Smoot - emsoot@nvdaily.com

Elizabeth Wyatt led as full and vibrant a life as any young woman of her generation. In the 1930s, at the age of 16, she attended college. After her husband died, leaving her with three young daughters, she started her own organic farm. As the women's editor of a weekly newspaper, she once interviewed the Beatles.

"I interviewed the youngest one," she recalls. "What was his name? Paul?"

But vision and hearing losses and the inevitable slow-down that comes with age, left her frustrated and isolated as she moved into her 80s.

Unable to see the closed captioning on her television screen, read the beloved books lining her living room shelves or write letters to her family and friends, Wyatt recently sought help. Small changes introduced to her by Phebe Burgess, a low-vision rehabilitation specialist at Valley Health, now mean the difference between sitting silently in her recliner and fully participating in the meaningful passions of her life.

"It's really easy to feel lost sometimes if you can't watch TV, read books," says Wyatt, 89, at her Strasburg home recently. "I pride myself on my independence and my world fell apart when I couldn't cope with the everyday nuts and bolts."

As people age, the quality of their vision diminishes naturally. Most changes are not severe. But some conditions, such as macular degeneration, glaucoma, cataracts and diabetic retinopathy, can permanently affect the quality of sight for adults, especially the elderly. As Valley Health's low-vision rehabilitation specialist, Burgess meets with visually impaired people in their home, identifies obstacles to safe and independent living and recommends ways to work around those hurdles.

Burgess helps about 150 people a year, but could help many more. Patients must have a doctor's referral to receive assistance, but doctors don't always think beyond the medical issues facing their clients, Burgess says. They often forget to ask patients how they are performing their daily tasks, questions that could bring them to Burgess' attention.

"Sometimes doctors forget to have that conversation with their patients," she says.

Sometimes adding to the problem is a patient's hesitancy to admit they have vision problems because they fear being placed in a nursing home. "They don't know there's hope out there, someone to help them."

After a patient is referred to Burgess, she does an assessment of their health and their environment. "I go in and listen to what their story is, what's important to them."

In Wyatt's case, additional lighting, raised surfaces to help her feel light switches and stove controls, and magnification devices are just some of the things that have given her back the ability to communicate with the outside world and improve the safety of her home.

The solutions are often simple. Wyatt, who suffered profound hearing loss two decades ago, could see well enough to drive just last summer, but macular degeneration quickly left her vision so fuzzy not only could she no longer drive, she found nearly every daily task draining. Her daughter moved her from the Atlanta area to the valley to be closer to the family. Together, they sought help in an effort to allow Wyatt to write letters to her friends back home, read, operate her microwave and put the key in the lock of her front door.

One of the first problems Burgess noticed was light from her living room window cast a glare on the desk, making tasks difficult. Simple repositioning of the furniture solved that problem. A task lamp next to Wyatt's recliner helps as well.

"Lighting plays such a critical role to make sure the person can maximize their vision," Burgess says.

To make reading possible, Burgess suggested a modestly priced hand-held, lighted magnifier. Burgess' family also purchased a video magnifier, sometimes referred to as Closed Circuit Televisions. The device features a flat, LCD panel monitor that enlarges text and other objects and increases the contrast and visibility of items viewed under the magnifier.

"I didn't know there was such a thing," Wyatt says. "It's possible to read books and I'm an avid reader. To me, that's a miracle."

Not all solutions are as expensive as the video magnifier. Specially placed duct tape solved a host of problems. Placing a piece of tape on the keyhole of her front door allows Wyatt to feel where her key goes instead of having to find the small hole visually.

Burgess placed red duct tape around the kitchen receptacles so that Wyatt can now see and feel them easier, reducing the chance of her sticking her fingers in the receptacle holes.

The kitchen presents a host of problems for someone with vision problems. Raised dots were placed on the stove controls. When Wyatt turns her oven on, she only has to line up the dots to know that the burners are on medium heat.

More dots on the microwave identify the various buttons to make it easier to operate. A white cutting board replaced the brown one that made it hard to see items placed there. Red tape on her trash can button helps her find the lid. Tape on the end of a knife identifies the sharp edge.

"Kitchens are tricky. There are lots of hazards," Burgess says.

Taking medication also can be challenging for the vision impaired. "Often they can't even tell the difference between pills," Burgess says. One simple solution is finding a dark surface for people to place their medicines on. Wyatt now uses a black plate that helps her see her pills.

Magnifying glasses now allow Wyatt to watch television. The glasses enlarge the screen and the closed captioning.

Part of Burgess' job is to know what's available in the community to help people. Oftentimes, vision impaired people use 411 to find phone numbers but they don't realize they get charged each time they do that, she says. Burgess can petition the phone company to waive those fees for the vision impaired.

Burgess focuses a great deal of energy on improving a person's independence. One issue that is often overlooked, she says, is signing one's name. Family members have a tendency to take over those duties from an older relative, particularly one suffering vision problems. One solution is to ask the bank for visually enhanced checks. These large-print checks allow people to continue to do their own finances.

"When people stop signing their name, that's giving up," Burgess says. "Loss of vision doesn't mean a loss of hope. I feel like I can empower them so they don't have to give up."

Special pens with dark ink also make it easier to write. Pens have helped Wyatt with the many letters she shares with friends. "People seem to enjoy my letters in this world of email," Wyatt says.

Pens are an easy and inexpensive solution, but not all families realize they don't have to spend a lot of money to ease the burdens.

"Everyone wants to figure out how to make money off this group. Kids want to buy them things. I say let me come in and evaluate first," she says.

Wyatt appreciates the changes Burgess has introduced. Standing in the middle of her living room, Wyatt jokes around about the first time they met.

"She told me, 'I can't cure your eyes, but I got a bag of tricks,' and believe me, she does. She makes it interesting, a challenge and sometimes fun."

Wyatt recalls another job she once had, working in a nursing home. One patient walked the halls, constantly muttering about not being able to see or hear. "It was pitiful," she said. "I realized I'd be just like him, but I'm not because of the help."

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