Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 1 Helen Keller National Center Paige Berry, National Coordinator Senior Adult Services Helen Keller National Center for Deaf-Blind Youths & Adults Clinical Assistant Professor Department of Rehabilitation Counseling Virginia Commonwealth University P O Box 980330 Richmond, VA 23298 [email protected] 804/827-0920 www.hknc.org Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 2 HKNC is the only national residential vocational and rehabilitation agency to provide services exclusively to youth and adults who have combined vision and hearing loss. 141 Middle Neck Rd Sands Point, NY 11050 (516) 944-8900 www.hknc.org Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 3 HKNC’s mission… is to enable each person who is deafblind, or who is experiencing severe vision and hearing loss, to live and work in the community of his or her choice AARP Song To commemorate her 69th birthday on October 1, 2007, actress/vocalist, Julie Andrews made a special appearance at Manhattan's Radio City Music Hall for the benefit of the AARP. AARP SONG (tune “My Favorite Things” Maalox and nose drops and needles for knitting, Walkers and handrails and new dental fittings, Bundles of magazines tied up in string, These are a few of my favorite things. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 6 Cadillacs, cataracts, hearing aids, glasses, Polident, Fixodent, false teeth in glasses, Pacemakers, golf carts and porches with swings, These are a few of my favorite things. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 7 When the pipes leak, When the bones creak, When the knees go bad, I simply remember my favorite things, And then I don’t feel so bad. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 8 Hot tea and crumpets, and corn pads for bunions, No spicy hot food or food cooked with onions, Bathrobes and heating pads, hot meals they bring, These are a few of my favorite things. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 9 Back pains, confused brains, and no fear of sinnin’, Thin bones and fractures and hair that is thinning’, More of the pleasures advancing age bringsWhen we remember our favorite things. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 10 When the joints ache, when the hips break, When the eyes grow dim, I simply remember the great life I’ve had, And then I don’t feel….so bad! The End! Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 11 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 12 . “Deaf-Blind” Basically – 4 categories 1. Individuals who are hard of hearing and partially sighted or visually impaired 2. Individuals who are deaf and partially sighted. 3. Individuals who are blind and hard of hearing. 4. Individuals who are deaf and blind. (Individuals in this category are a minority. Many individuals retain some useful vision or hearing, or both). Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 13 Legal Blindness Legal blindness is a level of vision loss that has been legally defined to determine eligibility for benefits. The clinical diagnosis refers to a central visual acuity of 20/200 or less in the better eye with the best possible correction, and/or a visual field of 20 degrees or less. What a person with healthy eyes can see from 200 feet away, a legally blind person can see only from 20 feet away. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 14 VISUAL IMPAIRMENT? • 20/60 or worse, in the better eye with best correction • Limitation of side vision, abnormal color vision, or presence of double vision in one eye may also determine visual impairment. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 15 State of Illinois Driving Requirements Visual Acuity: (in at least one eye) Restrictions (if any) > 20/40 No restrictions 20/41 - 20/70 No driving when headlights are required 20/71 - 20/100 < 20/100 Bioptic telescope required unless living in a town with a population of 3000 or less •Must achieve 20/40 or better with no more than a 3x telescope •Requires a vision specialist statement indicating the individual has had the telescope a minimum of 60 days and has been trained to use the telescope when driving •Requires a behind the wheel test •Must be approved by a medical review board •No driving when headlights are required without a special review License denied Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 16 The Big Five • Cataract • Macular Degeneration • Glaucoma • Diabetic Retinopathy • Retinitis Pigmentosa Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 17 Vision with cataracts • clouded, blurred or dim vision • blocks light from reaching the retina. • harder to see at night • sensitivity to light and glare • halos around lights • fading or yellowing of colors • double vision or multiple vision in one eye Surgery is a common solution for cataracts. Most cataracts can only be detected with special instruments, so encourage consumers to make an appointment with their eye doctor if he/she notices vision clouding. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 18 Vision with Macular Degeneration Age-related macular degeneration (AMD) occurs when tissue in your macula — the part of your retina that's responsible for the center of your visual field — deteriorates • blind spot forms in the center of your vision • AMD is one of the most frequent causes of vision loss in people age 60 and older. • usually can't be reversed, but caught early, might be able to reduce the extent of your vision loss. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 19 Normal Cover one eye and look Abnormal at the black dot – lines should be straight Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 20 Charles Bonnet Syndrome (visual hallucinations) • Less frequently diagnosed – patients don’t tell family/doctor/friends • More common in elderly due to prevalence of vision loss later in life. Seen most often in patients with Macular Degeneration. • May persist for a few days to many years • The imagery is varied and may include groups of people or children, animals, and panoramic countryside scenes Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 21 Charles Bonnet Syndrome Visual Hallucinations Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 22 Glaucoma “Sneak Thief of Vision” Loss of peripheral vision. Like looking through a tube. Often have problems tripping over objects, or bumping into things. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 23 Glaucoma Glaucoma is a group of diseases that are usually associated with an elevated fluid pressure inside your eyeball. Normal eye pressure ranges from 12-22 Pressure can damage your optic nerve — the millions of nerve fibers that carry visual information from your eye to your brain. As optic nerve deteriorates, blind spots develop in your visual field. detected early, glaucoma is treatable with medication or surgery. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 24 At Greater Risk African Americans After cataracts, glaucoma is the leading cause of blindness among African Americans and people of African descent. Glaucoma is six to eight times more common in African Americans than in Caucasians. People Over 60 Glaucoma is much more common among older people. You are six times more likely to get glaucoma if you are over 60 years old. Family Members with Glaucoma The most common type of glaucoma, primary open-angle glaucoma, is hereditary. If members of your immediate family have glaucoma, you are at a much higher risk than the rest of the population. Family history increases risk of glaucoma four to nine times. . Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 25 Hispanics in Older Age Groups Recent studies indicate that the risk for Hispanic populations is greater than those of predominantly European ancestry, and that the risk increases among Hispanics over age 60. Asians People of Asian descent appear to be at increased risk for angleclosure glaucoma. Angle-closure glaucoma accounts for less than 10% of all diagnosed cases of glaucoma. People of Japanese descent are at higher risk for normal-tension glaucoma. Steroid Users Some evidence links steroid use to glaucoma. A 1997 study reported in the Journal of American Medical Association demonstrated a 40% increase in the incidence of ocular hypertension and open-angle glaucoma in adults who require approximately 14 to 35 puffs of steroid inhaler to control asthma. This is a very high dose, Illinois onlyDept. required in cases of severe asthma. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 26 Eye Injury • Injury to the eye may cause secondary open-angle glaucoma. This type of glaucoma can occur immediately after the injury or years later. • Blunt injuries that “bruise” the eye (called blunt trauma) or injuries that penetrate the eye can damage the eye’s drainage system, leading to traumatic glaucoma. • The most common cause is sports-related injuries such as baseball or boxing. Other possible risk factors include: •High myopia (nearsightedness) •Hypertension Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 27 Diabetic Retinopathy – Bleeding in the retina may cause vision to become hazy, blurry, spotty or even disappear altogether. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 28 Visual Impact of Diabetic Retinopathy Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 29 Retinitis Pigmentosa • Inherited eye disease that affects the retina • most cases, linked to a recessive gene, a gene that must be inherited from both parents • progressive vision loss (tunnel vision – lose top to bottom as well as side vision) • In some cases, a new mutation causes the disease to occur in a person who does not have a family history of the disease. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 30 Usher Syndrome hearing loss or deafness and progressive vision loss. loss of vision is caused by retinitis pigmentosa (RP), which affects the layer of light-sensitive tissue at the back of the eye (the retina). major cause of deaf-blindness in U.S. Three Types of Usher Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 31 Usher Syndrome Type 1 Hearing Vision Vestibular function (balance) Type 2 Profound Moderate to deafness in severe hearing both ears from loss from birth birth Type 3 Normal at birth; progressive loss in childhood or early teens Decreased night vision before age 10 Decreased Varies in night vision severity; night begins in late vision childhood or problems often teens begin in teens Balance problems from birth Normal to near-normal, chance of later problems Normal Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 32 Macular Degeneration Diabetic Retinopathy Cataract Retinitis Pigmentosa/Glaucoma Charles Bonnet Syndrome Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 33 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 34 Fonts – which can you read with ease? 12 Point 14 Point 16 Point 18 Point 20 Point 24 Point 32 Point 36 Point 44 Point 54 Point Times Roman 60 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 35 Sun wear for indoors and outdoors Low Vision Devices Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 37 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 38 These kinds of glasses may be helpful in TV viewing and reading Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 39 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 40 Writing Guides Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 41 Check Writing Guide Envelope Address Guide Signature Guide Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 42 Large Print Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 43 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 44 "Loss of vision means losing contact with things, but loss of hearing means losing contact with people“. -- Helen Keller Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 45 How We Hear • • • • • • • Sound travels through the air as vibrations or waves. The eardrum is similar to a drum; it is a membrane that stretches across the ear canal at the threshold between the outer ear and middle ear. When sound waves hit the eardrum, the eardrum vibrates and sends the vibrations to the middle ear, where they pass through, in order, the hammer (malleus), anvil(incus), and stirrup. These three bones are the tiniest bones in the human body. Stirrup passes the vibrations along the cochlea, in the inner ear. The inner part of the cochlea is lined with thousands of hair cells, called cilia (sil-eeuh). When the cochlea vibrates, the cilia move, stimulating the auditory nerve, which sends the vibrations to the brain. The brain then interprets them as sound. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 46 How is hearing loss measured? •Audiogram: chart showing how well you hear. •Loudness (decibels) is plotted from top to bottom. •Frequency (tone) is plotted from left to right. •Hearing Loss (HL) is measured in decibels (dB), not percentages. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 47 Meet The Audiogram Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 48 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 49 1. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 50 Hearing Aids • • • • Do not create ‘20/20 hearing’ Tailor amplification to loss Amplify all noises at those frequencies Work best in 1:1, quiet situations – intake interview _ one-to-one visits I can hear you but I can’t understand you Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 51 In the ear hearing aid (ITE) Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 52 Behind the Ear (BTE) Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 53 Canal Aid Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 54 Completely In the Canal (CIC) Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 55 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 56 What is a Telecoil or T-switch • A telecoil is a small copper coil that is an option on most hearing aids and is built into cochlear implant processors. • also known as t-coils and were originally used to boost the magnetic signals from the telephone handset. • telecoil is activated by a t-switch on the hearing aid or cochlear implant. • All landline and some cell phones are designed by law to be used with a telecoil. 57 Telecoil/T-switch Functions • Connects the listener directly to the sound source while most back-ground noise is eliminated • Increased amplification of speech from telephone through hearing aid and eliminates background noise • Can be used with Assistive Listening Devices (ALDs) such as: – Pocket talker/Personal FM system – Loop systems used at: • • • • • • Auditoriums Movie theaters Airports Banks Churches Workplace - Infrared system Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 58 Assistance to purchase hearing aids and assistive listening devices: Hearing Loss Association of America has an extensive list of programs and foundations that assist with the purchase of hearing aids. http://www.hearingloss.org/content/financial-assistanceprograms-foundations Lions Affordable Hearing Aid Project (AHAP) email: [email protected] www.lionsclubs.org The AHAP is only available through local Lions clubs. Contact a club in your town for more information. Hear Now Program 6700 Washington Ave S., Eden Prairie, MN 55344 1-800-648-4327 V/TTY Website: http://www.starkeyhearingfoundation.org/hear-now.php. Provides recycled and used hearing aids to low-income persons. Veterans Administration Vocational Rehabilitation Cochlear Implant • A cochlear implant has both internal and external components: • The external component consists of a sound BTE Headpiece processor in the form of either a behind-the-ear (BTE) or box-shaped device. This device is connected by a cable to a headpiece that rests on the scalp above the ear. The sound processor is Speech processor sometimes called a speech processor Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 60 Internal Component • The internal component consists of the actual “cochlear implant”, which nests within the mastoid bone. • The implant’s magnet connects from beneath the skin with a magnet in the headpiece outside the skin. The implant contains a computer chip and an electrode array, a very thin wire that is lined with electrodes and threaded through the cochlea. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 61 Cochlear Implant vs Hearing Aid • cochlear implant bypasses the damaged or missing cilia and directly stimulates the auditory nerve, enabling the implant user to hear sound. • Hearing aids, by contrast, depend on whatever cilia are present and capable of being stimulated. If there are no cilia, or if they all are damaged, the auditory nerve cannot be stimulated. In this event no hearing aid will enable an individual to hear. The person can then consider the option of a cochlear implant. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 63 One to One Communication Devices-Wired • Pocketalker Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 64 Personal frequency modulation (FM) systems Wireless • like miniature radio stations operating on special frequencies. • consists of a transmitter microphone used by the speaker (such as the teacher in the classroom, or the speaker at a lecture) • a receiver used by the listener • receiver transmits the sound to your ears or, if you wear a hearing aid, directly to the hearing aid. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry Use with Headphones; Neckloop if equipped with Telecoil (T-switch); Ear bud 65 Loop Systems Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 66 CART Computer-Assisted Realtime Transcription • What is it? – Speaker’s words displayed on screen or laptop – Usually a verbatim readout with disk/printout available after class • When is it used? – Meetings, workshops, presentations, training classes Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 67 Voice Carryover with LVD Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry 68 CapTel USB™ View Large-print CapTel Captions on a Computer Monitor connects directly to your computer to display conversation captions on your computer screen. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry CapTel phone conversations! You control the size, color, and font style of the captions on the computer screen for easiest reading. Choose large text sizes, high-contrast colors, or a special font to create optimal viewing. You can save and print conversation captions on your computer. CapTel phone connects directly to your computer via USB port. Designed specifically for users with low-vision concerns. 69 Interactive Text Communication Devices Interpretype UbiDuo 70