Remote Area Medical (RAM USA)
So how did the Tennessee Lions Low Vision Rehabilitation Project fit into the clinic?
Two weeks ago, the Tennessee Lions Low Vision Rehabilitation Project had the opportunity to volunteer at the Remote Area Medical Clinic at Red Bank High School in Chattanooga, TN.
The Remote Area Medical Clinic (RAM) is a free medical clinic created to serve anyone in the community without access to quality medical care. It is hosted by local partners and organizers and all medical professionals at the clinic volunteer their time and resources. Remote Area Medical Clinic (RAM) is based in Rockford, TN (just outside of Knoxville), but they serve communities across the country and the Globe. According to the RAM website (https://ramusa.org/about/), they are involved in local and international mobile clinics, disaster relief, and rural veterinary care. See the RAM website for more information.
Cheryl Saucier (TNLLVRP Director), John Moon (Lions District 12-O Vice District Governor), and I visited the RAM headquarters in Rockford in May and were welcomed by Ron Brewer and the entire RAM staff. We had the opportunity to discuss the current issues facing individuals with low vision in rural America and how the Tennessee Lions Low Vision Rehabilitation Project could help people attending the RAM clinics. Mr. Brewer and the RAM staff were incredibly supportive and welcomed us into their clinic.
When we got to the RAM clinic, we were shocked! What a case study in logistics! Hundreds of people line up for hours before the clinic. When the doors are opened people are guided through the building to all of the services that they need. There were hundreds of volunteers and hundreds of patients. It was truly an amazing sight to see so many people receiving medical care!
So how did the Tennessee Lions Low Vision Rehabilitation Project fit into the clinic?
Well, we had a small table set up in the vision center and as doctors saw individuals with uncorrectable vision loss, they sent them to us. We had the opportunity to help 13 people with low vision by educating them about resources, tools, and techniques to help them function in daily life. We also requested referrals to low vision specialists, occupational therapists, and state services in their area. We were lucky to receive donated equipment, such as magnifiers and glare shields, by Eschenbach and other manufacturers to give away at the clinic. Those devices make a huge difference in individuals’ abilities to read and write. We also were able to provide writing guides, reading glasses, large print paper, large print pens, large calendars, and much more!
To say the RAM clinic was a success was an understatement! We saw 13 people out of the 292 patients at the clinic. According to the 2015 American Community Survey, approximately 2.5% of the population in Hamilton County has a significant, uncorrectable visual impairment. Based on that data, we would have expected to see about 7 people with low vision.
That means we saw almost TWICE as many people as expected!
While the RAM clinic was a success for the individuals served, it was also a success for the Lions and professional partners! We engaged 5 professional partners from Siskin Hospital, Southeast Vision Rehabilitation, Signal Centers Assistive Technology Center, and the Tennessee State Services for the Blind and Visually Impaired. We also engaged Lions Volunteers from the Signal Mountain and Red Bank Lions Clubs.
Big thanks to Kassandra, Krista, Lana, Amy, and Cheryl for all of your help!
The Tennessee Lions Low Vision Rehabilitation Project is excited about the next RAM clinic and looks forward to future rural clinics. We would like to thank RAM for such an amazing experience. In addition, we want to thank the professional partners and Lions volunteers for supporting us in helping individuals with low vision find the help that they need.
P.S. The next RAM clinic that we will be attending is at McMinn High School on July 8th and 9th. The Parking lot will open at midnight (July 8th) and Tickets will be handed out on a First Come First Serve basis at 3 AM (July 8th). The clinic doors will open at 6 AM.
McMinn High School, 2215 Congress Parkway
Athens, TN 37303 United States
I am an occupational therapist and I recently interned at Signal Centers Assistive Technology (AT) Center. Signal Centers is partnered with Southeast Vision Rehabilitation and Siskin Hospital for Physical Rehabilitation as part of the Low Vision Network of Chattanooga. Signal Centers AT Center is a non-profit organization that offers services for all individuals with disabilities but also provides specific services for individuals with visual impairment. My role at Signal Centers AT Center is to modify and implement the Confident Living Program (CLP) for individuals with visual impairment.
Low Vision Services include:
What is the value of Occupational Therapy in independent living?
Traditionally the CLP was run by a rehabilitation teacher (RT). RT’s offer tremendous value to independent living skills groups due to their training in adapting the home environment for individuals with visual impairment, while also providing specific vision rehabilitation. Individuals with visual impairment should be seen by an RT when adjusting to blindness.
Occupational therapists are also trained in occupation (activity) adaptation, compensatory training, adaptation of the environment, therapeutic use of self, grading of activities, and providing client-centered, holistic services. When assessing a client, who has a visual impairment, it is important to consider all aspects of independent living (i.e. living situation, functional status performing activities of daily living, family/friend support, person’s roles, habits, and routines; and financial management). It is also important to assess the client’s cognitive ability, physical ability, and overall quality of life. Considering all listed factors allows an occupational therapist to design a course of treatment centered around the client.
Occupational therapists are also trained in group process. Utilizing theory and varying frames of reference to design a group is another unique quality of an occupational therapist. By doing so, a therapist can structure sessions appropriately and track progression. With compassion and therapeutic use of self, the CLP is instructed to increase level of independence and confidence in each participant. Functional independence is the purpose of the program and the mission of occupational therapy.
What is the Confident Living Program?
The CLP is an independent living skills program for individuals who are visually impaired. Most clients who are referred to Signal Centers are individuals who are recently blind or have recently been reentered into the community. Loss of vision can cause loss of independence, which can lead to decreased self-efficacy and depressive thoughts (Zhang et al., 2013). Therefore, relearning daily living skills adapted to accommodate vision loss provides an opportunity for clients to gain independence, improve self-efficacy, and explore meaningful activities.
The CLP is apprised of skill building, problem solving, social interaction, and improved self-efficacy in the context of relearning daily living skills. Those skills include use of writing guides, labeling and organizing, cooking skills, fall prevention, use of assistive technology, leisure and recreation, and more. Activities are adapted to promote independent performance of each client. Signal Centers offers three cycles of class sessions per year.
How long is a semester for the CLP?
1 semester = 12 weeks
2 sessions per week (24 classes total)
2 hours per session
Here is a look at some of the activities performed in the CLP:
Four of our sessions explore cooking a variety of items to meet basic nutritious needs. Pictured below is a “healthy” dessert that is diabetic friendly. Skills involved include:
Leisure and Recreation
Performing meaningful activities unrelated to work is important for quality of life and occupational balance. As part of the CLP, leisure activities are incorporated to explore different leisure pursuits and to demonstrate adaptations to previously enjoyed activities.
Use of writing guides provides independence for individuals through not having someone else writing information down for them. A variety of guides are utilized to aid individuals with writing lists, writing checks, signing a document, addressing an enveloped, and other note taking needs.
Most individuals with visual impairment use a smartphone to increase functional independence. In the CLP, a variety of applications are explored to adapt a task. For example, the NantMoblie Money Reader app reads currency when a bill is placed in front of the phone’s camera.
Is there a cost?
The fee for enrolling in the class is $20 per participant. However, services are never denied at Signal Centers AT Center, so scholarships are available for clients who are not able to pay the fee for the class. Also, clients from Georgia who are referred to Signal Centers AT Center through vocational rehabilitation can receive funding for the class from their vocational rehabilitation counselor.
How can I sign up for the Confident Living Program?
Requirements: Diagnosis of visual impairment
Referral process: If you have a vocational rehabilitation counselor, ask them to refer you to Signal Centers AT Center for vision services. OR, if you or if you have a friend/family member who lives with visual impairment, come by Signal Centers AT Center and talk to us about our vision services.
Fall Semester: TBD
Location: 2300 Bailey Ave Chattanooga, TN 37404
Contact: 423-629-4174 or firstname.lastname@example.org
Zhang, X.,…Saaddine, J. (2013). Association between depression and functional vision loss in persons 20 years of age or older in the United States, NHANES 2005-2008. Journal of American Medical Association Ophthalmology, 131(5), 573-581.
I am an occupational therapy student working with the Low Vision Network in Chattanooga, TN. During this internship, I have taken a special interest on the impact of vision loss on mobility. Low vision can cause changes in the clarity of vision or the field of vision which make it difficult to perform everyday activities, especially those that require mobility.
What do I mean by mobility?
Mobility is the ability to get around one’s home and community environment safely. After vision loss, this is very difficult. Things that were once simple, like going to the mailbox or going to the grocery store, become big challenges.
Think about going to the grocery store. You have to get there, find the entrance of the store, navigate through the aisles of the store to find the items you need, navigate to the cashier to pay, go back home, bring in the groceries, and put them away. After vision loss, a person must figure out how they are going to get to the store, find all the items they need, pay and get back home. This is just one of the many activities that requires mobility skills that is impacted after vision loss.
What is the impact?
Persons with low vision often limit their activities because they are afraid of falling, getting hurt, and they are not confident in their abilities to get around. Persons with vision loss often are afraid of falling because they have difficulty seeing obstacles like bumps in pavement, curb cuts, steps, signs, and much more. This makes going out into an unfamiliar area very frightening. Commonly, if a person does go out into the community, they have assistance from another person. Needing assistance from others all the time can make them feel like a burden on others. If a person with low vision does not have the mobility skills they need, they will decrease their participation in activities in their communities. This leads to individuals who are socially isolated and depressed. For these reasons, it is important to continue participating in activities in the home and in the community.
So, what can be done?
It is important that a person with low vision to receive training on mobility skills. There are two professionals who commonly address aspects of this training, occupational therapists and orientation and mobility specialists.
What do orientation and mobility specialists do?
Orientation and mobility (O&M) specialists teach persons with low vision how to navigate safely within their homes and communities. Some examples of skills O&M specialists teach are:
What do occupational therapists do?
Occupational therapists (OTs) work with persons of all ages and ability levels. The focus of occupational therapy is to help individuals participate in activities that are meaningful. OTs can specialize to work with people who have vision loss to help them maximize their independence and participate in activities that are meaningful. OTs address mobility by
Does someone with low vision need to see both professionals?
O&M specialists and OTs often collaborate when working with persons with low vision to determine if the individual needs services. Persons with low vision need to have strong basic mobility skills learned in orientation and mobility training before they can learn more complex tasks such as using public or private transportation services to get from place to place.
O&M specialists may refer an individual for OT services if the person has problems caused by other conditions that interfere with mobility. For example, a person with diabetic retinopathy may have a loss of feeling in their fingers which makes finding their bus pass in their wallet difficult.
OTs may refer to an O&M specialist if the individual they are working with is having trouble with mobility skills. For example, the person is bumping into objects, falling due to not detecting obstacles, or changes in pavements.
What happens when mobility is addressed?
Persons with low vision learn mobility skills, find and access transportation services, and navigate their home and community environments safely. This increases the person’s confidence in their ability to travel in the community and decreases their fear of falling. With this increase in confidence and skills, persons with low vision can participate in activities in their homes and communities that are meaningful to them. Being able to continue participating in meaningful activities helps reduce social isolation and depression, and leads to an overall better quality of life.
For More Information:
Check out VisionAware’s page http://www.visionaware.org/info/everyday-living/essential-skills/an-introduction-to-orientation-and-mobility-skills/123
For more information about Occupational Therapy’s Role in Low Vision:
Check out AOTA’s page on low vision http://www.aota.org/Practice/Productive-Aging/Emerging-Niche/Low-Vision.aspx
What is Low Vision?
Low Vision Rehabilitation
Lions District 12-O Needs Assessment
The Lions Clubs of Multiple District 12 (Tennessee) are a group of dedicated community servants who meet the needs of various individuals in their community. One of the unique aspects of the Lions Clubs is their unique focus on improving, restoring, and preventing vision loss. In some cases, that involves helping individuals with low vision.
This article briefly describes low vision, it's impact on daily functioning, and what can be done to help. It then describes the reasons for an in-depth assessment of the resources and needs regarding low vision services, followed by a description of what you can do to get involved.
What is Low Vision?
Low vision is a form of vision loss that cannot be corrected with typical eye care, such as glasses, contacts, medication, or surgery. It often leaves people with some vision, which differentiates it from complete blindness. Low Vision diagnoses include age-related macular degeneration, glaucoma, diabetic eye disease, and neurological impairment (stroke, brain injury, eye injury).
People with low vision many times have problems performing their daily activities such as reading, cooking, taking care of children and grandchildren, or even basic self-care. However, there are ways to help people with low vision get back to doing the things that they need and want to do.
Low Vision Rehabilitation
Low vision rehabilitation is a form of vision care that focuses on the person and their daily functioning after the eye doctor has provided medications and/or surgery. This unique form of vision care integrates various medical and community-based services such as optometry, low vision therapy, orientation and mobility, assistive technology, and community volunteering. By utilizing all of these resources, people with low vision have the opportunity to live engaging and fulfilling lives.
The Lions Clubs International is the largest community service organization in the world. Their unique focus on vision-related service has made a global impact on individuals with visual impairments. Lions Clubs volunteers have the opportunity to help individuals with low vision through various types of service projects both in-person and behind-the-scenes. One of those projects is to gain a better understanding of the services available to individuals with low vision within their local communities.
Lions District 12-O Needs Assessment
The Lions Clubs District 12-O (18 counties in middle and eastern Tennessee) has recently received funding and support from the Lions Clubs International Foundation, the Chattanooga Ophthalmological Foundation, and the Chattanooga area Low Vision Network to develop and distribute a survey to medical providers, rehabilitation providers, and community organizations to better assess the low vision services and needs within the district. This information is vital to developing educational, community service, and research programs to help people with low vision. The Tennessee Lions Low Vision, District 12-O needs assessment survey is the first step towards changing the lives of hundreds of people in our region.
How can you help?
There are multiple opportunities for involvement in the Tennessee Lions Low Vision Needs Assessment. The list below describes the different ways that you can help.
1) Take the Survey
This opportunity is primarily for medical providers, rehabilitation professionals, and community organizations within the Lions Clubs District 12-O (Click here to see the map). It only requires about 10 minutes of your time and will have a direct impact on the programs that are developed as a result of the findings. Just follow the link below to get involved.
2) Sign up to Volunteer
Volunteering opportunities are specifically for members of the Lions Clubs. The club officers in each of the Lions District 12-O clubs have been sent information regarding how club members can get involved in deploying the needs assessment survey. See your club officers for details or request volunteering information in the box below to get involved.
Subscribing to our website will give you the opportunity to stay up to date about project updates and events. As we continue to grow, there will be more opportunities for you to get involved. You can subscribe by leaving your information in the form below.
Who are we?
The Tennessee Lions Low Vision Rehabilitation Project is a collaborative effort between Lions Clubs volunteers, low vision medical providers, and community organizations to serve individuals with low vision through community service, education, research, and advocacy.