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O&M FOR LIFE: ORIENTATION AND MOBILITY FOR OLDER INDIVIDUALS
WITH VISUAL IMPAIRMENT
AER INTERNATIONAL ORIENTATION & MOBILITY CONFERENCE 2013
Nora Griffin-Shirley, PhD, Texas Tech University, [email protected]
Laura Bozeman, PhD, University of Massachusetts Boston, [email protected]
Anita Page, MEd, Texas Tech University, [email protected]
Objectives
1. Participants will learn strategies to work with older clients (55+) in the provision of O&M instruction.
2. Participants will explore issues commonly experienced by older O&M clients.
3. Participants will have a simulation activity after which a dialogue will ensue concerning their experiences and solutions for effective instructional strategies.
Today’s Agenda
Short Presentation
Simulation Activity
Dialogue
Issues Commonly Experienced by Older O&M Clients Other Than
Visual Impairment Health
Psychological – depression, isolation, dementia, lack of self-confidence & self-esteem, unavailable informal supports (family, friends), cumulative effect of many losses & inadequate coping skills (Brennan & Bally, 2007)
Physical – hearing; orthopedic; diminished touch, taste & smell; other conditions (e.g., high blood pressure, diabetes, heart disease, etc.)
Issues……. Financial – longer hospital stays, increase in doctor’s
visits, poverty
Falls
Non-driving concerns
Older adult’s attitude toward blindness (Brennan, Horowitz & Reinhardt, 2004)
Strong sense of spirituality (Brennan & Bally, 2007)
Impact of deafblindness
GROUP ACTIVITY
What are some issues you have noticed when
providing O&M services to this population?
Simulation Activity
1. Pair with a partner
2. Go to all stations & complete activities
3. Note concerns you had completing the activities & what you did to successfully accomplish the task or cope
4. Jot down items for discussion
Discussion
What concerns did you have when completing the activities?
What did you do to successfully accomplish the task or cope with it?
Strategies for Providing O&M Training to Older Adults
Exercise Tips
Increase physical activity on a daily basis Get seniors involved in a regular exercise
program such as walking or Tai Chi after their physicians have given permission for starting an exercise program
(Griffin-Shirley & Welsh, 2010)
Discuss with personal trainers and exercise program instructors how they can modify their teaching to include verbal cueing and assisted movement, if needed, for students to be successful.
Have seniors try new recreational
activities with a friend and discover what modifications may need to be made with the actual recreational skills and the environment
Access transportation and routes to a fitness facility, and advocate for familiarization to this facility and access to educational materials distributed by the facility
Have seniors journal their thoughts and feelings while they are starting an exercise program to document the effects it has on their lives and the impact on their orientation and mobility
Have seniors initiate social interactions with friends and others to make them feel comfortable about exercising together
Have seniors experiment with their low vision devices during recreation activities to understand what works best and how to care for these aids
(Griffin-Shirley & Welsh, 2010)
O&M Tips
Use an andragogical approach
Schedule lessons at the most appropriate time of day to maximize a senior’s learning based on her functional abilities
Plan the duration of a lesson to accommodate for a senior’s health condition and stamina
(Griffin-Shirley & Welsh, 2010)
Choose the locations and content of lessons that are going to contribute to meeting the most immediate O&M goals of a senior
Adjust the delivery of a lesson’s content to facilitate a senior’s comprehension
Share with the senior observations of her performance and her evaluation reports
Discuss O&M goals with the senior and her family members as well as their feelings about independent travel and how it fits into their lifestyles
(Griffin-Shirley & Welsh, 2010)
Provide initial objectives that are meaningful but readily attainable & lead to successful experiences relevant to attainment of the senior’s orientation and mobility goal
Create teaching materials that enhance the senior’s comprehension of lesson content, involve a multi-sensory approach, and tap into the senior’s preferred intelligences
(Griffin-Shirley & Welsh, 2010)
Make sure the older adult does not think you are overprotecting her due to her age because the senior’s perception of overprotectiveness could interfere with her desire to become an independent traveler (Cimarolli, Reinhardt & Hororwitz, 2006).
Choose highly motivating routes to
teach seniors (Griffin-Shirley & Welsh, 2010)
Choose the most appropriate environmental modifications for the senior’s home to maximize safety and travel efficiency
Use memory techniques and devices if the senior has memory problems
Respond promptly to senior’s who are crying or extremely emotional during lessons
When appropriate, include caregivers in your lessons, teaching them ways to support the senior’s independence and safety
(Griffin-Shirley & Welsh, 2010)
Recognize that senior’s may use a variety of mobility tools and orientation aids
Become well versed in the use and maintenance of tools and aids and how to train the senior’s to use them
Use a team approach
(Griffin-Shirley & Welsh, 2010)
Collaboration with Other Team Members When Serving Older
Clients Needed for communication, respect and
joint decision-making on behalf of senior
COMS defines what independence resembles for senior (Pogrund & Griffin-Shirley, 2011)
Teams in assisted living facilities, hospitals, nursing homes, VA BRCs, low vision clinics representing various professionals
Different models – What model do you see used most often?
References Brennan, M. & Bally, S.J. (2007). Psychosocial adaptations to dual sensory
loss in middle and late adulthood. Trends in Amplification, 11(4), 281-300. Brennan, M., Horowitz, A., & Reinhardt, J.P. (2004). Understanding older
Americans attitudes, knowledge, and fears about vision loss and aging. Journal of Social Work in Disability & Rehabilitation, 3(3), 17-38.
Cimarolli, V.R., Reinhardt, J.P. & Horowitz, A. (2006). Perceived overprotection: Support gone bad? The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61, 18-23.
Pogrund, R. & Griffin-Shirley, N. Collaboration in providing orientation and mobility to the older adult. In N. Griffin-Shirley & L. Bozeman, O&M for Life. Unpublished manuscript.
Griffin-Shirley, N., & Welsh, R. L. (2010). Teaching orientation and mobility to older adults. In W.R. Weiner, & R.L. Welsh, Blasch, B.B., (Eds.) Foundations of Orientation and Mobility (3rd edition, p. 286-314). New York: AFB Press.
U.S. Department of Health and Human Services, Center for Disease Control & Prevention, (2010). Summary of Health Statistics for U.S. Adults: National Health Interview Survey, 2009. (CDC No. Number 362.1’0973’021s—dc21) Retrieved http://www.cdc.gov/nchs/nhis/new_nhis.htm
