Glaucoma?

This week on Parents Are Hard To Raise, Diane’s special guest expert, Rehabilitation Specialist for the Blind, Jill Feigelis, is here to share some great tips and resources for helping the visually impaired live their best lives ever.

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Show Transcript

Parents Are Hard To Raise® S03 Episode 108 Transcript

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Announcer [00:00:24] This week on Parents Are Hard To Raise®, Diane's special guest expert, rehabilitation specialist for the blind, Jill Feigelis is here to share some great tips and resources for helping the visually impaired live their best lives ever.

[00:00:52] Join 180 million monthly subscribers who can now listen to Parents Are Hard To Raise® on Spotify.

Diane Berardi [00:01:10] Welcome to Parents Are Hard To Raise®, Helping families grow older together without losing their minds. I'm elder care expert, Diane Berardi.

[00:01:20] Growing old has its challenges. Growing old blind...that's a total game changer. Weather loss of sight is caused by genetics, infection, disease or injury it can significantly, maybe more than any other physical challenge, limit a person's ability to live an independent life. Normal daily activities like shopping, climbing stairs, pouring a cup of coffee, making a phone call, even dressing, become much more challenging if not all but impossible as sight diminishes. Blindness and low vision can affect more than just our independence and daily routine. Loss of sight can drastically reduce a person's ability or desire to socialize and meet new people, which impacts negatively on their emotional health as well. And because the eye is responsible for providing information to the brain, loss of vision can alter balance and contribute to falls.

[00:02:17] My guest expert this week is one of those rare dedicated and passionate health care professionals, who at the end of the day still loves what they do and can't wait to wake up and do it all over again.

[00:02:30] Jill Feigelis is an expert in blind and low vision rehabilitation. She holds academic degrees in blind rehabilitation, orientation and mobility and sociology, and advanced degrees in developmental disabilities and gerontology. Throughout her 37 year career she has worked with everyone from infants to seniors. And fortunately for us she's taking time out of her busy schedule to share some of her hard-eraned knowledge with our Parents Are Hard To Raise® family.

[00:03:00] Jill Feigelis, welcome back to Parents Are Hard To Raise®.

Jill Feigelis [00:03:05] Thank you so much Diane. Very happy to be here.

Diane Berardi [00:03:09] Well, we got so many listener e-mails from the last show you did with us, and it was on macular degeneration. And people were saying how helpful your tips were. So what do you have for us this week?

Jill Feigelis [00:03:26] Well, I was thinking about it and you know as we said with macular degeneration, just to review, that is when people lose their central vision. And the best advice I could give to that is high contrast, low glare in their daily life routine. And I was thinking, another unfortunate disease that afflicts a lot of people is glaucoma. Where that's the opposite of macular degeneration in most cases. It takes your peripheral and you have a little bit better central vision.

[00:04:07] So with glaucoma the issues then are lacking depth perception. So there's a lot of problems with walking down stairs, stepping off curbs, potholes. So if you're at the point where your diagnosis for glaucoma has advanced where you have these issues with lack of peripheral and depth perception. I mean the best honestly useful tool that you can have is the white cane, because in the country and out of the country, people that carry the white cane have the right of way. That's the white folding cane with the red tip. We have different tips at the very end of it. When I first started, way way back it was just called a straight pencil tip. Now we've got a lot of roller tips that roll over all the crevices and the breaks on the sidewalk so you don't get charged a little bit. But just having this simple device, this folding long white cane. Again it identifies people for safety reasons in a court of law that if an accident were to happen somebody sighted, a car run over, anything, in a court of law that the person carrying the white cane has the right of way. So it's almost like carrying a little bit of an insurance policy to tell you the truth. But besides that, if you think about it, the white cane will extend... First of all let me backtrack.

[00:05:39] That the person you would get a white came from or you should get a white cane from is called an orientation and mobility instructor. And I believe as I said at the last time we got together every state has usually a commission for the blind. Not usually, I'm pretty positive they all do. And through the commission for the blind, you can call your state office and this is a benefit to state residents. There is no charge for the service and an orientation and mobility instructor will be assigned to your case. They'll come out to your home. They'll do an evaluation. They'll look at your height. They'll look at the way you walk. They'll look at your posture, because there's there is the long way cane. And there is a support white cane.

Diane Berardi [00:06:31] OK.

Jill Feigelis [00:06:32] They as a professional will pick the right height and they will order you the right cane, and they will instruct you how to use this cane. So with just this stick basically that should stand about... We measure to the sternum or a little higher, depending on the instructor. And that gives you enough time that when you use the cane out fun you, tip down, and you use it left to right in an arc in the proper way that you'll be instructed, it gives you enough time to react to the problem before you encounter it. So that will prevent falling down the stairs, walking into a pothole. You know, it's such a simple thing. I mean you know I love that part of it that it's just a basic kind of white stick that could totally save somebodies life from so much injury, you can travel across the country, within the country. It's a simple  design that works.

[00:07:37] So that that adds a lot of safety to people with glaucoma. Because with them not having their side vision or depth perception that opens up their field that you know protects them from all that they would encounter.

[00:07:52] So I have people that have you know even if they've lived in their homes for like 40 years. Sometimes when the vision fails, they can't get around as you know expertly as they did with vision. Especially you know out down the steps outside, taking a walk around the block. You know they didn't notice the cracks of the sidewalk. They didn't notice potholes.

Diane Berardi [00:08:20] Right.

Jill Feigelis [00:08:21] And you know, one fall, you know one fall really can change somebodies life pretty bad.

Diane Berardi [00:08:28] You know, depth perception. I mean, I remember when I was young and I was in high school and I had scratched my cornea and they put a patch on one of my eyes. And, oh my gosh. I didn't realize, without that depth perception. Oh my gosh. I just fell right down a flight of steps.

Jill Feigelis [00:08:48] It's very dangerous. And you know that opens up other areas too because when like you said so you had one eye patch right that gave that gave you a binocular vision one eye which changed it, changes how you would know your gait how you'd walk looking down. And then also something came up just recently, with my mom's friend I'll share that.

[00:09:14] She's wearing her bifocals while she's walking. And she is falling, weekly. You can't wear bifocals or any lenses with any kind... you know, anything that's going to throw off your accuracy when you're looking down, or you're gonna fall off. There's just no way around it. You're going to fall. You know when you put any kind of a different color. Well like you said, the one eye... that made a big difference. The bifocals you know anything like that needs to be very careful.

[00:09:51] And like I said I mean one fall to people, breaking a hip, breaking a leg, breaking... that's a tragedy. So  it's hard to recover after that bad fall with a lot of the elderly people. So that's what our goal is.

[00:10:07] So the cane you know we do encourage them if they're lacking that depth perception, that's really the best tool to have is that white cane. I mean I've had people over the years I've been telling them they're using an umbrella. I've had people use a fishing pole. I've had people use all kinds of crazy things that they come up with you know.

Diane Berardi [00:10:26] Yes.

Jill Feigelis [00:10:27] You know I mean they were being creative. So you know I'm not going to take that away from them. But again, the best thing in this conversation would be a white cane with the red tip, it identifies the people as visually impaired to blind. So now they have the right of way as well as using correctly. You know it's a very I can't say it's 100 percent, because as you move it you know you could miss a little on each of each side but it's very very great tool to use for anybody lacking depth perception whereas we say like tunnel vision or loss of peripheral. Because we want a widen that field and give them that extra tool to feel what they can't see, to cover that space.

[00:11:14] You know even I'll bring up you know how the older people now they used to work with walkers. A lot. And now you see them walking with "Rollators", we call  them.

Diane Berardi [00:11:24] Yes.

Jill Feigelis [00:11:24] OK. They're wonderful. Because I love the rolllators. I mean a physical therapist is more you know they're the professional to decide whether you're going to use a walker or a rollator...

Diane Berardi [00:11:37] Right.

Jill Feigelis [00:11:38] But I love either one but the rollator is wonderful. They have a seat. You know that that people when they get tired. They most of them have a seat that they can sit down in. You know they have the little basket. They've got brakes on it. The wheels in the front with the brake. But what I love about the Walker and the rollator is as I told you the Cane stands out in front of you a few feet, the walker in the rollator. For people that don't see very well, act almost as a bumper as well. Because the front of the Walker or the rollator is going to encounter the drop off.

Diane Berardi [00:12:19] Yeah. Right.

Jill Feigelis [00:12:20] The wall, the piece of furniture before the person's body. Again reaction time. So that's wonderful for them. You know it's safe. Safer.

[00:12:31] So that's all... That's all good stuff.

[00:12:34] You just always want to... And that would bring me into, I was going to talk today a little bit about walking with the blind or visually impaired person. And we call it cited guide technique.

Diane Berardi [00:12:48] OK.

Jill Feigelis [00:12:48] And you can also learn that from orientation mobility instructor. But when I do in-services and I ask for volunteers to show me how they'd work with the blind person.

Diane Berardi [00:13:00] Right. OK.

Jill Feigelis [00:13:02] Most people get up and they put the blind person in front and they take their arm and kind of grab the back of their elbow and go walk in front and I make them look at the situation. I'm like, Do you really think this is the right way? Because again as I talked about the Walker, the rollator, the cane, all as like bumpers to tell you what's coming, you want to put the sighted person in front.

Diane Berardi [00:13:28] Right. OK. You make perfect sense.

Jill Feigelis [00:13:31] Right? You don't want to flip a blind person in front. So what we do for sighted guide is you would take the person that's visually impaired. Well you don't take them... [laughing] [00:13:42] You do ask them to grab the back of your vertical part of your arm.

Diane Berardi [00:13:50] OK.

Jill Feigelis [00:13:51] If you can understand, what I'm trying to say. Like do you take.. You grasp the person that cannot see will grasp the back of the sighted person's arm.  But the whole trick, and they take a nice script not too lose, not too tight. And then you know the person that's guiding you should have like an L shape of their arm. And then that person takes a vertical next to them that's blind. And the trick is again you don't walk side by side. The whole trick to this is the person with vision walks a few steps in front. So again, they can be the buffer.

Diane Berardi [00:14:38] Makes sense. Perfect sense.

[00:14:42] Right. So if the person with sight trips or missteps the the blind person to let go before they go down.

Diane Berardi [00:14:51] Right. Oh my gosh. Yet people don't think that. And they actually... Yeah that's perfect.

Jill Feigelis [00:14:59] Yeah. So. So what you want to do is again. I'm sorry. Explain it like this but I do want to confuse anybody but if you're sighted and you're walking with the visually impaired or blind person you're going to walk up to them. First of all you always ask them you know do you need any help. You don't just take them right. You don't grab 'em... So if they say, yes. What you want to do is they should know. But if they don't... They take your vertical part of your arm and they hold on to it like you know your thumb on the inside your four fingers on the outside of the arm. And then that's on, like I'm on the right side. I'm sorry the left side. And then they walk next to you but you're a few steps in front of them. And in that way you don't have to count steps for them. You don't have to... They're going to feel your body, all the movement of your body as you walk.

[00:15:58] You know if you go up, if you go down, it's a good situation, more than if you like take a piece of the clothing and hold on to it.

Diane Berardi [00:16:06] Right.

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Announcer [00:18:17] You're listening to Parents Are Hard To Raise®. Now... Thanks to you... The number one eldercare talk show on planet Earth.

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[00:19:38] So Jill, you were talking about walking with a visually impaired person.  I would imagine. So you do in services on just that. Most people probably don't even realize that that's something they would need to learn how to do.

Jill Feigelis [00:19:55] Like I said, when I work with somebody that really hasn't had an experience walking with somebody who is visually impaired or blind.

Diane Berardi [00:20:04] Right.

Jill Feigelis [00:20:05] As many skills, you know, I see in a different perspective you know because I've been taught and I've learned all these years. But a new case to the family of somebody that's visually impaired and blind. They really should call in someone that does like what I do. So that we can share with them a lot of common sense is really besides the white cane that needs specific training.

[00:20:30] But looking at it from our perspective and from someone that's never worked you know we really can make a lot of suggestions that just make the life easier for that person that really doesn't see as well anymore.

[00:20:44] Going along with that, with this we call it Sighted Guide techniques, if you are bringing somebody that is visually impaired like to a chair... Do you bring them to the back of the chair? Do you bring them to the front of the chair?

[00:20:59] You know you really can do either one. But they have to learn also that you know before they just sit down they should like run their hand down the side of the chair see if there's arms on the chair, they want to center themselves, feel the back of the chair, put the back of their legs to the chair before they sit down. You know clear the seat. Give a circle to the seat make sure there's nothing on the chair. You know just simple things like that.

[00:21:28] When you're walking, let's say you know you and your dad are walking in the mall and he's not seeing very well and you want to go into a store in the mall. Space to a blind person is very scary. Sounds and space that they're not familiar with.

Diane Berardi [00:21:44] Right.

Jill Feigelis [00:21:44] You never want to say like, Just wait here.

Diane Berardi [00:21:49] Okay.

Jill Feigelis [00:21:50] You would never do that. You want to give them something solid maybe to be touching before you leave their side. So if you're in the mall let's say and you're with somebody that doesn't see and they definitely should be still going to the mall even though they don't see they can still be getting out and shopping and doing things that we could talk about, more.

[00:22:10] But have them sit on the bench and wait for you or even stand next to a wall outside the store that they have the wall to kind of touch.

Diane Berardi [00:22:20] Right.

Jill Feigelis [00:22:21] Because contact gives them instant security. When you're, if you go home and you try to do things and you're just in space, even in a familiar area,  you're much more insecure than the one the second you touch a wall or the couch or the chair you're going to all of a sudden feel more confident, comfortable, secure in your environment.

[00:22:47] Space is definitely a problem for us even as an O&M instructor, walking in space is tough. Because even if people assume they're walking a straight line, most of the time they're not.

[00:23:01] So once they use a term we call trailing, the trailing technique. You are touching, your arm is out in front of you, again, as a buffer. You don't walk learning an area with your arm at your side. You put it out in front of you on an angle. And you do it like you're gripping like a tennis ball.

[00:23:23] Your fingers are down. And we'll put it out in front of them and they can feel good around the perimeter of the new room environment or even around like where the chair is and the desk in the couch, let them feel it. So they get a real good sense of what's going on in the room, the space of the room, the feel of the room. So that's helpful to them.

Diane Berardi [00:23:47] So that's part of orientation and mobility.

Jill Feigelis [00:23:52] Yes. Orientation of course is you know learning your environment, orientation to your space. And mobility is anything to do with ambulation, with walking.

[00:24:05] So there is a specific degree in college, College based, called orientation and mobility.

[00:24:13] So my degree was blind rehabilitation, orientation and mobility and I dualed with social services. And you know you can go on and do a lot of. And then there's a degree for a skills for daily living instructor- a VRT.  And then, low vision.  You know there's a there's a field. And it's a very good field to go into with our population living longer.

Diane Berardi [00:24:39] There's such a great need there.

Jill Feigelis [00:24:41] There really is. We are small a small group at this point. We you know definitely encourage young people, anybody, if they want to you know get involved in this field. You know they can look up the colleges that are offering these degrees and that would be wonderful. We need more people.

Diane Berardi [00:25:00] I was amazed by sixty five years of age one, in three Americans have some form of vision impairing eye condition. And Yeah...we're living longer. My gosh. Yeah. You have your hands full. [laughing]

Jill Feigelis [00:25:17] I do.

[00:25:18] I mean this is a show for the elderly. But I do also work with infants 0 to three. And just genetic things that are going on.

[00:25:30] You know people are using new alternatives to have children, which has some affect on some things. You know there's a lot of need out there for people in this field.

[00:25:42] And definitely the eye issues. You know macular degeneration as of now there's no cure. There are throwing around some, I mean, is it from the ultra violet rays of the sun? Is it people with lighter eye color? There's a lot of different things going on with the why.

[00:26:05] And then of course diabetic retinopathy. People with diabetes unfortunately it can affect the vision over time.

[00:26:17] You know the glaucoma.  The retinitis Pigmentosa on my caseload. And other things, you know trauma. Things like something you know like that. So again like you're saying, that population again is in need of people that have the training I have to help them learn how to live a quality of life again and they can they absolutely can.

Diane Berardi [00:26:46] And that's wonderful to hear.

[00:26:48] Parents Are Hard To Raise® family. We want to thank Jill Feigelis again. And we will have her back, because I  have another question on the bifocals so we're definitely going to have her back.

[00:26:59] Jill thank you so much. How can people reach you?

Jill Feigelis [00:27:04] JillFeigelis@gmail.com I'd be thrilled to help anyone I can in any way.

Diane Berardi [00:27:10] Thank you. Thank you so much Jill and Parents Are Hard To Raise® family. We love getting your e-mails and questions so please keep sending them. You can reach me at Diane at Parents Are Hard To Raise® dot org or just click the green button on our home page Parents Are Hard To Raise® is a CounterThink media production the music used in this broadcast is managed by Cosmo Music New York New York and New York producer is Joshua Green. Our broadcast engineers well Gambino and from our London studios the melodic voice of our announcer Miss Dolly D.

We love our parents but parents sure are hard to raise.

Thank you so much for listening.

Till next time may you forget everything you don't want to remember and remember everything you don't want to forget.

[00:27:57] See you again next week.

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