The Illinois Department On Aging 3 rd Annual CCP Supervisors’ Conference April 22-23, 2014 Crowne Plaza: Springfield,

1. The Illinois Department On Aging 3rd Annual CCP Supervisors’ Conference April 22-23, 2014 Crowne Plaza: Springfield, IL Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

2. HelenKeller 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 paige.berry@hknc.org 804/827-0920 www.hknc.org Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

3. 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

4. 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

5. AARP SongTo 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.

6. 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

7. 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

8. 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

9. 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

10. Back pains, confused brains, and no fear of sinnin’, Thin bones and fractures and hair that is thinning’, More of the pleasures advancing age brings- When we remember our favorite things. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

11. 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

12. What does the term “Deaf-Blind” mean to you? Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

13. . “Deaf-Blind” Basically – 4 categories Individuals who are hard of hearing and partially sighted or visually impaired Individuals who are deaf and partially sighted. Individuals who are blind and hard of hearing. 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

14. 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

15. 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

16. State of Illinois Driving Requirements Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

17. The Big Five • Cataract • Macular Degeneration • Glaucoma • Diabetic Retinopathy • Retinitis Pigmentosa Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

18. 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 • Surgeryis 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

19. 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

20. Amsler Grids Normal Cover one eye and look at the black dot – lines should be straight Abnormal Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

21. 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

22. Charles Bonnet Syndrome Visual Hallucinations Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

23. 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

24. 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

25. 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

26. 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 angle-closure 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, only required in cases of severe asthma. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

27. 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

28. 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

29. Visual Impact of Diabetic Retinopathy Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

30. 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

31. 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

32. Usher Syndrome Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

33. Diabetic Retinopathy Macular Degeneration Cataract Retinitis Pigmentosa/Glaucoma Charles Bonnet Syndrome Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

34. Low Vision Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

35. 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 54Point Times Roman 60 Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

36. Sun wear for indoors and outdoors

37. Low Vision Devices Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

38. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

39. 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

40. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

41. Writing Guides Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

42. Check Writing Guide Envelope Address Guide Signature Guide Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

43. Large Print Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

44. Hearing Loss Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

45. "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

46. 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-ee-uh). • 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

47. 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

48. Meet The Audiogram Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

49. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry

50. 1. Illinois Dept. on Aging April 22, 2014 Helen Keller National Center-Paige Berry