Over half of all blind people in this country are 65 years of age or
older.  When blindness or visual loss occurs later in life, it can be
extremely frustrating.  But more importantly, assistance with the
necessary adjustment to blindness is often much more difficult to obtain
than it is for younger persons.  Every state has a government-funded
rehabilitation program, with many states having separate agencies for the
blind.  These programs are mainly established to help people get back to
work.  If a person is of retirement age and is not looking for employment,
he or she may not be eligible to receive services from these programs. 
Some states have established independent living programs to provide
services to older blind individuals.  Often a newly blinded person does
not know where to go to find out about how to continue functioning as a
blind person.  Many people do not know about tools and methods which exist
to make it possible for blind senior citizens to remain in their own homes
and continue to be contributing members of society. 

     Here are some of the most frequently asked questions we receive about
older blind persons, along with our answers. 

"My mother is going blind. Where should she live?"

     A blind person can live comfortably and safely almost anywhere he or
she chooses to live.  Certainly, the same choices about living quarters
should be available to the blind as are available to sighted individuals. 
     In recent years thousands of older citizens have found it desirable
to move into senior citizens' villages, apartment buildings, mobile home
parks, or clusters of houses reserved for retired people.  Some of these
include group dining rooms and recreation facilities, while others have
very few special services.  Undoubtedly, some blind people will find
arrangements such as these desirable.  Some will not.  Blind people should
have the opportunity to live in these senior citizen villages along with
everyone else.  Assuming that the blind person does not have health
problems that make nursing home care necessary, elderly blind individuals
should be able to learn alternative skills to care for themselves and live
in whatever type of housing situation they prefer. 

"My mother is losing her vision. What is available to her and what can I do to help her feel useful again?"

     It is not necessary for a blind person to be helpless or dependent.
With proper training, encouragement, and opportunities, a blind individual
can be active, self-sufficient, and productive. 
     The most important thing for your mother to do now is to gather
information about how blind people function effectively in the world. 
This includes the use of daily living skills and work-related skills. 
Most alternative methods that blind individuals use are very simple,
common-sense methods.  There is not much special equipment that is
required.  You will find many suggestions and ideas throughout this book. 
     Your mother may want to consider learning Braille.  She may find it
very helpful.  Even while the skills of reading and writing Braille are
being learned, she can make use of Braille in labeling canned goods and
medicines.  While she doesn't need to have labels on everything, she will
enjoy the ease of life around the house as she is able to know what spices
are on the rack, what kinds of soups are on the shelf, etc.  She will also
be able to note phone numbers and addresses without difficulty. 
     The place to start in looking for activities that will help your
mother feel useful and productive is with the things that she has enjoyed
all of her life.  Just because a person loses vision doesn't mean that she
can no longer do the things that have interested her.  There are a few
simple techniques and devices that can allow people to continue doing most
things. 
     If your mother enjoys sewing, there are needle threaders and
self-threading needles which make this possible.  Sewing techniques useful
to blind persons are discussed elsewhere in this book.  We know blind
people who knit, crochet, make latch-hook rugs, or make their own clothes. 
     If your mother enjoys knitting, crocheting, crafts, or macrame, she
can still do these things.  It is just a matter of learning to perform
certain tasks by touch rather than by sight.  Encourage your mother to
experiment with things she has always enjoyed doing.  Another easily
learned craft is making latch-hook rugs.  If you purchase rugs that have
large areas of the same color, and if you can work with her some on
marking points where colors change, latch-hook can be very enjoyable. 
     If gardening is something that holds an interest for her, there is no
reason why she can't continue to garden.  There are ways to perform all
the gardening tasks by touch rather than by sight. 
     If your mother was active in church groups or clubs, there are still
many things she can do to contribute.  We realize that transportation may
be a problem.  However, there may be someone who could offer her a ride to
some of the activities in exchange for help with the gasoline purchase.
Often, there is a real need for people to do telephone calling from their
homes for church activities. 
     The most important element in getting started on some of these things
after a person loses vision is believing that it can be done.  Learning to
do things in a different way can initially be frustrating, but if you
already have the skill, it does not take long to learn to do things by
touch.  Please encourage your mother to try some of these things. 
     Throughout the country there are libraries that lend to blind
individuals books and magazines that have been recorded on records or
tapes, as well as Braille materials.  The libraries also provide record
players (talking book machines) and specially adapted cassette players
without charge.  Any person who is unable to read standard print is
eligible to borrow these materials.  The materials can be sent through the
mail to and from the library free of charge, so this service does not cost
the blind borrower anything.  The service is provided by state and federal
funds.  Library services are available upon application from the library
for the blind in your state.  Most of these libraries are part of the
network of the National Library Service for the Blind and Physically
Handicapped of the Library of Congress. 
     We have found that one of the most useful things for newly blind
people is to meet and interact with other competent blind individuals.  We
can get your mother in touch with the local chapter of the National
Federation of the Blind nearest her. 
     It is very important that you encourage your mother to be active and
to do as many things for herself as she can. 

"Can an older blind person learn Braille?"

     Whether or not a blind person at an advanced age would benefit from
learning Braille depends upon many factors.  If the individual is mentally
alert, has a reasonably good memory, and is able to feel and distinguish
the dots, it may be beneficial for him or her to learn Braille.  The older
blind person may want to learn enough Braille to put labels on things or
to write down telephone numbers.  Numbers in Braille are the same as the
first ten letters of the alphabet with a number symbol placed before the
letter.  If you know the numbers and a few other letters, it is possible
to use Braille playing cards. 

"Are there any games that are adapted for the blind?"

     Many games do not require adaptations.  The use of a reader may be
the only change that is required with others.  You can obtain sets of
checkers, chess, monopoly, cribbage, scrabble, and other games that have
been adapted for use by the blind.  In the case of checkers and chess, it
is not necessary to know any Braille at all in order to use the adapted
sets.  The pieces are shaped differently so that one color can be
distinguished from the other.  The boards are adapted so that the pieces
are not easily pushed out of place when the blind person uses his or her
hands to find the location of the various pieces. 

"Can you recommend a nursing home for my father who is blind?"

     Any good nursing home can accommodate blind people adequately.  It is
essential for people to understand that just because a senior citizen
becomes blind, that does NOT mean that nursing home care is necessary.
Assuming that the blind person does not have health problems that make
nursing home care necessary, elderly blind individuals should be able to
learn methods to care for themselves and live in whatever type of housing
situation they prefer. 

"My sister is blind and has other health problems that make nursing home care necessary. What should I look for to make sure she gets the care she needs?"

     Blindness, in and of itself, is not a sickness.  Most people who are
blind do not live in nursing homes.  However, some people who need nursing
home care for other reasons happen to be blind. 
     Here are a few things to consider in choosing a nursing home suitable
for a person who is blind: 
     Are there other blind people living in the home?  What do they do all
day? 
     Do they have talking books?  If not, they may receive them without
cost from the National Library Service for the Blind and Physically
Handicapped of the Library of Congress. 
     Are blind residents encouraged to travel independently around the
home?  Will staff members show new residents where to find the dining
room, or is it automatically assumed that blind people must be taken
everywhere they wish to go? 
     Do blind residents participate in the regular activities of the home? 
They should. 
     Are residents who want to learn Braille encouraged to do so? Do staff
members speak to patients upon entering or leaving a room? 
     Do staff move the personal belongings of residents without notifying
them or asking their permission? 
     Are blind residents who used to enjoy needlework encouraged to
continue with this hobby and shown ways to do needlework as a blind
person?  Knitting, crocheting, weaving, and other such skills are truly
"handwork" and do not require sight. 
     Are large print or Braille bingo cards, playing cards, and scrabble
sets available? 
     Does the home have good lighting?  Can people have high intensity
lamps with low glare in their rooms?  Are public areas well lit?  Is
attention paid to reducing glare? 
     Are blind people in wheelchairs routinely told about their
surroundings if they are being pushed from one place to another? 

     It is sometimes hard, particularly if a person has a severe hearing
loss, to tell very much about surroundings while sitting in a wheelchair.
This purpose can be accomplished in the course of a general conversation. 
     Ask the director of nursing if there has been a staff training
session on blindness recently.  If there has not, we can probably find a
local blind person who would be glad to offer staff training. 

"I am over 65, and I am legally blind. Am I eligible for any financial or medical assistance other than Social Security and Medicare?"

     If you are 65 or older, you will not receive any additional money
from Social Security just because you are blind.  If you are under age 65,
it is very important for the Social Security Office to know that you are
blind.  If you are eligible for Social Security Disability Insurance, you
may continue to receive disability benefits (which may be higher) until
you are age 65, at which time your payments will convert to Social
Security based on the fact that you have attained age 65. 
     Medicare pays hospital and doctor expenses under certain rules and
limitations, but if your income is very low and/or you have some large
medical bills, you may be eligible for some other medical assistance
through your state or local programs. 
     Depending on your financial circumstances, it may be possible to
qualify for medical assistance through your State Department of Social
Services.  Most states also have what is called a "spend down program." 
If you are found eligible for this, you will pay a set amount of medical
expenses for a six-month period of time, and the Department of Social
Services will pay anything above this amount.  Please check with your
State Department of Social Services for further details. 
     There are university hospitals in most states which are teaching
hospitals for medical students.  They are often able to provide medical
services at a reduced rate.  Other hospitals which have been constructed
with federal funds are sometimes required, at least for a number of years,
to provide some assistance to low-income individuals.  Please check with
hospitals in your area for this type of program. 
     If you are a Medicare recipient, there are some doctors who will
accept for payment the amount that Medicare will pay.  Many hospitals have
doctor referral services and can tell you which doctors will accept
Medicare patients. 
     If you are 65 or older, a U.S. citizen or legal resident, and you do
not have access to an ophthalmologist that you have seen in the past, you
may be eligible for the National Eye Care Project.  If you think you may
be eligible, call (800) 222-EYES (3937).  Callers who meet the eligibility
requirements are mailed the name of a participating ophthalmologist near
their home.  Participating doctors provide medical eye exams and treatment
for conditions or diseases if necessary.  Qualified callers will receive
treatment at no out-of-pocket expense for the doctor's services.
Eyeglasses, prescriptions, hospital services, and other medical services
are not covered under the program.  Doctors accept insurance assignment as
payment in full. 
     It is the responsibility of the agency on aging in your state to act
as a referral agency for older citizens.  There is also a state
rehabilitation agency for the blind in your state which should be able to
give you information.  There may be other state or local services for
which you may be eligible. 
     The most important thing for you to remember is that you have a
lifetime of experience to offer your family, friends, and the rest of the
world.  Just because you have lost your vision, does not mean that you
don't still have a lot to offer to other people.  Some new techniques,
such as the ones discussed elsewhere in this book, are required.  Learning
to read and write Braille takes time and motivation.  Using records and
tapes instead of reading with your eyes takes some getting used to. 
Finding and learning to work with readers is a skill to be developed. 
Budgeting money to pay readers or finding volunteers is a new approach. 
Using public transportation and arranging for drivers are also changes. 
These new activities are skills that require new attitudes.  You must come
to understand that everyone has needs and that those of the blind are not
necessarily greater than those of others.  All people must find ways of
giving to others, as well as getting others to help them.  You probably
will not feel OK about blindness until you realize that you still have a
lot to offer to others.  It is easy to become overwhelmed by your own
needs and forget that the greatest need of all is to continue giving. 
     Do you knit or crochet for your grandchildren?  Do you tell
entertaining stories?  Do you bake good cookies?  Do you make quilts or
wooden toys?  Do you teach Bible study lessons?  Do you take flowers to
friends who are ill?  Some of these things may seem unlikely for a blind
person, but they aren't.  We know many blind people who do all of these
things and more.  Believing that it is possible is the first step.  The
next step is using imagination, initiative, and persistence.  When you
need encouragement or support, be sure to contact other, more experienced,
blind people.  They will undoubtedly be happy to talk to you. 

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