Self-reported independent living outcome measures of blind elders attending adjustment training

Abstract

This descriptive study was a 2-year follow up of Adjustment to Blindness training and filled gaps in the literature by using self-report to measure an array of adjustment to blindness outcomes. Trainee participants strongly validated the positive impact blindness training had on their daily lives. Survey response rates were high. Results showed participants were very satisfied with training, experienced better post-training adjustment to blindness and regularly used a variety of the adaptive devices and techniques with which they were trained. Research related to aging is critical. The American population is aging; the “oldest old” or those over age 85 will number approximately 19 million or 5 % of the U.S. population by 2050 (U.S. Bureau of the Census, 1995). As more people live to older ages, the incidence of chronic debilitating conditions such as heart disease, diabetes and visual impairment/blindness increases. These circumstances dramatically affect independent living skills (Administration on Aging, 2001). Rehabilitation agencies have focused efforts at serving the growing population of elders with vision loss. A current issue in rehabilitation is the measurement of outcomes. In adjustment to blindness training “outcomes can be portrayed as the acquisition of skills, higher self-esteem, a better quality of life and improved attitudes toward blindness…” (Crews & Long, 1997, p. 124). Most post-service outcome studies are completed within a short time after training. There is little information about the adaptive devices and techniques most commonly used by the blind. There is however increasing evidence that self-report is useful and reliable when measuring outcomes (Meyers, Holliday, Harvey, & Hutchinson, 1993). Minnesota Services for the Blind has provided Adjustment to Blindness classes for a number of years to interested legally blind individuals over age 55. This outcome study done in Fall 2001, surveyed individuals who completed the Minnesota Adjustment to Blindness classes during fiscal year 1999, nearly two years earlier. The objectives were: (a) to determine level of satisfaction with the instruction received; (b) to determine the degree to which the participants’ attitudes about blindness have changed; (c) to assess adjustment to blindness as measured by the Adaptation to Vision Loss (AVL) scale (Horowitz & Reinhardt, 1998) and other researcher developed survey questions, (d) to identify the 4 most frequently used alternative techniques in daily living activities and (e) to identify the 4 most frequently used adaptive devices. A 60% survey response rate afforded considerable confidence when generalizing the results to the trainee population. Training satisfaction was high, with 70.2% reporting that they were “very satisfied” with training and 23.8% reporting that they were at least “somewhat satisfied”. Change in attitude regarding blindness was reported as “ much better” by 40.5%; “somewhat better” by 34.5%; “about the same” by 17.9% and “worse” by 1.2%. Trainees also showed good adjustment. The mean score on the AVL scale was 18.3 (range of 7 – 23.6) with a SD of 3.6. Training was critical for daily life. Most techniques and devices were used for instrumental daily life activities. The 4 most frequently used alternate techniques were: tactile markings on appliances, 68.3%; asking for assistance in the store, 57.1%; dialing the phone by touch, 53.2%; and tactile or folding methods to handle money, 44.4%. Most frequently used adaptive devices were: time telling pieces, 83.1%; better lighting, 80.2%, darker writing devices, 74.4%; and talking books, 60.9%. Self-reported outcomes from elders who attended Adjustment to Blindness training show significant life impact of the training.