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Low Vision Program
Patient Case Study

 

PROBLEM:
Janice is a 78 year old woman who lives alone with no family or friends nearby. She no longer drives
and struggles to get into the doctor’s office. Out-of-town family took her to the doctors’ office for
her first visit in eight months, and she presented with significant weight loss, frail and unkempt
appearance. She stated she had been feeling very weak and dizzy.
Janice reported to her physician of having a recent fall due to tripping on a shoe on the floor in her
hallway. She denied injury, but was hesitant to report that due to being shut in her home more, she
feels sad and has not been out of the home in weeks. She had not talked to anyone until this occurred.


INTERVENTION:
The physician initiates Home Heath to evaluate the patient and home situation due to her diagnosis
of Macular Degeneration and her recent fall. During the assessment, the RN identified that the
patient was not able to read the labels correctly on her medication bottles and was unable to set up
her pills correctly. She had been relying on a mark on the top of her bottles to tell her what she was
taking. The nurse finds she may have mixed up the bottle caps.

Occupational therapy was initiated to work with the patient and provide Great Lakes Caring's
Low Vision Program to maximize the use of her remaining vision moreeffectively and to provide
ractical adaptations for activities of daily living. The therapist also found the patient’s inability
to safely prepare adequate nutrition routinely and a walk through the home noted clutter
blocking pathways which would be a hazard and potentially lead to another fall.The patient
was unaware of her clutter falling over into frequently used pathways. Adjustments were
made to assist her with properly identifying her medications with a dot system which the patient
found easy to follow. The occupational therapist provided the patient with practical adaptations of
improved lighting in her environment due to the darkness, contrast set up for identification of tools
when cooking or grooming, some modification of her environment by decluttering and opening
pathways, introduced enlarged printing and the use of magnification and glare control to assist for
proper identification of modifications, medication administration, food preparation, reading and
writing.


RESULT:
With the Low Vision Program, the patient was able to remain in her own home,
occasionally leave the house for trips, and begin reading and writing again. She was
able to resume communication with family and friends through letter writing, which
significantly reduced her isolation and improved her mood and outlook for the future.
 

Presented by Sarah Thurston, LMSW
Great Lakes Caring Director of Education
July 2017