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As your loved ones get older, there’s a…
Date Recorded
October 09, 2018 Health Topics (The Scope Radio)
Vision Transcription
Announcer: Need reliable health and wellness information? Don't listen to the guy in the cube next to you. Get it from a trusted source, straight from the doctor's mouth. Here's this week's listener question on The Scope.
Interviewer: All right, today's patient question is from a gentleman named Ken. He says that his dad is starting to lose his eyesight, and they're concerned that his driving isn't as good as it needs to be.
So how do you have that conversation to take away the keys? It can be a scary thing to do. And to help answer this question we have Lisa Ord. She's a licensed clinical social worker. She also has a PhD in social work and is the Patient Support Program Director at the Moran Eye Center.
So how do you have that conversation?
Lisa: Having that conversation with one of your parents is probably one of the toughest conversations you're going to have, especially here in the West where we rely so much on driving and how much of our individual freedom is attached to be able to get in the car and go where you want when you want to. But the problem is that when someone isn't seeing as well as they need to be seeing, it gets frightening.
And it's not only frightening for them, but it's frightening for anybody else that's on the road or walking on the side of the road. So being able to have the conversation with your parents is very important. And to start with saying, "You know, dad, you've just had your eye checkup, and I see that it's not getting better. They can't correct it. Have you thought about other ways of getting to where you need to go other than driving yourself?"
Interviewer: And then you just pause and wait for that answer?
Lisa: And you pause and wait. Exactly. And it may be met with anger and just being able to be with that and say, "I know that this is a tough conversation, not something you even want to talk to me about." But the tougher conversation is the conversation after you've hit somebody because you didn't see them.
Interviewer: So this is a conversation that if you feel that somebody that you love is not seeing well, you need to have a . . . you outlaid a very direct approach. Are there other ways, if you don't think the direct approach is going to work with your particular loved one?
Lisa: I've had patients use different approaches. One patient said, excuse me, one daughter of one of my patients said that she finally said, "My children will not ride with you in the car. We either need to have someone else drive, or you're not going to be able to take them where you want to take them." So it was kind of like putting it in terms of, "I don't feel safe enough to be in the car with you. I don't feel safe enough for you to take my children in the car with you."
Interviewer: And that really kind of brought the reality to bear?
Lisa: To bear, yeah.
Interviewer: Is there somebody else you could involve, like a health care professional perhaps, because maybe they would be more willing to take it from a third party?
Lisa: I have a lot of patients that say, "But my license doesn't expire for another two years, so I don't have to worry about it." And that's not the case. You're still going to be very much liable whether your license is expired or not. If you're not safe to be driving, your eye care professional will have to fill out a medical form stating what your visual acuity is, and your visual field if you are not being able to be corrected to 20/40 or better. So that is something that they're going to have to do. Having the health provider have that conversation with your parent is sometimes easier because it does kind of put that onus on the healthcare professional.
The other thing is that if you really can't have the conversation, you really are concerned about your parents' driving or anyone's driving, you can make a report to the DMV, and they will take it upon themselves to have that person do a driving test.
Interviewer: Okay. All right. Probably not the way that most people would want to handle it. But I guess as a last resort . . .
Lisa: As a last resort. And I have had some family members who say their parents are so adamant that they're, you know, having extra keys made every time the keys are taken away from them, things like this. And so you're left with no other resort, except for to call in the people whose ultimate responsibility is to take away the license, and that is the driver's license division.
Interviewer: Ultimately, though, if somebody is faced with a vision impairment that could endanger them or others while driving, whatever you do, you would recommend something has to be done.
Lisa: Yes.
Interviewer: Don't leave it to chance.
Lisa: Don't leave it to chance. Not a good plan.
Announcer: Have a question? Ask it. Send your listener question to hello@thescoperadio.com.
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Vision loss impacts every aspect of a…
Date Recorded
September 20, 2018 Health Topics (The Scope Radio)
Vision Transcription
Announcer: Health information from experts supported by research from University of Utah Health. This is thescoperadio.com.
Interviewer: When first faced with the reality of vision loss, life can seem overwhelming. Denial, anger, fear, grief, hurt, rejection, abandonment, those are just some of the common psychological reactions that somebody could have when faced with the reality of life without or just even with limited sight. And without proper guidance, in many cases there's a great potential for isolation, depression, and dependence. That's why it is important to intervene early if somebody's losing their vision to help avoid some of these things happening.
Lisa Ord's a licensed clinical social worker. She also has a PhD in social work and is the Patient Support Program Director at the Moran Eye Center. It sounds like that vision loss is a lot more than just a physical issue, which a lot of people obviously know. There's a lot of psychological and mental stuff going on that we might not be aware of.
Dr. Ord: It really does affect every aspect of your life. It affects how you see yourself. It affects your roles with other people. You have to grieve it.
Interviewer: Yeah. And it affects your family. It affects the individual. So I'm somebody that has a loved one that's going through vision loss. And now, because of this first little bit here, I realize that there's a lot more going on than just the physical loss of sight. So how could I better support a loved one going through this?
Dr. Ord: I think the first thing you need to do is acknowledge with them that, you know, Mom, Dad, I know that you don't see as well as you used to, and I know that that can also affect other things that you've got going on in your life, and I want to know how I can best help you if you do want help, or help you to learn how to do what you want to do without as much sight as you've had.
Interviewer: Got you. So just open that dialogue.
Dr. Ord: Open the dialogue.
Interviewer: Do you find that most times that people are pretty responsive with that, or are they like my parents? They'd be like, "Oh, I'm fine."
Dr. Ord: It's the generation. Isn't it? You know, some are, some aren't really. But even if they, you know, "I'm fine," to you, they've heard you, and they know that you're aware and that you're there and that you want to help.
Interviewer: How much should you push the conversation at that point?
Dr. Ord: I would never push too hard. I have patients who say, you know, "My family, they won't leave me alone."
Interviewer: Oh, yeah? And that's all they want, is just leave me alone.
Dr. Ord: And there's others, they're just like, you know, "I really need some help, and there's nowhere to be found." So there's a happy medium.
Interviewer: That's right. Okay. So do you have any tips on how to approach the conversation? I think you gave us one already, just open up with, "I understand that this can be an issue that can lead to other issues. How are you doing? How are you feeling? Can I help you?" What other tips?
Dr. Ord: Exactly. I think, you know, acknowledging that maybe what you've been seeing in the anxiety of, "Am I going totally blind, or am I just losing some of my vision? What's going to happen? How am I going to manage?" Those kind of conversations I think are super important to have and just opening up to them and saying, you know, "I've been reading. I've heard that things can be very difficult. And how are you doing? How are you feeling about this?" Allow them and encourage them to continue doing the things that they want to do. And there is a way of doing everything if you know how to do it without sight. Sometimes they just need some tips and tricks on how to do something without being able to see it as well as they have in the past.
Interviewer: So tell me about some of the programs that you have at the Moran Eye Center.
Dr. Ord: So we have support groups. It's very important they get a lot from being able to talk with other people going through very similar things that the individual is going through at the time. We also have psychotherapy because it is a loss. You need to grieve it. There's a lot of anxiety. There's a lot of depression, so we do counseling. We also do skills, some basic vision loss skills and how to do things. We have an orientation to vision loss once a month on a Saturday that we talk about magnification, lighting, contrast, using your other senses, giving some tips on how to do things in a different way.
Interviewer: Yeah, my dad had macular degeneration, and I didn't really realize any of these things existed, and it would have been great to have had access to that sort of thing. We're very lucky here in Salt Lake City to have access to, you know, those resources at Moran Eye Center. Somebody who's not in Salt Lake City, how can they find resources?
Dr. Ord: There is a great website. It's the American Foundation for the Blind or afb.org, and there is a directory that you can search by state to find services in your area. Every state will have some kind of services for the visually impaired and blind. Sometimes it goes through the Office of Rehabilitation, sometimes it goes through the Office of Education, but every state will have some services.
Interviewer: And it sounds like people that use these resources find them very beneficial.
Dr. Ord: Oh, very beneficial.
Interviewer: It might be difficult to get somebody there at first but well worth it.
Dr. Ord: Absolutely. If you're losing your vision, it's okay to really have some strong emotions about it. It's okay. Then it comes to a point where it's like, "Okay, what am I going to do about it?" So then you take the next steps in learning how to live life fully, even with your vision loss.
Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com.
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