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.