People who are blind or have low vision have special needs for interpreting their environment. By following simple guidelines you can help make their hospital stay as easy and as comfortable as possible.
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A good start
- Introduce yourself and address the patient by name, so they know you are talking to them and not to another patient in the next bed.
- Introduce the patient to any roommates.
- Ask the patient what they are able to see. Few patients are totally blind.
- Ask the patient what assistance they need instead of assuming what they need.
- Ensure that the patient is included in discussions about procedures and medical plans. Being blind or vision impaired does not mean they cannot hear or understand what is being said.
- Say goodbye when you finish a conversation and indicate when you are leaving the room.
Patients in bed
- Put a 'Patient Identifier sign' above the patient's bed and/or door stations.
- Consider extra adjustable lighting for the patient with useful residual vision.
- Mark their pill bottles with large print labels or a tactile marking such as Braille or Polymark.
- The patient may prefer a corner bed to help make location easier, to avoid confusion with another patient's equipment and to help them arrange their belongings more easily.
- Don't unnecessarily move the patient's belongings. If items are moved, let them know their new location.
- Always inform the patient before undertaking any procedure; it can be very unnerving for the patient to be touched without warning.
- If bandaging their eyes, make sure the patient's ears and other sensory organs are not obscured.
- Knowing the time can help provide structure to their daily routine. Ensure the patient has access to a radio, talking clock, talking watch, Braille watch or clock with large numbers.
- Orient the patient to their room by starting from a central point, such as their bed.
- When orienting the patient to a new area, walk with them rather than giving only verbal directions. This helps them learn distances and pick up sensory cues, so next time they can make the trip independently.
- Keep pathways and corridors clear of obstacles where possible and inform the patient of any changes to their environment.
- Ask the patient if they would like to take your arm for guiding purposes. If so, let them hold your arm above the elbow with their thumb to the front.
Medical staff should talk to parents to discuss any special needs the child may have, before they are admitted. If this is not possible, initially one parent should stay with the child or make a lengthy visit while the environment is still unfamiliar.
Leaving a baby who is blind, lying on their back for long periods, even though they seem content, puts them at risk of sensory deprivation. Their lack of responsiveness must not be mistaken for deafness or intellectual handicap. Appropriate, consistent stimulation, such as soft talking and gentle touching, is imperative.
A baby who is blind learns about their surroundings through mouthing, and later through tactile exploration. Ensure the baby has familiar and enjoyable toys within easy reach. Toys should have varied textures, make interesting noises, and be safe and pleasant for the mouth.
Toddlers and preschoolers
- A toddler should be able to explore their environment freely and as independently as possible.
- Always explain what you are doing and describe new surroundings and situations.
- Use a hands-on approach to introduce new objects. Show them where their food or drink is on the tray and how to open containers.
- Avoid talking about their condition in their presence.
- Avoid unnecessarily moving furniture and be aware of any possible obstacles or hazards such as sharp corners and extension cords.
- Encourage them to practice their abilities, such as feeding.
- Engage in age-appropriate play and group playing.
- Read aloud menu items and let the patient choose their meal.
- Tell the patient when their meal has arrived and where their tray is placed.
- Colour contrast can be important for people who are vision impaired. Placing a dark tray or cloth under a light plate can define the plate edges making it easier for them to locate the food.
- Describe the contents of the tray. You can either use the clock-face method, e.g. the meat is at 6 o'clock, or by saying items are at the top, bottom, right or left side of the plate. Meat should be placed at 6 o'clock, as this is easiest for cutting.
- Ask the patient if they would like assistance with removing packaging from items.
- Ask the patient if they need assistance with their meal, rather than offering to cut their food.
- Provide any hot drinks in non-spill containers and tell the patient where they are placed.