Sight impairment and disability

This post will focus on a specific impairment and associated disability rather than a broad issue like communication.

First something about terminology

DISABILITY is the disadvantage or restriction of activity caused by a society which takes little or no account of people who have impairments and thus excludes them from mainstream activity. (Therefore disability, like racism or sexism, is discrimination and social oppression).

IMPAIRMENT is a characteristic, feature or attribute within an individual which is long term and may, or may not, be the result of disease, genetics or injury and may:

1. Affect that individual’s appearance in a way which is not acceptable to society,
And / or
2. Affect the function of that individual’s mind or body, either because of or regardless of society,
And / or
3. Cause pain, fatigue, affect communication and / reduce consciousness.

This covers people with learning difficulties, physical impairments, sensory impairments, facial disfigurement, speech impairment, mental illness, mental distress.

Impairment neither causes, nor justifies disability; however only people with impairments are subject disability; they may also experience other forms of oppression simultaneously.

http://www.leeds.ac.uk/disability-studies/archiveuk/thomas%20pam/Defining%20Impairment%20within%20the%20Social%20Model%20of%20Disability.pdf 

It is important to understand the difference between impairment and disability. I believe that we all have a responsibility to support those with impairments by making changes to the way that we do things so that they are not disabled by the world that we all co-create.

Sight impairment

From the NHS http://www.nhs.uk/conditions/Visual-impairment/Pages/Introduction.aspx

Visual impairment is when a person has sight loss that cannot be corrected using glasses or contact lenses.

There are two main categories of visual impairment:

• being partially sighted or sight impaired – where the level of sight loss is moderate
• severe sight impairment (blindness) – where the level of sight loss is so severe that activities that rely on eyesight become impossible

There are specific impairments and these include

• Colour blindness - red-green impairment is the most common, affecting 5% of the male population and 1% of the female.  One in twelve people using the web are colour blind. 
• Night-blindess - difficulty seeing in low light. People with diabetes may experience this.
• Cataracts -  these are usually treatable. It is estimated that one third of people over 65 will develop cataracts. Again those with diabetes are more prone. Cataracts make it difficult to see in low light and very bright lights may cause glare.

Key Facts  

• There are almost two million people in the UK living with sight loss. This figure includes those that have uncorrected refractive error or cataract that may be reversed. It also includes around 360,000 people registered as blind or partially sighted in the UK, who have severe and irreversible sight loss.
• Sight loss affects people of all ages but especially older people: 1 in 5 people aged 75 and 1 in 2 aged 90 and over are living with sight loss.
• There are almost 25,000 blind and partially sighted children in Britain. That is equal to 2 in 1,000 children. As many as half of these children may have other disabilities.
• There is a link between sight loss and reduced wellbeing. Over one third of older people with sight loss are also living with depression.
• Two thirds of registered blind and partially sighted people of working age are not in paid employment.
• The number of people in the UK with sight loss is set to increase in line with population ageing: by 2050 the number of people with sight loss in the UK could be nearly four million.

From the Thomas Poclington Trust

Further information can be found here.

The impact of visual impairments

The impacts of visual impairment are many and varied. If we think about our daily lives and the centrality of vision to much of what we do we can see that it affects

• Carrying out daily living tasks - such as cooking, telling if food is passed its sell by date, putting together a colour co-ordinated outfit, cleaning, keeping track of the days and remembering things
• Self-care e.g. cutting nails
• Getting about within the home and garden
• Travelling (e.g. driving and night driving) and following directions
• The ability to work 
• Receiving and giving information
• Communicating in person - much of our communication is visual with facial expressions and body language
• Telling the time
• Shopping
• Meeting people
• Knowing who is talking in a gathering
• Leisure pursuits - reading, watching the TV, crafts, participation in sports etc
• Going out in the evening
• Doing jobs around the home e.g. changing a plug or putting in a new light bulb
• Caring for family and pets
• Dealing with banks and public authorities
• Getting cash and paying bills
• The list is almost endless.

There is also the impact on confidence and mental health, sight loss can be extremely isolating. It can also make people feel unsafe and insecure. There are also issues associated with falls and bumps.

Making changes

If we start with our own congregations and local communities then we need to know who has visual problems and what these may be. Things such as colour blindness are hidden from view but as it is so prevalent it is to be expected that in most of our communities there will be at least one person who is colour blind.

We don't necessarily need to know what issues there are for individuals but we do need to be mindful that existing or future members may well have sight problems. 

Our buildings

So first our buildings - here is some advice about living space for people with visual impairments from a local authority http://www.sunderland.gov.uk/CHttpHandler.ashx?id=11077&p=0 - page 70

Potential health and safety issues must be designed out e.g. preventing electric flexes from trailing the floor by providing ample electric sockets; providing rounded corners where walls meet or at door recesses.

Lighting, colour schemes and tonal contrast, casting of shadows, audible signals and tactile information must also be taken into account. There should be a contrast between ironmongery, doors, door frames and walls to distinguish these clearly; the new Part M requirements of the Buildings Regulations should be considered. Defining walls and floors can be resolved by providing different textures. Different floor coverings can be used to help ‘way finding’ by producing different sounds. Additional lighting can help to identify the toilet and bathing area or work areas in the kitchen, while being careful not to introduce glare into the area.

Avoid shiny surfaces, especially shiny floor surfaces. Non reflective materials, such as matt wall finish tiles and flooring, especially in bathrooms and kitchens, reduce glare. Highly patterned floor and worktop surfaces should be avoided as this makes objects set against them harder to distinguish.

We need to make sure that our lighting is good enough when people are expected to read things or to walk about.

This is a useful publication which covers a range of disabilities but if you search on the word 'visual' it will take you to all the relevant sections.

Meeting people with visual impairments

Here is some information about etiquette - it come from an Open University (OU) page which I think may be disappearing soon hence I have copied and pasted here. As it is about the OU it talks about students.

Many people are unsure of how to communicate naturally with a blind person or how – or indeed, whether – to offer assistance. It helps if you remember the following.

• When greeting a student who is visually impaired, say who you are when you start to speak.
• To shake hands or not? Be guided by the actions of the visually impaired person because they may not be able to see your proffered hand.
• Speak naturally – do not avoid visually descriptive language or phrases such as ‘see you later’.
• Indicate that a conversation has ended or that you are leaving in order to avoid the student speaking when no-one is there.
• You may need to explain the reason for sudden loud noises or laughter.
• Guide dogs are working dogs and must not be distracted or fussed over. Unless you are involved in making an arrangement to accommodate them, they should generally be ignored; eye contact is discouraged.
• It can sometimes be helpful to give information about the physical environment.
• A blind student may or may not use a white cane or stick. ‘Symbol canes’ are usually just held, and their purpose is to advise that the person has difficulties seeing. Long canes are used to check the ground (e.g. for obstacles, steps, kerbs) for several paces ahead. A cane or stick with a red band means the person also has a hearing impairment. Do not move a blind person’s cane without their permission.
• A blind person learns the location of things, do not move them around without letting the person know.

And another short guide

Guiding people with visual impairments

Here is some advice about guiding people with visual impairments

Large print hymns

There should always be large print hymns available. Sing Your Faith - the Purple Book - can be bought as a large print edition. We have found that it is too big to hold and the individual hymns should be taken out for the person before the service starts. I cannot find the link but if you would like to buy a copy contact the General Assembly.

The provision of information

I have covered the provision of information in the previous posting.

Travel and times of meeting

If people stop coming or only come out during daylight hours it may be worth asking why and offering transport assistance. Meetings may be held in the evening and for most of the year this will mean travelling either both journeys or just the return journey in the dark. Certainly in places with a wide-spread congregation or in smaller towns and rural areas most of the travel will be by car and night-blindness may be an issue.

Summary

Sight impairment is a vast subject. The most important thing is to expect this to be an issue for some of our local community and to be committed to making changes to improve their experience of their local faith community. Attitude is key.


Further information

Information about eye conditions http://www.kent.gov.uk/adult_social_services/your_social_services/services_and_support/sensory_disabilities/deafblind_information/types_of_visual_impairment.aspx  

Information about creating accessible websites http://www.cardiff.ac.uk/accessibility/keyaccessibilityissues/visionimpairments/index.html

Cataracts http://www.bbc.co.uk/health/physical_health/conditions/cataracts1.shtml 

Information about churches and visually impaired people http://uk.life.crossmap.com/article/your.church.visually.impaired.people/81.htm - very small font 

Guidance re websites http://www.churchedit.co.uk/website-tips/church-website-accessibility/

UUA guidance re people with visual impairments http://www.uua.org/accessibility/visual/index.shtml

How to guide someone http://www.rnib.org.uk/livingwithsightloss/helpingpeople/meetgreet/Pages/howtoguide.aspx 

Design guidance for the built environment http://www.icipaints.co.uk/support/specifications/colour/accessibility/visual_impairment.jsp - small font

A long list of organisations involved in visual impairment issues http://www.vision2020uk.org.uk/links.asp?section=000100050013