It’s Best To Be A Veteran

If You’re Going To Have To Be Blind, It’s Best To Be A Veteran
TheDay - Connecticut
Judy Benson
6/17/2007

West Haven VA Center offers crucial skills to aging population

Among the growing population of older Americans with poor eyesight, Frank Quagan, Larry Thompson and Virginia Beltz might consider themselves the lucky ones.

“I used to be a commercial artist, so it was very difficult for me to lose my eyesight,” said Quagan, 82, who lives in Warwick, R.I. Quagan was diagnosed with macular degeneration six years ago and, like the vast majority of those considered legally blind, has a smidgen of sight left.

One morning last month, Quagan wasn’t looking the part of a person defeated by a disability. He was sitting at a computer in a room on the sixth floor of the main hospital building at the Veterans Affairs Connecticut Healthcare System’s busy, sprawling campus in West Haven, having a one-on-one refresher course in computer skills with blind-rehabilitation teacher Jim Waldron. They were using equipment with special software for people with low vision.

Though inside a hospital, this unit looks more like a vocational boarding school, with dormitory-style bedrooms, a lounge, group dining room, and uniquely equipped classrooms. There are none of the IV poles, gurneys and white-coated doctors seen elsewhere in the hospital hallways.

Named the Eastern Blind Rehabilitation Center, the West Haven facility is one of 10 in VA hospitals around the country. The West Haven program serves blind and low-vision veterans from 15 states. Last year, about 300 went through the six-week course, said Penny Schuckers, chief of blind rehabilitation services. It costs the VA about $30,000 per patient.

The VA began these programs almost 40 years ago, originally to help veterans blinded by a combat injury. Over the years, it has evolved into a program that takes in mostly older veterans with low vision due to macular degeneration, glaucoma, or diabetes. It is a special point of pride in the VA system.

“This program often helps people to be able to stay at the level of care they’re currently at, and can keep them from having to go into a nursing home,” said Schuckers. “We can teach them how to take their medicines accurately (using special touch-sensitive devices) and how to make sure they’re not eating food that’s expired …, and not getting cut with a knife.

“Blindness can be such an isolating condition,” she said. “People tend not to reach out and get help.”

That, she said, is why bringing together people with this condition to teach them new ways of accomplishing everyday tasks in a focused, residential setting is so valuable.

“The blind rehabilitation program at the VA is unique,” she said. “If you’re going to have to be blind, it’s best to be a veteran.”

According to the National Eye Institute, part of the National Institutes of Health, the number of Americans with vision loss is projected to increase substantially through 2020. Already, about 3.3 million people over age 40 — one in 28 — have low vision or blindness. That number is expected to reach 5.5 million over the next 13 years.

The most common cause is Macular Degeneration, which occurs when the part of the retina that enables clear central vision effectively goes dead. The vast majority of cases are untreatable. Glaucoma, cataract , and complications of diabetes are other frequent causes of vision loss in older people.

A 2004 report from the eye institute said vision loss is “becoming a major public health problem,” which can lead to loss of independence and quality of life.

“My goal in coming here was to feel more independent,” said Larry Thompson, an Air Force veteran from West Grove, Pa., who has glaucoma. During his stay, he has been practicing his writing and computer skills, learning woodworking on machines he can read by touch, and calling the nightly Bingo games.

“I’m in my third week here, and I’m really enjoying it,” he said as he applied polyurethane to a wooden coat rack in one of the program’s classrooms.

Quagan, who served in the Air Force in World War II, first came to the blind rehabilitation center four years ago for his six-week stay. Few non-veterans with low vision have access to a comparable range of extended-stay and outpatient services and equipment as that provided by the VA for free or at a low cost to veterans. Charges depend on an individual’s finances and service history.

“There’s nothing as powerful as this group experience, that shows the guys what they can do,” said Maureen Carr, blind rehabilitation specialist. “Some of the guys come here and they’ve been signing their name with an ‘X.’ This is one of the little dignity-robbers. When they come here, they can reclaim some of that dignity.”

During his time in the program, Quagan made new friends, learned housekeeping skills in the program’s kitchen, had a six-hour eye exam with an optometrist who specializes in low vision, and learned how to use computers with adaptive software, closed-circuit televisions, special low-vision lights, new eyeglasses and magnifiers. Much of that equipment, provided by the VA, is now in Quagan’s home.

“Before I came here, I really didn’t think I would benefit that much,” said Quagan. “But after I came here, I got so enthusiastic about the things I could do when I got home. Before I had left I made three pieces of pottery. I was actually doing artwork on a closed-circuit TV.”

Those who enroll in the program can also learn Braille and keyboarding skills. Many are also given white canesand taught to use them by sweeping the ground in front of them to walk down the street and to cross a busy intersection. Teachers take the students on mobility lessons around the campus and into downtown West Haven.

“I’ve learned how to use my stick,” said Howard Allen, an Army veteran from Newark, N.J. “This is an extension of my eyes. Now, if I go out without it, I feel like something’s missing.”

Allen said he didn’t use a walking stick at all before he came to West Haven, and wouldn’t cross the street without help. Sometimes he would wait five or 10 minutes for someone to come along. In mobility lessons, he learned how to use the stick on busy streets and sidewalks and how to listen for cues in traffic when crossing a busy intersection.

The program also sends teachers to veteran’s homes for refresher courses, to troubleshoot equipment problems, or to work with those who can’t come to the six-week program.

“A lot of blind rehabilitation is ongoing, because computer equipment changes, vision changes, and people have life changes,” said Kathryn Wiseman, supervisor of blind rehabilitation services.

The VA spends an average of $29,052 for each veteran who completes the six-week program. That includes the cost of the stay, the lessons at the center and follow-up lessons at home, the fixed operating costs of the facility and of the low-vision and special computer equipment each veteran brings home, Schuckers said.

Among the few female veterans at the program recently was Virginia Beltz, an 82-year-old from Newport, R.I., who served in the Navy. She first came two years ago for a six-week stay, and was back last month for a refresher computer course. This time around, she was most excited about learning how to use a book reader program. She was an avid reader before losing most of her eyesight to macular degeneration.

“You can put in any book, and it will read it to you,” she said. “The technology is always evolving.”

One of the initial steps for all who enter the program is a comprehensive eye exam with Dr. Kara Gagnon, director of low vision optometry. It can last up to seven hours, Gagnon said, because she spends a lot of time pinpointing the exact location on the retina that’s still healthy, and teaching patients how to make the most of what they have left.

“We can really train them to get right to that sweet spot,” she said. “We teach them to eliminate the head movement and use just eye movement.”

To find that “sweet spot,” she combines the patient’s own descriptions with what she can see when she looks at their eyes through a scanning laser ophthalmoscope, a sophisticated piece of equipment few private-practice optometrists have. Her exam also often leads to new eyeglass prescriptions for several kinds of glasses for different uses, and for other equipment like lighted magnifiersand closed-circuit televisions. These closed-circuit televisions, also called video magnifiers, allow a blind person to read magazines, newspapers and documents.

“I’m very invested in empowering these patients,” she said.

It works.

“I’m much more confident,” said Allen, the Newark, N.J. veteran. “I have no hang-ups now going up stairs or getting on and off elevators. This program has made a tremendous impact on my life.”