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What We Don’t See

Enhancing Inclusivity and Accessibility for Patients with Vision Loss

The Americans with Disabilities Act (ADA) was passed in 1990 with the goal of protecting people with disabilities from discrimination. However, many places, including the healthcare environment, are still inaccessible to people with disabilities. Barriers to access isolate people with visual impairments from engaging in public life, leading to reduced independence and decreased acceptance from others. It can negatively impact quality of life and increase risk of loneliness, depression and dementia.

In healthcare, these barriers are exacerbated by inaccessible spaces, information, and processes. Very few physicians provide accommodations in the clinic space or in the patient interaction that allow patients with visual impairments to receive equitable care. Furthermore, not every patient with visual impairments will appear disabled, and patients will not always self-identify. For this reason, it is imperative to design spaces and processes that enable patients with visual impairments to access the clinic.

Collaborators:
Victoria Xiao, University of Massachusetts Chan Medical School, Medical Student
Elizabeth Myska, Company/Association, Atty
Michael Marciello, MD, Maragal Medical, Physician

Additional Help:
Blair Wong
Maria Martinez
Colleen Oncay
Jon Cili

Recommendations

  • Main principles
    • Ask listen learn (ALL)
    • Announce narrate describe (AND)
    • Nothing about us without us
    • Show (tactilely and tactfully) AND tell (audibly and descriptively)
  • Considerations for your patient arriving to the clinic
    • Understand the local bus stop and route to the office
      • If possible, improve safety of route
    • Understand that paratransit may be unreliable and build in flexibility when scheduling patients
    • Maintain a clear, ice-free environment in winter
    • Understand purpose and positioning of truncated domes
  • Considerations within the clinic environment
    • Train office staff on how to greet and interact with people with low vision or visual impairments
      • Announce yourself first
      • Be prepared to describe the office setting and intake process
      • Accept forms of ID besides driver’s license
    • Have signature cards at the desk
    • Have non-glossy, high-contrast, large-print versions of handouts
    • Remove barriers along walking routes
      • E.g. chairs, medical equipment
    • Have accessible scales
    • Describe the exam room and narrate what you are doing in the room
      • Don’t do it for, do it with someone

Additional Media

Navigating Urban Mobility

You met her in person, and she met W. Kamau Bell on CNN. Donning a blindfold and white cane, Bell took on the streets of Worcester Massachusetts like many visually impaired people do everyday. What wasn’t discussed during his walk was the other struggles VIPs face. A stroll in the park is nice, but what about when you accidentally step in poison ivy and need to go to urgent care? How about pulling out the right amount of cash at the grocery store?

A Better World, a Different Window



Blind — Caught in Action!