NCBI's work in 2009
1. Service Delivery
In spite of the economic downturn, the response to the demand for NCBI’s services continued to increase in 2009, creating unique challenges for the organisation, as we continued to operate in a financially difficult environment. Our strength continues to be our staff, who remain committed to those who use our services and continue to provide a consistent, quality service to those with impaired vision around the country.
Throughout the year we have been looking at what services people are accessing and how changing demographics are currently impacting upon, and will continue to effect, service delivery. This analysis enables us to look at the needs that are emerging and how services must develop to meet the change in the pattern of needs.
NCBI’s Midlands office moved into a new HSE, purpose-built, resource centre for people with disabilities in Athlone, Co. Westmeath in July 2009 along with the MS Society, the Irish Wheelchair Association and HSE therapy staff.
A total of 1,729 people were referred, or referred themselves, to NCBI during 2009, bringing the total number of people using our services to 14,659 by the end of the year. In total, 7,812 individuals accessed NCBI’s services during 2009, an increase of 8% on 2008.
NCBI is committed to implementing a person-centred approach to service provision at all stages of the life cycle.
NCBI’s work with children and young people
While younger people made up a smaller percentage of new referrals in 2009, with 9% under the age of 18 and 4% under the age of six, NCBI continued to see a demand for support from children and their families. Our staff work with families on a one-to-one basis, providing information and advice on eye conditions, education, government benefits and entitlements, to name a few, and also assess where vision impairment is impacting on the child’s development.
One of the important areas of work with children with low vision is to encourage them to maximise their useful vision through the use of low vision aids. While the use of high-tech magnification systems, like closed circuit televisions (CCTVs) or magnification software, have had a huge impact on the integration of children with vision impairments in the classroom, it is also important to look at how non-technical devices such as close distance magnifiers can help, both in and out of the classroom. One of the main benefits of such low vision aids is that they are portable and can be used for non-school activities like reading signs, looking at photographs, personal reading, checking oncoming bus numbers and so on.
NCBI’s community resource workers work closely with the visiting teacher service in the Department of Education to make sure that children who are blind or vision impaired have access to and can thrive in mainstream education. NCBI’s Early Learning Centre in Clondalkin, Dublin, remains in demand by families with a child with sight loss. Specialist staff are on hand to develop an education programme to suit each child, in conjunction with their parents.
Services to people of working age
A significant proportion of new referrals in 2009, 22%, were of working age (18-65), presenting with low vision problems in higher level education and employment as they come to terms with their sight loss in both an emotional and practical way.
NCBI’s network of community resource workers (CRWs) are available in every county in the country and provide emotional and practical support to people experiencing difficulties with their eyesight. CRWs meet with people in one of our centres or, in exceptional circumstances, their own home to assess how the individual is coping with their sight loss and to put them in touch with the relevant services within NCBI and externally, where appropriate.
Support offered by CRWs may include advising on benefits and entitlements, adaptations to the home, aids and appliances and lighting, as well as discussing the impact of vision loss on the individual and their family and providing information on NCBI’s services.
Support is also available from counsellors, giving people an opportunity to talk with either a peer counsellor, who will also have experience of a disability, or a family therapist who can talk about sight loss, its impact on the individual, their families and their relationships.
Support for people who wish to enter education or retain or gain employment is available nationwide, through individualised skills training which may look at independent living skills, mobility training, job seeking and IT training. NCBI also liaises with mainstream agencies to ensure that people with vision impairments have equal access to education, training and employment. NCBI’s Rehabilitation Training Centre, in Drumcondra, Dublin, offers an opportunity to build confidence and gain new skills and independence, offering modules such as mobility training, independent living, IT training, job seeking and Braille, amongst others. Smaller modules of what is offered by the training centre in Dublin are also available in our centres around the country.
One of the greatest losses people with sight loss face is not being able to read. Our staff can help people find a solution to improve access to information and communication through the use of assistive technology, which includes software that enlarges print on the computer screen or reads aloud what is on the screen. Scanners transfer printed material onto the computer, while portable note takers and talking mobile phones may also be of use.
Our technology trainers work with people on a one-to-one basis, and will recommend the types of technology that may be helpful. People can then test out the equipment to make sure that it works for them before NCBI installs it for them in their home, workplace, college or school. We can also provide follow-up support and training in either groups or individual classes.
Mobility also presents a great challenge to people who are blind or vision impaired. NCBI offers mobility and orientation training on an individual basis, with take up highest among those of working age. Most training takes place in the individual’s own locality, with particular emphasis on routes that the person has chosen. Some people may have enough useful vision to move around independently, while others may require a mobility aid such as a long cane.
Increased demand from older people
The age profile of those referred to NCBI in 2009 reflects the fact that more and more people are coming to NCBI having acquired sight loss later in life, creating a greater demand for low vision services. In 2009, 54% of new referrals were over the age of 76. According to the Health Status Report 2008 (1), which was published in 2009, life expectancy in Ireland is at its highest level ever, at 76.8 years for males and 81.6 years for females. Central Statistics Office projections (based on the 2006 census) indicate significant growth in the future population, especially in those aged 65 years and over, with this group predicted to increase by almost two fifths by 2016, and to treble by 2041.
Almost 50% of all those using NCBI’s services are over the age of 76. Among this group are people who have lived with sight loss for all, or most, of their lives and who are now growing older. Then there are people who acquire sight loss as they get older, which NCBI is seeing more of each year and which places greater demand on services tailored towards those with low vision.
At NCBI’s low vision service, people who are experiencing significant difficulty with their eyesight meet the low vision assessment team, which includes an optometrist, a community resource worker and a technology trainer. Following that assessment, the person may be prescribed appropriate low vision aids which will help them with everyday activities such as reading and seeing things at a distance. They will also have a chance to discuss any issues they may have, try out some of the practical items available to assist people in their everyday lives, view technology that may be helpful and organise further training in the use of low vision aids and technology, if necessary. NCBI has found that using low vision aids is more effective if people come at an earlier stage in their sight loss, when they can start off with low level magnification.
It can be difficult for older people with vision impairments to access appropriate day care services. Specialised services, such as NCBI’s day care centres in Dublin and Wexford, have been developed to cater for the specific needs of people with vision impairments. However, demand for places is high and we are concerned that many older people with low vision are missing out on a valuable social experience, as mainstream services are often not in a position to provide appropriate services to an older person who is blind or vision impaired.
Elaine Howley
Director of Services