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OIB Live Forum - Remote Instruction

We invite you to participate in a conversation about remote instruction on Thursday, March 19, at 2 pm eastern, 1 pm central, noon mountain, and 11 am pacific on the OIB-TAC's Community of Practice (www.oib-tac.org). As we are all limited in how much interaction we can have with our consumers, we want to share ideas and resources that can help us to provide services. We look forward to a lively discussion and your participation. To participate in the forum, please click any "add a comment” button with any questions or insights you may have about the topic. Information will be added for an hour while our experts answer your questions. There is no audio or video.

If you have trouble logging in to your account or cannot access your account, please email Simon Marcy at smarcy@colled.msstate.edu. He can notify you of your user name or edit your password.

Sylvia Perez and Kendra Farrow, from the OIB-TAC, are both experienced certified vision rehabilitation therapists. Their direct service experiences and extensive observations of OIB programs across the country will help them in leading our discussion on providing remote instruction during the COVID 19 outbreak. Feel free to post your questions or ideas on how remote instruction might occur.

Comments

Marilynn Ward-Tluszcz's picture

how do we comfort the fears of our consumers?
Sylvia Perez's picture

Individuals with visual impairments may be experiencing tremendous amounts of anxiety and fear during the Coronavirus. They likely already experienced some level of isolation, especially if an older person with a significant visual impairment. Now, they are forced to isolate themselves. They may have lost the support system they had in place, such as family or friends who were available to assist with grocery and medicine pick-up. In some areas, basic services such as medicine and Meals on Wheels deliveries may be interrupted or canceled. Your contact does and will continue to be so important to help them get through this challenging time. It is so important that we, as professionals working with people with visual impairments, contact those we know are the most vulnerable and who have limited or no support system. Providing good information and referral is the best thing we can do. As a social worker, we are all almost asked to become social workers for our consumers. Find out what resources are still available in your communities for people who are older and those with disabilities. Get the important contact persons and phone numbers. If possible, mail a shortlist in large print, Braille, or email to your consumer. 211 is a great resource in many areas. The United Way is another great resource. And, of course, the Area Agency on Aging is likely mobilizing many efforts to meet needs in each community. Holding support groups via phone might really help reduce feelings of isolation and fear among your consumers. If you can’t do a group or arrange a peer-led group, then connect them to one of the existing telephone or online groups out there. The OIB TAC has a list of these resources. There are also many free conference lines and, of course, video conferencing platforms such as Zoom and Skype, or even try a Facebook group. These are tough times, and our consumers need us more than ever, just maybe for slightly different priorities.
Marilynn Ward-Tluszcz's picture

thanks...great information
Debra Mendez's picture

Thank you for the helpful suggestions on how we can assist our visually impaired and blind clients calm their anxiety, both now and any time. Here at Services for the Blind and Visually Impaired at the OK Dept. of Rehabilitation Services, we have already contacted our clients to let them know most of our staff are working from home, and they are welcome to contact us by cell phone at any time. Since many are over 60, as a VRT, I may not be able to have personal contact with them in their homes, but just knowing they have someone to call is very calming. I can walk them through most situations over the phone as many of them don't use the internet. I also believe telling people the truth using known facts provides much needed trust. I imagine they are hearing so much on television that they don't know who to trust. Our responsibility as professionals is to give them as accurate information as possible.
Crystal Jackson Cheek's picture

This is helpful information. In NC, a Hope Line has been established for older adults who are struggling with feelings of isolation due to social distancing measures.
Malinda Carlson's picture

Who set that up Crystal? County aging administration?
Cassandra Diplock's picture

How do we use our time in the most functional/efficient way? Is there any additional resources to help our seniors that we are currently unable to see due to restrictions?
Kendra Farrow's picture

Yes, there are a number of resources we can share with clients. We just updated a handout on telephone support and activity groups. Check it out under the resource tab of our website www.oib-tac.org.
Cassandra Diplock's picture

Hello, I don't see a resource tab. The only tabs I see on the website's home page include home, best practices, direct service, program administration, and continuing education. Where would I go? Also, would this work for those in Maine? Thank you.
Simon Marcy's picture

Here is a direct link to the resource that Kendra spoke of above. https://www.oib-tac.org/sites/www.oib-tac.org/files/Telephone%20Support%20and%20Activity%20Groups%202020.3.12%20B.pdf
Kendra Farrow's picture

Look through the goals for open clients and consider if any of the topics might be taught by phone. Keep phone calls short, not more than 30 minutes, as it can be tiring to receive training in this format. Call back frequently, as much as once a day, review what was taught the day before, and give some new information. Document the progress to make sure this format is effective and to show that services are being provided.
Nancy Scharpenberg's picture

Your comments were so true. Often times in our quest to share information and answer their questions, we may forget how they are feeling and do too much. Everyone is different and can benefit from different amounts of training at a time. Checking understanding and how they are feeling throughout lesson is so important.....keeping in mind that sometimes more is less. Since change is difficult for some, we start slow and gradually progress, always starting with the familiar.
Crystal Jackson Cheek's picture

Have you tried 211? Here in NC they are fielding calls for resources and information.
Kendra Farrow's picture

Yes, this is a great resource, but it is not available in every area. They have a comprehensive list of agencies and programs that can help nearly any situation.
Pat Duyck's picture

I am currently attempting to complete assessments over the phone with the promise to schedule a home visit and review this when the restrictions are lifted. Is anyone ordering equipment? If so, how are you training on the more technical items?
Marilynn Ward-Tluszcz's picture

I have ordered a replacement cord and had it shipped directly to consumer...Eschenbach is open and taking orders. i've also used a local vendor to ship an Orcam and I'm going to provide training over the phone.
Sylvia Perez's picture

Telephone assessments are likely to become very common for the next few months. The goal of these assessments at this point is to assess safety. It’s a different world right now. We need to determine what their major challenges are as a result of being isolated in their homes. Some important questions to ask might be: • Are you able to dial the phone to call 911, important family or friends, etc. • Are you able to get your medications and food? • Are you able to safely navigate your home? • Do you have activities to keep yourself engaged or busy? Then providing some basic resources (info and referral) can be provided over the phone. The OIB-TAC Lessons for Living have great instructional content, including teaching a person to dial their phone. As a counselor or teacher, you can review these and work with clients right over the phone or using video chat. If possible, to get them talking books and have books about coping with vision loss sent to them, that can be a great resource. If they are having difficulty getting medication or food, connect them to local resources such as pharmacy delivery and Area Agency on Aging. Connecting them to a peer or support group, whether one you run or another one, will be of great benefit to the consumer as well. Regarding equipment, it is probably best to keep to the most basic equipment, so the individual does not get overwhelmed. If you have an eye medical you might could “sort of,” and I use that very loosely figure out a hand-held magnifier that could help. I guess now is not the time to talk about Best Practice, as we are all in Crisis Practice so that it might be a guessing game, but a magnifier sent out might help. I am not sure how many items you will be able to order, so hopefully some still have stock.
Pat Duyck's picture

thank you!!! very helpful and useful information, much appreciated
Debra Mendez's picture

Very helpful information. Thank you.
Taylor volrich 's picture

Our agency is also looking to attempt at completing assessments over the phone. Is anyone else trying this method and how is this working for them? In addition, we have some clients whose equipment is ready to be dispensed and trained, we are looking into having this equipment dropped off to them and then calling them by phone to explain in detail on how to use the adaptive aids such as talking watches, large print items etc. has anyone else done over the phone training and found it successful? We are trying to do as much as we can for our clients at this time without impacting their health and safety as well as ours, any other suggestions would be helpful!
Crystal Jackson Cheek's picture

We did a conference call with our field staff on Monday. The question came up about delivering and training. We decided if it was something small like a magnifier or talking watch they could mail it and do a follow up call. For the larger items we decide to wait because we did not want to risk dropping it off without training or risking their health. I would suggest to minimize risk to your clients and staff unless the Independent Living aid (ILA's) is an essential need to hold off.
Sylvia Perez's picture

I agree. Just provide essential items at this point. I think it would be overwhelming and confusing to many of our older individuals. Younger people who can possibly figure out things (that are not easy to break) may be okay to get lots of technology--as they now have time to really work on it .
Lisa Sluszka's picture

I am a CVRT who has just begun to provide telephone/facetime instruction. Today's lesson was using a voice recorder. I charged and labeled device and left it in plastic bag outside clients home at appointment time. I also included large print (and digital instructions). Since I was there I sat in my car in front of her house and provided instruction over the phone. It was a bit tedious, but I think it is the best way to do instruction now.
Sylvia Perez's picture

That is certainly clever. We hope to get some recorded lessons out very very soon.
Cathleen McGuire 's picture

That was a great idea
Melissa 's picture

I'm looking into this sort of instruction here. it would be nice if there could be a way to see what the client is doing so that appropriate feedback could be given any ideas? did facetime work? do you drop off a device with 3g and facetime capabilities to the client? many of mine do not use this technology.
Lisa Sluszka's picture

We used mostly phone because I knew the device so well and because client's iPad wasn't charged to use FaceTime (Grrr!). I have several clients who have a kitchen table, stairs, chair near front door with storm door or window (where they can sit). I wonder if having client sit near window where I can see them, then provide phone instruction would work.... What do you think????
Melissa 's picture

I think that would work! Not so much here in Montana with the weather being 30 degrees but could be a possibility soon with summer coming.
Sylvia Perez's picture

Many are saying they need or want the ability to "observe" consumers for assessment and training. Zoom is very accessible. It might be difficult for the consumers who do not have access to either a smart phone or computer. Zoom is free. We are putting another post. You can be on for about 40 minutes and have multiple participants. We will try to put up some links soon on how to use Zoom. And, if there are family members available they can be a great support and learn strategies too.
cheryl Snow's picture

I worked with a client over the phone on voiceover on her iPhone. She called me on her home landline and we worked together to learn several gestures with voiceover. we were even able to adjust some accessibility settings such as shortcuts and rotor options.
Lisa Sluszka's picture

I really like the Hadley audio tech instructions. They are very clear and easy to follow. I am thinking of playing them over my phone while client examines their device while listening to Hadley instruction. Then we can pause if client has questions.
Sylvia Perez's picture

Some tips I would recommend for organizing your day would be the following: Set up a schedule at the start of the week with individuals you plan to contact or groups you plan to host on a call/virtual conference. Each morning review your calendar. Develop very specific curriculum and write out lesson plans for how you will teach by phone or conference. Be sure to check out the www.OIB-tTAC.org direct services tab and the lessons for living. These are a great resource for exactly how to describe specific training areas. Don’t forget to document!
Karen Klein's picture

In addition to following up via phone to provide training on any equipment; my staff are considering FaceTiming with family members to demonstrate how to use equipment, YouTube as a back-up option/resource, etc. I think the key to retention is having the individual teach it back to you after instruction has been done multiple times, especially with phone training since it can't be done in person.
Kendra Farrow's picture

You can mail equipment to consumers using free matter. I think that might be the most efficient way to deliver equipment.
Crystal Jackson Cheek's picture

Hi Kendra, is there a size limit when using Free Matter for the blind?
Kendra Farrow's picture

Hi Crystal, please see https://about.usps.com/publications/pub347/pub347_v03_revision_102015.htm for the regulations. It doesn't appear that there is a weight or size limit. I have been told that there is a 15 pound limit if you send a package internationally, however I haven't heard or read about any limits inside the U. S.
Carla M Kirby's picture

What is the best way to organize our day?
Sandy Neyhart's picture

Here are some suggestions that i gave people I work with: Working from home: Maintain your regular work schedule: it’s easy to lose the work and life balance that exists generally while you work in an office. Try to follow your normal work schedule and take regular breaks including your lunch hour. Create a designated work space in your home: try to eliminate distractions, create an environment that helps you to remain focused on activities. Set Clear Expectations with your supervisor: Talk about what you can realistically complete or not complete while working from home. Keep your supervisor updated on what you’ve been able to do each week. Communicate often with your coworkers: Continue to hold meetings, and chats with coworkers. Call them and provide support. Reevaluate if your struggling: It may take awhile to find a routine that works for you when working from home. If you are struggling talk to your supervisor and identify solutions that will work.
Marsha Egan's picture

Here is a link to a brief video on Life After Sight Loss, Creating a Daily Routine. https://lifeaftersightloss.com/how-creating-a-daily-routine-can-help-you-gain-momentum/ We viewed this as a team last month with regards to supporting our clients, but reminded staff about doing the same thing as we work from home as all of our schedules have changed.
Kendra Farrow's picture

Using a calendar, write in appointments, similarly to how you would do when scheduling appointments with consumers. Block time for calling consumers, doing documentation, ordering items, researching resources for specific situations, checking and responding to email, following up with new referrals, etc. It may be helpful to turn off your email so that you aren't distracted by new messages popping into your inbox. Once you start a task, stick with it for the pre determined time block. Sometimes you need to be flexible, but scheduling time on the calendar will help you to organize your time and be efficient with the tasks on your to-do list.
Malinda Carlson's picture

I've shared with my team what their "regular" duties are. These included:1. 1. Cancel appointments – 2. Catch up on reports 3. Call all open clients – a. We will be sending a letter to all clients restating what we are doing as an agency. c. Please stay in touch with all your open clients every 7 -10 days. Document calls. Consider discussing: How are you doing? Is there anything I can do for you over the phone, I’m still working and you can call me, review 211 program (you can study up by going to this website - https://www.unitedway.org/our-impact/featured-programs/2-1-1), conduct appropriate remote lessons - special team assigned to gather, assess and organize remote lesson resources 4. Contact new referrals as they are coming in – special team assigned to process map this 5. Do HR mandatory lessons (state requirements) 6. Keep your calendar up to date. Remember that calling clients is in all likelihood direct service. Please keep track on our calendar how much time you spent doing that. 7. Information is changing quickly – stay on top of your emails and phones calls.
Marc Wentz's picture

As regards Orientation and mobility, I can interview over the phone but will not be able to assess or evaluate O&M skills until meeting in person, but I would like ideas on how I can be of further assistance beside offering a listening ear. Sometimes though, that is all that is needed. Any thoughts?
Lisa Sluszka's picture

Hi Marc!!! Regarding O&M clients, I am still continuing to see clients that have some skill and are able to respond to verbal instruction with regard to correcting their technique. These clients meet me outside their home and we walk in their area; while staying 6 feet apart!
Kimberly Stumph's picture

Lisa, But in some areas, that is not recommended. Also, we, as service providers, may be in the high risk group and need to observe precautions
Lisa Sluszka's picture

That's why I am only providing instruction on a case by case basis.
Marc Wentz's picture

Good advice Lisa! Yes, there are some clients that feel comfortable but we respect those who do not. Our organization also has a protocol with questions and answers so that client and instructor feel safe. An area without a crowd of people is ideal under this situation.
Kimberly Stumph's picture

Marc, You can look at the topics that CAN be addressed over the phone such as Creating a Transportation Plan or Sharing Resources. You can share info on attending a Hadley Discussion group and attend it with them. Follow up after the group with identifying how it applies to them. Check for existing online offering (maybe thru Hadley or VisionAware or OIB-TAC) and work thru it with them. There are many concepts that can be taught without being in person. Also remember that you can use skype, google chat, facetime, etc to create that face-to-face feeling.
Marsha Egan's picture

Any thoughts on providing tips on human guide techniques for those who rely on this type of support during this time of social distancing?
Malinda Carlson's picture

If client or family member has access, use You Tube videos or send diagramed instructions - or Skype if client has a family member that can join in the training. Washington State School for the Blind has some excellent human guide videos
Marc Wentz's picture

Texas School for the Blind have good videos too. A side note, be very selective when choosing you tube videos to share regarding human guide. Unfortunately, this never takes away from hands on training.....

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