Jennifer Ottowitz: Welcome to OIB Tax Monthly webinars, where our presenters share valuable information and helpful resources to support professionals working with older adults who are blind or vision impaired. Let's check out this month's webinar.

Lindsey Angst: Hi, my name is Lindsay Angst, and I am an occupational therapist and certified low vision therapist in Green Bay, Wisconsin, and I practice in outpatient hands and low vision therapies.

I have been practicing for 16 years, and I appreciate you taking the time to take this webinar entitled Hands-On Independence Adaptations for older adults with limited use of their hands.

The objectives of this webinar are to identify common conditions that occur in individual's hands as they get older, and how intervention-based adaptations and strategies can greatly improve their independence. Did you know that hand function declines in older adults? What age is considered an older adult?

Well, according to the CDC, individuals who are age 65 years and older are considered an older adult. However, research supports after age 60, there is a rapid decrease in hand grip strength of 20 to 25%. Knowing this can be useful when working with this population because you can potentially screen their bilateral hand strength.

One simple technique is having the individual squeeze each of your hands. If in fact they have two functional hands to use and you can compare one hand from the other and kind of get a sense of their grip strength, you always wanna remember you're tailoring resources to the individual and not their age or impairment.

General structural changes that occur within the hand as one gets older are specific to the musculoskeletal system, and they include muscle loss. Tendons that weaken and a decline in bone density. And these all contribute to hand dysfunction or decline as you get older. So losing muscle strength, super common as we age, and muscles are important because they support your joints.

Tendons start to weaken tendons, connect muscle to your bones, and when they lose their tensile strength, that can cause generalized weakness in the hands and wrist. And a decline in bone density usually occurs after the age of 50, usually earlier in females versus males, and that can really impact weakness, fine motor coordination, and dexterity of the fingers and hands.

Some of the common age-related hand deficits that we will look at today include decreased strength for gripping, for pinching. Decreased dexterity and fine motor coordination and just generalized hand pain and how those greatly impact an individual's ability to complete day-to-day activities. So there's age-related factors that we just talked about that can impact hand performance.

Hand function can further be impacted when there's an underlying age-related condition or disease, which we will look at next. One of the very common age-related conditions that you'll see in an older individual is arthritis, and arthritis can commonly be broken up into two different forms. The first one is called osteoarthritis or OA, and that actually becomes more prevalent in individuals after the age of 45.

So that is the wear and tear of the cartilage, which lines the articular surface lines between the bones in your hands and wrist and the rest of your body. And when that breaks down or gets worn out as we age, it can cause pain, fingers, stiffness, joint swelling. It can significantly restrict your movement for any of those reasons and can cause deformity, and that will make activities of daily living, or ADLs, significantly more challenging.

Rheumatoid arthritis is another form of RA that's a chronic inflammatory condition, and it can cause similar symptoms as well as significant deformity to the hands. I usually educate clients on what arthritis is, especially osteoarthritis because it is so common. I kind of compare it to like the brake pads in someone's car when they're wearing down.

You can definitely hear it and feel it. When you have healthy brake pads, your car runs more smoothly, and it's kind of the same concept with the surface or the lining that is in between the bones in our hands. Next, we're gonna talk about carpal tunnel syndrome, which can occur in young adults, but becomes more and more prevalent in older adults, and that is when the median nerve becomes compressed.

As it travels from the arm to the hand and fingers, and the compression happens at the wrist level, this can present or cause pain, paraesthesia, which is numbness and tingling, and a loss of strength. So a lot of people will report that they drop things or they can't feel things, and so they will essentially drop them or not be able to hold onto them.

Nerve damage or nerve inflammation can also occur in the neck. Or be from a disease other than carpal tunnel or a medication side effect. So carpal tunnel syndrome has a lot of symptoms that can be mimicked by other things. So you just wanna keep that in mind. Commonly, individuals will report that their hand is falling asleep on them and they'll attempt to shake it out.

We rely on our hands to do so much in our day-to-day, and as we get older and our hand function starts to decline. That can be a big challenge for a lot of individuals in a lot of different areas. It can impact dressing the individual's ability to eat or feed themselves, or meal prep, grooming tasks, personal cares, personal hygiene, communicating, whether it's texting or typing on a computer, writing, gardening, yard work, driving.

Leisure activities, gesturing when we talk, cooking, and the list goes on. So just having awareness and some basic knowledge of these conditions and age-related factors can help facilitate an even more client-centered approach to your services. So conditions we will address include neuropathy or numbness and tingling, which is common from diabetes or a nerve dysfunction like we talked about with carpal tunnel.

Tremors, which can be both at a resting position or action-based when an individual is using their hand, and that's common from Parkinson's or neurological conditions that are also very prevalent as one ages or gets older. Arthritis impairments, we talked about both osteoarthritis and rheumatoid arthritis, and then just having functional use of really only one hand.

When working with an individual, how will these conditions present? They can present with having hand or finger pain, a decrease in range of motion in the fingers or thumb, decreased grasp or pinch strength, which makes just simply picking up things in sustaining a grip or hold on them difficult, and you can observe this in individuals when they're constantly dropping things or decreased sensation in their hands.

When they complain about them falling asleep, or they can't feel things, or they can't feel temperature. How do these affect an individual on a functional level? All these changes can have a significant impact on someone's ability to complete everyday activities of daily living, or ADLs. These can include better or not limited to buttoning, zipping a jacket, grasping a cup, opening a jar or bottle, eating, writing, and grooming tasks.

So just keeping the awareness always based on functional and functional independence. So how can we help as providers? Research strongly supports the importance of interventions to address hand problems in older adults. The goal of adaptations to the task or environment is to improve the individual's functional ability to use their hands to make everyday task performance simple and safe.

So now that we have spent some time on the age-related conditions and how they impact hand function, let's look at ways that we can help. So let's start with an individual's home or living environment, and whether you are able to go to the individual's home or whether you're just making recommendations for within their home.

Moving commonly used items within arm's reach can greatly improve an individual's access to them, and it really will reduce their need to lift or grasp or repetitively do so, and they're not reaching as far. So if they have some of those impairments, like decreased range of motion or hand pain, this can alleviate that.

I have a picture of a three-tiered cart that's on wheels, so it can easily be transferred or moved between different rooms. Again, this, this is just a nice concept, and they can do this in multiple rooms and for multiple different activities. Some ideas of things to keep on the carts.

A lawn handled grabber. Any type of automatic openers. Automatic is always easier or electric devices because that will really save on the joints. You can also add a contrasting towel or piece of cloth to each of those trays so that visually it's easier to identify the objects. So if a lot of the objects in the top tier are darker, you could put a white colored towel or lining.

You could also add some contrasting tape. To the edges so that it's easier to identify within the rumor space. Adding task lighting is always a great idea because you're not spending as long on a task if you visually can see it better or easier. So that's one area that you can address easily within the home.

Body mechanics become more and more important, especially as we get older, but I am a huge advocate that they're good to address at any age. So starting out, educating individuals if they have function in both hands, to use both hands whenever available to them. So if they are gonna be grabbing a plate of food from the countertop, educating to use two hands versus one.

So that's a lot less strenuous to the joints and a lot less grip strength or pinch strength required in just one hand. Keeping your arms closer to your body to lift or carry things. So that bag of groceries, maybe you move, you educate the individual to move the bag straps up their arm to their elbow crease versus carrying it in their hand and fingers.

And it's a lot less strenuous to the smaller joints in your hand and wrist when you can carry things closer to your body because you're gonna engage bigger muscle groups. Sliding rather than lifting is a great thing to keep in mind. Just educating someone to slide a plate or slide a cup across the countertop.

It's a lot less strenuous and hard on the joints and a lot less amount of time that you have to maintain a grip or pinch on something if it's in front of you versus out across the table. Educating someone to take rest breaks before they start to notice fatigue or pain or symptoms starting and then educating them to break up a task into smaller parts.

So if they're going to be making a meal or doing some food prep, maybe they do the cutting and chopping the night before, or they get out all the different utensils or equipment they're going to be using because that is 50% of the task done and now they have more energy and more functionality of their hands to maybe get through the task without the onset of any symptoms.

Now we're gonna look at specific activities of daily living and what are some adaptations and modifications that you can take away and essentially add to your practice with the goal of enhancing an individual's confidence and independence. So starting off, we'll look at dressing and grooming. So for an individual that might have range of motion deficits or strength or weakness in their hands, an electric shaver is a great option.

They're less prone to cutting or having little nicks in their face, especially if they have a visual impairment. Electric shavers don't require shaving cream or changing the blades out. So overall, less maintenance, which means less use of your hands. A lawn handled grabber with built up grips for lower extremity dressing.

A sock aid. If you're not familiar a sock aid essentially holds the sock open, making it easier for the individual to slide their foot in, especially for an individual with decreased finger range of motion, strength decreased dexterity or just hand pain. Electric toothbrushes generally have a built up grip, which is really nice for individuals that have range of motion deficits.

And if you can look for one that has contrast, that's easier to identify visually and it's always good to educate individuals to always put things in a consistent place. They're easier to find and it decreases the need for having to do a lot of fine motor controller dexterity with the toothbrush with a regular manual toothbrush versus an electric one.

Educating to always take rest breaks. Keeping items on a contrasting tray and everything always has its place. Makes it a lot easier with your hands to find things. Older adults, especially, can be very set in their own ways and routines, so your ability to educate them and explain the why behind some of these recommendations is so important.

Another technique that I did not put on the slide was for the toothpaste with an electric toothbrush. Educating to use a pump toothpaste or an automatic dispenser would be a lot better for someone's hands, versus having to squeeze or pinch out the toothpaste in a tube. So, as shown, the bristles and the toothbrush are contrasting in color.

There's a much larger, wider grasp area. The power button is of really nice contrast as well. Hand tremors can be both resting and action-based like we had talked about earlier. So in educating those individuals to maybe stabilize or rest their elbow on the table when they want to use their hand can significantly help decrease the tremors.

Especially when they're gonna do an activity, trying a weighted cuff of some type to apply makeup or for other fine motor tasks. Weighted utensils are an option, like a weighted brush or comb for their hair. The weight helps to stabilize the hand movement due to the added resistance that it offers, which then can improve motor control of the hand.

Silicone coasters are available for pretty much all objects. You can apply silicone underneath, like the anti-skid silicone I'm talking about. You can apply that under anything, making it a lot more stable. And so if you would bump it or hit it, it's not as prone to falling over. Portable pill taker removers a hand-free dryer is a great option because then you can just.

Have the individual underneath the hair dryer, but they're not having to hold it manually and manipulate it as they're drying their hair. You always want to educate and prioritize activities with someone who has tremors. If they are, if their hand tremors are less intense or less noted in the morning, that's when you wanna do more of your important daily activities versus the afternoon.

If their tremors are more intense or more noted as they use their hands throughout the day. This is just an example of one type of weighted handcuff for individuals who have hand pain. Motion lights or clap lights are a great recommendation to make throughout their home or for the rooms that they spend the most time in.

A pill cutter is a safer option and it doesn't require the individual to have to pinch or hold the pill or the vitamin and then stabilize it while they're trying to cut it. So that's highly recommended. And they also make those with magnifiers attached to 'em as well. A lawn handled shoehorn. Rest breaks are always encouraged to both conserve energy of the joints and of the hands.

And you wanna encourage rest breaks with any task before the onset of hand pain to try to keep their hand pain at a minimum and not allow it to flare up. Recommending slide on shoes or Velcro shoes or elastic shoe laces. They don't need to then be tied, which can be a challenge, both for hand function deficits, revision deficits, and it's strenuous on the musculoskeletal system, the neck and the back specifically if you think about it, because the individual is having to bend over to tie their shoes.

So these are all good options. Magnetic jewelry clasps. For any piece of jewelry, relatively cheap. If you go to your jewelers they can switch those out for you. But for patients that have neuropathy or just decreased dexterity, that's a great option. Using a button hook or a zipper pull it just gives a larger, more wider base so it's a lot less strenuous on the joints and really can increase the individual's independence with dressing.

A clapper. Motion lights, a lot of times they're just like a peel and stick and you can put them in cupboards, you can put them in closets, or you can put them in rooms. And they're relatively very low cost. An individual that has really only functional use of one hand. A table clamp mirror with an adjustable gooseneck.

Allows them to really adjust and modify where the mirror is in order to be able to do grooming tasks or to put eyedrops in or whatever they're trying to do. Up close a sock aid, a dressing stick for both upper and lower extremity dressing. A pill cutter, an eyedrop guide. You wanna educate independence and compliance to individuals with their eye drops or medications, especially with glaucoma patients, a button hook, a zipper pole, and energy conservation techniques.

When you only have one hand, you really wanna be mindful so that you don't. Overuse the hand to increase pain or to really cause fatigue, and then the frustration increases in, in the individual as well. So educating to take breaks and to plan ahead, especially for those really heavy hand required tasks.

This is an individual using the eye drop guide with just one hand and what that would look like. It's also good to mention if you have individuals that have the hand tremors or a lot of deformity in their hands because of arthritis and they can't maintain or keep their eye open, this is a great option for individuals that present with fine motor coordination deficits, large or wide close pins.

Are a lot easier for those individuals to use if they want to hang their clothes out. On the laundry line, you can also add a piece of that silicone strip or Velcro for in increased tactile input. It's also easier to visually identify them and you can educate an individual to use a Palmer or lateral pinch.

With your thumb on top to pinch, or if they have a lot of thumb pain or arthritis, then you teach them to switch their pinch and put their index and middle finger on top, which is less strenuous to the thumb. Vertical eyeglass holders, they're a lot easier to set your eyeglasses in than you're trying to manipulate and slide them in a horizontal one.

And they usually have a firm like silicone kind of base that keeps it in place on the table. Motion lights. Pre-threaded sewing needles. These take away a step in sewing that commonly can, can increase joint pain and inflammation, and essentially can take a great deal of time and causes a lot of frustration for people.

So this is a great alternative for them. The button and zipper aids again and built up grips for pen.

These are the larger close pins, and as you can see, they're wider. So it gives the individual the ability to put multiple fingers to pinch on them, making it easier to open them and manipulate them to hang their clothes. And you can also easily apply something in high contrast or something tactual to make them easier to see and to manipulate and use.

Now we'll take a look at adaptations and strategies for eating and food prep. Looking again at the individuals that have difficulty with range of motion of their hands or strength. Recommending a mug with a handle versus a glass makes it easier for the individual to slide their hand in and they don't have to sustain a grip or pinch on a glass.

Hopefully they're less likely then to drop it, which can obviously be a big frustration for anyone recommending built up grips on writing and eating utensils. A bigger handle is less strenuous and hard for finger range of motion, and it's also a lot easier if they have hand pain recommending a rocker knife electric versus a manual can opener or anything manual.

If you can get them to switch to electric, that's a lot easier on their hands and joints. The use of a cut resistance glove that is gonna allow them to safely stabilize food for cutting or preparing food. And they'll feel the pressure of the knife before they would actually cut their hand. The of glove is easier to get on or to donne than an oven, MIT, or glove would be.

So for individuals that have finger or hand deficits or deformities, that's gonna be a lot easier for them. The grip jar opener can be placed under cabinets. So now both hands are available to use to slide in an object and then grip and twist it versus having to pinch and then try to turn a, a jar or a bottle to get it open.

So this is pretty slick. It's relatively very cost effective, and you just apply it with three little screws, or you can peel and stick it and put it underneath the cabinet. In someone's kitchen, and essentially you just slide, whether it's a nail polished bottle, a water bottle, or a big jar of pickles like seen in this picture.

Once it hits those grooves, it just slides in and you just twist and the cover pops off. So that's a great one for individuals that have hand pain finger deficit range of motion, any of these, any of these things that we've talked about, this is, this is a great one to recommend. For individuals that may have hand tremors, there are different adaptive utensils including both swivel and weighted utensils, and these can be helpful to counteract and stabilize the tremor, and they're generally a half pound or so.

So just to keep that in mind. Use of a divided plate can help prevent pushing or moving food when they may not want to. The use of Dyson is very effective because it'll stabilize pretty much anything that is resting on it. A cut resistant glove. An Ergo water bottle opener. These typically come in a variety of colors, which is really nice.

They have plastic, thick prongs giving more leverage to an individual to grab and pinch onto it. It's also really good for pat or individuals that have hand pain, maybe from osteoarthritis carpal tunnel, or if they have decreased sensation.

This is an example of the stay and eat divided plate. You can see that there is some raised borders to kind of divide the food on the plate, and also a really good contrast as well

for individuals with hand pan. A tomato or onion slicer is a great recommendation. You essentially just place the onion or tomato inside the slicer and it's a, it's a cut and push in one simple step versus multiple. Chopping or cutting or slicing which again, takes a lot of stress to the joints and hands, so you're promoting joint protection.

Also, it's a, it's a safer option for individuals as well. Big grip eat utensils. A rocker knife, which I have mentioned before, essentially a rocker knife. It's a round blade with a large, thick candle, making it easier to grasp. And this can increase stability and can be ideal for someone with functional use of one hand.

An individual with hand pain. So I know I put it under the hand pain list, but really these, a lot of these can cross over. So just keep that in mind. And then again, educating to take rest breaks so that you are preventing the onset or increase or spike in hand pain. And then the, my grip jar bottle opener as well because that's a lot less stress to the joints.

This is an example of that rocker knife. And really the individuals has a lot of different options as to how they wanna grasp or hold the knife. So that makes it a really adaptable device that you can use in the kitchen. Peripheral neuropathy and sensation loss was, was not covered a lot in this webinar, but I did wanna address it real quickly.

It's important because you wanna always know if an individual has any loss of sensation in their hands because that can impact their ability to feel pain or temperature or touch. And so it's becomes important even more so to educate on ways to compensate with the use of visual compensation while they're using their hands.

Or maybe you recommend wearing a heat resistant glove if they don't have good temperature sensation, or if they have lost the ability to really feel pain, then an anti cutting glove when they're preparing or doing meal prep.

For individuals with functional use of one hand, a palm peeler can stabilize and peel at the same time with use of one hand a plate guard, the use of Dyson. So things kind of keep in place and they're not moving around when you're trying to do something in the kitchen. A one-handed cutting board, a lawn handle pan.

And you also wanna remember to educate the individual to keep that arm close to their body when they're lifting that pan with that one arm because it's a shorter lever arm and it's not as strenuous to the joints use of a liquid level indicator. This beeps and vibrates when the liquid reaches the top.

So if they can't feel what their other hand when that liquid is getting to the top, this can kind of indicate it for them. This is the example of what a palm peeler would look like, and I think that they're demonstrating peeling a carrot, but you could use it on any food or vegetable for individuals with fine motor coordination deficits.

Again, the palm peeler, a rocker knife, a finger guard with knife use. Just to keep in mind, this does require the individual to have functional use of both hands. Weighted utensils make it a lot easier to grasp and use them. Building up the grips, all of these things can make it easier to support a functional pinch or grasp in the kitchen.

And not just for individuals that have a fine motor coordination, but also if they just have hand weakness or hand. Another resource to note is the blind kitchen. She is an instructor that recommends an individual wear an anti-cutting glove when you're using like a food grater or when you're chopping food.

And that's a great strategy to really recommend for safety reasons, because when you're, when you're grading your food and you visually cannot see it, you have no idea when your fingers are gonna be the next thing that you grate. So wearing an anti-cutting glove, that would be a great recommendation when you're grading food.

Here is a picture of a finger guard, which is a shield for your fingers of the stabilizing hand while cutting food. Now we will look at some adaptations and strategies regarding writing and communication.

For an individual that has range of motion or strength deficits, pen grips are great because they build up the grip so it's less strenuous for the individual to hold the pen to do writing weighted pens. The use of bold line paper. If you have never seen bold line paper, there's essentially, I mean, they have the bold lines, but there's more space to write on the line, which can be a lot easier for an individual that is struggling to pinch or hold the writing utensil.

Tactile- lined paper, a line guide, which just helps the individual keep their line of print straight as they write, which can be a lot harder to do if you have a visual deficit plus a deficit with range of motion or strength in your hands. Encouraging rest breaks. So if an individual at Christmas time is wanting, their goal is to wanting to write out their Christmas or greeting cards, you encourage them to maybe write out two or three and take a break and then go on and do another two or three, and they'll essentially be able to get through them all without having pain or not being happy with how their writing is looking because of their hand fatiguing or getting tired.

Large print or site guide checks and registers can really be a nice option because they can increase the independence for an individual to complete their finances. And it's a lot easier to write a large print paper of any kind for the same reasons that we had talked about before. And these large print site guide checks and registers individuals can get those through their banks or credit unions.

They just have to ask for them, and then when they go to order, reorder their checks or registers they can do so by just requesting that.

Again, if an individual maybe has some deformities to their hands, or they have a hard time grasping or holding onto the pen. That bold line paper makes it a lot easier because they have more space to write.

For an individual that has hand tremors or hand pain. Recommending an individual use headphones or earbuds when they are using their phone and they're not having to hold their phone in their hand, which if you ask anybody at any age even the older population nowadays, everybody holds their phone and is on it way longer than they even think they are.

And having to stabilize and grasp and hold the phone can really increase a lot of hand pain in individuals. And maybe not when they're actually holding their phone or their tablet, but they'll notice the pain when they go on to do their next task or activity. And it's really brought on from holding the phone.

So if they're not having to hold their phone up to their ear or in their hand to text, using headphones or earbuds is a great way to kind of alleviate that. A card playing holder, you're avoiding that sustained pitch pinch when you're having to hold the cards. When you're playing a game, you're not having to manipulate the cards in your hand, which requires a lot of fine motor coordination.

And so that's a great option, and they make different styles based upon how many cards you need to hold. A stand for a phone or tablet is a great thing to recommend. You can use a built-up one and you can also recommend one that is maybe head-worn if they don't have a free hand to be able to hold it.

A pop socket that requires a smaller grasp. So someone that has limited range of motion of their fingers from arthritis or another hand deficit, that's a nice option. A phone kickstand is a great idea if they're gonna be on their phone or a tablet for a long period of time. This is a great way to give their hands a rest break and still be able to do their task.

So this is an example of a card-playing holder. And again, it comes in different styles depending on the game and how many cards you wanna hold. But really good if you only have functional use of one hand. Decreased sensation, decreased pain, or decreased strength, or if they have hand pain for an individual that has functional use of one hand.

Recommending the use of voice assistance or dictation software that's so available on phones and tablets and computers. But for the individual that's older, they maybe have always relied on. You know, dialing a number or typing something or texting something. And so it's just educating them that this is an option and it's a great option.

If you don't want to use your hand and fatigue or tire out your hand, you can use your voice to do it for you. Recommending text-to-speech apps that are available, the use of headphones or earbuds so they're not having to hold something in their hand. And the same for a head-worn mouse.

For individuals with fine motor coordination deficits and writing is impacted and a goal you are addressing, the writing bird offers more of a grasp versus a pinch, and it's an oval shaped plastic piece, essentially with a hole kind of up in the front where you can then put your writing utensil in and then tighten it, whether it's a pen or a pencil. So essentially you're resting your arm and hand on the table and using wrist and hand movement versus finger movements to create the ready motion.

And you're not having, the individual doesn't have to sustain a pinch on the pen and kind of coordinate their fingers to do so, and this can be hard, especially if you don't have good manipulation of your fingers or control of your fingers. Also, it's a great option for individuals with tremors because they can stabilize their forearm and wrist when they're using it.

Another option is tactile dots on the keyboard. There's a lot of options and varieties for these, but it makes it easier to identify keys that an individual may miss or want to hit more frequently. And last is something called sticky keys. And these are a feature that can be enabled and when it's turned on, you don't need to press and hold multiple keys at once to trigger keyboard shortcuts.

Rather, you select them one at a time, and Windows recognizes them as if they were being pushed down or used simultaneously. So essentially pressing one at a time rather than all at once. And an individual can activate this in Windows and deactivate it, the sticky key feature, by pressing the shift button five times.

Now we'll look at reading and what we can do for adaptations and strategies. For an individual that has range of motion or strength deficits in their hands, recommending use of a reading stand is a great option. It elevates the print or the book, and it also can hold the book open to the page that they want and they don't have to sustain. When you're holding a book, if you think about it, you're sustaining that pinch or grip on the book, and for some people they'll read for hours.

That's a long time to be using the joints of your hands. And using the grip strength. And then later when you wanna go do a task, your hands are fatigued. So recommending a cookbook stand, a lap desk or a reading stand is a great alternative. You can also use Dycem again to stabilize the stand as well. Over the counter wrist supports or hand splints can help prevent prolonged wrist flexion when individuals are reading or if they're holding the book or anything in their hands.

And I just wanted to mention that because, you know, if, if the individual has carpal tunnel, this may be a time that you recommend that they put on their splint if they have one when they're doing reading. Audio books are a great option because you're no longer having to hold the books. And books can get very heavy.

The weight of them can, especially if they're a large print book, you're not having to use fine motor coordination to turn the pages or to pinch the pages and turn them. So audio books are another great option. And also always encourage rest breaks, not only for the individual's hands, but also their eyes.

This is an example of a collapsible adjustable reading stand. Again, recommending use of a reading stand. It's not just great for their hands, but also for their neck because they're not having to lean down. It promotes good posture as well, and they can purchase these relatively inexpensively. Or if they have a cookbook stand, they can use that as well.

When it comes to reading for individuals that may have hand tremors or hand pain recommending if they're using a magnifier to help them read, I would recommend the use of a stand versus a handheld magnifier. You just set the magnifier on the page and the focal distance is in place and they don't have to maintain that working distance like they would with their handheld magnifier to maintain focus.

It's recommended and better for more prolonged reading. And when they have a hand tremor that essentially takes that pretty much out of the picture because they're able to stabilize their hand. You also wanna recommend a clipboard or something to elevate the print so they're not leaning forward with their neck again when they're using the magnifier.

A table clamp magnifier is another great option as it's hands free. And so you can just clamp, clamp the magnifier on the table, use a gooseneck, and then position the magnifier and essentially have your hands free and you're saving act energy with your hands to do another task. Dycem weighted cuffs.

Inclined work desk station screen readers rather than holding the print material. Using a screen reader is a great option, especially if you're reading larger print and more prolonged reading, because larger print tends to be heavy bulkier, and so it's a lot more strenuous on your hands. This is an example of a stand magnifier.

Having functional use of one hand or fine motor coordination deficits regarding reading tasks, the use of a finger page turner is good for decreased dexterity or decreased sensation. A dome magnifier, hands-free readers. You're gonna use those with a very, very close working distance, so keep that in mind.

A desk magnifying lamp with a light and a clamp frees up both your hands and you have direct task lighting on the activity that you're going to do. This is an example of a desk magnifying lamp with a light and clamp. And it's really,J you're really able to manipulate it and position it where you would like.

So for an individual that may have just one hand, this allows them to use their hand on the task and not have to hold the magnifier.

When recommending optical devices, they should ideally be prescribed by an eyecare provider or a low vision optometrist. But this is not always the case. Skilled training on proper functional use can be provided by a very wide variety of pro providers depending on both the setting and the skillset.

Thank you for your time for taking this webinar, and I hope you learned a lot of adaptive strategies and techniques and adaptations for older adults that have limited use of their hands. All the resources that were mentioned in this webinar will be put together in a resource list that you hopefully can utilize within your day-to-day practice, and that will be provided as a PDF or a Word document as well.

Jennifer Ottowitz: This has been OIB-TAC’s monthly webinar. Thanks for tuning in. Find recordings of our past webinars on our YouTube channel and discover all of our many resources at O.I.B. hyphen T.A.C dot org. That's oib-tac.org like us on social media and share our resources with your colleagues and friends. Until next time.