Part 5 in a series of articles by Margaret E. Cleary, M.S., R.N., CVRT, based on principles from Thomas J. Carroll’s book Blindness.

Loss of Recreation

a group of seniors gathered at a bowling alley

Carroll’s Concept: Recreation is refreshment, reanimation, the giving of fresh life, especially after wearying toil, work, or anxiety. In one form or another, it is important to everybody and most of all to those under stress.

Recreation varies a great deal with individual needs, temperaments, and habits. People with visual impairment may be unable to discuss reading materials, go to the movies at will, play cards or a chess game, watch television, attend a sports event, eat out, drive for a pleasure ride, organize a stamp collection, go hunting, hit a golf ball, ride horseback, or spend time in the workshop. The mercy of someone else’s time or interest may dictate when they can do the things that invigorate them.

Cleary’s Observation: Self-managing diabetes can take time away that people would ordinarily spend in relaxing activities. A doctor’s visit takes priority over fun activities. They may feel that too many adaptations to tasks and routines may be involved in planning a trip, and that spare cash is necessary for medications, not dining out.

Restoring Recreation

Carroll’s Concept: We need to be clear that restoring recreation does not mean a series of activities designed to fill every moment of leisure time. It refers to activities that allow room for true leisure and contemplation and send the person with visual impairment back refreshed to his daily living and working.

Cleary’s Observation: People with diabetes and visual impairment may have to face the fact that some favorite activities are out of bounds due to cost, dangers, and unavailability. An interest in a new sport can be encouraged. Golfing may be resumed with a sighted companion acting as caddy or coach. It’s also important to find time to relax.

My Reflections: Throughout the years, I was told about one single action that seemed to affect people the most: having to turn in the driver’s license. More than once, I heard gratitude for the mobility instructor who provided information about the various alternatives for travel, as well as encouragement to resume recreational activities.

Loss of Career, Vocational Goal, Job Opportunity

in an office setting, a woman is seated at a computer while a man stands next to her, pointing at the large print on the monitor

Carroll’s Concept: The loss of a career, of a vocational goal, of job opportunity, is an important loss for most persons and a most serious loss for some. The question of employment is often confused with the question of income and financial security. Blindness can have a real and imagined impact on vocational plans.

To lose a job, close out a career, or stifle vocational aspirations can be devastating to the person with visual impairment. The losses have a deeper meaning and importance than providing financial income and keeping busy. They are bound up with the dignity of the individual, the dignity of the job or position, the dignity of the work, and social pressures.

Cleary’s Observation: People with diabetes facing visual impairment have many attitudinal barriers to confront, skills to master, financial security to consider, and fewer opportunities to use previous skills. The road back to employment is much longer and harder than when first pursuing a career. Physical, emotional, and familial barriers provide tough obstacles.

Restoring Career, Vocational Goal, Job Opportunity

Carroll’s Concept: For almost all persons with visual impairment in their productive years, the keystone of the rehabilitation process lies in final placement in suitable and dignified employment. This may mean reorganization, reeducation, and retraining into a job where vision isn’t essential.

Cleary’s Observation: People with diabetes and visual impairment can develop adaptive skills; restore diabetes self-managing abilities; participate in blindness rehabilitation; reassess interests; develop new capabilities; and learn new work habits. All of these are preparation to convince employers they can do the desired work independently and self-manage their healthcare. Both the employers and employees may need guidance to understand their rights and responsibilities.

My Reflections: Bruce, a personable traveling salesman, was devastated by vision and job loss. Linda, a vocational rehabilitation counselor, explained that his blindness qualified him for disability benefits, which included Social Security, Medicare, rehabilitation services, pre-employment counseling, and equipment to perform a job.

Loss of Financial Security

Carroll’s Concept: Although loss of job and loss of financial security is not necessarily the same thing, for the average person the loss of a job does mean the loss of income. Few people have sufficient savings to cushion the sudden increase of financial need and financial dependence.

Besides the loss of income through loss of employment, blindness can cause financial difficulties to the person with visual impairment by increasing expenses. In addition to medical costs, expenses chiefly occur due to the losses of mobility, written communication and techniques of daily living. The ability to manage money becomes difficult.

Cleary’s Observation: People with diabetes and visual impairment experience astronomical costs of medical treatment, some covered by insurance, welfare, or pharmaceutical companies, some not. Related expenses include costs of hospitalization, medicines, nursing care, medical/surgical care, various therapies, and diabetes education.

Restoring Financial Security

Carroll’s Concept: This loss could be completely eliminated if society so wished. The more types of work and jobs that are opened up to persons with visual impairment, the greater number will be able to achieve the resulting financial security. All options for available aid while exploring rehabilitation and job preparation need to be explored.

Cleary’s Observation: It becomes important for people with diabetes and visual impairment to learn about opportunities for securing the Patient Protection and Affordable Care Act (ACA), Social Security and Social Security Disability Insurance, or Supplemental Insurance and Medicaid while striving to return to a full-time, fairly compensated job.

My Reflections: The aforementioned Bruce completed basic pre-vocational preparation, an interest inventory, and work assessment to determine his abilities to return to work. He was rehired as a salesperson. With an adaptive computer, he performed most of his sales transactions at home, hiring a driver as necessary for personal contacts.