Veterans Administration Services and Vision Loss

Hadley

Veterans Administration Services and Vision Loss

Presented by Ricky Enger

Ricky Enger: If you are a veteran or know someone who is, it's so important to be aware of all the low vision services available to you. In this episode, Geo Athappilly of the Hines VA joins us to discuss more. I'm Ricky Enger, and this is Hadley Presents. Welcome to the show, Geo. So good to have you here.

Geo Athappilly: Thank you very much. I appreciate it, Ricky.

Ricky Enger: I am delighted to have the chance to talk with you as we learn a bit more about the services available to our veterans. We actually have a member or two who have gotten services from the VA, and they're always such fierce advocates for it. They love to tell anyone about all the cool things available. I'm so looking forward to learning more about that from you as well. Before we get into our questions, why don't you just tell us a bit about who you are and what you do. You're here at Hines VA close to Chicago, right?

Geo Athappilly: That is correct. As you said, my name is Geo Athappilly, and I am a legally blind individual. I was able to do my internship after my studies here at Hines at the Blind Center in the VA. I've been here about a little bit under 20 years right now.

Ricky Enger: Wow. Now, that's some longevity. You must really love your job to have stayed there that long and I can imagine why, because it sounds like you all do some really, really cool stuff there at Hines. I'm curious, I know that there are a lot of services offered to veterans with vision loss, and I'm wondering if we can just go through a few of those things that are available.

Geo Athappilly: Absolutely. Any veteran that has the ability to receive services from the VA qualifies to get services from the VA Blind Center. When they come to the Blind Center, they are able to participate in training in a lot of different skill areas. They include classes in living skills. This covers learning how to do things for everyday life like activities of daily living, communications, working in the kitchen, and learning braille. Then we also offer training in orientation and mobility. This allows veterans to learn how to use the long white cane for independent travel. We also offer manual skills. This is a class in which veterans get to learn how to use their non-visual skills and adaptive techniques in different activities like leather work, woodworking, small engines, and music. We also have a class in visual skills. This is where we are able to teach veterans how to use and maximize their remaining vision with different things like magnifiers and other low vision aids.

And then finally we have the access technology department where we teach both computers as well as smartphones like the Apple iPhone and other iOS devices so that they're able to use the growing technology bubble that we are in today.

Ricky Enger: Oh yeah, for sure, it's so, so important. So let's say that someone has a need for a magnifier at home and once they learn how to use that, are those devices provided to veterans, or how does that work?

Geo Athappilly: Absolutely. So yeah, that's one of the greatest benefits that we are able to do through the VA Blind Center is to be able to issue different things like computers and all the peripherals that come with the computers, iOS devices like the iPhone, iPad and different things like that, as well as magnifiers, CCTVs, and other low vision aids.

Ricky Enger: That's fantastic. One question that has come up when I've spoken to veterans, and I'm sure that people wonder, they might think, "Well, I lost my vision once I was not on active duty, so I probably don't qualify." But I'm wondering if that's true. Do you have to have experienced your vision loss during your service? Or what if it's something like age-related macular degeneration or anything like that, do you still qualify?

Geo Athappilly: So the answer to that question is that any veteran that is eligible to receive services through the VA is eligible to receive blind rehabilitation services.

I think one of the unique factors that we are able to do that might be slightly different from other rehab centers such as at the state level and things like that, is that a person may not need to even be legally blind. You may have some functional vision loss, and you can still be able to be eligible to get some services through the blind rehab VA program.

Ricky Enger: Yeah, absolutely, you're right, because with state services, you may need to be legally blind. But just because you have some functional vision loss, that doesn't necessarily mean that you're legally blind. But nevertheless, you still qualify for these services, which is really, really good. I guess that begs the question then, how does someone get started to apply for services like this? What's the process?

Geo Athappilly: So most of the veterans that come through our program, just like most individuals that experience vision loss, they didn't expect this to happen to them. It was not something that they were born with, so they probably started off going to their primary care doctor and that's where they started experiencing some vision loss. Then they probably went to the eye clinic and then followed up with their eye care. And at some point, they get connected to what is called the VIST coordinator, which is the Vision Impairment Service Team. This individual is the one that usually schedules them to come to the Blind Center to receive services. Once they have connected with the VIST coordinator, they will usually get an admission date within 28 days. Once they get that admission to the Blind Center, then they are able to get services either through inpatient training, outpatient training, or through VA Video Connect, which is the remote training.

Ricky Enger: Okay, awesome. So, it sounds like the VIST coordinator is really the key to getting everything going for you, if you’re looking for services. And if you are getting your care through the VA, they’re going to know who that person is and be able to get you in touch with them.

Also wow, that's an incredibly short waiting period actually, especially if we talk about other services, you may be waiting nine months, a year, in some cases a couple of years. And that is true for various kinds of services. So just because you're getting orientation and mobility training, you may still be waiting for technology training. So it sounds like with services from the VA it's happening a lot more quickly, which is wonderful. Let's say you're doing outpatient services, you're not going through some of the more intensive training that you might do in an inpatient setting, are all of those services happening at once, or do people get signed up for a couple and then maybe a couple more? How does that work?

Geo Athappilly: Usually that's very dependent on the geographical location of the veteran and what services are available. Not every location has blind rehab outpatient services. And typically when they do have outpatient services, it's usually one skill area at a time. So somebody might come out and teach them mobility for two hours and then they might have to come back after a week or two or three to do additional training. The more comprehensive training is when you come to the inpatient program, and that's when you'll have all the skill areas, and you'll have a daily schedule to go through all the classes.

Ricky Enger: How long do those inpatient services usually last? So what's the commitment if you’re going to come in and do inpatient? How long are you going to be there?

Geo Athappilly: So every program is individualized to the veteran's needs, but I would say an approximate average is four to six weeks. Usually a veteran will come in and that first week, week and a half, they go through assessments. During the time of the assessments, the veteran and instructors can be able to decide together what are the goals that the veteran needs to accomplish, and that can determine how long they want to be able to stay. So I would say about four to six weeks is a good average.

Ricky Enger: Yeah, that totally makes sense. Once someone has done very intensive inpatient services or maybe they've gotten a couple of outpatient things and maybe they've learned to cook, they've done some cleaning, but suddenly they're like, "Hey, I really need to brush up on my technology skills." Is there a limit to the amount of services that a veteran can get, or as you're going through your daily life that you need something then the VA services are here for you?

Geo Athappilly: There are no limitations on how many times a veteran can come through the program, whatever program that may be, whether it's inpatient, outpatient, or remote training. However, when we work with the veterans during the inpatient program, we do encourage them, "Go home, use the skills that you have learned, see what works, see what doesn't work, and give yourself some time to do that." So we encourage them, "If you've been here recently, wait about a year so you can really figure out what works, what doesn't work." And then when you come back, instead of just doing the same thing over again, now you can focus on the new skills and understand, "Okay, this is what I tried to do when I went home that was not very effective. Let me focus on that." So for example, if they've been through the inpatient program one time already, they got a good overview of everything that they've done, but they didn't do a lot of cooking. But the second time they come around, they may do a little bit more exploration of the adaptive kitchen skills and try a little bit more cooking.

Ricky Enger: Right, because it can be difficult to learn everything you need to know all at once. You may be really concentrating on one area, and then once that's down and you've really had some time to practice it, then you're thinking, "Okay, hey, I conquered this. I'm ready to tackle something else." You've mentioned a couple of times the virtual or video visits. Is that in addition to say maybe you come home from the inpatient service or maybe you decide not to go in for that, is that how the virtual video visits work or is it just in addition to whatever you've done or is it instead of coming in for an inpatient?

Geo Athappilly: It could be either way. The most traditional way is always to be able to do the inpatient training. You get the most hands-on experience that way. You also get to meet a lot of other veterans that are also going through the journey of vision loss. So those are the definite pros of coming in through the inpatient program. But if a person is not able to come to the inpatient program for whatever circumstance, then they can always do the remote training. It is also popular for people to do some follow-up remote training once they've completed the inpatient program.

Ricky Enger: Gotcha. So far, we've talked about some really practical aspects of adjusting to vision loss, learning to cook, learning your technology, figuring out orientation and mobility skills. Are there also services or support groups for just the social or the emotional aspects of adjusting to vision loss and whether that's for the veterans or are there also things for families as they're adjusting to the change in vision?

Geo Athappilly: Yes, we are blessed to have a lot of different services available for veterans in the inpatient program. So when they're here, we have a full medical staff that can monitor and help them with any medical needs. If appropriate, follow-up needs to take place in the main hospital, we can do that, for example, if they have to follow up with audiology or podiatry or something like that.

We also have both social work and psychology in the inpatient program, and veterans can follow up with them for their one-on-one needs. There's also a lot of group classes that we offer, and in these school group classes, we discuss different options of how to transition through the journey of vision loss, how to improve confidence and empowerment, how to integrate what you learn into everyday life and society.

On top of that, we also have recreational therapy, and we have a lot of different recreational outings. We encourage veterans to participate in these outings, and this is another way that they can go out, integrate into society, learn to advocate and communicate what they need as a person with vision loss. So these are all ways that we can accomplish that goal.

Ricky Enger: That's great. I think it is so powerful, just as you said before, to be able to meet other veterans who are going through this journey just like you are. We know that having that community feeling, that feeling of it's not just me and I'm not alone can really go a long way in the adjustment process.

Geo Athappilly: Absolutely. As well as for the family program training, there are a couple different ways we can do that as well. So whether veterans are in the inpatient program, outpatient program, or through the remote training, we can connect with family members and we can educate them by usually giving them a hands-on experience on how to do different tasks, sometimes under the blindfold. Also, giving them resources to be able to go through the journey of vision loss along with their loved ones. So if a family member is able to come into the Blind Center, we can be able to make appropriate arrangements for that. If they're not able to travel for whatever means, we are able to do conference calls or even video calls with family members. So these are other ways that we can work with family members to be able to help them go through the process as well.

Ricky Enger: That's fantastic. What we've talked about so far is in Chicago. So you are speaking from the experiences at the Hine VA. But with that said, there are other centers around the country that do very similar things. Now, I'm sure that you're biased and you're like, "Hey, ours is the best," but if someone is not located in the Chicago area and they still would like to get information for either finding their VIST coordinator or finding out what centers are in their area, is there an easy way, maybe a website, that people can go to get that information?

Geo Athappilly: I would say probably the easiest way for veterans to get information is they probably have a primary care doctor at the VA, and then through that doctor they can get connected to their local VIST coordinator. And from there, they can see what services are close to them and what are available for them. I think that would be probably the easiest way for people to be able to get information. There is the VA website, and you can go through that link to be able to find different information, but some it may be different in different places throughout the country.

Ricky Enger: And then of course it can be confusing doing these searches on sites and you go down a certain rabbit hole and you're like, "How did I end up here?" So it sounds like the VIST coordinator is really the best place to start and just to get in touch with that person through your primary care individual at the VA. Wow, this has really been very informative and I'm so happy to know that there are so many services, whatever it is, that you need as a veteran, whether it is you're at the beginning of the adjustment process or maybe you've been at this for a little while and you need to update some skills or you're curious about what devices are available to you. All of these things can be done through these low vision services through the VA. Geo, is there anything that we haven't touched on yet that you were hoping we'd have the chance to explore before we wrap up here?

Geo Athappilly: I would just say that I think whenever anybody goes through vision loss it's a very difficult process. And so the beginning steps of trying to receive training is always the most intimidating and difficult decisions to make. I think that's one of the things that we hear from our veterans too. They want to come in, but they're not sure if they want to come in because they probably haven't been away from home for some time and they don't want to travel by themselves and things like that. But I would say to any veterans, if you have vision loss and you are struggling to do activities of daily living, come check us out. I definitely think that we can do some productive things to really be helpful for you and we can spread the word so that more people are aware of the services that we are able to offer.

Ricky Enger: Excellent. Thank you so much for that and for all the awesome information that you've given us today. Geo, thank you again, we really appreciate your stopping by. And I've had a lot of fun and learned a lot.

Geo Athappilly: Thank you very much, Ricky. I appreciate the time. Stay blessed.

Ricky Enger: Got something to say? Share your thoughts about this episode of Hadley Presents or make suggestions for future episodes, we'd love to hear from you. Send us an email at [email protected]. That's [email protected]. Or leave us a message at 847-784-2870. Thanks for listening.