Adapting the Environment
In the Home
When our eyes are not functioning properly light does not focus on the retina as it should. As we age our eyes need more lightning than we did when we were younger. Increasing illumination for people with low vision can make it easier for them to see to navigate their environment, with specific lighting being useful for reading and close tasks.
Poor lighting and shadows can increase the risk of falls, particularly on stairs and uneven surfaces. The need to adjust to different light levels when moving between rooms can be alleviated by keeping lighting levels in the home consistent wherever possible.The lighting needs of people with vision impairment will vary depending on the condition affecting their sight. For most people, additional lighting will improve their ability to see enough to navigate their environment or carry out daily tasks. However, we can never make an assumption, as increase lighting can cause glare for some and will cause considerable discomfort.
For people whose vision is limited to light perception, a light source can act as a useful navigational cue if it is a consistent light source.
As light travels from its source it will spread and weaken. By bringing the light source closer to a task or having additional lighting illumination levels will increase. Although increasing the voltage of a lamp is an alternative that can be beneficial , care must be taken to ensure that the voltage is not too powerful for the light fitting and the light shade.
Fluorescent strip lights fitted with a diffuser distributes light more evenly. Alternatively spotlights positioned to direct light in all directions are options for the kitchen, laundry or bathroom, however, although functionally useful some may not be pleasing to the decor in other areas of the home.
Other options such as down lights that are available to use with fluorescent, incandescent or halogen lamps positioned at even intervals can allow for an even spread of light.
Consider bringing light sources closer to a task such as positioning strip lighting under kitchen cupboards that can provide a more even and direct spread of light on countertops when preparing food etc. Additional lighting in the pantry directed over shelves can assist with identifying food items. Standard floor lamps and table lamps can add further illumination to a room.
Lighting tips in the home:
- Walls painted with pastel colours will reflect light
- Make use of natural daylight
- Net curtains can obstruct natural light
- Reduce glare from strong sunlight with vertical/horizontal blinds
- Add more wall lights to spread light evenly
- Choose a light shade that will not restrict spread of light
- Add lighting to stairwells and entrances
- Consider fluorescent strip lights with diffusers
- Add strip lighting under cupboards
- Don’t increase voltage of lamps/globes without checking they are compatible
- Don’t use high gloss paintwork, this may cause too much reflection and glare
Some scatter cushions in darker colours would provide some contrast for the lounge suite. Walls in contrasting shades can also help, however, if cost is an issue for re-decorating a picture on the wall can also give some contrast and act as a visual cue in a room.
Kitchens, laundry rooms, bathrooms
Although lighting is reasonable in the kitchen (pictured directly beneath) there is no contrast and the dark décor makes this kitchen look dark. Added to that the shiny surface of the countertop shows light reflections that can cause distortion.
The kitchen (pictured directly below) shows a bright kitchen with good lighting, however, the white cupboards against a white wall provide no contrast and are difficult to see. Some utensils here are contrasted so would be easy enough to locate.
When choosing appliances look for contrast on controls so that setting the dials is easier. Some control dials are contrasted to the appliance itself. Check wither the dial also has visible markings for setting. Alternatively, contrasting visual markers such as bump-ons or Velcro dots can be applied on appliance controls.
Non-slip mats (pictured left) are available in a range of colours and can have a dual purpose in providing contrast but also as a safety measure in preventing slippage of any items placed on them. Oven proof mats in contrasting colours can also be useful to highlight where to place hot pans, avoiding accidents and preventing damage to counter tops.
Likewise when serving up meals, think about the dishes that are being used and the food being served. For instance white fish, mashed potatoes and cauliflower on a white plate will not be visible, whereas the same meal on a darker colour plate again offers contrast. It will be difficult to see the liquid rise when making a cup of coffee using a dark coloured cup, change to a lighter colour or white cup and you have some contrast.
Clear transparent dishes will become invisible and water in a glass is easily missed with a risk of knocking over and breaking.
Hall, stairs and landing
Good lighting in entrance halls, particularly around stairs and landings is important to reduce risk of falls. The example below left, offers little contrast. For a person with low vision it is likely to be difficult to judge the depth of the stairs.
In addition to good illumination contrast on steps and stair risers (eg below right) will make it safer and easier to negotiate. Likewise contrasting sturdy hand rails will be more visible for a person with low vision ensuring they are extended to the last steps or beyond at the top and bottom of flight.
Similarly for bedrooms contrasting décor can be an advantage eg with bed linen in a contrasting shade to the bed frame, likewise for bedroom furniture. Full length mirrors may also benefit from visual indicator stickers. Clothing and footwear can be organised in drawers , cupboards and wardrobes for easier identification. Sorting clothing by colours is one way or hanging up outfits that are regularly worn together. Pairing socks in colours is also a useful tip. Think about contrast when placing everyday items on bedroom furniture. A black comb will be difficult to find on furniture that has a dark finish. If furniture is dark an option could be using a contrasting mat in a lighter colour on top of a bedside table or chest of drawers and placing the black brush/comb or other dark items on the light mat for better visibility.
How to improve contrast
Depending on the décor
- Door handles in a contrasting colour
- Pictures on cupboard doors will provide contrast
- Contrasting coloured tape (electrical tape) on shelf edges
- Contrasting coloured tape on the bottom edge of cupboard doors
- Line shelves with contrasting non-slip mat
- Contrasting non-slip mat on counter top
- Contrasting visual markers such as bump-ons or velcro dots on appliance controls
- Mark appliance controls for frequently used temperature settings
- Add visual indicators such as stickers with static cling that are available in a variety of designs including colourful pictures to glass doors and glass shower cubicles
- shiny surfaces for countertops and flooring that will reflect light and cause glare
- glass doors and glass shower enclosures become invisible, reflect light causing glare and can be a hazard unless marked clearly
For people who have severe vision impairment or who are blind it is more important to ensure everything has its place and is not moved without consulting with the person. With little or no vision, organising the home will assist in locating items and navigating in the home.
Large open spaces can be more difficult to negotiate. It is important to keep open plan areas free from clutter to avoid risk of falls. Some people are able to use a “mental map” to set out in their mind where everything is located in a room. Some people will use pieces of furniture, walls and fixtures as cues when moving from one part of a room to another or to other parts of the home. Moving items of furniture can be frustrating and cause a person to become disorientated. In some cases a person’s safety is affected when items of furniture are placed within their usual path.
Different floor surfaces can act as a cue when moving between rooms. Carpeting and vinyl flooring have a softer feel under foot in comparison to wooden flooring or ceramic tiling. A person with dual sensory loss can gain a perception of the size of the room from the type of furnishings. Each will provide a different sound and feel to a room with sounds being absorbed by carpet, vinyl floor covering and soft furnishings reducing noise and echo, whereas sounds will bounce off harder flooring and furnishings causing the opposite effect.
Hazards in the Home
The following are some hazards we are all familiar with and affect everyone, however they are more of a risk to people who have little or no vision and with an awareness and some consideration, can be alleviated or minimised significantly:
- Doors ajar – leave a door either shut or fully open. A half-open door is easy to bump into.
- Cupboard doors should not be left open, they are often at eye level presenting additional risk of damaging any remaining vision.
- If visiting a person in their home and you have brought a bag or any items of equipment make sure you do not place them in a position where they will become a hazard for the individual to trip or fall over. If in doubt ask the person where you should place your items.
- When sitting at a dining table, make a note of where the chairs are positioned and replace them before you leave, a chair is easy to bump into or fall over.
- Rounded edges on tables, work surfaces in a kitchen or bathroom and other furniture will cause less of an impact if bumped into than sharp corners.
- Pot handles left unattended and protruding on counters or oven tops can be knocked causing burns or scalding.
- Trailing wires and rugs with curled edges again can become a trip hazard.
Reduce hazards to reduce risk.
Adapting for Deafness or hearing loss
Other solutions for situations where we rely on our hearing to know when:
- someone is knocking at our door or ringing the doorbell
- the telephone or fax machine is ringing
- the smoke alarm is activated
- a baby is crying or in distress
People who are Deaf or have hearing loss may be at risk should there be a fire and be unable to hear the traditional smoke alarm. Smoke alarms can be set up with an extra loud ring or a flashing visual alert. However, people who wear hearing aids will leave them off during the night, therefore extra loud or visual alert functions may not be useful. An additional feature of these alerting systems is to have the smoke alarm connected to a vibrating pad placed under the pillow that will vibrate should the smoke alarm be activated.
The vibrating pillow pad is also useful to work with an alarm clock alerting the user should they need to be up for work or an appointment.