vrt and ot professionals working together
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VRT and OT Professionals Working Together. Kendra Farrow, CVRT. What is a VRT?. VRTs address the physical, emotional, and social implications of vision loss Provides counseling and training in NEW skills and adaptive techniques - PowerPoint PPT PresentationTRANSCRIPT
VRT and OT Professionals Working Together
Kendra Farrow, CVRT
VRTs address the physical, emotional, and social implications of vision loss
Provides counseling and training in NEW skills and adaptive techniques
Success is based on level of independence and emotional adjustment
Work to enhance vocational opportunities, independent living, and educational development
What is a VRT?
What is an OT?
OTs address physical, cognitive, psychosocial and sensory performance
Provides activities with an aim towards improving health, well-being, and quality of life
Success is based on increasing participation and performance
Engagement in daily life activities (occupations) that support health and participation in home, school, the workplace, and community life (AOTA, 2008)
Differences In Services
OT Work with all impairments as
well as states of wellness If billing insurance,
• Treatment is defined in the Plan of Care (POC) written by the OT & authorized by the physician
• OT must perform an evaluation to identify medical necessity of services
Anyone can refer. • If utilizing medical insurance
requires physician involvement
VRT Focuses on blindness
and vision impairment Has community B/VI
connections Free services,
generally Flexibility in service
hours Anyone can refer
Two OT approaches1. OTs with training to work with Low Vision and may also work in the Blindness Stream.
• Services are directed at LV patients
2. OTs who work in other settings and may occasionally have a patient who is also experiencing vision loss.
• OTs in hospitals and nursing homes without LV training frequently provide vision services to clients with field limitations and loss secondary to brain injury
Why is language important?
If we don’t use the same words with the same meanings, it leads to; misunderstandings, confusion, and frustration.
If we can’t communicate, we can’t work together.
International Classification of Functioning
Disability and Health (ICF) Developed by the World Health
Organization to help communication Offers specific terminology and
definitions to describe disability and functioning
OTs use this language
Differences in Language OT Patient SNF (skilled nursing facility) MCB Physician Prescription or
Orders Plan of Care (POC) Training, Participation Eccentric Viewing Training
(EVT) Using Preferred retinal locus (PRL)
VRT Client Nursing Home Medicare part B Referral Individualized service
plan Teaching Eccentric viewing
Confusing Terminology Low Vision – OT uses
this phrase to describe vision rehabilitation, including legal blindness.
Low Vision – VRT uses this phrase to describe specific training
New Terminology for (some) OTsTerms
Blindism Acuity Photophobic Charles Bonnet
Syndrome Lumens Diopter
Concepts Perceived brightness Color perception Contrast sensitivity Focal distance Color temperature Principles of task
lighting
New Skills for (some) OTs
Reading an eye report Measuring low vision using near and
distance charts Knowledge of low vision aids and
appliances
Services specific to VRTs Braille instruction Transition services Advocacy skills Concept development Training under blindfold Adjustment to vision loss counseling Link to vocational services Sighted guide and protective technique
One way to divide the work
OT referrals must have:• Visual acuity of 20/70 or worse• Must have doctors’ orders and use
medical codes, CPT and ICD9 VRT referrals are for clients who:
• Want to learn Braille• Are not eligible for OT services• Need only one appointment
Low Vision Rehabilitation Delivery Model
http://www.mdsupport.org/deliverymodel/deliverymodel.html Model developed 2007 by a group of
professionals representing:• Ophthalmology• Low Vision, optometry• Vision Rehabilitation• Occupational Therapy• The Consumer
OT & Vision Impairment In 2002, Medicare issued transmittal AB-02-78: Medicare
Coverage of Rehabilitation Services for Beneficiaries With Vision Impairment
All licensed rehabilitative therapists eligible to provide and bill services provided to those with vision impairment• “Medicare beneficiaries who are blind or visually
impaired are eligible for physician-prescribed rehabilitation services from approved health care professionals on the same basis as beneficiaries with other medical conditions that result in reduced physical functioning.” (Centers for Medicare & Medicaid Services, 2002)
Flow of Services
Diagnosing Physician
Older Blind or
VocationalOccupationa
l TherapyVRT O&M
Community Services
Low Vision Evaluation
Tips for interacting with OTs
Keep a positive attitude Respect the OT Offer training Offer shadowing opportunities Give resources Keep the door open for further
communication
Things I have learned from OTs
Using a hand squeeze to detect tremors and strength
Exercises for hand-eye coordination improvement
Awareness of tripping hazards like throw rugs
The Numbers
Occupational Therapists Over 100,000 OTs
Vision Rehabilitation Therapists Approximately 600 CVRTs Up to 2,500 working in the field
Training for (General) Ots
Overview of types of vision loss• Causes• Different patterns of vision loss• LV devices are not one size fits all
Training for OTs
What is a Low Vision Exam?• The importance of LV exam• LV doctors in your area• Stress the importance of using the
correct device for each task
Training for OTs
Blindness Services• Your services and how to make a referral• Funding for LV devices• Courtesy rules for blindness• Other specialized services
• NLS, Newsline• O&M services• Support groups
How can OTs inform VRTs
Introduction to Functional vision impairment assessments & screens
Consideration of co-morbidities Centralized OT domain articulating
occupational roles, participation & performance
Treatment, progress & discharge notes
What do OTs have to share with VRTs
Introduction to functional and acuity assessment tools
Implications of other disabling conditions
Scope of work of the OT Documentation
Continuing Education Opportunities
AFB eLearning The Carroll Center Lighthouse University of Alabama at Birmingham Hadley School The NRTC on Blindness and Low Vision
Books
Low Vision Rehabilitation: A Practical Guide for Occupational Therapists, Second Edition
Occupational Therapy Interventions for Adults with Low Vision
Final Thoughts for VRTs
Be proud of what you do Keep up your certification Educate yourself about medical
terminology Take opportunities to talk with OTs Provide education when appropriate
Final Thoughts for OTs
Your role is valuable and needed VRTs can be a great resource Referring your patient to the VRT does
not mean your services are unnecessary
Keep learning, you can never learn everything about vision loss
Thoughts for Administrators
Communicate with your staff Have specific expectations and goals Support the VRT staff Require LV qualifications from OT staff Debrief and assess service delivery Communicate with staff
Thank You
Carmen Garcia-Hommel, OTLOccupational TherapistVisionCorps 244 N. Queen StreetLancaster, PA 17603717.205.4145717.291.9183 fax www.visioncorps.net
ReferencesNumber of OTs http://www.bls.gov/ooh/healthcare/occupational-therapists.htmAOTA overview of LV Certification https://www.aota.org/-/media/Corporate/Files/
EducationCareers/CE/SCLV%20Overview.pdf VRT Scope of Practice www.acvrep.orgOT Scope of Practice www.aota.orgInternational Classification of Functioning http://www.who.int/classifications/icf/en/
Contact Information
The National Research and Training Center on Blindness and Low Visionat Mississippi State Universitywww.blind.msstate.edu