Successful Placement of the Older Consumer with Visual Impairment
A Training Curriculum
Prepared by
National Agenda on Vision and Aging Goal 5 Working Group
Pris Rogers
and
Peggy Anderson Mike Beck Paige Berry Julie Brock Kathy Gallagher Rita Houston David Jeppson Zeze Miller Alberta L. Orr Marie Simpson Frank Synoground Helen Thomas
April 2002
Table of Contents
Introduction
Module 1: The Changing Work Environment
Module 2: Understanding Psycho-Social Transitions and How These Relate to Employment of Older Persons Who Are Visually Impaired
Module 3: Understanding Physical Capabilities and How These Relate to Employment of Older Persons Who Are Visually Impaired
Module 4: Understanding Your Role as Counselor
Module 5: Marketing the Older Consumer
Module 6: Evaluating the Workplace Environment Vis a Vis the Older Worker’s Needs
Module 7: Knowing National and Local Resources Available to Help with Placement
References 74
Appendix A: Key to Self-Check
Appendix B: Job Analysis Form
Appendix C. Declining Senses Simulations
Appendix D. Fact Sheet: Have the “Vision” to Retain or Hire an Older Worker Who Is Visually Impaired
Appendix E. Self-Employment Case Studies
Appendix F. Experience Works Case Studies
Appendix G. PROJECT VIEW
Appendix H. Functional Resume
Introduction
This curriculum is designed to provide Vocational Rehabilitation (VR) counselors, rehabilitation teachers, and other vision rehabilitation professionals the information they need to work effectively with older persons with visual impairments to achieve their employment goals. Both the counselor and the instructor can play crucial roles in empowering the older consumer to retain or regain self-esteem, self-confidence, and independent living and other skills necessary to return to work or to remain on the job.
Very often older individuals who experience vision loss decide to retire upon the onset of vision loss and do not realize they can remain at work if they receive the vision rehabilitation and adapted devices they need. Also, older persons with visual impairments may need additional income or a productive activity to maintain the quality of life they desire. Again, remaining on the job or returning to the workplace, with support from vision rehabilitation professionals, can be viable options.
It is critical that vision rehabilitation professionals make sure that older consumers realize employment is an option. They should encourage older consumers on their caseload to work and not dismiss their vocational potential due to age or disability. To place older individuals successfully, vision rehabilitation professionals should build on the many strengths and life experiences older individuals with visual impairments possess.
These strengths include the following (Brady & Fortinsky, 1991):
* the value older consumers place on work
* a sense of accomplishment
* good relationships with co-workers
* solid work histories
· ability to embrace the mission of their companies or organizations
* interest in and ability to learn new things. * Another strength is a deep motivation to work, reflected by (Brady & Fortinsky, 1991) for the following reasons:
· desire to feel useful
· need for supplementary income
· benefits derived from meeting people
· desire for a challenge
· need to do something different
· desire for fringe benefits
· need for medical insurance
Older workers find reward in the act of work and in the work environment itself. “Traditionally attention has focused on issues such as wages, insurance, and other fringe benefits, but older workers are also interested in other aspects of employment...non material benefits...those intimately connected with the experience of work itself.” (Brady & Fortinsky, 1991, p. 37).
As you can see, older individuals have a great potential for work and great motivation. Often they need your support and interest to remain on the job once they have lost their vision or re-enter the workforce. You are a key to their success.
How This Curriculum Can Help You
This curriculum is intended to give you the information and techniques you need to help older consumers with visual impairments remain on the job or return to work. They will need your assistance and support, in most cases, to overcome self-imposed and societal-imposed barriers.
The curriculum is divided into 7 modules, each dealing with a different aspect of placement and employment of the older consumer. The manual begins with a pre-test of your knowledge of visual impairment. You will have a chance to take a post-test to find out how much information you have learned.
Each lesson contains the following information:
· Learner’s Goal
· Learner Objective(s)
· Lesson Content
· Learning Activities
· Key Points
· Self-Check (test of knowledge of material)
Now, please take a moment to complete the following pretest before starting the lessons. Good luck! The key to the pre-test is in Appendix A.
Successful Placement Pre-test
Indicate whether the statement is true (T) or false (F) in the space provided.
___1. One in four Americans between the ages of 65 and 69 has at least a part-time job and 80 percent of the baby boom generation wants to continue to work past age 65.
___2. The employment of individuals with significant disabilities has improved but the employment of older consumers has not followed suit.
___3. Individuals who are 65 and older must watch their earnings so they will not exceed the earnings limitation.
___4. Decreased financial security and of diminished opportunities for productive activity are major problems for older persons who lose their vision.
___5. The counselor’s role in the placement of older consumers is to point them in the right direction and check on them periodically to see how they are doing.
___6. Older workers use sick leave on average less than do younger workers.
___ 7. Older workers are generally more expensive to place than are younger persons.
___8. Some recommendations for accommodating older persons in a work situation include: job sharing, flex schedules, part time work, and self-employment.
___9. People who are over 65 are too old to work, cannot be expected to do much, do not have the skills to work on today’s jobs, and cannot learn the tasks associated with them.
___10. Experience Works is a senior employment program which can help counselors in the placement of older persons who are visually impaired.
You can take this test again at the end of the curriculum to check what you have learned from the curriculum. Answers are in Appendix A.
Module1: The Changing Work Environment
Learner’s Goal:
To understand the changing work environment and how this affects older persons with visual impairments.
Learner Objective:
At the end of the module, you will be able to discuss future trends in the work environment and the current status of employment of older persons with visual impairments.
“Two facts stand out: (1) older people will need the financial support of work; (2) the economy will need older workers because the growth of the workforce has slowed. Before the full effect of the aging of our population on our work force is felt, it is important that policy makers, legislators, employers, and older workers look at ways to plan and assure that we do not waste the valuable resource of older, disabled workers" (Cisco, 1991, pp. 11-12).
The U.S. Department of Labor’s forecast calls for total employment to grow by 1.3 percent through year 2006–not counting the added demand for replacement workers for retirees or those changing occupations. The supply of workers is expected to increase by only 1.1 percent annually. This translates to a shortage of about 4.5 million workers (Radtke, 1999).
“As a nation, we are growing older, and so is our Workforce. Today, there are 49 million workers in American aged 45 years and older–approximately 35 percent of America’s labor force–and by 2008 that number will grow to 62 million, or about 40 percent of the workforce. One in four Americans between the ages of 65 and 69 has at least a part-time job and 80 percent from the “baby boom” generation intends to keep working past the age of 65. Increasingly, older Americans want to work and for most, the opportunity to work adds not only to the length but also to the quality of their lives” (Clinton, 2000).
Currently only half of all working age people with disabilities are employed. The situation is worse for older persons with visual disabilities. A study of VR closures in 1998 ( Cavenaugh & Rogers, in press) showed that 24 percent of a sample (n =2102) of consumers with visual impairments aged 55 years of age and older were closed in competitive-sector employment (competitive, self-employed, or Business Enterprises Program (BEP).
The employment of people with significant disabilities has improved recently and the projected tight national labor market coupled with computer technologies and acceptance of home-based work should help to change the work status of older people with disabilities.
However, you are key to the employment of older persons with visual impairments. Your role will be explored in Module 4.
Learning Activities–You may try these activities to practice what you have learned.
1. Conduct a literature review of JVIB and other journals to find articles about older workers and write a summary of what you find.
2. Interview 2-3 people who are under 65 and over 65. How do people in each age category feel about work? How about continuing to work (full or part-time) after retirement?
3. Find out about technology training programs available for older workers in your area.
Congratulations! You have finished Module 1. Now go on to the key points section to review what you have learned. You will find these at the end of each module.
Key Points
1. When the economic picture improves, it is projected there will be a shortfall in the supply of workers in the workforce within the next decade.
2. The numbers of older workers who are visually impaired are not keeping pace with the numbers of older workers in general.
Self-Check
You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.
Please answer each True or False and check Appendix A for answers.
____1. Only 10 percent of older persons who are visually impaired currently work.
____2. Older persons are not interested in working.
Module 2: Understanding Psycho-Social Transitions and How These Relate to Employment of Older Persons Who Are Visually Impaired
Learner’s Goal:
To understand the psycho-social transitions older persons experience as they age and encounter visual impairment and how these relate to working.
Learner Objectives:
At the end of the module, you will be able to describe some of the psycho-social transitions older persons experience including personal losses and the challenges they present in coping with everyday life.
You will be able to describe the role of the family in dealing with these transitions and the challenges they present.
You will understand the role work can play in helping older persons cope with psycho-social transitions.
A. Understanding Psycho-social Transitions Older Consumers with Visual Impairments May Experience
1. The losses and challenges associated with age-related vision problems can be both real and perceived.
An older person who has recently lost vision may have experienced a variety of other losses, recently or concurrently. It is important for the counselor to know and understand what the older person has been experiencing. The older consumer who is ready for work has more than likely gone through a period of adjustment, but may still be dealing with some of these issues.
· Decreased independence or feeling the need to depend on someone else for everything.
· Reduced ability to move about in familiar or unfamiliar environments.
· Inability to drive a car.
· Decreased control over one’s life; for example, feeling unable to do anything or find anything in the environment, having to wait for others to complete tasks such as reading mail, going shopping.
· Loss of control over the physical environment such as the inability to locate things.
· Diminished access to written material and information in general, feeling cut off from the world.
· Decreased privacy such as needing someone to read one’s personal mail, assist in paying bills.
· Loss of anonymity or obscurity; for example, feeling stared at when using a cane, a sighted guide, or a magnifier.
· Decreased ability to read or respond to letters.
· Loss of opportunity for non-verbal communication such as being unable to see gestures and non-verbal feedback.
· Diminished feelings of self-confidence, adequacy, self-esteem and self-worth.
· Loss of roles and responsibilities and value in society such as work, volunteerism, feeling unable to carry out traditional roles in the home such as carrying out garbage, cleaning house, etc.; not being able to help others in some meaningful way.
· Lessened opportunities for productive activity such as volunteerism, involvement in recreational pursuits.
· Loss of social network, or feeling cut off from friends, feeling out of the mainstream of life.
· Decreased financial security due to loss of employment, increased costs of living due to disability. · Loss of sense of being whole or feeling as though part of one’s self is gone. (Orr, 1998)
2. Psycho-social Transitions Associated With the Aging Process
Some of the transitions and challenges associated with the aging process are similar to those related to vision loss such as:
· Diminished social network of all ages, feeling isolated or segregated (such as moving into senior housing).
· Loss of roles such as work or volunteer.
· Decreased financial security.
· Diminished control over one’s life.
· Loss of self-confidence and self-reliance.
· Decreased physical and/or psychological mobility.
· Diminished self-worth or self-esteem.
· Loss of a sense of being whole.
3. Other Psycho-social Transitions Associated With Growing Older
· Death of spouse or significant other.
· Loss of siblings, neighbors, friends and peers (note this refers to physical loss not distancing or psychological loss which may occur as a result of loss of vision).
· Decreased geographic proximity to children and grandchildren.
· Diminished health due to chronic disease or acute illness.
· Decreased physical capabilities such as hearing, mobility (Orr, 1998).
B. Understanding Family Relationships and Peer Support
1. Role and Involvement of Family members
“A strong body of evidence has been amassed documenting the important and supportive role played by the family in the lives of older people and... in the rehabilitation of disabled older people, including those who are visually impaired” (Silverstone, 2000, p. 160).
In the early stages of visual impairment, family members may not recognize that there may be a problem. Those living with the older family member experiencing vision loss are more likely to experience stress related to the older family member’s reaction to vision loss such as severe depression (Silverstone, 2000). The older person who is working may feel he/she has to give up working. Family members may or may not support the older person in this decision making process.
Involvement of family members in the vocational rehabilitation process is difficult. The Rehabilitation Act calls for development of an individualized plan which emphasizes client choice and self-determination. However, the counselor should be acutely aware of the role that family members play and be ready to provide appropriate interventions if needed.
Major family situations to which counselors should be attuned:
a. The older person’s concern about his/her vision loss is greater than that of the family, or he or she does not want the family involved.
b. The family of the older person is concerned with the vision loss but does not perceive a crisis.
c. The family is experiencing a crisis in relation to the older person’s vision loss and often experiences a great deal of stress (Silverstone, 2000, p. 166).
2. Counselor interventions can include:
· assessment of the family situation
· distribution of educational materials
· educational forums
· support groups
· open houses for families
· individual or family group meetings
· family counseling (Silverstone, 2000).
If family members choose not to be involved or are unavailable, older consumers with visual impairments can still benefit from individual counseling or group support meetings where family issues are discussed. The main thrust of this approach is to enable the older person to understand that he/she has control of his/her own life but that it is “ok” to seek help from family members or peers (Silverstone, 2000).
C. Role of Work in Helping the Older Person Cope with Transitions and Challenges of Aging and Visual Impairment
Although the older person may experience psycho-social transitions and lack of family support, this does not mean he/she is not a viable candidate for employment. In fact, going back to work or remaining on the job can help the older person deal with the challenges these transitions present by providing the following:
* additional income
* opportunity to be with others
* sense of self-worth
* opportunity to learn new skills
* health insurance and/or other benefits
* something worthwhile to do
Learning Activities–You may try these activities to practice what you have learned.
1. Take each psycho-social transition associated with vision loss. Write down an example which comes to mind of someone in your life who has experienced similar transitions and how he or she was affected.
2. Take each psycho-social transition associated with aging. Write down an example which comes to mind of someone in your life who has experienced similar transitions and how he or she was affected.
Congratulations! You have finished Module 2. Now go on to the key points section to review what you have learned.
Key Points
1. Older persons experience a number of real and perceived losses as a result of the aging process.
2. Some of these psycho-social transitions are similar to those experienced as a result of losing vision.
3. The family of the older person can be a positive or a negative force in the older person’s adjustment to challenges associated with aging and vision loss.
4. Work can help the older person to deal with these challenges by providing something worthwhile for the older person to do.
Self-Check
You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.
Please answer each True or False and check Appendix A for answers.
____1. Loss of roles and responsibilities and value in society such as work or volunteerism is a major psycho-social transition experienced by older persons with vision loss.
____2. Research indicates that families have little or no effect on the adjustment of the older person to vision loss.
Module 3: Understanding Physical Capabilities and How These Relate to Employment of Older Persons Who Are Visually Impaired
Learner’s Goal:
To understand the physical capabilities of older persons with visual impairments and how these relate to working.
Learner Objective:
At the end of the module, you will be able to describe some of the physical losses older persons experience and how these affect their ability to cope with everyday life.
Understanding Physical Capabilities
“The physical aspects of aging are less important than workers’ ability to maintain good attitudes, safety practices...The positive attitude of older workers and the fact that they do not decrease in productivity or coordinated activities within their physical scope show they can be efficient workers...” (Isernhagen, 1991).
Understanding physical health and limitations of the older worker. (For more information on health and limitations, go to www.aging.unc.edu/ioalearning/mod1Intro.asp and take the course on the Aging Body).
Experiencing vision loss along with other sensory impairments, particularly hearing loss, intensifies the social impact on the individual. Vision loss has an even greater impact when it occurs together with acute physical health problems, such as arthritis. The more counselors know about the life circumstances associated with the loss of vision as part of the aging process and other concomitant losses, the more successful their interventions can be.
Most older persons have at least one chronic health condition and many have multiple conditions. Approximately 30 percent of older people have a significant hearing impairment.
Brain and Cognition
Normal Changes
With age, decreases normally occur in the number of nerve cells, the weight of the brain, and cerebral blood flow. These can result in reduced short-term memory loss, slower reaction times, less precision in doing tasks, lengthier time for learning new information, and forgetfulness. However, most older adults remain mentally alert and capable, even those who live well into their 80's (www.aging.unc.edu/ioalearning/mod1BrainNervousSystem.asp).
Disorders of the Brain
A common brain disorder is dementia, a group of symptoms caused by changes in brain function. Some symptoms include: becoming disoriented in familiar surroundings, asking questions repeatedly, losing track of time. One form of dementia which affects approximately 4 million older persons in the U.S. is Alzheimer’s Disease (www.aging.unc.edu/ioalearning/mod1BrainNervousSystem.asp).
Nose and Smell
The sense of smell generally begins to decline beginning in the 40's and by age 80 approximately 80% of older people experience major loss in ability to smell. Smell affects the ability to discriminate among tastes such as the difference in chicken and turkey.
These changes may result in decreased interest in food and inability to determine quality of food and may result in malnutrition. Also, the older person may lose the ability to detect body odors or warning odors such as gas leaks or smoke (www.aging.unc.edu/ioalearning/modd1NoseSmell.asp).
Taste
As a result of age, the number and sensitivity of taste buds declines, resulting in decreased ability to distinguish between salt, sweet, or bitter tastes (www.aging.unc.edu/ioalearning/modd1Oral Health.asp).
Hearing
People who are deaf or hearing impaired use vision and touch to compensate for functions of hearing. Their language is visual and many of the tools and devices they use are also visual. People who are blind use hearing and touch. They also use audio cues to orient themselves and to travel. Persons who are deaf-blind or hearing impaired/visually impaired use the vision and hearing they have. Their senses of touch and smell act as receptors for information from other people and the environment.
Individuals experiencing a vision and hearing loss often find access to communication to be quite frustrating and quite challenging. Communication and mobility are obvious challenges to employment.
The age of onset of the vision and hearing loss will largely determine the communication preference of the individual. For those individuals who are deaf and for whom sign language is the preferred mode, it is critical that the provider either be fluent in sign language, or acquire the services of a certified interpreter. It is important for the rehabilitation provider to be aware that for native signers, English is a second language. Therefore, relying on note writing and/or lip reading for the exchange of important information should be avoided.
Points to consider when working with an individual with a combined vision and hearing loss:
· Provide reasonable communication accommodation based on the preference of the consumer.
· Assist the consumer in determining the most effective way to communicate with a supervisor and peers.
· Determine if the consumer would benefit from amplification in order to hear environmental sounds, as well as to hear and discriminate speech.
· Familiarize yourself with visual, auditory, and tactile adaptations needed for the home and work environment (see chart below).
· Ask the consumer how he/she prefers to be approached by others (such as by a tap on the back or shoulder or by flipping the light switch several times to get his/her attention).
· For consumers who use sign language, using a qualified interpreter for at least the first week or two of training on a new job is highly recommended.
· Use a qualified interpreter any time when critical information is being exchanged.
· Determine if there is a TTY (telecommunication device for the deaf) available at the workplace and that staff know how to use it. If for some reason a TTY is not available, staff in the workplace and the consumer should be trained on the use of the state’s relay service.
· Make certain the rehabilitation provider’s office is TTY accessible.
· Be aware that placing hard-of-hearing workers in jobs where there is constant exposure to noise might cause further damage to hearing.
· Avoid work areas where the consumer will experience glare or shadows.
· Avoid brightly colored and patterned walls, which can disrupt effective communication.
· Reduce environmental distractions such as noise and movement.
· Be prepared to repeat and rephrase information.
· Determine what computer technology accommodations are needed (large print; braille access; and amplified voice access). · · Ask the consumer to review key points of the conversation to ensure understanding.
Accommodation Considerations for Individuals with Hearing and Vision Impairments
Accommodation ConsiderationsNeeds/ NA Home Work Visual Auditory TactileCertified interpreterCART (computer assisted real time captioning)Assistive listening device (ALD)Braille LiteHearing Aid(s) ___Left ___Right T-switch Yes___ No___Telephone __large button __amplified ringer __flashing light __tactile alert __hearing aid compatible __voice carry over __TTY (large/regular print __Braille TTYDoor alert Auditory/visual/tactileClosed caption decoderClock __Braille __Talking __Large numbers
Wake up alert __visual (flashing light) __auditory (loud ringer) __pillow vibratorSmoke Detector __visual __tactile __auditory For more information or technical assistance in serving individuals who are deaf-blind or hearing-vision impaired, contact the Helen Keller National Center (HKNC)at 111 Middle Neck Road, Sands Point, NY 11050 or visit the HKNC website at: www.helenkeller.org/national/.
Speech
As a result of aging, the lower face and lips may start to droop. Weakness in the muscles around the mouth can affect word formation or dentures may not fit properly (www.aging.unc.edu/ioalearning/mod1Oral Health.asp).
Muscle, Nerves, Coordination
Muscle strength, motion, and reaction time can change. Reaction time can slow but is much less likely to occur in individuals who maintain physical activity. Overall, exercise and activity slow the aging process of muscles and, in some cases, reverse it.
Coordination is a combined function of brain, nerves, and muscle. With age, speed of coordinated movements can slow but overall accuracy generally does not decrease. Older workers who are trained and who continue to perform tasks should not experience any decrease in coordination (Isernhagen, 1991).
Moderate work loads, for the most part, are manageable for older workers. For the most part, physical demands of jobs are well below the maximum capabilities of older workers. (Meier & Kerr, 1976).
Bones and Joints
Women lose bone mass at a much greater rate than men. Exercise is crucial to reducing and even reversing this bone mass loss.
Osteoarthritis–the process of slow degeneration of the joints–is prevalent in the older population. Normal activity does not affect osteoarthritis and exercise is important to maintaining full range of motion. An arthritic joint can functionally limit work, particularly bending low to lift, and job modifications may be necessary based on a medical evaluation (Isernhagen, 1991).
Arthritis
Arthritis affects one in every seven Americans and occurs more often as a person gets older. There are more than 100 different types of arthritis and related conditions. Arthritis most often affects areas in or around joints. Studies show that exercise can help reduce the pain and fatigue of many different types of arthritis. Being overweight can worsen the effects of arthritis. (www.arthritis.org/AFStore/Start).
The Arthritis Foundation’s website www.arthritis.org, contains much valuable information about the different types of arthritis, including symptoms and treatment. The Foundation also offers a valuable brochure entitled Arthritis and Employment which is useful for counselors and consumers and can be ordered from the foundation’s website.
Cardio-Pulmonary Capacity
Heart
As we age, the heart wall thickens, arteries lose flexibility, and blood pressure may increase. However, these changes do not mean that the older person has cardiovascular disease, but can be signs of normal aging and adjustments. (www.aging.unc.edu/ioalearning/mod1Cardiovascular.asp).
Maximum heart rate can decrease with age and result in a diminished ability to respond to physical or psychological stress rapidly. Again, exercise and activity can keep heart capacity from declining significantly. Older workers with diminished heart capacity should not be placed in work situations requiring fast cardiac response (Isernhagen, 1991).
Pulmonary Capacity
The aging process can lead to a reduction in lung capacity due to decreased lung elasticity and less absorption of oxygen into the blood stream.
Aerobic exercise can lessen both heart and pulmonary decline. Older workers should avoid situations which can create severe pulmonary stress such as quick, long, or endurance movements (Isernhagen, 1991).
Balance
Balance and equilibrium are affected by changes in the inner ear and changes in muscles and tendons which can be worsened by inflammation, osteoarthritic degeneration and trauma. Balance problems occur particularly when rising from a sitting and kneeling position or when standing on one foot or on uneven surfaces. Individuals with vision loss experience balance problems at times (Saxon and Etten, 1987; Isernhagen, 1991). Mobility training may help the older individual with vision loss regain a sense of balance and exercise may mitigate some of the physiological changes which affect balance.
Digestive and Urinary System
Diet and lifestyle result in more changes to the digestive system than does normal aging. Kidneys may decrease in size but normally continue to function normally.
Normal aging can result in increased need to urinate and lessened ability to hold urine and the possibility of incontinence.
As a result of changes in the digestive and urinary systems, older people may eliminate medications more slowly than do younger people, therefore requiring smaller doses (www.aging.unc.edu/ioalearning/mod1DisgestiveUrinary.asp).
Temperature Regulation
Older individuals are often sensitive to cold or heat. Thus, they may require a work environment which is temperature controlled (Isernhagen, 1991).
Diabetes
Diabetes is a disease that affects the body’s ability to produce or respond to insulin. Diabetes falls into two main categories: type 1, which usually begins in childhood or adolescence and type 2, which usually occurs after age 45. The disease prevalence increases with age. Approximately half of all diabetes occur in people older than 55. Nearly 18.4 percent of the U.S. population age 65 and older have diabetes. Certain racial and ethnic groups are at greater risk of type 2 diabetes: African Americans, Latinos, and Native Americans (www.diabetes.org/ada/facts.asp).
Complications
Many people do not become aware of diabetes until they develop one of its life-threatening complications. These include heart disease, stroke, vision loss, amputations and kidney disease (www.diabetes.org/ada/facts.asp).
· Blindness–diabetes is the leading cause of new cases of blindness in people age 20-74.
· Kidney disease–diabetes is the leading cause of end stage renal disease. In 1995, approximately 27,900 people began treatment for kidney failure due to diabetes.
· Nerve disease and amputations–about 60-70 percent of people with diabetes have mild to severe forms of diabetic nerve damage, which can lead to lower limb amputations. Each year more than 56,000 amputations are performed on people with diabetes. Persons with diabetes must take care of their feet. Any injury to a foot or sore must be monitored closely.
· Heart disease and stroke–people with diabetes are 2-4 times more likely to have heart disease or to suffer from stroke. Approximately 77,000 deaths occur due to heart disease in diabetics occur annually (www.diabetes.org/ada/facts.asp).
Treatment
Diabetes is one of the most costly health problems in America. Health care and other costs directly related to diabetes treatment, as well as the costs of lost productivity, run $98 billion annually. It may be possible to prevent or delay the onset of type 2 diabetes by reducing lifestyle risk factors through weight loss and increased physical activity (www.org/ada/facts.asp).
In working with older consumers, the counselor needs to be aware of the warning signs of diabetes, the implications of diabetes, and how these may affect the older individual’s ability to work. The first priority is obtaining a dilated eye exam to detect eye disease related to diabetes. Through laser treatment, diabetic retinopathy may be treated quite successfully if caught early enough.
Starting in 2001, the Health Care Financing Administration, now known as Centers for Medicine and Medicaid Services (CMS), the Foundation of the American Academy of Ophthalmology, and the American Optometric Association have created a national initiative to address eye care for Medicare beneficiaries, transportation and cost. In addition to the CMS, FAAO and AOA partners, the initiative has mobilized many other organizations and people at both the national and local levels. CMS' national network of Peer Review Organizations (PROs) is playing an essential role by sending postcards and brochures to Medicare beneficiaries who qualify for the program to raise awareness of the Diabetes Initiative. State ophthalmological and optometric societies are partnering with the PROs to help spread the word about the initiative to the local media, celebrity spokespersons have contributed public service announcements and even carriers have helped spread the word to their providers through mailings. Increasing awareness of the connection between diabetes and blindness as well as the eye exam initiative through the national and local media and professional journals has contributed greatly to the early success of the project. The PROs are also working to address the transportation issues through state and local groups. For more information check the American Diabetes Association web site at www.diabetes.org/ada/preventblindness.asp).
Older individuals with diabetes can work, quite successfully. It is important for the counselor to educate the older person about complications, treatment, and preventive measures, such as weight reduction and dietary control. The person who is on insulin may need help working out a system on taking insulin while on the job and to work out problems such as storage of the insulin.
Learning Activities–You may try these activities to practice what you have learned.
1. Using simulators for sensory and other losses, try the exercises in Appendix C.
2. Using the simulators, role play an interview between yourself as consumer and another person as counselor or vice versa.
Congratulations! You have finished Module 3. Now go on to the key points section to review what you have learned. You will find these at the end of each module.
Key Points
1. Older persons experience a number of changes physically which may affect how they work.
2. The more counselors know about the life circumstances associated with the loss of vision as part of the aging process and other concomitant losses, the more successful their interventions can be.
3. Diabetes is the leading cause of new cases of blindness in people age 20-74.
4. Most older persons have at least one chronic health condition and many have multiple conditions. Approximately 30 percent of older persons have a significant hearing impairment.
Self-Check
You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.
Please answer each True or False and check Appendix A for answers.
____1. The physical aspects of aging are less important than a worker’s ability to maintain good attitudes, safety practices.
____2. Moderate work loads, for the most part, are manageable for older workers. For the most part, physical demands of jobs are well below the maximum capabilities of older workers.
Module 4: Understanding Your Role as Counselor
Learner’s Goal: To understand the counselor’s role in assessing, coaching, placing, and supporting older persons who want to work.
Learner Objective: At the end of this module, you will know specific strategies to use in interacting with, assessing and placing older persons.
A. Coaching Interactive Process
It is important for the counselor to establish a trusting, supportive relationship with their older clients. Counselors must get to know their clients so that they can help them overcome any negative feelings they may have about their age and visual impairment and discover their strengths. Older consumers may be affected by the negative views of others toward aging, blindness and other disabilities. Support and encouragement during the placement process comprise the two main ingredients for success.
Most older consumers possess a wealth of experience, but they may need help to recognize what they have to offer an employer. Uncertainty and fear are often the primary impediments to employment. The two most common questions asked by older visually impaired consumers are: “Who would hire me?” and “What can I possibly do?” Counselors must help their older clients recognize that they are still capable and able to perform to employers’ expectations.
The counselor may need to use projects or activities to enable the client to gain self-confidence. Work experiences, on-the-job training and even short-term volunteer work can be used as a prelude to permanent employment. Senior Community Service Employment Programs like Experience Works (formally Green Thumb) can provide an opportunity for the client to gain experience in a less threatening environment. Experience Works, Inc. is a national organization that focuses on the employment of people age 55 and over).
1. Building and Sustaining a Trusting Relationship
It is important for counselors to get to know their clients and what they want to do. Counselors should explore how their clients feel about themselves, what they like and do not like to do, their life experiences and, most importantly, their activities and employment background.
Counselors should remember that:
· Home visits are desirable for initial interviews.
· Frequent contacts may be necessary to keep the client from giving up.
Older consumers often do not initiate contact with the counselor in the beginning nor do they demand attention as younger persons often do. It is easy to let these cases sit or to assume that they really do not want to work. Remember that the counselor has to contact the client and provide encouragement along the way. Older clients may tend to give up without support.
2. Overcoming Negative Feelings and Uncertainty
The counselor must help older clients:
· overcome any negative feelings about themselves and their disabilities.
· explore how they may be allowing the way others view them to limit their choices.
· help them recognize their strengths and their capabilities.
Some older clients may have been out of the workforce for a long time and lack confidence. Some may be adjusting to recent vision loss, often compounded by other losses. The counselor should:
· explore options with the client.
· set realistic goals.
· show clients that they can be productive.
· build up their confidence and their skills.
· remind them of their strengths.
· encourage them along the way.
The counselor may need to give older clients a project or an activity to demonstrate their ability to perform effectively.
3. The Initial Interview
There is no format for a successful interview with an older visually impaired client. However, we have developed a formula for success. It is critical that the counselor believes in the ability of older individuals to perform in employment settings and has some enthusiasm for working with this population. It is important that the counselor does not mistake fear and uncertainty for lack of motivation to work. The counselor must be willing to take the time and have the patience that is sometimes required to work successfully with older adults.
Listen. The first rule is to listen to the clients. Start by getting to know them, what they like and dislike. Let them talk about their experiences and their interests. Help them to feel comfortable. Building a trusting relationship is the first critical step.
Establish rapport. Contact the client by phone first to begin to establish rapport with them. Making a home visit for the initial interview often helps to put the client at ease and gives the counselor a chance to get to know him or her better. Give the client the choice of a home or office visit. Explain the vocational rehabilitation program and ask the client about hobbies, activities and what is important to them. Let them talk.
Help the client identify strengths and capabilities. The counselor helps the client to recognize the skills they already possess and the strengths that lend themselves to employment options. This can be accomplished by letting the client talk about what they feel they can do, what they have done in the past, and what they want to do. Most older adults possess a wealth of experiences to draw on.
Explore options with the client. Help to set realistic goals. Often individuals with recent vision loss can be easily discouraged even when they express the desire to work. The counselor can explore how the client may be allowing how others view them to limit their choices or goals. The counselor can help the client overcome negative feelings and uncertainty by showing them that they can be productive and by helping to build up their confidence.
Identify any barriers. Help work these out. Discussing things like transportation, family members and medical problems will provide useful information. Sometimes, there are issues that need to be resolved before the client can even consider employment or training. Be patient and let the client gradually explore vocational goals and choices. Encourage the client to make decisions and let clients know that they will be supported in their choices.
Discuss the type of job the client may be interested in. The client may not be ready for this step. Do not push the client for an answer at this point.
Assess from the conversation what is needed to achieve an employment outcome. Often the client may not know what resources and services are available so it is important to explain these. The counselor concentrates on establishing a good relationship, helping the clients feel comfortable, encouraging them and letting them know that they are supported. If this is accomplished in the initial stages, gathering the necessary information to proceed comes about naturally.
Some information you will need to obtain during the interview or at a subsequent interview (in addition to the standard information normally required):
· Explore tasks the client normally carries out at home or through volunteer work such as using a computer, sorting mail, preparing meals, doing household repairs. Have him describe any problems he may be having in doing these using functional terms. Differentiate between vision-related problems, functional problems due to other disabilities, or other factors (such as family concerns for safety, etc.).
· Review previous work or volunteer history and discuss how these translate to needed skills in today’s employment market.
· Discuss education and training and the possible need or interest in updating skills or learning new ones.
· Determine what services or assistance is needed to attain the job goal. It may be too soon to explore this at the initial interview.
· Determine if a formal vocational assessment is needed or if the client is even ready to discuss this option.
B. Evaluating the Older Consumer
Use common sense in working with older individuals. Some very comprehensive assessment tools have been developed for assessing persons with visual impairments such as the Comprehensive Vocational Evaluation System (CVES) by Dial, et al with support from the Texas Commission for the Blind. The CVES constitutes a “systematic approach to vocational, educational, and neuropsychological assessment of visually-impaired and blind.” (Dial, et al, cover page).
However, not every older person needs a complete assessment and may be “put off” by having such an evaluation imposed on them. Counselors need to do a thorough interview and listen closely to insure they capture the wealth of experience that older persons have to offer. Older individuals with very involved physical situations may benefit from the CVES or those with little work history.
Most older consumers come to the table with life experiences, “street smarts" about the ways of the world,” skills, work ethic, and motivation to work. They may only need to be “pointed in the right direction” and be given the appropriate assistance to do their work such as job modification, or skills training for specific job tasks. Their physical capabilities need to be kept in mind, not for the purpose of excluding them from work. Rather, physical limitations can present a challenge to the counselor and the rehabilitation team to assist older job candidates to succeed in the job search. The counselor and rehabilitation team must help the older worker to come up with new ways of carrying out job tasks, despite these limitations.
A vocational assessment should include the following components:
1. Vocational Assessment
A thorough vocational assessment (Power, 1991) takes into consideration medical, social, educational, and vocational information, including:
* low vision examination results
* vocational and psychological test scores (as needed)
* skills (work-related as well as problem solving and organizational), abilities, and aptitudes
* interests and leisure activities
* personality and temperament
* values, attitudes, and motivations
* physical ability and work tolerance
* ability to benefit from additional training or education
* employment potential within the local job market
* social and interpersonal skills
* work habits
* work adjustment
* family situation
2. Assessment of Work Readiness
Work readiness in older individuals who are blind or visually impaired consists of three major components:
* making sure the older consumer is ready to go to work, physically and mentally, and that he/she has the appropriate independent living, travel, and communication skills (such as those outlined in the next section).
* ensuring the older consumer has the skills necessary to carry out job tasks
* making sure the consumer has the skills needed to adapt to the environment because of vision loss.
The challenge for the counselor is in bringing the three components together in each older job candidate.
The VR counselor working with older clients should have the following skills and abilities:
* good diagnostic and interactive interviewing skills
* a willingness to listen and to regard the older person as a “whole person” who has many applicable work experiences.
Unlike many consumers with whom counselors work, older persons bring extensive life experience and work histories with them. It is essential that counselors fully understand the work histories and life experiences of older clients.
With a lifetime of working and living, many older persons bring with them knowledge and skills associated with one or more jobs as well as the behaviors expected of any worker such as:
* adhering to work schedules and attendance policies
* following safety procedures
* working as part of a team
* using courtesy and respect in all interactions.
A major challenge for the counselor is to help older consumers realize their previous work and life experiences are of value regardless of vision loss. Since they do not come from a generation replete with older blind and visually impaired role models working successfully, they must be helped to believe in their own vocational potential.
At the same time the diagnostic interview process is being completed and counseling begins, the older client should be encouraged to take an independent living training program to learn needed skills and to build self-confidence.
To assist the consumer to make the final leap to work, the counselor may arrange one or more job shadowing experiences. Successful experiences will help in propelling the individual towards a job search and will build self-confidence.
If a counselor has a number of unanswered questions about the work-readiness of the individual and/or types of work the older consumer might be suited to, the counselor should recommend a vocational assessment as described above.
3. Assessment of Independent Living Needs
In many cases, after vision loss, the older person refrains from socializing or participating in community activities, especially those related to employment. This is due in large part to the obstacles they face in managing their personal needs. As a result, the older consumers develop feelings of low self esteem and the lack of self worth. They generally feel unsuitable to be in public, because older people often hold the view that "proper" appearance is critical to their feeling like a whole person.
Some older individuals may reject assistance for many reasons, including:
a. Fear of admitting that they have a vision problem and that they need assistance
b. Loss of self esteem, self confidence, and having feelings of worthlessness and uselessness
c. Feeling anger or depression.
To overcome any of these hurdles and any other stereotyped views they may hold about blindness and aging, they will need training in independent living skills, education about blindness and visual impairment, adjustment counseling, and training in self-advocacy.
Assessment of Independent Living Skills Generally Needed to Restore Self-Confidence
In general, older people will make an effort to learn techniques to maintain their independence at a level which is comfortable to them. Therefore, the counselor/teacher must have an understanding of the consumer's life style and his/her future goals and individualize vision related rehabilitation services to meet the needs of each consumer. Independent living skills which are related to work and should be evaluated and addresses include (but are not limited to) the following:
Home and Personal Management Skills
· Coordinating clothing
· Applying make up and care for nails · · Shaving safely
· Combing and/or styling hair
· Identifying medication
· Preparing meals safely and efficiently
· Carrying out home management techniques
· Caring for clothes
· Maintaining good dental hygiene
Communication Skills
* Identifying money
* Telling time efficiently
· Dialing a telephone
· Use of readers, tape recorders, braille, large print, and low vision aids for accessing printed materials
· Proper use of writing aids, such as writing guides
· Effective use of adaptive technology, such as screen magnifiers and screen readers
· Ability to budget and keep records
· Ability to use a calculator
· Ability to keep up with addresses/other correspondence
Independent Travel Skills
The counselor/teacher must insure that the older person develops independent travel skills including:
· Orienting oneself in familiar and unfamiliar environments
· Using a long white cane or other mobility device
· Traveling to and from work
· Shopping for groceries and other items
· Using public transportation or establish a support system for transportation if public transportation not available.
· Getting around safely in the community and home
· Asking for assistance from others when appropriate
4. Assessment of Physical Capabilities–See Module 3
C. Approaching Placement
Older clients may need more interaction with the counselor during the placement process. The counselor may need to assist with the resume, help complete the application and prepare the client for the interview. Conducting mock interviews may be helpful in building confidence. The counselor should be willing to pave the way for the older client when necessary. It may be necessary for the counselor to:
· Help the client prepare a resume
· Contact the employer first
· Screen the job
· Sell the client to the employer
· Set up the interview
· Prepare the client for the interview · · Accompany the client to the interview, if necessary
· Coach the client and provide support at each step
Preparing A Functional Resume
In helping the client prepare a resume, it is important to select a resume format which reflects job history and skills. Unlike younger clients, older consumers have many positive life experiences and skills which can be presented to advantage in a good resume. A functional resume which includes a work objective, skills, and accomplishments will enable the older client to emphasize critical skills and knowledge obtained through paid or voluntary work.
For example, an older woman may have little paid work experience, but may have many attributes for an employer such as the ability to coordinate and juggle many responsibilities; ability to research, collect and evaluate bids, ability to organize and work as group leader or team member, ability to communicate and to make public presentations, and the ability to train (gained through church, scouting activities, etc.).
See Appendix H for example of a functional resume.
D. Interactive Placement
The counselor should contact the client to provide information, review the information with the client and offer support as needed. Co-active participation helps to overcome the client’s fears. However, care must be taken not to take away the older person’s autonomy and dignity.
A good example of how this interactive placement process can work is a case study from PROJECT VIEW (visually impaired experienced workers), a project run by the Florida Division of Blind Services to place older persons with visual impairments. See Appendix G.
E. Support Services on the Job
The counselor should be available when the client first starts the job. The client may want the counselor there to help orient him or her on the first day, and possibly, do some job coaching. The counselor may need to continue to build up the older person’s confidence and/or skills.
The counselor’s job does not end with placement. It is essential to keep in close contact with the older worker and the employer for several months through phone calls and even visits. Often job coaching may be needed for a few weeks, as required. Knowing that the counselor is available and supportive is critical to the success of the placement.
“Counseling must further the empowering process for the consumer.” (Radtke, 1999, p.44).
Some elements of this empowerment process include:
1. planning that is person-centered
2. a consultative approach to the consumer
3. communication focusing on active listening and dialogue
4. building around the concepts of quality of life and informed choice
5. using proactive techniques that allow the consumer to become independent
6. providing services that meet the perceived needs and expectations of the consumer (such as interest in working part-time)
7. developing goals of counseling around the older consumer’s ability to:
· develop self-marketing skills
· make informed choices/decisions
· engage in self-advocacy
· accept, foster, and tolerate change.
· be knowledgeable about job markets and job demands such as awareness of labor market trends such as self-employment and working at home, and how the older consumer can fit into this new way of work. (Radtke, 1999, pp.44-45).
F. Need for Accommodation for the Work Site
Work-site modification involves making environmental changes both to the workplace and work station. These modifications can be low tech and should involve a common sense approach to looking at the work site.
Modifications Which May Be Made to the Work Station Include:
· job tasks
· time or work schedule
· personal work behaviors
· adaptive equipment and tactile markings
Commonly Used Modifications Include:
· Braille or other tactile markings such as for file tabs
· organization of needed work items
· modified tools
· tactile guides such as for tools
· removal of sources of glare
* use of color contrast
* installation of appropriate lighting
* use of reading tables * * modification of existing equipment through adaptive devices
* use of specialized equipment (Scadden, 1991) such as:
- low vision devices
- electronic magnification devices (CCTV's)
- computer screen magnification
- speech output
- optical character recognition
- adaptive technology
Learning Activities–You may try these activities to practice what you have learned.
1. Develop a functional resume for an older person seeking a job as a teacher aide. 2. Role play a discussion with a consumer about the types of accommodations her/she will need for a job as a teacher aide.
Congratulations! You have finished Module 4. Now go on to the key points section to review what you have learned.
Key Points
1. Assessment of the older person’s work capabilities should include some of the following components: assessment of skills developed through work or life experiences, assessment of physical capabilities, and assessment of independent living skills.
2. It is important for the counselor to establish a trusting, supportive relationship with the older client.
3. Older clients may need more interaction with the counselor during the placement process.
4. Using a functional resume which includes a work objective(s), skills, and accomplishments will enable the older client to emphasize critical skills and knowledge obtained through paid or voluntary work.
Self-Check
You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.
Please answer each True or False and check Appendix A for answers.
____1. The physical aspects of aging are less important than the older person’s attitude toward and interest in work.
____2. Interactive coaching and placement are keys to working effectively with older persons interested in employment.
Module 5: Marketing the Older Consumer: Understanding Employer and Workplace Needs
Learner’s Goal: To understand the societal myths which affect vocational rehabilitation agencies, counselors, consumers and employers and their impact on the employment of older persons.
Learner Objective: At the end of the module, you will understand these myths and be able to debunk them.
“Minds are like parachutes–they only work when they’re open” (Cetron, Rocha & Luckins, 1988).
“The most practical approach is to identify the most important "intervention points” and develop major strategies which will, in effect, change policies and practices to create more employment opportunities” (Morrison, 1991, p. 30).
A. Societal Myths and Overall Impact on All the Players
· People over 65 are too old and cannot be expected to do much.
· Most older people have poor health.
· Older minds aren’t as bright as younger minds.
· Older people are unproductive.
· Older people cannot work independently. (Corthell, 1990).
Debunking These Myths
Insurance company data indicates that older workers use less sick leave on average than younger workers. Furthermore, they are less likely to quit, are generally as productive as younger workers, have good attendance and punctuality, tend to set more realistic goals, and use their practical knowledge to get work done (Morgan & Walters, 1980).
“Cicero said it best: ‘Exercise and temperance can preserve something of our early vigor even in old age.’ This essentially is the philosophy of those who work in their older years. Work produces pride; work produces positive social interactions. Work allows a person to be physically as well as mentally productive, and productivity is a hallmark of our society.” (Isernhagen, 1991).
B. Employer Myths
· Older people do not have the skills to do today’s work or conversely the older person seems overqualified. (www.aarp.org/working_options)
· Older people are unproductive/inefficient, inflexible.
· You can’t teach an old dog new tricks--older people cannot learn new technologies.
· Older people cannot hold down a job due to poor health (Corthell, 1990).
· It’s not worth the time to train a person who will soon retire (www.aarp.org/working_options).
· Older people are less productive.
· Older people are cheaper. (www.aarp.org/working_options).
Debunking These Myths:
Employers have certain belief systems regarding all individuals with disabilities. Therefore, it is important for rehabilitation professionals to determine the degree to which a potential employer subscribes to these overall beliefs and to set about dispelling them. One strategy might be to invite an employer to a technology or rehabilitation center to observe what persons who are blind can do with the appropriate training and use of technology–both high and low tech.
· Employers are faced with a hard reality. According to the Census Bureau, the number of 20-34 year olds in the U.S. has declined by 6 million over the last decade while the number of people over 50 has increased by 12 million (www.maturityworks.org/new/ap_ncoa_partnership.html).
· A study of 240 US businesses revealed that 97 percent regard older workers as thorough and reliable in completing their work. They also said older workers have lower turnover rates (88%), are not rigid and unwilling to change (85%), are interested in learning new tasks (81%), and do not miss time from work because of health problems (94%)."
· "Older workers represent 10 percent of the workforce but account for 22% of the nation's job growth since 1995" (Experience Works, formerly known as Green Thumb).
· “Make Age Irrelevant”, says Sally James, Executive Director of Career Encores who offers the following suggestions to older job seekers and counselors:
* stress valuable skills and commitment
* keep skills current
· learn about the company before the interview
· show enthusiasm for the job
· tailor the resume to the job; show skills on resume which relate to the job directly
Dealing with Age Discrimination
Under the Age Discrimination in Employment Act (ADEA), an employer cannot discharge, refuse to hire, or otherwise discriminate on the basis of age. For more information about this act and how to proceed, check (www.aarp.org/working_options/agediscrim/home.html).
C. VR Agency Myths- Marketing the Older Consumer within Your Own Agency
* Spending case load money and time on older consumers is not worth it; you’ll never get a 26.
· Employers will not hire older workers.
· Older people do not want to work.
· Older people cannot do the work that employers expect these days.
· Older workers cost more (Corthell, 1990).
Debunking These Myths:
Many new studies debunk the old myths that older people cannot perform and are a drain on employers. In fact, older workers add value to the work place by bringing skills, experience, and a stable work record, all traits which employers consider most valuable in today’s changing work place (www.aarp.org/working_options/barrier/home.html).
Increasingly companies are coming to realize they are missing out on important assets to their businesses. Large companies such as CVS pharmacy, Mellon Financial, AT&T, A&P, Exxon/Mobil are forging partnerships with AARP and the National Council on the Aging to increase their pool of employees. (www.maturityworks.org/news/ap_ncoa_partnership.html).
VR agencies can be prepared to meet future workforce needs of older individuals with disabilities and employers if:
· Your agency can facilitate access to the open job market through the Internet.
· Your agency can facilitate access to work through the hidden job market.
· Your agency sets production goals for employment outcomes and recognizes/rewards performance.
· Your agency can provide or facilitate provision of technical expertise related to alternative employment including self-employment or temporary agencies.
· Your agency has a strategic plan in which employment of older persons with disabilities is included (Radtke, 1999, p. 79).
· Your agency is open minded and ready to “meet future workforce needs.”
D. Counselor Myths
· Counselors have concerns about their ability to work with older people
· Counselors often inculcate VR agency and societal myths
· Counselors feel employers may hold negative stereotypes about older workers
· Counselors have the following concerns about older workers:
· older consumers are a hard sell
· older consumers take up too much time; not enough “bang for the buck”
· older consumers cannot be expected to become self-employed late in life (Corthell, 1990).
Debunking These Myths:
* Counselors need to start to work with older consumers to help them get over their fears. Older people have many of the same issues and concerns as do younger clients. However, they do bring a wealth of experience to the table. They already understand the work ethic. Stress these positives with employers.
* Older consumers may take more time to place, but once on the job are more likely to stay. Followup studies with Project VIEW clients indicated that many older people in their 70s and 80s have remained on the job for several years and have required little in the way of ongoing support. Furthermore, employers are begging for more “good workers.”
· In 1998, older individuals who were self-employed made up one-quarter of the total placements of older people with visual impairments (Cavenaugh & Rogers, in press).
E. Consumer Myths/Myths of Significant Others
· Consumers and family members feel the older person is too old to be hired or start a new career.
· Consumers feel visual impairment limits ability to work any more.
· Consumers fear potential loss of benefits.
· Consumers and families often inculcate societal myths about age and disability (Corthell, 1990).
· Consumers fear rejection and feel older workers are not welcomed in the workplace (Miller, 1991). (aarp.org/working_options/profiles/jamesprofile.html). .
Debunking These Myths
· Negative Attitudes
Generally, older consumers have grown up having negative attitudes towards vision loss because of the myths that the public had about blindness. Blindness was and still is to many people a tragedy worse than death. Most older consumers are devastated when they learn that they are losing their vision, or will become legally blind because the fear of darkness is quite frequently among the most common fears people have.
Blindness is so feared by the older person that in many cases other more potentially dangerous diseases are perceived less threatening and more welcoming than visual impairments. The fear usually stems from the feeling of loss of independence and the loss of self identity.
· Loss of Benefits
With the signing of H.R. 5, the "Senior Citizens' Freedom to Work Act of 2000, financial disincentives for work for individuals 65 and older were eliminated. This bill amended Title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act and repealed the limitation on the amount of outside income which beneficiaries who have attained retirement age may earn (earnings test) without incurring a reduction in benefits.
The bill as signed by the President on April 7, 2000 (P.L. 106-182) did not contain a provision for restoring the link between SSDI recipients and retirees 65 and older (American Foundation for the Blind, 2000 (WFW, May 8, 2000 , Vol. 106 No. 11) .
Through the Ticket to Work and Work Incentives Improvement Act of 1999 (TIA/ WIA), financial limitations to Medicaid benefits have been liberalized in some states. For example, in Connecticut a person can earn up to $75,000 and retain Medicaid benefits.
Social Security Act Changes. Section 112. Expedited Reinstatement of Disability Benefits.
The act establishes that an individual: (1) whose entitlement to SSDI benefits had been terminated on the basis of work activity following completion of an extended period of eligibility; or (2) whose eligibility for SSI benefits (including special SSI eligibility status under section 1619(b) of the Social Security Act) had been terminated following suspension of those benefits for 12 consecutive months on account of excess income resulting from work activity, may request reinstatement of those benefits without filing a new application. The individual must have become unable to continue working due to his or her medical condition and must file a reinstatement request within the 60-month period following the month of such termination.
While the Commissioner is making a determination pertaining to a reinstatement request, the individual would be eligible for provisional benefits (cash benefits and Medicare or Medicaid, as appropriate) for a period of not more than 6 months. If the Commissioner makes a favorable determination, such the individual's prior entitlement to benefits would be reinstated, as would be the prior benefits of his or her dependents who continue to meet the entitlement criteria. If the Commissioner makes an unfavorable determination, provisional benefits would end, but the provisional benefits already paid would not be considered an overpayment. (Ford, 1999).
Resources
1. Employment Barriers outlines and systematically refutes some of the barriers which older persons often assume exist to employment (www.aarp.org/working_options/barriers/home.html) :
a. “My work experience makes me overqualified for available positions.”
b. “Older persons cannot compete with younger workers.”
c. “Mature workers increase costs to the employer.”
d. “Older workers are rigid, not as adaptable and slow to learn.”
e. “I have not kept up with all the technology changes in the workplace.”
f. “I do have some physical limitations.”
g. “I will lose some of my Social Security benefits if I go back to work.”
h. “I am taking care of a frail family member.”
i. “I really want to work but my family insists I should retire.” (www.aarp.org/working_options/barriers/home.html).
2. Two other excellent resources for older workers seeking employment and for counselors are:
a. Senior Employment Tips for Older Workers which can be found on the Senior Employment Program website. (www.sremploy.org/seniors.html)
This web site contains information about:
· writing a senior resume
· how to use classified ads
· how to sell yourself to an employer
· job interview checklist
· reasons for an unsuccessful interview
· 20 reasons older people don’t get hired
· occupational survival skills
· negative evaluations from employers.
b. Working Options which can be found at www.aarp.org/working_options. This site contains information about:
· writing a winning resume (including a functional resume)
· changing careers · · job search
· keeping your career healthy · discrimination
· self-employment
· making age irrelevant
· and links to information about career opportunities.
Debunking the Myths Overall:
Debunking the myths can be achieved by:
a. educating the public and consumers
b. providing consumers with counseling services
c. discharging the myths held by professional counselors and teachers and related staff that consumers are too old to work
d. working to dispel employer myths about older visually impaired workers
Learning Activities–You may try these activities to practice what you have learned.
1. Talk to or listen to a tape of an older consumer who is currently working to find out about his/her experiences.
2. Talk to or listen to a tape of a counselor who has placed older clients to find out about his/her experiences.
3. Role play a discussion with an employer in which you attempt to dispel his/her myths about hiring an older person.
4. Role play a counseling session with an older client who is interested in going back to work but who needs some positive reinforcement.
5. Role play a discussion with another counselor who is stating he/she will never work with older clients because “they’re just too old to work.”
Congratulations! You have finished Module 5. Now go on to the key points section to review what you have learned.
Key Points
1. A societal myth which must be overcome is that people over 65 are too old to work and cannot be expected to do much.
2. A critical employer myth is that older people do not have the skills to do today’s work and are incapable of learning them.
3. Counselors must overcome the myth that older consumers take up too much time and do not result in a placement.
4. Consumers have to overcome the dual myths that they are too old to work and that visual impairment eliminates their ability to work.
Self-Check
You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.
Please answer each True or False and check Appendix A for answers.
____1. Persons 65 of age and older can now earn only $2000 per year without incurring an income tax penalty.
____2. Older workers are a bad investment. They do not remain on the job and have little interest in their work when they are there.
____3. According to a recent study, 97% of businesses regard older workers as thorough and reliable in completing work and have a lower turnover.
____4. Older persons who experience age discrimination in employment have redress under ADEA.
Module 6: Evaluating the Workplace Environment Vis a Vis the Older Worker’s Needs
Learner’s Goal: To understand the types of jobs older persons can fill, where jobs can be found, skills needed for the jobs, and accommodations which are needed to carry out the jobs.
Learner Objective: At the end of the module, you will be able to evaluate the older person’s employment needs and identify appropriate work environments and work modifications for the prospective employee.
A. Types of Jobs Held by People 55 and Older Who are Visually Impaired
Here are just a few examples of current jobs filled by older persons with visual impairment:
· Bookkeeper (using computer) · Attorney · File Clerk * Reservations clerk (telephone job) * Caregiver * Realtor * Stock broker * Farmer * Dishwasher * College professor * High School teacher * Computer Programmer * Legal Assistant * Social Worker (based on RSA data on 1998 placements)
1. Employment through Companies
Several large companies and governmental agencies hire older workers as a matter of policy. For example: Walgreens, CVS , McDonalds, Sears, Walmart, U.S. Bureau of the Census, the CIA (personal correspondence, Lita Levine Kleger, Experience Works (formerly known as Green Thumb).
2. Staffing Agencies and Temporary Workers–the Future Is Now
A University of Iowa Study (1998) examined how Manpower Inc. employs people with disabilities and found the following:
· 90% of those studied were at work within 10 days of applying.
· 90% were placed in industries/jobs which matched their skills.
· 90% remained in the workforce during the course of the study either in regular jobs or in temp positions.
· 60% moved from no employment to regular employment–as opposed to 40% of Manpower’s other clients. (Radtke, 1999).
Working for a temporary agency has changed dramatically in the last decade. Some agencies now offer a number of benefits such as holiday and bonus pay, tuition reimbursement, access to medical and life insurance, and healthcare discount programs and referral bonuses. Aquent, an employment agency catering to free-lancers, provides health, dental, life, homeowners, renters, condominium, business, professional liability, long-term disability, and long-term care insurance.
Temporary staffing agencies cater to different staffing needs. For example, Manpower recruits for positions in information technology, engineering, telecommunication, finance, industrial, call center, administrative and other professionally related positions. Office-Team, on the other hand, staffs customer-service positions such as receptionists, administrative and executive positions. Image staffing employs food servers and cooks (Hurd, 2000).
Would-be employees can sign up for temporary staffing programs through the Internet.
3. Self-Employment
· “People with a work disability are self-employed at a higher rate (12.2%) than people without disabilities” (Arnold, 1996, p. 56).
· The study of employment of older workers with visual impairments instituted by the goal 5 group of the National Agenda on Vision and Aging (Cavenaugh and Rogers, in press) indicated that 20 percent who become employed are self-employed.
· Project VIEW case studies
Several of Project VIEW’s successes were individuals who were self-employed such as greeting card editors, tax accountants, and travel agents (see Appendix E).
B. Top Ten Fastest Growing Occupations Today for All Age Groups:
· computer engineer
· computer support specialist
· systems analyst
· database administrator
· desktop publishing specialist
· paralegal or legal assistant
· personal care aide or home health aide
· medical assistant
· social service assistant or human service assistant
· physician assistant (www.aarp.org/working_options/greatcareers.html).
C. Skills Needed for Jobs
Workplace know-how skills: Current demands of the labor market and employment stability
· basic academic skills–reading, writing, and math; personal characteristics–honesty, responsibility, creativity, and positive attitudes
· task achievement competencies– attendance, punctuality, appropriate attire, flexibility, and problem solving
· behavior with respect to organization–understands and embraces mission, safety awareness, and takes and follows directions
· interpersonal skills–teamwork skills, works well with co-workers, respects diversity, sociability
· basic verbal skills–ability to communicate (Radtke,1999, p. 13)
· building, honing, and fine-tuning technological skills and computer based skills, including use of adaptive technology
· developing skills for information gathering and networking (Radtke,1999, p. 33)
D. Workplace and Job Modifications Needed (Such as Access Technology)
1. Accommodating the Needs of Older Workers in the Workplace
· part-time vs full-time work– According to Senior Job Bank, age discrimination exists more in the full-time job category than in the part-time category (www.seniorjobbank.org/zzindex.htm).
· job sharing · · flex schedules
· home-based work
· self-employment
· employers offer training such as self-paced tutorials; OJTs, English as a second language (ESL).
· employers offer benefits such as medical plans, salary rates, or pension plans tailored to the needs of the workers (Cisco, 1991).
2. Job Analysis: The Older Worker Who Is Visually Impaired.
The purpose of a job analysis is to identify the characteristics of a specific position, not to identify the suitability of a specific individual for a position. The process of integrating the two is called “matching”. In other words, does the job seeker have the skills and abilities to perform the specifics of a given position? A job analysis is not conducted with a specific gender, attitude, or disability in mind.
In general, as a result of the aging process, older individuals may experience changes which may affect their ability to carry out certain job duties.
The job analysis outline, which can be found in Appendix B, is intended only as a tool to help the counselor. An * (asterisk) has been placed in front of those items which might require specific consideration when working with older persons. The recognition of these particular items is not to imply that the individual cannot do the job, but simply that an effort should be made to avoid placement of an older individual into a position which causes stress on their physical and mental capabilities.
3. Workplace Modifications Related to Vision Loss
· need for optical and non optical devices · · use of sensory and technological devices (Note: Other types of accommodations may be needed for individuals with additional losses such as hearing loss (refer to Module 3 for information about communication devices, etc.)
· need for visual skills training (scanning, eccentric viewing)
· need for environmental modifications
· ensure illumination and glare control
· use color contrast
· avoid visual clutter such as patterns in rugs, wall coverings
· provide organization of work space
· ensure uncluttered travel areas (Connolly, 1991).
Learning Activities–You may try these activities to practice what you have learned.
1. Review the case histories on self-employment in Appendix E. Select one and role play a scene between a counselor and a client as you discuss setting up a business.
2. Read the case history of an of older person with a visual impairment employed through Experience Works in Appendix F.
2. Select a work environment and conduct a mock job analysis for an older consumer who has applied for a job as (your choice)____, has macular degeneration, mild hearing loss, and arthritis which affect his mobility.
Congratulations! You have finished Module 6. Now go on to the key points section to review what you have learned.
Key Points
1. The types of jobs which older persons with visual impairments currently fill are varied and match, to a great degree, the most prevalent types of jobs held by people of any age group.
2. Older workers today have many options for finding work: the traditional way, through companies and governmental agencies whose practice it is to hire older workers; through temporary staffing agencies; and through self-employment.
3. To compete in the workplace, older workers need a variety of skills, most of which they have gained over time with work and life experiences. However, they may need to add to their repertoire the ability to use computers, adaptive technology, and other technologies.
4. Some modifications may be needed in the workplace to accommodate vision loss and losses such as hearing loss.
Self-Check
You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.
Please answer each True or False and check Appendix A for answers.
____1. Self-employment is not a good option for older workers.
____2. Temporary staffing agencies now are a good option for employment of older job seekers.
____3. Examples of accommodating the needs of older workers are flex time and part-time work.
Module 7: Knowing National and Local Resources Available to Help with Placement
Learner’s Goal: To understand the placement resources available to counselors.
Learner Objective: At the end of the module, you will understand the placement resources which are available and how to use them.
J. Placement Resources
Counselors seeking to place older consumers should check with the Senior Community Service Employment Program (SCSEP), a part-time employment program for low-income persons age 55 or over. Program participants work at community and government agencies and are paid the Federal or State minimum wage, whichever is higher. They may also receive training, and can use their participation as a bridge to other employment positions which are not supported by Federal funds. A list of these follows:
National Organizations Devoted to Older Workers:
* AgeLight Institute (www.agelight.org)
* AARP Senior Community Service Employment Program (www.aarp.org/scsep/)
* Asociación Nacional Pro Personas Mayores (National Association of Hispanic Elders–Project Ayuda) (www.nia.nih.gove/rd.139.html)
* Experience Works (experienceworks.org) (Formerly Green Thumb, Inc.)
· Geezer.com –an Experience Works site which encourages the marketing of products created by older workers.
· Experience Works!–a nationwide staffing service available on line and specifically designed for mature workers regardless of age and income.
* National Asian-Pacific Center on Aging (www.napca.org/)
* National Caucus and Center on Black Aged (www.ncba-blackaged.org)
* National Council on the Aging (www.ncoa.org)
* National Indian Council on Aging (www.nicoa.org)
* National Urban League (www.nul.org)
* National Senior Citizens' Education and Resource Center (www.nscerc.org)
* U.S. Forest Service (www.fs.fed.us/rd/hossier/docs/scsep.htm) Additional SCSEP program information can be found on line at: www.dsc.doleta.gov/seniors/
Electronic Job Development
Placement resources have changed greatly with the introduction of electronic job development. In addition to the information about senior-related sites, many other placement resources are available on line.
Other Workforce Development Resources
HeadHunter.net An employment resource for both employers and job-seekers.
2. CareerPath Search Help Wanted ads and employer profiles among 500,000 new jobs posted monthly on this site.
3. FedWorld Information Network Home Page
Search a Federal job information network and databases for employment opportunities.
Job Center Employment Services Register to receive daily e-mails listing jobs that match your employment profile.
America's Job Bank (ajb.org) (Includes America’s Talent Bank and Job Scout)
hoovers.com (employer information)
flipdog.com/home.html (job leads) 8. fedworld.gov/jobs/jobsearch.html (federal employment)
9. careermosiac.com (job search by careers)
10. jobbankusa.com (private sector job search)
11. monster.com (search engine to job banks)
12. collegegrad.com (job listings for college graduates)
13. coolworks.com (job bank)
14. jobtrack.com (job bank)
15. workers.gov (search site for government employment) (www.asbdc-us.org)
16. Association of Small Business Development Center
17. Small Business Administration (www.sba.gov)
EARN (The Employer Assistance Referral Network), a service of the U.S. Dept. of Labor’s Office of Disability Employment Policy
and a national clearinghouse for employers with job openings and service providers with qualified employees (www.earnworks.com).
19. Check local newspapers for a website for classified ads job leads for a given area
B. Additional Information
1. The National Council on the Aging website has an article entitled “Job Searching on the Internet: The How-To Reference Tool” by Barbara Hoenig. It can be found at www.maturityworks.org/job_searching_on_the-internet.htm.
The Senior Employment Program has a list of popular job search websites which should also be consulted. These can be found on their website: www.sremploy.org/seniors.html.
The Senior Job Bank also has a list of employment links for Seniors. These can be found at www.seniorjobbank.org.
2. State Occupational Information Coordinating Councils (SOICC) and a national SOICC (NOICC) are available to use for job search. These provide information about careers and link the user to companies that have particular kinds of jobs based on career choices, including giving the HR director's name in those companies. The Alabama site, for example, is: www.adeca.state.al.us/SOICC/SOICC/default.html.
3. Local Employer Development leads to job vacancy information, is also available through active participation in the following organizations and their state and local chapters:
· Society for Human Resource Management (SHRM). Human resource management staff belong to this organization and use it for networking.
· Chambers of Commerce, particularly in the more rural areas because this is where business talks to business.
4. Local Business Directories, utilizing their SIC (Standard Industrial Classification) codes, can generate information on company staffing patterns so job seekers which types of companies are possible employers.
5. Local Employer Development Networks, which staff can join, link rehabilitation counselors with existing employer disability advocacy movements, the most recent being the Business Leadership Networks (often linked to VR programs and the brainchild of the President’s Committee on Employment of People with Disabilities).
6. Placement Tools such as the following can make placement easier
Promotional File Folder
Florida Division of Blind Services (FDBS) has had a great deal of success using such a file folder for placement of clients. The exterior of the folder includes the following information:
* employment services offered by FDBS
* benefits to employers
* list of district offices and contact information
The inside pockets include related brochures (tailored to the employer or other marketing target).
* Are You Looking for a Few Good Workers
This brochure was developed by the AFB Employment Team. It contains many useful inserts including an insert developed by the Goal 5 group of the National Agenda on Aging and Vision. The insert is entitled Consider Older Workers who are Visually Impaired. The brochure is available through AFB.
* Have the “Vision” to Retain or Hire an Older Worker Who Is Visually Impaired is a fact sheet, also developed by the Goal 5 group (see Appendix D).
Learning Activities–You may try these activities to practice what you have learned.
1. Check out some of the SCSEP websites for information about senior employment.
2. Find out about SCSEP programs in your area.
3. Design a senior employment kit for your agency.
4. Develop and write out a strategic plan to place more older persons into employment. Set objectives and time lines. Determine who in your office or unit should be involved in the plan (e.g. rehabilitation teacher, deaf/blind specialists, assistive technology specialist).
Congratulations! You have finished Module 7. Now go on to the key points section to review what you have learned.
Key Points
1. The Senior Community Service Employment Program provides job opportunities for older workers.
2. Electronic Job Development is a tool that counselors can use to find appropriate placement opportunities for older consumers.
Self-Check
You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.
Please answer each True or False and check Appendix A for answers.
____1. Geezer.com. is a website devoted to nursing home recommendations.
____2. Career information is available through State Occupational Information Coordinating Councils.
Successful Placement Post-test
Indicate whether the statement is true (T) or false (F) in the space provided.
____1. One in four Americans between the ages of 65 and 69 has at least a part-time job and 80 percent of the baby boom generation wants to continue to work past age 65.
____2. The employment of individuals with significant disabilities has improved but the employment of older consumers has not followed suit.
____3. Individuals who are 65 and older must watch their earnings so they will not exceed the earnings limitation.
____4. Decreased financial security and of diminished opportunities for productive activity are major problems for older persons who lose their vision.
____5. The counselor’s role in the placement of older consumers is to point them in the right direction and check on them periodically to see how they are doing.
____6. Older workers use sick leave on average less than do younger workers.
____ 7. Older workers are generally more expensive to place than are younger persons.
____8. Some recommendations for accommodating older persons in a work situation include: job sharing, flex schedules, part time work, self-employment.
____9. One of the selling points a counselor can use to place older workers with employers is that they are “cheap labor.”
____10. Monster.com is a search engine which helps one locate scary movies.
REFERENCES
Arnold, N. (Ed.). (1996). Self employment in vocational rehabilitation: Building on lessons from America. Missoula: University of Montana, Affiliated Rural Institute on Disabilities, Research and Training Center on Rural Rehabilitation Services.
Brady, E.M. and Fortinsky, R.H. (1991). Images of success among older workers in new jobs. Work. 2 (1), 33-37.
Cavenaugh, B. & Rogers, P. In press.
Cetron, M.J., Rocha, W., and Luckins, R. Long-term trends affecting the United States (July-August, 1988). The Futurist.
Cisco, K. Employment of the older worker with a disability: An overview. .Aging, disability, and the nation’s productivity: A report on the 15th Mary E. Switzer Memorial Seminar (October, 1991). L.G. Perlman and C. E. Hansen, Eds. Reston, Virginia: National Rehabilitation Association, pp. 11- 15.
Clinton, W. J. A proclamation for National Older Workers Employment Week, 2000, (www.greenthumb.org/primetime/whitehouse02200.html).
Connolly, J.K. (1991). Considerations for the visually impaired older worker. Work. 2(1). 19-28.
Corthell, D.W. (Ed). (1990). Aging in America: Implication for vocational rehabilitation and independent living, 17th Institute on Rehabilitation Issues. Menomonie, WI: Research and Training Center, Stout Vocational Rehabilitation Institute, University of Wisconsin.
Dial, J.G., Mezger, C., Massey, T., Hull, J.A., Grat, S., Fong, C. ( ). Comprehensive Vocational Evaluation System: A systematic approach to vocational, educational, and neuropsychological assessment of visually-impaired and blind. Macaroon-Dial Systems: Dallas, TX.
Ford, M (1999). Excerpts from Conference Report (H. Rept. 106 478) submitted by the Committee on Ways and Means to the House of Representatives on November 17, 1999.
Hurd, S. (2000). Tamping: A great way to test the water before you dive in. San Diego Union-Tribune, Employment Extra., November 14, 2000.
Isernhagen, S.J. (1991). An aging challenge for the nineties: Balancing the aging process against experience. Work. 2(1), 10-18.
James, S. (1992). Making Age Irrelevant. www,aarp.org/working_options/profiles/jamesprofile.html.
Meier E. and Kerr, E. (1976). Capabilities of middle-aged and older workers: A survey of the literature. Industrial gerontology, 147-156.
Miller, G. (1991). Aging, vision, and work. JVIB (April), 149-153.
Morrison, M.J. Employment of older workers with a disability: attitudes and legal issues. Aging, disability, and the nation’s productivity: A report on the 15th Mary E. Switzer Memorial Seminar (October, 1991). L.G. Perlman and C. E. Hansen, Eds. Reston, Virginia: National Rehabilitation Association, pp. 27-32.
Power, P. (1991). A guide to vocational assessment (2nd edition). Austin, TX: PRO-ED.
Orr, A.L. (1998). Issues in aging and vision: A Curriculum for University Programs and In-Service Training. New York, NY: AFB Press.
Radtke, J. (Ed).(May, 1999). Meeting future workforce needs. 25th Institute on Rehabilitation Issues. Menomonie, WI: Stout Vocational Rehabilitation Institute.
Saxon, S. & Etten, M. (1987). Physical change and aging: A guide for the helping professions. New York: Tauruses Press.
Scadden, L. (1991). An overview of technology and vision impairment. Technology and Disability. I, 11.
Silverstone, B. (2000). Aging, vision rehabilitation, and the family. In J.E. Crews & M.J. Whittington (Eds.), Vision loss in an aging society. New York: AFB Press, pp. 155-180.
Walters,D. (1980). Performance of older workers. Paper presented at meeting of American Foundation for the Blind.
Words from Washington ( May 8, 2000). American Foundation for the Blind, Vol. 106 No. 11).
Websites
www.maturityworks.org/new/ap_ncoa_partnership.html www.aarp.org/working_options/barriers/home.html www.aarp.org/working_options/agediscrim/home.html www.greenthumb.org/primetime/whitehouse02200.html. www. diabetes.org/ada/facts.asp www. arthritis.org/AFStore/StartRead.asp. www.sremploy.org/seniors.html www. seniorjobbank.org www.aging.unc.edu/ioalearning
Appendix A: Key to Self Check and Pre/Post Test
Module 1: 1.F; 2. F
Module 2: 1. T; 2. F
Module 3: 1. T; 2. T
Module 4: 1. T; 2. T
Module 5: 1. F; 2. F; 3. T; 4. T
Module 6: 1. F; 2. T; 3. T
Module 7: 1. F; 2. T
Pre/post test key:
1. T; 2. T; 3. F; 4. T; 5. F; 6. T; 7. F; 8. T; 9. F; 10. T
Appendix B: JOB ANALYSIS
Company Name: ___________________________________________________________
Type of Service/Employment : _______________________________________________
Job Title: _________________________________________________________________
Job Duties:
Job Skills Needed:
Hourly wage (range) ____________________
Number of Hours/ week: _____ Months/Year(seasonal) ___________________________
Employer’s Tax Credits Other: Financial Requirements: (e.g. TJTC, OJT)_______________
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Benefits of Job: Yes / No None Yes / No Free or Reduced Meals Yes / No Sick Leave Yes / No Other (Specify): Yes / No Medical/Health Benefits Yes / No Paid Vacation/Annual Leave Yes / No Dental Benefits Yes / No Employee Discounts Yes / No Flex time - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Employer Very Supportive Supportive Indifferent to Negative toward Attitude: of Older Workers with Workers with Workers with With Disabilities__ Reservations__ Disabilities___ Disabilities____
Specifics/Comments: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Accessibility of Job Site: Condition Accommodations
Steps/Ramping
Flooring
Water fountain
Bathroom
Elevators/Escalators
Cafeteria
Lighting in the facility
Task lighting
General lighting
Work area accommodations
Assistive technology available
Physical barriers
Noise levels
Temperature regulation
Environmental pollutants
General Directions:
Indicate the most appropriate response for each item based on observations of the job and interviews with employers, supervisors, and coworkers.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
1. Schedule: Weekend Work Evening Work Part-time Job Full-Time Job (Circle Yes or Required Required No for each Item) Yes / No Yes / No Yes / No Yes / No
Specifics/Comments - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2. Travel Location: On Public On Handicapped (Circle Yes or No for Transportation Transportation Route each item Route
Yes / No Yes / No
Specifics/Comments - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3. Street Must Cross Must Cross Must Cross Must Cross Crossing: 2 Lane 2 Lane 4 Lane 4 Lane Street with Street W/O Street with Street W/O Light_____ Light_____ Light_____ Light_____
Specifics/Comments (alone or with help?)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4. Strength: Very Light Light Average Heavy Lifting and Work Work Work Work carrying: (10 lbs)___ (10-20 lbs)___ (30-40 lbs)___ (>50 lbs)__
Note frequency:
Specifics/Comments - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5. Endurance: Work Required Work Required Work Required Work Required for 2 hours___ for 2-3 hours___ for 3-4 hours___ For >4 hours__
Specifics/Comments - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6. Orienting: Small Area One Several Building Building and Only_____ Room___Rooms___ Wide____ Grounds
Specifics/Comments - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7. Physical Sit/Stand in one Fair Ambulation Stairs/Minor Full Physical Mobility Area_____ Required_____ Obstacles_____ Requirements__
Specifics/Comments - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8. Work Pace Slow Average Steady Sometimes Fast Continual Fast Pace____ Pace_____ Pace_____ Pace_____
Specifics/Comments - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
9. Standing Hours per day_________ Surface______________________
Specifics/Comments (is sitting an option?) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
10. Grasping/Reaching__________ Strength required ___ Frequency __________
Specifics/Comments (can extension be used?) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
11. Bending
Frequency
Specifics/Comments
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
12. Object Does not need to Must Distinguish Must distinguish Discrimination: Distinguish Between Between Work Supplies Between Work Work Supplies_____ with an External Cue___ Supplies_____
Specifics/Comments
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
13. Reading None Printed forms Handwritten documents Computer Braille screens Required
Specifics/Comments (is worker reading to others?) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
14. Writing Method: hand writing typing braille Required Type: Forms___ Messages___ Reports__
Specifics/Comments (is worker writing for self or others?)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
15. Tool Calibrations___ Positioning Measurement General Utilization__ & guiding___ marking___ safety___
Specifics/comments (provide own tools?)
– - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
16. Machine Reading dials Buttons & Operation LED/LCD displays___ other controls ___
Specifics/comments (speed required?)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
17. Skills Needed Manual Dexterity___ Visual Tasks___ Auditory Tasks_ (Physical Demands)
Specifics/comments
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
18. Communication Talking in person_ Talking on the phone Using keyboard__ Taking Skills or using switchboard__ Messages__ (Need for hearing aid, assistive listening devices, interpreter)
Specifics/comments
--------------------------------------------------------------------------------------------------------------------------
19. Computer skills using keyboard Seeing or accessing monitor Need for speech or braille output Knowledge of Windows__ Data processing skills__ Word processing skills__
Specifics/comments (note speed/ accuracy needed on keyboard) -------------------------------------------------------------------------------------------------------------------------- 20. Other job skills/abilities needed:
Multi-tasking___ Meeting deadlines___ Working with groups Memorization___
Other___
Specifics/comments
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Summary of job analysis:
Summary of modifications needed:
Staff Name: __________________ Title___________________ Date_________
Appendix C
Declining Senses Simulations (www.aging,unc.edu/ioalearning/learningActivityExperienceSenses.asp)
In this learning activity, you are asked to "walk a mile" in the shoes of an older person as you try to complete a series of activities. For some of the activities, you will need a partner. As you go through the experiences, consider the impact each physical change has on you physically and socially and how your day-to-day activities might be affected if the change was permanent.
2. Sight
To simulate partially impaired vision, fold cellophane or plastic wrap (yellow is recommended) several times. Now try to look through the folded material at several items. Try:
* reading from a book
* looking at a computer or TV screen
* reading instructions from a medication container
* threading a needle
To simulate fully impaired vision, use night shades or opaque black paper to cover the eyes completely. Now try moving around the room or eating a meal.
2. Hearing
Industrial earplugs are most effective for simulating volume loss in hearing. Alternatives include cotton balls, swimmers earplugs, earmuffs, or stereo headphones. Select one of these options and then try:
* listening to the radio or television
* having a conversation 3. Taste 1.
Foods that are bland or saltless can simulate a loss of taste sensitivity. Try sampling the following foods:
* unsalted crackers vs. regular crackers
* colored water vs. fruit juice.
4. Smell
To simulate loss of the ability to smell, use noseplugs, place cotton in the nose, or simply hold your nostrils closed. Find a partner and have them blindfold you, then have them present you with various foods, odors, etc. Can you identify the smells and/or detect differences?
5. Touch
To simulate the loss of tactile sensitivity, wear latex/surgical gloves or wrap tape around the tips of fingers. Now try:
* finding a number in a phone book
* touching a heating pad to see if it is warm
* threading a needle.
Questions to Consider
1. Describe the feelings you experienced while completing each activity.
2. If you could no longer see or hear well, how would you feel about going into new situations, new places, or meeting new people? Describe the impact this might have on your social relationships.
3. Come up with a list of potentially dangerous situations you might experience because of sensory decline (e.g. inability to smell food burning).
4. How would permanent sensory decline affect your day-to-day life?
5. Based on your experience, what implications are there for working with older people who have experienced similar changes? How could you improve your interactions with them? What suggestions could you give them for making their life easier?
6. What are the functional implications for older persons who wish to return to work?
Appendix D Have the “Vision” to Retain or Hire an Older Worker Who Is Visually Impaired
The number of older Americans who are experiencing age-related vision loss is growing. Yet, these individuals often may want to continue to work if given the chance by an employer and help and guidance from vocational rehabilitation services.
What should an employer do to help an older employee who is losing vision?
Find out about low vision services and devices and vision rehabilitation services which can make it possible for the employee to learn adaptive techniques to carry out his/her job functions. By taking advantage of these services, the employee can avoid premature and unnecessary early retirement, and the employer can avoid losing a skilled, productive and reliable employee.
Why would an older person who is visually impaired want to continue or go back to work?
Older persons who are visually impaired are interested in work for the same reasons as most older people who want to work:
1. additional income 2. the opportunity to be around other people 3. the opportunity to continue to learn new skills 4. health insurance and/or other benefits 5. sense of self-worth 6. opportunity to feel productive
I can understand why I would want to retain a good worker but...Why should I consider hiring an older person with a visual impairment?
Older persons have:
* a proven work history a strong work ethic * life-long work related skills * job-related education and training * the capacity to learn * no earnings limitations after age 65 * typically no dependent children at home who require care * interest and attention to safety issues (less likely to take chances which may result in injuries)
What help is available to employers and older workers?
Accommodations such as:
* Additional lighting and/or lighting positioned directly on work tasks
* Low vision optical devices such as hand-held or stand magnifiers
* Devices such as talking clocks and watches, writing guides, large print rulers
* Adaptive equipment such as screen enhancers which magnify the image for ease of reading, computers and other equipment with speech output
Services such as:
* Eye medical care * Vision rehabilitation services * Low vision services * Job site modification * Individualized orientation to the job and to the work site * Job training or retraining
For more information about hiring older workers, call Pris Rogers, 423-921-8456 or Alberta L. Orr, 212-502-7634 at AFB. (American Foundation for the Blind Fact Sheet, www.afb.net)
Appendix E Self-Employment Case Studies
Self-employment and work at home opportunities are often desirable options for the older worker. Older workers usually have the discipline and motivation to work on their own without supervision and self-employment provides the flexibility of scheduling that may be needed.
Working out of the home is sometimes a necessity because of transportation issues and health limitations that may impact the individual's ability to maintain a regular work schedule. Self-employment allows an older person to work at his/her own pace and can be a perfect supplement to retirement income.
At age 62 "Mary" was closed successfully working out of her home as a medical transcriptionist earning $2,000 to $2,500 a month. Because of severe health problems including heart disease and kidney failure, in addition to blindness, she was not able to maintain a job with a regular work schedule. Because Mary works at home and is paid by the page for reports that she submits to physician's offices, she is able to set her own pace. She often works long hours when she feels well. There are days when she cannot work at all because of illness and there are times when she has to stop and rest for long periods of time between reports.
"Betty" is 81 years old and self-employed teaching piano lessons to children and adults in her home, several a day, six days a week. She has been doing this since she retired from her job with the state at age 65, before losing her vision. Betty is blind in one eye and severely visually impaired in the other, extremely hard of hearing, and now uses a wheelchair to get around because of hip and leg problems, but she keeps busy and is devoted to music and her beloved students. There are times when she gets depressed, and she cries when she says that working is what keeps her from just giving up and dying.
"Ed" was successfully closed at age 81. He is self-employed as a tax accountant working out of his home and was earning $1500 a month at closure
several years ago. Ed was retired from a successful career and was able to learn how to use access technology to complete tax returns
There are many others like Mary, Betty and Ed who want and need to work for whom self-employment is a viable option. Older workers often have the background and experience to start their own business.
At age 57 "Roberto" is using his background in management to start his own business providing medical identification cards. "Marian" and "Henry" are working out of their homes as greeting card editors to supplement their retirement income. "Ralph" is self-employed as a travel agent booking cruise packages out of his home. They are all doing work that they enjoy and self-employment provides them the level of flexibility that they need.
Appendix F Experience Works Case Study
Michigan
The Traverse City Area District Library, (TADL) has a new and very technically advanced facility that includes a library for the blind. TADL decided to take on a new project by bringing a person who is blind on board. She is former Experience Works participant, Mrs. B.
A library staffer, coached Mrs. B until she was comfortable at her job. It was a joint effort funded by Experience Works, the Commission for the Blind and the District Library. In this case one organization paid Mrs. B's wage while another provided adaptive equipment and TADL provided the work setting. TADL agreed to do this because Ms. B has skills that will be useful for the library beyond the time of the initial funding.
The library was able to hook up Mrs. B's own Braille equipment to their computer system allowing her to do research just as a sighted person would. The advantage to the library is that because Mrs. B is blind she has insight and can empathize with those calling about services for people who are blind and recommend tapes and equipment available to them. She anticipates their needs.
The work assignment at the library served as an experiment. It was so successful that Mrs. B was hired to continue her work as a library employee. This work experience represents another step toward independence in her struggle to learn new techniques for living. Although she was hired at minimum wage for twenty hours per week, there are other benefits. Mrs. B's success has led to a request from the Association for the Blind for Experience Works to coordinate with area public schools, a training program for older, inexperienced workers who are visually impaired.
Appendix G: PROJECT VIEW
Practice Notes: Strategies for Employing Older Workers with Visual Impairments
Background
The National Aging and Vision Network established the National Agenda on Vision and Aging in 1998 and identified employment opportunities for older individuals with visual impairments as a major goal. A working group was formed to address this goal. One of its first tasks was to identify examples of strategies to increase the employment of older persons with visual impairments. Project VIEW was selected to epitomize a model program for the employment of older workers.
Project VIEW
The Orlando District of the Florida Division of Blind Services (DBS) started Project VIEW: Visually Impaired Experienced Workers, a pilot program intended to expand vocational rehabilitation services provided to blind and severely visually impaired individuals age 55 and older, in 1992. A counselor was assigned to work specifically with Project VIEW. Funded under contract with a local community rehabilitation program, this counselor was chosen for her interest in working with older persons and her university training in aging and vision loss.
During the first project period, 111 older persons were screened. Of these, 56 persons ranging in age from 55 to 95 expressed interest in working and were determined eligible for services. By the end of the first project period, 24 cases had been closed as successfully rehabilitated. Of these, 18 were competitively placed in full time or part-time employment. These individuals ranged in age from 55 to 82. Occupations included food service worker, grocery store bagger, teacher, security guard, electronics technician, baker, senior day care worker, housekeeper, office cleaner, lawn care and ticket taker. Two were closed as unpaid family workers. Four were closed as homemakers. Three of these were working as volunteers in the community.
The pilot project continued for three years with an average of 16 successful closures per year and an average caseload size of 40. Project VIEW addressed older consumers' social and psychological need to work, the need to feel productive and useful, and not just the economic need to work. Some individuals served were at risk of losing their jobs because of vision loss and they were able to retain employment. Most were placed into employment, often in occupations unrelated to their former careers. Some individuals had not worked in years. Options were explored based on their current interests and reasons for wanting to work. Self-employment was an appropriate option for some. Occupations such as medical transcription and tax preparation enabled consumers with transportation barriers and health limitations to work at home at their own pace. Although the emphasis was on competitive employment, some consumers wanted to do volunteer work and did not need the income. Project VIEW originated at a time when older individuals were often overlooked and underserved in the Vocational Rehabilitation (VR) Program. Referrals of individuals age 65 and older were routinely directed into independent living programs. Even when these individuals wanted to work, VR counselors typically questioned their motivation and ability to perform to employer specifications.
After three years of funding as a special project, Project VIEW was integrated into a state VR caseload. A part-time placement specialist was retained under contract to assist the DBS counselor with job development. This model was not as successful in achieving placements. With changes in funding and staff turnover, the project then evolved into part of a regular VR caseload with the state counselor performing the job development and placement activities.
Observations about Project VIEW indicate that having a dedicated position to work with older consumers, if feasible, is preferable for several reasons. Counselors have been more successful when they are able to maintain a small caseload, actively recruit referrals, focus on resources and strategies for placing older clients and have time to work closely with the older consumers throughout the placement process. Recently, training in aging has been provided to some VR Counselors, but even those who have been trained and who work with older clients report that it is difficult to devote the time and energy necessary due to other caseload demands.
Project VIEW has been successful by actively recruiting older consumers rather than ruling them out, by providing encouragement rather than questioning their motivation to work, and by utilizing the counselor's knowledge of the special needs and concerns of older visually impaired workers to make the right job match. The success of Project VIEW demonstrated that older workers were good candidates for successful rehabilitation and that, in a large metropolitan area, maintaining a separate caseload of older persons was feasible.
Implications for Practice
Counselor Selection
The counselor should have enthusiasm, a belief in the ability of the older person, and knowledge about aging and vision loss. A nurturing counselor can help older blind and visually impaired adults overcome negative feelings and provide the encouragement they may need to become successfully employed.
Counselor Training
The counselor should have adequate training in aging and vision loss to ensure that he/she has the knowledge needed to understand the special issues and needs of older consumers and the supports and accommodations they may need. Training should address the physiology and psychology of aging and vision loss, common eye diseases associated with aging, other physical changes associated with aging, and information about the aging network and resources available to the client. Including facts relating to the productivity and dependability of older workers and the cost benefits to the employer is also important to assist the counselor's marketing efforts to employers.
The American Foundation for the Blind National Agenda workgroup has developed a comprehensive curriculum to prepare VR counselors and other professionals for working with the older consumers. This curriculum was used first to train the new Project VIEW counselor (Rogers, et al, 2002). This curriculum has also been piloted with counselors in Oklahoma and is being developed into an on-line curriculum by the workgroup and the Mississippi State Rehabilitation Research and Training Center on Blindness and Low Vision.
Caseload Size
The counselor should have a small enough caseload to allow sufficient involvement with the client in the placement process. Older clients may need more contacts and encouragement along the way. If possible, the caseload should consist only of individuals age 55 and older. In a mixed caseload, older clients can easily be neglected because they often