Proceedings of: Workshop on Improving Building Design for Persons with Low Vision

Vision Loss: A Growing Problem

Best estimates indicate that over 25 million Americans are experiencing vision loss, most with low vision. These numbers are growing everyday as the baby boomers age (slide 3).

[As stated in slide 4]: “Our architectural standards in this country have led to an invisible world, a world in which falls among the elderly cause more deaths than do medical conditions.”

[Slide 5] gives the idea of the [falls and the low vision] issue:

• People with reduced visual acuity are 1.7 times more likely to fall.

• They are 1.9 more times more likely to have multiple falls than are people with normal vision.

• The odds of hip fracture are between 1.3 and 1.9 times greater for people with reduced visual acuity (Legood, Scuffham, Cryer, 2002).

[Slide 6] indicates some major economic impacts, not only on the person, but the caregiver:

2007 Study by Prevent Blindness:

• Annual Cost of Adult Vision Problems in U.S.= $51.4 billion

• Non medical costs= $11.2 billion, most of which goes to nursing home care.

• Direct Medical costs=$16.2 billion annually

• Lost Productivity= $8 billion

• Informal care costs: $.36 billion

I really think we need to look at this aspect of it as a way of getting people interested in getting on the bandwagon with us. The whole [fall issue] is just so major. And it really may be something we could put our fingers on in terms of this lighting issue and everything else, because everybody’s concerned about this in nursing homes; everybody. So I’m just going to put that out here again to think about, because it is a major economic impact, and not just on people with low vision. It’s on everyone.

Designing with ADA

This is a picture (slide 7) of our center in Dallas. We have a lot of design elements there. Like I said, I’ve taken most of them out [see slides 11 – 16], but [as quoted on slide 7:] “ADA doesn’t have to be ugly. Come inside and decide for yourself.” We had two architects involved developing this building, and also DFW Airport, in the main terminal.

And one of the architects, [said in] his closing comments on the video [linked in slide 8—the link did not work, maybe Priscilla can make it available]: “ADA doesn’t [have to be ugly”]. So that’s why he’s there. And it’s true. I think we really need to think of that. It’s not just ADA. It doesn’t have to be [ugly], color contrast can be nice [slides 9, 10, 16 and 17 – links to videos did not work, maybe Priscilla can make it available]. But more importantly, it helps to [promote wayfinding].

The reason I put a couple of little videos in here is that we actually did a video on design principles with the two architects that I mentioned. And they talked about simple design principles and what they learned from being involved with us, in trying to design our building and the one at the DFW Airport. So I wanted to share these with you just because I think they’re neat, and then you might be able to use them in other [applications that] these architects are talking about what they actually learned from the experience.

Importance of Stakeholders

The other part I wanted to talk about is the importance of stakeholders and having those stakeholders involved, because that’s what happened with us both at our center and in Dallas at the airport is that, before anything was done – and believe we wanted stuff – we still brought in the stakeholders. Who is going to be involved? Who’s going to be using the building, and what is their interest in it, and what are their concerns?

And so we take [as] a basis what we do with ABA and all the rest of it. But then you actually have consumer involvement in it. And I know you’re talking about how you do your follow-up studies and all that afterwards to find out how the building actually works. You know, it kind of makes sense to talk about it ahead of time with the people who are going to be using [the building].

The biggest point that I’m going to make here today is that we need to think about [bringing in the stakeholders, early in the planning and design process]. And there’s nothing that I know of – maybe you all know something – that would keep us from doing that at the get-go.

And then you get to bring in not only the people with low vision, but also, like in the airport, for example, we brought in people with other disabilities because we have to look at all those kinds of issues.

One of the pictures that’s in here [slide 11] is how we use, in the airport, design on the floor, the tactile, so that people would know where the gate was – people with visual impairments. What they wanted to do was put murals on the wall in the airport. And they said, “Okay, we can have the murals, but let’s put them on the floor.” And then they used them at every single gate in the international terminal, so that now people will know, when they come to a gate, they’ll know it’s there. And it’s just a very simple concept. We still have the art and the beauty, but we have the tactile surface to help people know.

Well, it wasn’t in the way of wheelchairs. People could go across it and it didn’t deter from anything. But it’s a great wayfinding. It worked for everybody. Everybody in that stakeholder group talked about it; they talked about every single design element and how those would help people with different disabilities. And they came to a consensus. So that’s my major little thing that I wanted to talk about today.

Comment from [Participant]: It’s cool-looking.

Response from Priscilla Rogers: It’s cool-looking. It’s really neat. It adds a lot to the environment.

Summary of Design Concepts that Enhance Wayfinding (slide 18)

• Increasing “visibility” with high contrast.

• Providing sufficient lighting and glare control.

• Using logical, consistent layouts in building design.

• Eliminating extra/distracting sounds/echoes.

• Using tactile surfaces for flooring.

• Consistently placing signage in LP and braille.

Resources (slide 19)

AFB Senior Site (afb.org/seniorsite)

AFB publications including:

Janet M. Barlow, Billie Louise Bentzen, and Lukas. (2010). Environmental accessibility for students with vision loss,(pp. 324-385). In Foundations of orientation and mobility, Vol. 1. NY, NY: American Foundation for the Blind.