MINNEAPOLIS - Danielle Singleton-Askvig knows what it is like to have things stolen. Glaucoma robbed the 42-year-old of her vision. She can’t drive. She doesn’t leave her home at night. She was forced to quit her job. For decades, she worked as a teacher with elementary students.
Now, the little joy she has left disappears when she thinks about her future.
“I am expecting it to be something bad. I am really fearful of that part. Not knowing what is going to happen everyday,” she said. “How is it going to be the next day, am I going to go blind? My left eye pressure is higher than the right. If there are injuries to my eyes I could go blind. I am always careful of things not touching or hitting my eyes.”
Glaucoma, one of the leading causes of blindness in the United States, is a group of eye conditions that damage the optic nerve. Askvig said doctors declared her legally blind in 2006. That year, she said some of her sight was restored following Lasik surgery. A decade later, she can barely read the words on the newspaper in front of her.
Standing at 5-foot-1, the Apple Valley woman uses a black collapsed cane to get around. A constant worry in her life: The driver of a car hitting her while attempting to cross the street.
“I am fearful of that,” she said. “Plus, walking around leaving the house and bumping into people or things.”
But she is not alone. A growing number of Minnesotans are projected to report blindness or severe disability seeing by 2020. And, age-related macular degeneration (ARMD) is the leading cause of legal blindness in the older population in the United States, according to the National Federation of the Blind.
U.S. Census data shows between 2010 and 2030 the number of people age 65 and older will double in Minnesota.
And while the number of people over the age of 65 continues to grow, so does the cost associated with treatment. For example, The National Eye Institute reports Lucentis is a form of treatment administered once a month. Some patients may need it once every three months. It costs about $2,000. Other drugs are needed every six weeks.
Turns out, most insurers scrimp on benefits for eye rehab programs according to Ed Lecher, who is in charge of senior services with the Department of Employment and Economic Development. He said those on the cusp of losing their sight shouldn’t count on insurance covering rehabilitation treatment centers.
However, there are many tools for low-vision victims, but the devices intended to help can hurt their bottom line.
“The other part of that is that, despite the fact that an eye condition that causes vision loss is a medical type of thing, there is not space within the medical world to perform rehabilitative task,” he said. “Say somebody has macular degeneration, and there is not a medical treatment for that, the medical community doesn’t treat that individual. Medical insurance doesn’t cover magnifiers. Or rehab people to teach them how to do it. If you break your leg and you go to physical therapist and they help you get back on your feet. There is no component of medical that approaches vision loss in that way.”
State Services for the Blind's Senior Services unit, which operated under a $2 million annual budget, helps with learning activities of daily living, travel and alternative techniques of blindness. Last year, it served more than 4,000 seniors and 85-percent of them had macular degeneration, he said.
“The aids and devices and we offer have the ability for our consumers to get some training,” Lecher said. “It’s the technology they need to start working in the kitchen again. If they can’t see well and are used to making bread a new way you have to learn how to do it again. That sort of thing.”
Lecher said some of the challenge include helping seniors realize that objects exist even if not heard or felt. They now have to understand the relationships which exist between objects in the environment. The vision aids the state provides includes but is not limited to talking calculators, A talking blood pressure cuff and talking scales. The talking Blood Pressure cuffs range in price, however, less expensive models can be purchased for $35. For example, visual aids like enlarged telephones, reading and hearing devices add up. And, so does the cost of learning how to use the tools.
Lecher, who is also the Supervisor for Senior Services with State Services for the Blind, said anticipated healthcare costs for seniors with vision loss is tough to project.
“The costs would include diagnosis, shots for wet Mac D, laser treatments for diabetic retinopathy, regular diabetes management, cataract surgeries and other medical procedures to fix things like detached retinas (common in older folks),” he said. “There are no medical dollars for rehabilitation other than for vets at the VA.”
Data represents need
Hennepin County is home to 150,000 people. According to Census data, it was the largest County with residents age 65 and older in 2014. More than 19-percent were 65 and older.
These numbers influenced the creation of the Aging Eyes Initiative, a program sponsored by the State Services for the Blind.
Lisa Larges, the outreach coordinator with State Services for the Blind, said this program which was created in 2016 is one solution in addressing the upcoming need.
“We clearly can’t keep up with the number of seniors who need our help across the state,” Larges said. “Working with community partners in this way has several advantages. It allows our counselors to focus more attention on seniors in the later stages of vision loss who need more extensive services and more in-depth training.”
Larges said for seniors, being introduced to adaptive devices and other resource through trusted professional who are already in their lives, take some of the trauma and sense of helplessness out of the prospect of losing vision.
“It is amazing how the some encouragement a magnifier and access to books can relieve some of the fear and anxiety,” she said.
According to data obtained from the State Demographers office, the structure of the population in Minnesota is expected to change. In 2014, the total population of people 65 and older was 75,6077. The estimated increase for 2020 is up 28-percent. And Larges said the greatest need will be in Anoka, Hennepin, Ramsey and Wright counties.
In 2020, Hennepin County is projected to have 200,412 seniors. That’s up 27- percent compared to the 146, 134 in 2012.
Currently, the budget for the Aging Eyes Initiative is $112,500. It is a combination of funds from the Hamm Family fund at the St. Paul Foundation and funds from the Northland Foundation.
“In large measure these funds cover costs of aids and devices – such as magnifiers, glare reduction glasses, large print aids, and so forth that go directly to consumers through our trained community partners” Larges said.
These are tools Dan Froehlich says will help his son, Peter Froehlich, for years to come. His son, Peter, was born with a condition called retinal dystrophy optic atrophy.
“It is just very difficult for him to read like a whole book. He has to read word by word and put the page next to his eyes or use a magnifying glass,” Dan Froehlich said. “Magnifying devices for his school work have really been helpful. The public school took care of his needs for 18 years. When he graduated, he was on his own.”
A recent Pew Research shows people prioritize nonmaterial things – such as good health – as most important in life. A median of roughly two-thirds of people across the U.S. ranked their health (68%) as 10 – very important – on a 0 to 10 scale. Peter said his disability has diminished his quality of life.
“I want to work like everyone else does. It interest me to work and help other people. I want to get into social media stuff but I can’t," he said. "Mobility is the key. Getting around is the most challenging. I can’t do as much as other people as my family like go out at night."
But for Peter Froehlich, this has been the constant in his life. Imagine being unable to see becomes your new reality?
And while state leaders are preparing to help more people with vision impairment, the numbers pale when comparing to other states.
For example, in West Virginia, data shows the percentage of adults 18 years and older who reported blindness or severe difficulty seeing in 2014 was between 7.8 and 9.4 percent according to the Centers for Disease Control and Prevention. That's more than triple compared to the 2.5- 3.1 percent Minnesota saw during the same period. North Dakota ranks lower than Minnesota with 2.7 - 3.6 people reporting blindness or severe difficulty seeing.
Larges said resources available in Minnesota have helped keep the problem at bay. The hope is the creation of Aging Eyes Initiative will bridge the divide between an old life and new one.
The overall goal of the program is to help seniors adjust to vision loss by providing information about eye conditions common to seniors. It also provides low-vision aids and devices at no charge.
Singleton-Askvig said restored vision would change her quality of life. To her, being able to see again means more than money.
“I am always hopeful,” she said. “I keep telling myself that I am not blind.”