RESIDENT_____________________________________

DATE

PROBLEM

GOAL

TO DATE

INTERVENTIONS

RESP

DISC

Requires specific activities program due to limitations

Potential for decreased or unsatisfactory activities related to

Visual Impairment

As evidenced by:

Impaired: Sees large print, but not regular print in newspapers / books

Moderately Impaired: Not able to see newspaper headlines, but can identify objects

Highly Impaired: Object identification in question, but eyes appear to follow objects

Severely Impaired: No vision or sees only light, colors, or shapes; eyes do not appear to follow objects

Decreased peripheral vision

Resident will participate fully in chosen activities

Resident will verbalize satisfaction with activities

Resident will complete activities of choice

Make sure resident’s glasses are in place before activities

Seat resident for easier viewing

Place objects within resident’s viewing range

Place objects in same place each time

Assist resident to orient to space and locations, and assist as needed

Monitor activity setting for safety

Monitor resident’s safety during activity, and anticipate needs – describe adequately

Use “clock method” to describe where items are located

Large print items including playing cards, newsprint, books; audio books

Higher levels of lighting without glare

Magnifying glasses, light-filtering lenses, telescopic glasses

See Nursing care plan