Eli's Rehab Report

How, specifically, can therapists and MDS staff work together to get residents the therapy they need? Let’s look closely at low vision, one of several detailed examples Renee Kinder, MS, CCC-SLP, RAC-CT, , Clinical Specialist at Evergreen Rehabilitation in Louisville, KY offered in her AudioEducator session.

Tip: The MDS screening tool breaks down vision impairment more specifically than other areas, Kinder said.

Section B’s B1000 subsection may give your facility opportunities to tie in physical and occupational therapists who have special low vision training, Kinder noted. As a result, you have more detailed information than is typical in this subsection — information that MDS staff seeing changes across quarterly reporting periods can communicate to the rehab team.

MDS scores B1000 Vision as follows:

Ability to see in adequate light (with glasses or other visual appliances)

    0.  Adequate — sees fine detail, such as regular print in newspapers, books.
    1.  Impaired — sees large print, but not regular print in newspapers, books.
    2.   Moderately impaired — limited vision; not able to see newspaper headlines but can identify objects
    3.  Highly impaired — object identification in question, but eyes appear to follow objects.
    4.  Severely impaired — no vision or sees only light, colors or shapes; eyes do not appear to follow objects.

B1000 scores likely impact other scores in other MDS sections besides B. Individuals with impaired vision are:

    1.  Less likely to perform ADLs, IDALs
    2.  Less mobile
    3.  More isolated
    4.  Have higher rates of depression
    5.  Higher mortality rates
    6.  More prone to accidents and falls
    7.  Likely to make medication errors

Once any reversible causes for reduced vision have been sought, an occupational therapist may be called in to consider whether simple environmental changes such as better lighting or magnifiers would improve the ability to see, Kinder said. Therapists may teach patients how to use their remaining vision such as scanning and the fingertip method.