Helen Osborne: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and author of the book Health Literacy from A to Z. I also produce and host this podcast series, Health Literacy Out Loud.

Today, I’m talking with Joe Weisse, who is co-coordinator for the Low Vision Support Group of Natick for the Massachusetts Association for the Blind and Visually Impaired.

Now retired, for 33 years Joe was Public Information Officer for the Mass Commission for the Blind. Using his communications background, Joe is a long-time Amateur, or ham, Radio operator making contacts with stations worldwide.

I met Joe years ago through our town’s Commission on Disability. He was the Chair and I a member of this Commission. We have stayed in touch ever since. Beyond sometimes chatting about local news, Joe is always helpful when I want to know more about issues related to being blind or having low vision.

Welcome to Health Literacy Out Loud, Joe.

Joe Weisse: Helen, thank you very much. It’s a pleasure, as always, to be with you, and thanks for the opportunity to join you today.

Helen Osborne: I wanted your wonderfulness to spread worldwide through this podcast and really help listeners of Health Literacy Out Loud know more about issues related to blindness and low vision. And most of all, how to communicate more clearly. That’s the interest that all of us share no matter what our work setting is.

Can you start from the beginning and put in context for all of us about vision issues?

Joe Weisse: I’d be happy to, Helen. There are many different degrees of vision loss and legal and total blindness. Some folks are blind since birth. Others are newly blind in the past five to 10 years. Some folks have low vision and diminished vision, but still are able to function very well.

Each person is just like everyone else, having skills, independence, abilities and so forth to be able to go forward. It is an interesting aspect that goes along.

Society has this view, I think, that you’re either blind, meaning totally blind, or you’re not, and there’s nothing in between.

Helen Osborne: But that’s not at all the case, from what I’ve learned from you.

Joe Weisse: Exactly right.

Helen Osborne: Also, this happens over different periods of time. Some people are born with no vision, or are blind at birth. Other people lose it later in life.

Joe Weisse: That is correct. It depends on a person’s health situation in terms of birth. There may be various things such as being premature or having oxygen issues back in the day or what have you. The difference is that you, of course, grow up without knowing what it is to have vision, so it becomes more of a normal aspect of your life.

Whereas folks who lose their vision later in life, of course, have visual memory, which is a very important element for learning new things. But have had the loss of not being able to drive, not being able to do some things that they were otherwise able to do for many years. Maybe not see their grandchildren as well or at all. There are a number of factors that go into their adjustment of vision loss as time goes on.

Helen Osborne: Thank you for making that clear to all of us. Our common interests, for listeners of this podcast, are, “What can we do?” We all want to communicate about health. We all want to do it in ways that are respectful and helpful. Clue us in, Joe. For that whole spectrum of people who have vision issues, how can we communicate better?

Joe Weisse: Basically, when a person, for example, is coming to a medical facility or a building, and you’re taking the appointment for them, let’s say, by phone, the very first thing to ask in all situations either with a person that’s there at the counter or a person that is on the phone is, “How best can I help you?”

Each person is so different in terms of what they can see, what kind of travel situations they may be coming into the building with, whether they’re coming with someone who is sighted or not. All of that is going to pivot off of when you ask what their needs are.

Then you can direct yourself to try to provide that kind of information, whether it’s what door to enter, whether they’re coming by a ride or vehicle that may be individualized for them, to where the elevators are, where the office is and where the doors are. All of those kinds of issues come into play.

Helen Osborne: I’m at the desk and somebody comes who might have vision issues, but I’m not so sure. Is there a moment in there we should have the person share with us what their vision issues are? Should we just make the leap? Or ask this open-ended question of, “How can I help you?”

Joe Weisse: I would go with, “How can I help you?” because that is generic across the board for anyone. Many people who have some vision loss are going to be able to be forthcoming about, “I have this vision loss. I’m not able to see you,” or, “I’m not able to travel independently,” or, “I am.”

A cane may give some signal of what a person may be coming in with and whether they need a sighted guide to be able to walk down the hall, or being able to hold on to one’s arm and maybe walk a step behind.

There are a lot of aspects, but starting off with “How can I help?” cuts all of that away and is able to leave it to the individual to describe and give some direction as to where to go and how to do it.

Helen Osborne: Thank you very much. That covers some of those introductory in-person ways of setting the tone for the relationship that follows.

I know some issues come up about printed material. I’ve written about this and addressed this, and you’ve been helpful with this before. But I welcome you sharing again what we can do regarding printed and web information.

Joe Weisse: It’s a pretty wide stroke. By the way, I just want to say that using words like “look” and “see” are normal parts of our language and should be utilized. Don’t feel, “Oh my goodness, I don’t know what to say and how to say it.” Just use the regular conversation as you would. Again, ask the person how they can best accommodate in that situation.

Helen Osborne: Thank you for saying that, Joe. I’ve learned from you about that. When you think of our language, “look” and “see” are just figures of speech in there. If I had to stumble on that one, I’d come around, but . . . Thank you.

Joe Weisse: Sure. It’s an interesting aspect.

In examining printed materials, for example, it’s good to first of all have a lot of things in a 12-point type for everybody.

It’s amazing how many people will pick up a larger print version of something, even if they are not self-identified as a person who is visually impaired, legally blind or what have you.

They may just pick that up because it is easier to read on a print stock that is very simple, that is not going to have any issue of glare, reflections of lighting or anything else.

The larger print, 14-, 16- or 18-point of print, again, in a very simple style is also important, but you don’t want to get too large. The larger it can be, sometimes a person with a magnifier, glasses or lenses has to traverse that page even more so to pick up a much bigger letter.

Helen Osborne: That’s interesting.

Joe Weisse: That can be as debilitating as getting it in a sweet spot, which is where maybe their magnification would be. Roughly, that could be, let’s say, 16- or 18-point at most.

Helen Osborne: Thank you, Joe. I hadn’t really thought about using the magnifiers, but I had heard that if the font size is too big, the line length is too short. There are just too few words on a line.

Joe Weisse: Right.

Helen Osborne: I know that I’m struggling with some vision issues myself. These things happen. I’m getting much more comfortable with 14-point font than I ever used to be. I like your term, that sweet spot. That’s pretty good for me these days. It just feels more comfortable.

Joe Weisse: Absolutely. It’s more accommodating for everyone. That’s the thing. We don’t want to really separate out providing these services for visually impaired people. Basically, if you have some of these accommodations made at the get-go, then that can help.

There are some folks who use computers with speech or large print output on their computer. It’s possible in some instances where you may be able to email materials to them either ahead of time, after the fact or what have you. A person may be able to then use or read the attachment and be able to make it accessible that way.

It’s possible there, too, to ask if those items and resources are available.

Helen Osborne: Joe, I want to interject my experience with you. You and I know each other casually over the years, but now I want to do this podcast with you. I want to set up the date and exchange some information and all that. I do that by email. We don’t just do this by talking about it. You can’t see the printed word, is that correct?

Joe Weisse: That is correct.

Helen Osborne: What did you do at your end? It seemed as though magically I sent you this email and other information, and you sent it back to me. Ta-da, all was just easy breezy. What did you do at your end?

Joe Weisse: Of course, I use a speech output recognition, so I was able to go into your attachments. A Word document is safer to produce than a PDF because PDFs are basically images of the document on the screen. Some devices are better at converting those to speech than others. Ideally, if you can convert your printed materials to Word, that can be a safer way to go.

That’s what I did, and then I was able to follow your documentation and be able to respond back with that, or make some changes and send it back to you.

The email process is a great one, but there is this issue about technology. There are people who have it, and there are a number of people who do not.

Helen Osborne: Let’s go on to that one, because that seems to be where the world is going these days. Everything is electronic. You’re saying those emails worked. Thanks to technology, they worked at your end and they worked at mine. But what are some of those issues about technology and communication?

Joe Weisse: Some of the issues, of course, are just the practical. In a pharmacy or in an area where you’re getting a prescription filled, for example, how would a blind or visually impaired person find a bottle, let’s say, that’s the same shape as every other bottle that you might have on the shelf?

Some of the tricks of the trade could be putting elastic around one, and two elastics or two pieces of tape on the second or third. Those quick issues.

The other thing is the instructions and how the bottles are and what information they provide. There are some barcode readers out there that will make those accessible in speech.

There are apps on your phone that can basically allow you to read something on the fly. In other words, you get a piece of paper or a document and you’re able to then have the app read it to you in speech automatically.

These things are great, but again, the technology familiarity piece is the key element to make those things happen. Even though that’s growing, it’s not for everyone.

Helen Osborne: I know you said you’re very involved with the Low Vision Support Group. Are you finding, not just in that group but for all the work you do, a range of people who are comfortable using this technology, and a range of those who are not, or have access to it?

Joe Weisse: I find that about 50% of our support group is comfortable with using email. The other 50%, not at all.

In fact, in a couple of instances, people have difficulty in calling in to a voicemail line to be able to access our meetings during COVID. We have to call them because there’s that whole issue of timing where you have to call in, and then you have to give an ID within a certain period of time or it kicks you out.

This is very problematic for folks who need additional time to be able to read the phone number with a magnifier, go back to the phone, put in a certain sequence of numbers, go back to the magnifier to read the rest. Those kinds of logistics are very time consuming, and the phone systems don’t allow for that kind of time.

Helen Osborne: Boy, I’m always learning from you. That made it so clear.

I think you once told me that more people lose their vision as they age than are blind from birth. Issues of age and technology are also a factor. You’ve got low vision and age all happening at the same time, along with these fancy new devices that could be helpful, but aren’t always.

Joe Weisse: I think it’s for a certain population, and it’s growing, because people become more and more familiar to learn this technology to make sure they can communicate with their grandchildren. Those kinds of motivations take hold.

But there are a number of people who aren’t, so again, if you’re providing services to people, technology is not always the panacea it appears to be.

Helen Osborne: I want to get back to that initial question. You said that we should be asking, “How can I help you?” I would love to hear from you how else we can be helping you. For we, I mean all of us who are communicating about health.

Joe Weisse: I think, of course, the important thing is to look around your facilities and offices. Make sure that the elevators have some braille or large-print documentation in the doorjambs. Those kinds of things first.

Secondly, think about where the restrooms are and is there sufficient labeling on the doors and so forth there, just to be able to have access.

Third, when you’re coming off the elevators, how do you go, and do you need to pass certain things, water coolers and other landmarks that can help a person who is visually impaired be able to get to your office?

Be cognizant of those so that when someone does call, you’re able to give some sort of information that will be helpful for them to get to your location.

Helen Osborne: Joe, you’re so helpful to me, to all of us. I just want to thank you for sharing this information with us, sharing your perspective, for doing all you do and for being a guest on Health Literacy Out Loud.

Joe Weisse: Helen, it is my pleasure, as always, to work with you and to be a part of this. Thanks for the opportunity. Appreciate it.

Helen Osborne: As we just heard from Joe Weisse, it’s important to communicate clearly with everyone, including those where vision is an issue. But doing so is not always easy.

For help clearly communicating your health message, please take a look at my book, Health Literacy from A to Z. Feel free to also explore my website, www.HealthLiteracy.com, or contact me directly at helen@healthliteracy.com.

New Health Literacy Out Loud interviews come out every few weeks. Get them all for free by subscribing at www.HealthLiteracyOutLoud.com, or wherever you get your podcasts.

Please help spread the word about Health Literacy Out Loud. Together, let’s tell the whole world why health literacy matters.

Until next time, I’m Helen Osborne.

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