2016 NJ AER Newsletter

2016 NJ AER Newsletter

and

Conference Information/Registration

Included in this issue:

President’s Message

Laurel Leigh, NJAER Chapter President

My Car, My Self

Barbara Horner, TVI, COMS

We Look Good for our Age!

Lukas Franck

Foods you can actually eat with diabetes (and misconceptions of a diabetic diet)

Nancy Kasmar, Registered Nurse, Certified Low Vision Therapist

The Little Room- How to Encourage Babies and Young Children who are Blind to Explore their Environment

Rachel Pichette, COMS,CTRS,M.S.

Accessibility for the Visually Impaired on the PARCC Assessment

Elyse Giordano, TVI, COMS

A Newfound Appreciation of NJ’s Blind/Visually Impaired Services

Sheri Siegel, COMS

*NJ AER Spring 2016 Conference Agenda

*NJ AER Spring 2016 Conference Registration Form

*NJ AER Board Positions and Nomination Forms

President’s Message 2016

I have been trying to find the words that best describe my tenure as President of the NJ Chapter of AER and I find myself realizing that I still have a strong passion for this field and appreciate the opportunity I have had to give back to the profession through my work with NJ AER. In addition to these good feelings though, are the concerns I have for our chapter as it faces declining membership and attendance at our annual conference. However, during a recent review of the programs for past (and the upcoming) conferences I was pleased to see that our hard working group, although small, has managed to pull off some impressive programs. For this I must acknowledge the entire Board and thank everyone for the commitment of time and ongoing dedication to professional development, and to each of you who has managed to help keep me on task because without you, I would not have been able to see such success in our efforts!

NJ AER has worked hard to meet the professional development needs of our members by organizing the annual conference held locally and at a relative low cost. We all have something to learn, no matter how long we have been practicing our profession but we cannot provide our consumers with the best service unless we ourselves are at our best. Professional development opportunities help to keep us all current in best practice, help us learn new approaches and methods of teaching, and best of all provide us with a good dose of professional networking, all necessary to help us through the tough times.

In the past few years this commitment has been a struggle as we face the challenges of declining membership and attendance at our annual conference. The Board has been discussing and wrestling with ideas for change in an effort to increase membership and participation. There is an announcement for nominations in this newsletter so please consider joining in the challenges ahead as NJ AER looks forward to new and innovative ways to serve our profession.

This is my last year as President and I challenge all members of the New Jersey Chapter to consider either volunteering for a leadership position or nominating a colleague who you believe can work to bring this Chapter into a new era of Professional Development and Networking like we have never seen before!

I look forward as we “Drive into the future with NJ AER!

Laurel E. Leigh, President NJ AER

My Car, My Self

By Barbara Horner, TVI, COMS
Quoted in Time magazine in 1963, Edward McDonagh noted, “The car has become a secular sanctuary for the individual, his shrine to the self, his mobile Walden Pond.” (One wonders if Edward, whomever he was, was also a closet itinerant teacher.) Whether our vehicles take on the persona of a Monkeemobile, a Batmobile, or even a Millenium Falcon, we depend on our trusty automotive steeds to speed us away from that difficult school situation, towards that next successful home visit or anywhere in between, including the nearest WaWa. As much as we depend on our vehicles to take care of us, our vehicles depend on us to take care of them. One way to increase the chances that we and our cars are ready for whatever unexpectedly comes our way is to make room for an Emergency Road Kit (ERK). Admittedly, when I started in the field 30 years ago, an emergency was defined as driving out of the range of my favorite radio station. But times have changed, and with the advent of satellite radio, my definition of an emergency changed as well. The purpose of an ERK is to have on hand the materials and supplies necessary to ensure the safety of our clients, our cars, and ourselves. Below is an exhaustive but by no means complete list of materials and supplies that can be used in an emergency as well as to avoid what could turn in to an emergency. While a majority of the materials and supplies can be stored in a container in the trunk (a large tub with a fitted lid works nicely), there are some items that by necessity should be kept in the car and/or with the driver.

First Aid: Instant ice pack, eye wash, band-aids (assorted sizes), first-aid spray, sting-kill swabs, hydrocortisone ointment, rubber gloves (latex free), tampons (nosebleeds as well as their intended use), frosting gel (diabetic-related), and tweezers

Weather-Related: ponchos, one-size-fits-all gloves (child and adult, but then again, if one size fits all…), extra shoes and socks, sunscreen, hand warmers, towels and blankets

For the Car: safety flares, safety/reflective triangle, motor oil, fix-a-flat, kitty litter, windshield washer fluid, lock de-icer (get the small can that fits on your key chain or in your pocket – it’s not much good if it is frozen inside your car), small shovel, snow brush/ice scraper, nubby gloves, jumper cables, tire pressure gauge, and hide-a-key and spare key (On a related note: many auto supply and/or department stores have “pre-packaged” emergency roadside toolkits that can be quite handy if you are handy. They can include jumper cables, work gloves, a socket wrench set, pliers, a phillips-head and flat-head screwdriver, vinyl tape, auto fuses, a tire gauge, battery terminals, etc., and it all comes in a nifty little hard-shell case, sometimes in designer colors.)

Hygiene: paper towels, toilet paper, tissues, moist wipes, hand sanitizer, bags (assorted sizes – trash, gallon, baggie – zip-lock is best)

Sustenance: bottled water (good for the instructor, the student, and the car’s radiator if need be), disposable drinking cups (in plastic bag to keep them clean), pre-packaged cheese & crackers, peanut butter crackers (check for peanut allergies!), Slim Jims, and/or your snack of choice

Other Stuff: duct tape, dental floss, cell phone & charger, spare change, tokens, public transportation passes, a spare $20-bill or credit card for emergency gas purchases, maps/navigation system, flashlight and extra batteries, and AAA membership (if you are, like me, not a self-sufficient or live-dangerously kind of person)

And, last but not least, at least for me, riding shotgun is a St. Christopher’s medal. (St. Christopher was, and for many still is, the patron saint of travelers. Hey, it can’t hurt.) And now, load ‘em up and move ‘em out, and as Mel Brooks would say, may the Schwartz, especially the Liquid Schwartz!, be with you!

We Look Good for our Age!

By Lukas Franck

We have something to celebrate in this year. In October it will be one hundred years since a blind German veteran of the First World War named Paul Feyen graduated with the first product of the first formal guide dog training program, started by Dr. Gerhard Stalling in Oldenburg , Lower Saxony, Germany.

The program itself developed from the work of the German Red Cross Ambulance Association that was training dogs to search for and locate the wounded on the battlefield. At Oldenburg, to meet the pressing needs of blinded veterans, more than 600 teams per year could be trained.

From its infancy at Oldenburg the center of the guide dog training world moved to Potsdam where the German Shepherd Dog Association opened its own guide dog training center in September 1923. With higher quality training, and an output of approximately 12 teams per month, the modern movement was beginning to take shape. In fact several schools around Europe have their roots in these programs.

Just as humans have growth spurts so did the guide dog world. And just as chance and luck play a role in our development (just think about how you found yourself in this work!) So did the modern guide dog movement.

In 1927 a critical series of events set off by a visit to the Potsdam program pushed the young movement into its adolescence. The catalyst for change and development was not war but a magazine article called “The Seeing Eye” ,written about the Potsdam program, that appeared in the Saturday Evening Post. Written by Dorothy Harrison Eustis, the article’s appearance miraculously resulted in the bringing together of her skills and resources including the training and genetic skills of Jack Humphrey at her Fortunate Fields project in Vevey Switzerland ,with the impatience, frustration, idealism and raw courage of the very young Morris Frank of Nashville Tennessee.

Together they founded The Seeing Eye in the United States, but even more importantly Eustis and Humphrey were inspired to found L’Oeil Qui Voit (The Seeing Eye, in French). This was a training center that served as an incubator for guide dog training programs all over Europe. There in Lausanne Switzerland they laid the foundation for what became the global Guide Dog Movement - either as direct results of that program, or inspired by it.

As the movement matured it achieved young adulthood in Australia, Asia and Africa and now maturity as programs multiply and expand around the world including Eastern Europe and South America.

This 100th birthday is truly something to savor. Thousands of lives have been improved through the use of highly trained guide dogs. So Happy Birthday Guide Dog Movement! You look good for your age!

Foods you can actually eat with diabetes

(and misconceptions of a diabetic diet)

By Nancy Kasmar, Registered Nurse, Certified Low Vision Therapist

Diabetes self-management includes the tools of medicines, food, exercise, and diabetic glucose testing. Vision impairment affects the ability to read food labels, and may affect the stimulus for appetite if one cannot see the table settings or food presentation. Many people see a diabetic diet as one of restriction, where really it is a very healthy diet plan that anyone can follow. It does encourage people to follow a planned food consumption. It suggests people watch caloric intake, along with sodium and fat limitations.

The Basics of a Proper Diet

Usually a person consults a dietician for a personal dietary review of foods and calories consumed. Changes in activity or working off shift can make food procurement problematic. Older people require less calorie intake as they become less active. Children experience peer pressure. Diabetes related complications such as HTN, cardiovascular disease, renal disease, and vision impairment can alter dietary requirements. Most authorities consider a well balanced meal to contain 10- 30% fat, 12-20% proteins, and 50-60 % carbohydrates (CHO).

Sodium is hard on kidneys and can lead to kidney problems, or high blood pressure. Carbohydrate consumption can lead to high glucose readings, which can lead to long term diabetic complications. People may turn to diet foods which may contain artificial sweeteners such as fructose, sorbitol, zylitol, mannitol, which can all cause diarrhea.

The objective of food management, or a healthy diabetic diet, is to keep glucose level close to normal, keep blood fat levels close to normal, improve and maintain overall health with best possible nutrition, avoid long term complications, prevent severe hypoglycemia. Food is easy to obtain, yet it needs to be evaluated to see if it is a healthy choice in regards to how made or its portion size.

The food pyramid is a triangle with the foods to be eaten in smaller amounts in the top, and foods at the bottom being ones to be eaten most of, such as plant based. An easy way to put it together is to use a 10 inch plate, divide in half and cover that half with non starchy carbohydrates. Divide the remainder of plate in half for a protein choice, and a starchy carbohydrate choice. Do this by meal and you will be eating good healthy foods in correct portion amounts.

Serving sizes are expressed in units like ounces or cups. This can be difficult to figure out if you are not the chef. Using you own hand as a guide, your palm sizes is about 3 ounces, a half cup serving would fit in the palm of your cupped hand, 1 cup is your closed fist. Use a food scale to measure portion sizes, a 10 inch plate, a bowl that holds correct amount for a serving of cereal, measuring cups and spoons, to maintain portion sizes.

Food preparation can be healthy if steamed, boiled, roasted, micro waved, or sautéed in a small amount of oil. Chill soups to skim off extra fat, or remove skin and remove visible fat on meats. Choose fruit in its own juice, not in syrups. If using up syrup encased fruit, rinse the fruit with water. Fresh or frozen produce products have less sodium or salt in them. Rinse canned foods to decrease some of the sodium. Food is best when It remains closes to nature, least processed. Finances can create limitations on a food budget. Choose as varied a diet as one can afford. Drink water, up to 2-3 quarts a day.

Alcohol may be consumed; it is best taken with a meal as alcohol can cause low blood sugar. It stops the liver from producing glucose from stored resources. Avoid very sweet drinks, and limit the amounts taken; 1 drink for women and 2 drinks for men, on average. That is 1 ½ ounces of liquor, 5 ounces of wine, or 12 ounces of beer. Alcohol can add flavor to foods, such as white wine as poaching liquid, sherry as a marinade, red wine in tomato sauce, orange liquor to a salad, hazelnut liquor to coffee.

Carbohydrates are starchy or non starchy, simple or complex. The foods can be sweets, snacks, fruits, vegetables, grains, and dairy products. A measured amount is 15 grams. People will want to limit carbohydrate amounts to 45 to 60 grams per meal. Examples of 15 gram foods that are starchy or grains are a slice of bread, ½ English muffin, ¼ bagel, ½ cup to ¾ cup cereal, 1/3 cup pasta, 6 crackers, ½ medium potato, ½ cup beans. Fruit examples are 1 small apple, ¾ cup blueberries, ¾ cup oranges slices, 1/3 cantaloupe, 2 tablespoons of raisons, or ½ cup apple or orange juice. Sweets example are 1 tablespoon of sugar, ½ cup ice cream, dairy examples are 1 cup milk, 1 cup plain yogurt, or 1 cup artificially sweetened yogurt. Fiber is non digestible pant food, soluble and insoluble. Soluble fiber decreases fatty build up in arterial walls. Insoluble, which decreases constipation, decreases digestive problems and colon cancer.

Food labels are important to read, as company listed serving size is not always the standard portion size, and you must divide the total carbohydrates by 15 grams to learn how many carbohydrate portions are in the suggested serving size.

Misconceptions of a Diabetic Diet

1)Fruit juice is not really healthy as it raises blood glucose and has minimal nutrients, it’s better to eat a piece of fruit and get all the vitamins and fiber too. In the same fashion, Hawaiian Punch is not fruit juice nor is it good for you blood sugar.

2) Fruit, while healthier than fruit juice, still does raise blood sugar. It is not a free pass just because fruit is considered to be healthy.

3)Starches, although they do not taste sweet, raise the blood sugar tremendously since they turn to sugar as they are digested. This means that a large bowl of cereal, large bowl of pasta, or large bowl of rice is not typically okay for a diabetic.

Target Blood Sugars

Before meal target glucose levels are 80-120. One must check two hours post prandial, or post meal glucose to learn how the food at the meal has interacted with the prescribed diabetic medicine taken. Going up less than 50 points will indicate the amounts and type of CHO taken are a good mix with the medication used. If the glucose goes up higher than 50 points, it’s time to reevaluate amounts and types of CHO taken in. A random or bedtime glucose level target is between 100-140. A glucose level over 180 indicates a person is in the danger zone, where high glucoses are irritating the blood vessels in their body, and can lead to complications.

It is good to eat balanced diet, inclusive of a large variety of least processed foods, to keep day to day food intake consistent, and eat meals at about the same times every day, occasionally enjoy sweets and alcohol, and to avoid over treating low blood glucose levels. Taking prescribed medicines as ordered, checking glucose levels regularly, and enjoying a walk are all tools to assist people in managing their diabetes. Interestingly, the reality is that everyone should eat as well as a diabetic!