So here you are, in the middle of your typical diabetes education practice, seeing patients, when someone on your team pulls you aside and points out that you have a patient scheduled for an individual session later that day who is blind. "No problem," you think, "how hard can it be?" After all, you have heard of talking meters, and you know about insulin pens, so that's what you need to know, right?
And then, when you go to get your patient from the waiting room you encounter the first problem. You take his arm and try to move him to the examining room, and he says, "No! Please let me take your arm." So you do that, and although it's not graceful you somehow manage to get through the door and he sits on a chair, and you begin the assessment.
You soon realize that you are talking to a highly educated person, a person who has a graduate degree in Psychology; but you don't know how he reads, or what it's reasonable to ask about previous experiences with DSME. You learn that your new patient has type 1 diabetes, lost his eyesight rapidly in his 20's, lives alone, and does intensive management. Then he shocks you by pulling out his insulin pump!
Suddenly you realize you are going to need to know nonvisual methods for a lot more than blood glucose monitoring and use of insulin pens. As you learn that your patient needs to brush up on accurate carb counting, you wonder how to teach nonvisual food measurement. You realize that he needs a new physical activity plan, and wonder what sort of activity is realistic for him. He mentions that his old meter is 6 years old so he wants a new meter that he can download to his computer. You realize you know very little about the range of choices in talking meters. He mentions that his doctor has added 2 new medications recently to the 4 he was already taking, and you wonder how he tells them all apart. And you also realize your patient should monitor his blood pressure and weight, check his feet regularly, and know how to access resources to keep up with new diabetes information. This is what you should provide for everyone! Surely this graduate-educated, computer-literate person deserves no less.
And just to add insult to injury, you realize that all your lovely printed handouts full of pictures won't be worth anything to this new, blind patient who lives alone.
As you complete your assessment and work up a plan with your patient, you think that it's a good thing that you're going to the Third Annual Pennsylvania State Diabetes Conference on May 1 & 2 before you see him again. While you are there, you will get a chance attend the workshop, "When Your Patient Can’t See: Using Good Senses (like touch, hearing, & smell)" to find out how you can meet this patient's needs.