Andy/ August 24, 2021/ blindness, diabetes

Hello and welcome to another wonderful interview! This time I am joined by Kim Ladd, the Diabetes Educator/Health Education Specialist for the Virginia Department for the Blind and Visually Impaired (DBVI). She works directly with the Virginia Rehabilitation Center for the Blind and Vision Impaired (VRCBVI). Her role extends further than diabetes health education, including working with blind individuals of all ages to train them to become independent. VRCBVI teaches a plethora of exciting courses for the citizens of Virginia. You can read more about Kim and her role at the agency and visit the https://vrcbvi.org/ if you’d like to get more information about the Center. 

Kim Ladd Headshot from the Virginia Department for the Blind and Visually Impaired

Mohamed: Can you introduce yourself?

Kim Ladd: I’m Kim Ladd. I am the Diabetes Educator/Health Education Specialist for the Virginia Rehabilitation Center for the Blind and Vision Impaired (VRCBVI), aka the Center.

Mohamed: How long have you been with the Virginia Rehabilitation Center for the Blind and Vision Impaired?

Kim Ladd: In November, it’ll be six years. 

Mohamed: So, what does a Diabetes Educator do?

Kim Ladd: Diabetes is the number one cause of blindness in adults, and one-third of the American population is affected by it. It’s chronic, must be managed 24/7 with blood-sugar tests and constant oversight of diet and exercise. Here at the VRCBVI, my role is to empower the individuals we work with that have lost their vision due to diabetes. I share skills, tips, and accessibility options. We believe at VRCBVI that there is no reason blindness should get in the way of being healthy. 

Mohamed: Oh, that’s awesome, and do you have any other roles with the department?

Kim Ladd: At the training center, I help students understand and manage chronic diseases. I also conduct home-visits for individuals not independent enough in their medical management to attend the training center. I assist with vocational rehabilitation, so that students gain skills to become employed by helping conduct mock interviews and job readiness seminars. With limited staff at VRCBVI, everyone tends to wear more than one hat. Additionally, I certify the staff in CPR, AED, and First Aid because I am a Red Cross Certified Trainer.

Mohamed: And can you tell me a little bit about your background, what you studied and what led you to the department and ultimately to your position?

Kim Ladd: I have been a registered nurse since 1996. Most of my career has been in home healthcare, so I’ve come across diabetes a lot. In the 1990s and early 2000s, diabetes started becoming more common, and it was costing a lot of money to treat. For example, $327 billion was spent on diabetes last year. In 2007, I was diagnosed with diabetes. I’m the type of person that if I have something, I want to know as much about it as I can. So, I started learning more about it, then started teaching diabetes classes.

They don’t teach you anything about blindness in nursing school, but I’d learned a lot from the few blind patients I’d had through the years. I learned a lot just by talking to them. I realized that they’re not different, they just can’t see. 

Throughout the years, I would drive by the training center, and I just started reading about it. I just fell into this job six years ago and it was the best decision ever. I’m making a difference every day and helping people improve their lives.  

Mohamed: Can you tell me a little bit about the less common certifications you have? Like CPHQ and CDCES?

Kim Ladd: CPHQ is Certified Professional in Healthcare Quality. I believe quality and healthcare are of utmost importance because there are so many errors in healthcare. By paying attention and being safe, we can prevent deaths in healthcare. So, it’s a certification that I got when I was a Medicare Contractor for the federal government. I inspected home health and hospice agencies to ensure they were following guidelines and providing safe care. I instituted diabetes prevention programs, and helped oversee quality in hospitals. Healthcare quality also revolves around problem solving (PDSA). When you have a problem, you analyze it, you come up with a solution, you implement it, and you analyze. I use that knowledge in my current job too, because problem solving is a big thing that I do. 

The other one I got in 2018, is Certified Diabetes Care and Education Specialist. It used to be called CDE, Certified Diabetes Educator. It’s a specialty certification and you must be a clinician, a nurse, a doctor, a pharmacist, a nutritionist, a social worker – somebody that has a degree in the healthcare field. You must have at least two years of practicum experience, plus 36 CEUs and then you must pass a big test. It just shows that I am an expert in diabetes education.

Mohamed: So, what’s the mission of the department and what do they aim to accomplish?

Kim Ladd: The mission of VRCBVI is “…to encourage blind and visually impaired citizens of Virginia to achieve optimum vocational, educational, and social independence, and economic equality.” My take on it is three keywords: education, employment, and independence. We want blind people to be as independent as possible. We want them to be gainfully employed. Having a job makes you feel good about yourself; you’re giving back to society, and it gives you a reason to get up. Next, education, you always educate yourself. Some people think they can’t go to college because they can’t get around campus or they can’t see. Here, we have a summer program called STEPS to Success that just ended for teens. It’s a three-week prep course for going to college.

Mohamed: Can you tell me a bit about the structure of the department and where the rehabilitation center fits into it? 

Kim Ladd: The Virginia Department for the Blind and Visually Impaired (DBVI) has a commissioner named Raymond Hopkins who is appointed by the Governor. DBVI consists of 5 regional offices, Virginia Industries for the Blind (VIB) and the Virginia Rehabilitation Center for the Blind and Vision Impaired (VRCBVI). The VRCBVI Director is Melody Roane, and she oversees the entire training center. At the training center, I call it “Blindness College,” we have a campus, dorm, cafeteria, and a school/classroom building. The adult program is the main program. If you do not live in the Richmond area, you must live on campus in the dorms. If you live in the Richmond area, you can commute if you want to. Students at VRCBVI are in classes Monday through Friday, 8:15 AM to 5:00 PM. They take orientation and mobility for two hours, which is learning to walk with a cane, and Personal and Home Management classes for two hours, which is an independent learning class where you learn to cook, clean, balance your checkbook, etc. The other classes are for one hour: braille, keyboarding, computers, and access technology. Once someone passes keyboarding, they move on to computers where they learn the internet, email, and Microsoft Office products, and accessibility software such as JAWS or ZoomText. Then we also have Accessible Technology. That is anything that plugs in, such as a phone, an iPad, or any technology besides a computer. The instructors teach the students how to make them accessible, like using voiceover or talk back, so it reads out loud. Then we have other things, like a class once a week called CAB, which is Conversations about Blindness. It’s in a group setting where students talk about issues of blindness. For example, “how do you know you’ve accepted your blindness?” or “what are some myths about blindness that people say all the time like?”

We also provide interview and job readiness skills. For example, mock interviews and dress for success days where the students dress as if they’re going on an interview, and we will provide feedback. I also did a class on S.M.A.R.T. goals; setting goals for your life so that you can achieve what you want to do. I also do some health educational sessions on things such as understanding health insurance benefits. 

The training center schedule runs kind of like college semesters, but you can start anytime. We go from after New Year’s to June and then we close for the summer for the adults because during the summer, we have the teen programs. Then the adult program starts back after Labor Day to about the 2nd week into December.

Mohamed: Can you tell me the age range of people you work with?

Kim Ladd: The main adult program is for people aged 18 and older. During the summer we have the Life Program, which is for 14 to 18-year old’s and it’s five weeks. They do the classes as the adults do, but they also do a job/internship at places like Chick-Fil-A, the YMCA, or a hotel, where they do a three-week job internship to get some job skills. We also do confidence-building activities with them. We’ll go rock climbing or whitewater rafting, just because people think you can’t do it because you’re blind. Well, yes you can. So, we go and have all kinds of fun that builds their confidence. They also meet other teenagers that are in the same boat as them. 

All ages are served in the five regional offices throughout the state. People that don’t come to the training center, but need some services, get services in their home. I’m kind of a hybrid, I work in both programs (DBVI and VRCBVI) because I’m the only nurse for the whole state. So, it’s exciting, it’s never boring for me. 

Mohamed: Do you know roughly how many people make the Center function?

Kim Ladd: We have a small staff… there’s around 20 of us. That’s including the dorm staff, instructors, and ancillary staff. 

Mohamed: That’s a small group for so much work you guys are doing. Do you work with any volunteers?

Kim Ladd: Yes. We encourage all kinds of volunteers. One thing I do is to collaborate with the nursing school that I attended. The nursing students have a caring for diverse populations course. So, I get eight students a semester that come here to VRCBVI and work with me. It’s only for three hours but it gives them exposure to the world of blindness. I never learned anything about taking care of blind people in nursing school, and I’m trying to change that. You can still go to the hospital, and they’ll put a sign on the door, “patient is blind.” Well, it doesn’t matter if you’re blind or not. You should treat them the same that you treat everybody else. So, one of my goals at the center is to change that mentality in the healthcare world. 

About three weeks ago, I was listening to a world-renowned endocrinologist with the American Diabetes Association, and he received a question from a blind diabetic that asked, “I’m blind. I can’t see to check my blood sugar… So, what am I supposed to do?” And he didn’t have an answer. So, this world-renowned endocrinologist didn’t know anything about talking meters and using the apps for the continuous glucose meters and using voiceover. 

But you know, baby steps. In medical school or nursing school you don’t have time to learn about every single population of people. What you’re trying to learn is the body, how diseases affect it and how to treat them. That’s not an excuse, but usually you don’t come across diverse populations of people (like the blind) until you’re practicing in the field. But if I can just give them a glimpse of it, then they’ll remember, “I went to the center my senior year and she said told me ‘This’” That’s kind of the hope that I have to change that whole mentality about it.

Mohamed: Do you know how many blind or low vision people that you’ve helped or that you help currently?

Kim Ladd: The center, pre-pandemic, usually has about 22 students at a time. In total, the center serves more than 400 clients annually. About 180 are students, full-time, part-time, residential, or commuter. Others are enrolled in specialized programs, such as the diabetes education seminars and off-campus technology training or receive health education consultations at home. 

Mohamed: What’s the age range of the people you work with?

Kim Ladd: The summer youth LIFE (Learning Independence, Feeling Empowered) program is for ages 14 to 18 and then the regular adult program is 18 and older. Usually, people in their thirties and forties are the most popular age group, but we’ve had a guy who was in his eighties, and he wanted to learn how to use his iPhone. We don’t put an age limit on it, if you have goals that you want to accomplish, you can come.

Mohamed: So how has the pandemic affected you? I know you said you were shut down, but were you able to get online and able to help people virtually, or are you starting to reopen now?

Kim Ladd: On March 16th, 2020, we were shut down, we had to close the school, and all the students had to go home, and we had to work from home. So, that was an adjustment. Some people didn’t have laptops. But I must say within three days, we had developed a virtual training program. We ended up having all our instructors brainstorming a virtual training session overnight, and we scheduled classes. But there were also some other challenges. 

First, we had to learn Zoom And then we had a lot of students that did not have the skills to get on Zoom. So, we had to execute phone calls and training sessions to learn phone and computer functionalities of Zoom. We essentially changed our training overnight. The good thing was we got proficient at it, and we had a full schedule, and word got out and we had people from all over the world that would tune in to our virtual trainings. It was kind of cool. We averaged I think 50 people per class, some of them might’ve had 30 while some of them had maybe 150, depending on the topic. We had a lot of outreach that way and people are still asking us, “when are you going to do them again?” We did that from March of last year to June and then we did the summer program virtually with the kids last summer with kind of the same concept. 

In September 2020, we were able to re-open to in-person with restrictions; we could only take half our capacity, about 15 students. It was a lot of logistics and then we stayed open for in-person training until Thanksgiving. We were shut down again, but it was a seamless process that time. We opened back up in March this year and we’ve been in-person since then. The LIFE program and the adult program are both in-person this year. We’ll see how long we make it this year, but we’re ready. 

Mohamed: Do you expect to continue some of those virtual classes since so many people were excited for them?

Kim Ladd: Yes, we want to. The LIFE Program is kind of all-consuming because it’s a bunch of teenagers and they’re here 24/7, and there are a lot of moving parts. During the summer we kind of can’t do anything but the Life Program. We want to do virtual training though. Our goal really is to serve the people of Virginia, but I’ve had a lot of people want us to do stuff for their agency out of state. Unfortunately, we can’t do that all the time because our priority is Virginia citizens. But yes, long story short, we want to bring those back because they were so popular, and they help a lot of people. I’ve had people who found me on YouTube from some video I did at a virtual training. I had a person call me from Wisconsin. His mom went on a continuous glucose monitor and he said, “I saw you on YouTube” and I was like what are you talking about? So, I Googled myself on YouTube and there I was, I was like, wow! I did not know that somebody had put it on YouTube. Then, I’ll get these calls from different places, people who have questions about diabetes management and the blind. We love doing that stuff and we always tell people to call us. 

Mohamed: What makes you proud to be working for this organization?

Kim Ladd: I don’t even know where to begin. It’s very rewarding. As I said, you put all your energy into helping people, and you see positive results. As a nurse, I would get you and you were sick, and most of the time I never knew the result. In-home care, I did, but it wasn’t always a positive result. Here, there are some negatives, but overall, it’s such a positive result. And to see that change in people, I can’t tell you how many people we’ve had leave better than they came in. One person who came to the center was older when she lost her vision due to a rare disorder. She didn’t want to come to training, she wouldn’t leave the house. She said she couldn’t do anything because she couldn’t see anything. Her family dropped her off at the center and said, “you’re going to training.” So, she begrudgingly came. She was angry when she first got here because she did not want to accept her blindness. She ended up being here a long time because she wasn’t reaching her goals. I mean, she was making progress, but it wasn’t complete. Usually, somebody is here maybe six to nine months, she was here about a year. But if you take a video of her on her first day and her last day, she’s a completely different person. So now she is living on her own in an apartment, she works from home at a part-time job, she’s in consumer groups for the community, and she goes wherever she wants to go, and does whatever she wants to do.

There’s nothing better than that. You are helping people live their best life, and that is the most amazing thing in the world. If I’m in a bad mood, when I come to work, I’m like, “really? what am I complaining about?” I mean, look at these people trying their hardest to improve themselves, and I’m complaining about something, like “I spilled coffee on my shirt.” You know what I mean? It’s like the everyday hassles means absolutely nothing in the grand scheme of things.

Seeing the improvement in people, it might not be that they gained a job, but maybe they’ve accepted their blindness. For example, we had one lady who wouldn’t go downstairs for a year and a half. So basically, she lived on her top floor and a family member would have to bring her everything. She spent a week with us at a senior program and now she’s “moving and grooving”. She’s coming for the full program in the fall, it just built up her confidence. 

A lot of times people think they’re the only ones going through what they’re going through and they’ll meet people here that might have a similar experience. I can say that I understand blindness because I work in it, but I don’t really understand it because I have vision. I mean, I have diabetes, I could lose my blindness from diabetes. So, I’m preparing myself. But, if I go blind, I’m going to be a diva! It doesn’t scare me anymore. It used to scare me when I wasn’t familiar with blindness. Like if I lost my vision, I would have been devastated. But now being in a place where most of the workers here are blind and I’m one of the few that has vision, I forget that they don’t have vision because we’re all just people and we’re all doing the same thing. I run into the wall more than they do because I’m clumsy. It’s like they use their cane, and they know where they’re going and I’m just talking, and I’m not paying attention and run into stuff. So, I mean it’s just a really uplifting environment. I could go on and on, but simply, we make an impact. We have wonderful teamwork here. We all have the same mission and vision and I mean, there are bad days; there are people that don’t want to be here, and they leave. And they’re just not ready to accept it yet, but they eventually ended up coming back around, you know?

Thank you, Kim! Thank you for your dedication to the blind community and for sharing your story with me. 

To learn more about Kim, and her work with the Virginia Department for the Blind and Visually Impaired, please visit: https://vrcbvi.org/

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