I have a dear friend who has 90% vision loss and wants to remain independent. I live 2 1/2 hours away. How do I convey the reality of this?

I agree with Geaton. If this man is having hygene problems, it may be laziness or the beginning of dementia. Even depression. He may not be able to live alone. Does he not have family? Maybe you should write a letter to his doctor as a concerned friend telling him what you have witnessed. Going blind later in life has to be hard. Actually, I would be surprised if his eye doctor has not given info on where he can get help.

What are his other problems? Plenty of totally blind people are able to live independently for their whole adult lives, so I'd think it would be more than just loss of vision.

He is not independent, he is simply aging in place at home while other nice people orbit around him. It's such a dichotomy that loneliness is so rampant in the elderly but so many resist going where they will be with others, and many do enjoy (or at least benefit from) it. If your friend is still cognitively able, have you had a conversation with him about his future care? It would be better for him to accept and choose transitioning into a care community and come to peace with it. If he doesn't want to hear any of that, then you should let him know what your care limits are, and pls don't feel guilty over it. People have a long time to come to grips with this eventuality and it's everyone's responsibility. I wish both of you all the best!

In your last post I suggested Office of the Aging. Maybe even Adult Protection services. They may be able to help with resources in his area. There should be a Disabilities Dept in his Counrty. Both O of A and APS can evaluate his situation and go from there.