Care homes need to focus on eye health for residents

Specialist housing and support provider for people with sight loss, Thomas Pocklington Trust, is urging all care homes to place eye health among their key performance indicators.

Having conducted a comprehensive review of sight loss in care homes, in collaboration with the International Longevity Centre, the Trust highlights extensive problems that have resulted from the lack of a national policy on undetected sight loss.

Estimating that around half of care home residents in the UK – 200,000 individuals – have eye health issues, the report ‘Undetected sight loss in care homes’ nevertheless finds that many care teams do not consider this to be a priority issue.

Care training programmes do not always include issues of sight loss and eye health, and old age itself is often blamed for declining vision occurring, while the increasing quantity of residents with dementia means that assessments are more difficult to complete.

Dementia complications

Research undertaken by Strathclyde University offers further insight into why dementia can present barriers to eye health.

Community outreach manager of care signage company , Angela Neal, comments: “Dementia can cause sight related problems which can be a major factor in both diagnosis and care of people with the condition. Inability to recognise familiar objects can be interpreted as either a sight or a mental problem, and it is important that care providers are aware of how to distinguish between the two.

“Our recent research review, conducted on our behalf by Strathclyde University, clearly highlights that health conditions such as Dementia can also cause visual impairment beyond the typical sight loss due to ageing. Visual problems such as depth perception, visual hallucinations and an inability to recognise colour differences can create a steep challenge for carers trying to create a safe and comfortable environment.”

Statistics

Rebecca Sheehy, older people’s impact team manager at the Royal National Institute to the Blind (RNIB), comments: “Almost two million people in the UK are currently living with sight loss. Although it can affect anyone at any time, it becomes increasingly likely as we get older – one in five people aged 75 and over are living with sight loss.”

Home visiting opticians, , echoes these concerns, and founder and managing director, Paul Chapman-Hatchett, comments: “It is worth remembering that 95 per cent of over 65s require a spectacle correction and yet only 35 per cent of this age group have attended to their essential eye examination. As a consequence about 75 per cent of this population are suffering sight loss, which is deemed significant enough to affect their quality of life. Coupled to this, nearly half of us will suffer from cataracts in our lifetime and over 50 per cent of us will have some sight loss due to macular degeneration.”

Emotional benefits

Mr Chapman-Hatchett, who is also a Dementia Champion for Surrey, points out that there are numerous reasons for prioritising eye health, all of which have the potential to impact on the emotional health of each resident.

He continues: “Poor sight is a significant contributor to loss of confidence, which in turn leads to feelings of isolation and depression. Best possible sight enables us to read and view the television, which for individuals who are less mobile, are two of the most important factors in maintaining a feeling of independence and self-worth. Maximising sight also helps to reduce falls, most of which involve a very traumatic experience from which the majority of patients never regain their former mobility and independence.”

As regards residents with memory loss Mr Chapman-Hatchett comments: “People with dementia can often find it difficult to verbalise their loss of sight and are left untreated. There is also a perception that an individual with dementia no longer requires spectacles, yet it is well documented that improving sight helps individuals engage in the world around them, regardless of other health issues they may have.

“With simple and effective treatments for conditions such as cataract and macular degeneration and effective ways of obtaining an accurate prescription for individuals tested in their own homes, irrespective of their cognitive ability, there is no reason why these individuals should not receive regular and comprehensive eye examinations.”

Agreeing with the Trust, Complete Community Care calls for better awareness and education as to how carers can help residents maximise their quality of life in spite of eye health issues, while supporting more openness on the opportunities that exist to help them.

Regular examinations

RNIB’s Rebecca Sheehy recommends: “People over 60 should have a full eye examination once every two years and once every year after the age of 70. Early identification and treatment may be crucial to avoiding unnecessary sight loss. Older people may also have other conditions that may mask the symptoms of sight loss, such as stroke or dementia.”

The RNIB also offers a checklist so carers can look out for sight functions that individuals find difficult: these include recognising people, difficulty in bright and/or low light, finding things, locating food on a plate, and problems using their current glasses.

City University in London recently carried out a study funded by Thomas Pocklington Trust to test the value of ‘ambassadors’ delivering sight loss training directly to care home staff. A short interactive workshop was developed to improve awareness among care home staff, increase their understanding of the importance of good vision and help them recognise and react to common eye problems, for example by making small changes in care practice or arranging a specialist eye test.

The workshops were a success and the Pocklington Trust is now exploring who should take on the role of ‘ambassadors’ and also the idea of having a ‘vision champion’ in care homes.

A new leaflet ‘Sight tests at Home’ is also available here www.pocklington-trust.org.uk and care professionals can source more information by visiting www.rnib.org.uk/olderpeople