Eye care Are your residents getting

the eye care they need? Jessica Watson and Sally-Marie Bamford, of the International Longevity Centre-UK look at sight problems in care homes, some of the options available to support residents and what care home staff and managers can do.

T

he treatment of older people in care homes has been subject to a high degree of media scrutiny. The extreme cases of abuse that are hitting the headlines are quite rare, yet there are often concealed forms of disadvantage and discrimination older people face which are not as widely reported.

In a recent evidence review of undetected sight problems in care home residents, independent think tank, the International Longevity Centre – UK found that there are large numbers of care home residents experiencing problems with their sight. According to estimates, up to three in four of care home residents could have a treatable sight problem, with RNIB fi gures suggesting that at least half of residents experience some form of sight problem. Low levels of awareness of the issue among older people and their families as well as among care home staff further contribute to low levels of detection and support. The good news is a little more knowledge could see a large part of this problem rectifi ed. Falls are just one area where what seems like a small change to someone’s sight can have a big impact in terms of risk reduction. The medical cost of falls which are a direct result of sight problems has been estimated at £128 million. By identifying sight problems and helping residents to improve their vision or manage their visual impairment, this high risk of falling can be reduced, and these costs can be brought down. Residents’ happiness and wellbeing can also be affected by poor sight – visual impairment has been linked to higher rates of depression. A

contributor to the research reported: “In one of the care homes I visit, staff had assumed that one particular lady didn’t like to read – until she was given the right prescription in her glasses. Then she was reading all the time!” Anecdotal evidence gathered through the review also found that some staff reported less challenging behaviour from residents with dementia after a visual problem was corrected.

Ensuring better sight for residents can be achieved by making sure that staff are supported both in recognising the signs of sight loss, and are confi dent in raising the issue so that a formal sight test can be carried out and appropriate action taken.

Sight problems can develop very slowly, meaning that residents may not notice that their sight is getting worse. For residents with communication diffi culties, particularly those with dementia, trying to explain what is wrong can be problematic. Furthermore some of the patterns of behaviour exhibited by a person with sight problems can also be easily confused with dementia behaviours. Many changes to support visual impairment are very simple, do not require a lot of resources and are cheap or free to implement. For example, using contrasting colours for placemats and plates can make meal times much easier for people who are struggling with sight problems. Thomas Pocklington Trust has a number of guides available on their website to help improve the care home environment and make it more manageable for residents with sight loss or visual impairment.

22 Care Home Management | March/April 2013 Jessica Sally

These changes can have a dramatic impact on a resident’s life. The fi rst step to making these adjustments is to raise awareness of how common sight problems are for residents, for staff, families and residents themselves, helping to identify issues and ultimately transforming lives and ensuring high quality service delivery.

What can care home managers and staff do?

Make sure your residents are up to date on their sight tests. The current guidelines recommend a minimum of one sight test a year for people aged over 70, and one every two years for people under 70 (although there are some exceptions)

Ask about training for staff; some optometrists that do testing in care homes also offer training programmes for care staff. Look into changes that might be made around the home– for example lighting changes (see Thomas Pocklington Trust’s Frequently Asked Questions about lighting for older people and people with sight loss http://www.pocklington-trust.org.uk/ research/lighting/lighting_faqs)

The report ‘Undetected sight loss in care homes: an evidence review’ was supported by Thomas Pocklington Trust and is available as a free

download from the International Longevity Centre – UK website www.ilcuk.org. uk