Caregiving Tips for Patients with Vision Loss
Most older adults experience some form of vision loss as a result of normal aging. Nearly one-third of people with vision loss are older adults. While some vision loss is a part of normal aging, other times it is from a medical condition.
Changes in vision can have a significant impact on your patient’s lives, sometimes causing a significant loss of independence. Not being able to dial a telephone or read directions on a medication bottle, for example, can cause an elderly person to require assistance in their daily living, while being otherwise healthy.
Normal Age-related Vision Loss
Normal aging can cause a few changes in your elderly patient’s vision. The pupil of an older person takes longer to dilate and contract, affecting the person’s ability to adjust to glare, bright lights, and changes in lighting. This means that your elderly patient may have difficulty seeing when they come in from outside and may take longer to adjust to the dark when lights are turned off.
As they age, and elderly person’s eyes become less able to focus on closer objects. This can make it more difficult to read signs, menus, or other essential documents. Also, they may not be able to dial a telephone independently or be able to work controls on a hospital bed.
Normal aging also includes a certain amount of loss of peripheral vision. This means that it may stop elderly people from driving a car, further isolating them and forcing them to become dependent on other people to get around. It also means that they may not be able to see you as you approach from the side.
Older adults also have more difficulty seeing in the dark and need 2-3 times more light to see clearly compared to younger people. This means that more lights should be left on at night to make sure your elderly patients will not trip and fall when getting up to the bathroom.
Vision Loss from Medical Conditions
Some common medical conditions that can affect vision are cataracts, glaucoma, macular degeneration, and diabetic retinopathy.
Cataracts are a progressive clouding of the lens in the eye and are the leading cause of blindness in the world. This clouding causes a gradual blurring of the vision, almost like looking through a cloudy piece of glass. It also may make bright lights such as sunlight or fluorescent lights seem too bright or glaring.
With glaucoma, the pressures in the eye increase, damaging the optic nerve that carries information from the eye to the brain. This condition causes a permanent loss of peripheral vision and blurred vision.
Macular degeneration is a deterioration of the macula, the small central area of the retina that controls visual acuity (the sharpness of your vision). This condition causes a white-out effect in the central visual field, creating blind spots directly where you are looking. Depending on the type of macular degeneration, vision may deteriorate so much that people become legally blind.
Diabetic retinopathy occurs as a result of poorly controlled diabetes and causes progressive general vision loss. Symptoms include floaters and spots in the visual field, shadows, blurred or distorted vision, and double vision.
Changes in vision affect communication in older adults in many ways. Difficulty seeing can mean they might not be able to read menus or important papers they need to sign. Be sure to read any critical information to patients with vision loss, or have a trusted family member present to read for them. Make sure they are wearing their glasses and offer a magnifying glass when your patients are attempting to read.
With so many people caring for them, your elderly patients who are visually impaired may not be able to identify you by voice alone. Make sure to identify yourself clearly and make your presence known when you enter the room, so you don’t startle them. When assisting with care make sure to explain the purpose of your interaction. Place yourself at the patient’s eye level and speak directly to them using familiar words, gestures, facial expressions and non-threatening touch.
Meals times can be particularly difficult for your patients who are visually impaired. It can be challenging to find food and utensils, and people who are visually impaired are often embarrassed when they spill or make a mess. Make sure to assist your patient with menu choices and make sure to let your patient know what they are eating. When setting up a patient for meals, help the patient locate food and utensils and place items in a familiar location. Try using the face of a clock to describe the location of objects. By helping your patient orient themselves to their environment, you are allowing them to be more independent and feel confident socializing at mealtimes.
Safety is a significant concern for elderly people who are visually impaired. They may not see call bells, light switches, telephone numbers, wheelchair brakes and bed controls. They may stumble and fall in lower light levels when getting up to go to the bathroom. Impaired vision can also be frightening in an unfamiliar environment, affecting their ability to remember where they are.
Elderly people with visual impairment are particularly vulnerable to changes in their environment. When moving items in a patient’s room make sure to put it exactly where you found it, so the patient can locate it after you leave the room. Explain the layout of any new room the patient is entering and demonstrate how to use items such as the call bell and show them where the bathroom is located. Helping your patient to orient themselves in their environment increases independence and self-confidence.
Modifying the environment to increase safety is of utmost importance for elderly patients who are visually impaired. Always provide ample direct lighting and make sure any signs are in large, clear print and are at eye level.
Age-related visual impairment is prevalent in elderly people and can affect your patient’s independence, mood, and self-confidence. Understanding how visual impairment impacts your patient’s ability to care for themselves and interact with their environment will give you great insight into how to provide excellent care.