How to help someone with poor eyesight

Elderly care is a complex responsibility for adult caregivers due to various age-related comorbidities. Effects of vision loss is the most common ailment affecting seniors, compounded by diminished mobility, cognitive ability and often social neglect. Elderly people suffer falls due to low vision when they are not able to view household items that may cause them to trip over electric cables, loose carpeting, pets, stairs, furniture and even slippery floors.

Supportive care for the elderly is important to prevent severe injuries such as head trauma, hip fractures, spine injuries and even fires from damage or neglect of home appliances. In this article we will discuss practical tips for helping visually impaired seniors.

Dangers of Vision Loss in the Elderly

Falls are very common in seniors due to increased muscle weakness as a result of age-related sedentary lifestyles in combination with reduced vision. Falls can have a wide variety of consequences, inflicting injuries such as fractures and broken bones as well as in some cases resulting in death.

Low vision can increase the chances of falling as disturbed visual acuity not only reduces the seniors’ ability to perceive anything which may be hazardous or a potential obstacle but it also reduces their ability to detect a change in the terrain as easily.

As humans age, their peripheral vision also begins to decrease incrementally. This can negatively affect their field of vision and increase the chance of a senior falling. Furthermore, low vision can also help to increase the chance of a senior falling as both the proprioceptive and vestibular system work together in order to maintain balance.

What are the Common Causes of Vision Loss in the Elderly?

The eyes help the other bodily systems to self regulate and provides information about the surroundings which are used to govern movement, gauge obstacles and aid with depth perception. Therefore in individuals’ with low vision, less or incorrect information may be provided, increasing the chance of a misstep occurring and the senior falling over.

Whilst the eyes are complex key organs, low vision is common in seniors due to damage to the key structures within the eye which results in visual impairment. As individuals age, there is a decrease in muscular strength which can have an effect on the pupils.

Pupils help to control the amount of light that can enter the eyes however lowered muscular strength reduces the ability of the pupil to change in response to shifting lighting, which can cause visual disturbances. Additionally, medical issues such as stroke have a higher likelihood with increased age and this can also impact an individual’s vision due to cellular damage.

GLAUCOMA

There are a wide variety of causes for vision loss over an individual’s lifespan. These reasons may range from glaucoma, which refers to a group of eye-related diseases that can affect the optic nerve which is essential for sight as it helps to convey visual information and refractive errors which describes a problem with an individual’s physiological ability to accurately focus light on the retina due to the shape of the eye.

CATARACTS

One of the most common causes of low vision is cataracts. Cataracts describe the appearance of a cloudy area in the lens of the eye. This cloudiness can make it difficult to see and can potentially develop in both eyes. The severity of the cataract formation can be ascertained by an Optometrist using a visual acuity test to evaluate the function and investigate the extent of the damage.

DIABETIC RETINOPATHY

Other visual problems which can result in affected vision in seniors include diabetic retinopathy which is a disorder where damage to the Retina occurs as a result of Diabetes Mellitus, age-related macular degeneration which can also be known as macular degeneration and is a disorder that can cause blurred or no vision in the centre of the visual field. Corneal clouding is another factor that can cause low vision due to a loss of the transparency of the cornea which is responsible for focusing light.

MEDICATION SIDE EFFECTS THAT CAUSE VISION LOSS

The key responsibility of elderly care is maintaining a strict medication regimen for the myriad of complex chronic illnesses that most seniors have. Drug compliance is needed to help manage blood glucose, lipid balance, blood pressure and other health ailments. However over time such drugs may accumulate in various organs or directly affect the eyes, nerves and even visual centers of the brain.

Common side effects of such medications often include double vision, night blindness, development of cataracts, nerve damage, drowsiness, loss of ability to perceive the 3-D distance of objects) and even short term memory loss such that one may forget to put on their spectacles when moving around.

Caregivers need to be vigilant about the precise drug regimen and their unintentional side effects of vision loss in the elderly.

How to Help Seniors with Poor Eyesight

REGULAR HEALTH CHECKUPS

One of the most important ways to help visually impaired seniors is to make sure that their vision is regularly being checked up on and they periodically get their eyes tested. This is helpful not only with helping to maintain their quality of sight but additionally to make sure that any sudden drastic changes or reductions in vision are dealt with as soon as possible.

MEDICATIONS

There is a range of experimental medications that has shown great potential in improving certain degrees of vision loss in the elderly. Anti-VEGF (vascular endothelial growth factors) are a newly discovered class of pharmaceuticals that function to prevent the abnormal growth of blood vessels in areas of the eye which do not normally need extra blood supply, such as the cornea and retina. Cataract dissolving eye drops are another group of drugs that can revolutionise vision correction for the elderly.

The most effective pharmaceutical intervention would be to prevent the onset of the various chronic diseases that damage multiple organs – especially heart disease and diabetes. Medications that can effectively improve blood glucose and blood pressure can decrease the onset of vision loss, along with damage to other organs.

WATCH FOR SIGNS OF A SEVERE MEDICAL ILLNESS

Significant rapid reduction in vision can be a sign of a more serious problem such as specific types of glaucoma or a haemorrhage. It is key to keep track of symptoms such as if the senior is knocking over or bumping into objects more frequently or on accident, difficulty seeing something near to them and having to squint or orient their head in order to see better, if they have increased difficulty in walking or they are falling over more frequently, missing items when going to reach for them or a reduction in participation of vision requiring activities such as drawing, reading or watching videos or movies.

MORAL SUPPORT

It is also important to provide seniors who may be experiencing loss of vision a great deal of moral support. This is a key part of elderly care as losing vision can not only impact an individual’s autonomy and ability to carry out tasks unaided, but it may also drastically change their lifestyle and they may not be able to enjoy activities they may have previously partaken in such as cooking and cleaning up by themselves.

Providing moral support can help to reduce some of the negative emotions the individual may be feeling as well as helping to support their mental health and reduce the chances of them developing depression due to the significant changes.

SAFE HOME ARRANGEMENT

It is also important to make sure that the individual’s living space is well organized and easily navigable for them unaided. Additionally, using contrasting colours can help seniors to navigate their surroundings more efficiently as it can not only help objects to be more identifiable from other objects it can also stop smaller objects from blending into their surroundings and becoming lost or a trip hazard.

It is also important to ensure that there is a bar available next to any stairs they may have to use, in order to ensure that they can have additional support when moving around as well as a bar and/or non-slip math in the bathroom in order to help them maintain their hygiene with greater ease as well as reducing the risk of falling due to side effects of some medications that they may be one, especially drowsiness and double vision.

Bathroom floors should have anti-slip covering to absorb any spilled water and act as a cushion in the event of a fall. Bathtubs are a common place for falls when people misjudge the location of a handle or fail to grip onto a railing.

Increasing the lighting in their homes is a practical cost-effective method to aid the elderly in gaining some form of independence whilst waiting for vision-correcting procedures eg. cataract surgery, corrective prescription spectacle to be delivered or retinal surgeries.

MAINTAIN PHYSICAL ACTIVITY

Elderly people have sedentary lifestyles due to joint pains, muscle mass atrophy, poor nutrition and the effects of underlying health issues. Oftentimes a moderate and regular increase in physical activity can aid in improving reflexes and maintain the spatial memory of their living space. Even with poor vision, people may reflect on their memory of where a bedside table or a chair is kept to help in moving around safely.

Home assisted physiotherapy is not only essential for wellbeing, but to help acclimate their spatial abilities as their vision decreases over time. Even after corrective procedures are undertaken, an alteration of visual acuity takes time to adapt, hence the need for guided physical activity to help with vision correction.

DIGITAL HEALTH DEVICES

There are many digital health innovations in the form of remote patient monitoring (RPM) made to aid in effective home elderly care such as:

• Fall detection monitors
• Motion detection light sensors
• AR/VR vision aides
• There is ongoing research in the field of bionic eye transplants as well

CONCLUSION

 

Caregivers need to be proactive in finding practical tips for helping visually impaired seniors. Supportive care for the elderly requires a holistic approach with experienced specialised care professionals ranging from internal medicine (geriatrics), ophthalmologists, physiotherapists, pharmacologists, nursing support, dieticians and specialized home care services who can teach elderly caregivers about safe home design.

A comprehensive elderly care plan needs to raise awareness and provide adequate training to caregivers on practical tips to maintain nutrition, affordable physical support structures in the home, medication compliance and other methods; in preventing accidents in seniors with poor vision.

Bonus advice from our Resident Ophthalmology Specialist – Dr. Saad Sheikh, MD

“I would also recommend that homes and areas be well lit. Falls can also happen when the elderly visit new places or relatives homes and host need to be prepared for such visits – also avoiding stairs especially in new places, for instance in the dark when an elderly person may be going to the bathroom or looking for food, may be helpful.”

 

Dr. Saad Shaikh
Retinal Specialist & Consultant Ophthalmologist