Sight is precious

Jim took a lot of falls in 2012. His eyesight, dementia and arthritis were all conspiring against him. He’d wake up in the morning, forget he could not walk and think the lights had all been turned off.

We are introduced to Jim in a video produced by scie, dealing with sensory loss (see link below). The staff in the Cumbrian care home where he lives have had to learn to be very patient, and use concise, effective communication.  They try to communicate with Jim in a quiet area, so background noise doesn’t distract and confuse him.

It seems nothing can be done about Jim’s blindness, but that is not the case for many of those living in care homes and trying to cope with impaired vision. Whilst many homes diligently arrange sight tests for their residents, there are probably many more that do not see the need.

There is generally thought to be a correlation between dementia and sight loss, so a certain shrugging of the shoulders is inevitable, but dementia is already confusing enough for the person living with it so if there is anything that can be done to help them maintain senses like eyesight and hearing, it should be done.  Regular sight tests are important – it is possible to have an eye examination at nearly all stages of dementia  – to diagnose cataracts, check prescriptions are up to date and to assess for other conditions, treatable or otherwise.

Even if nothing can be done to improve a person’s sight, it is important to assess the quality of their vision so that carers can take it into account in their behaviour towards and around that person.

Yet, in a survey in 2014 the College of Optometrists asked their members how frequently they carried out domiciliary eye examinations in people’s homes or care homes.  Just 10% said they did so regularly in people’s homes and this dropped further to 6% for regular care home visits.

Such low numbers are not down to cost. If you are over 60, or over 40 with a close relative who has been given a diagnosis of glaucoma you are entitled to free eye examinations (in Scotland they are free for everyone). And for those unable to visit an optician unaccompanied due to physical or mental disability they are entitled to a free eye test at home.

So why are the numbers so low? First of all, there is undoubtedly a sense that ‘it’s just the dementia’. What’s the point in finding out about a person’s eyesight because it’ll make no difference? Those with that opinion should read the story of how the life of Suzy Webster’s Mum has been transformed (and how a potentially traumatic experience can be made so much more pleasant by involving the family) – see link below.

Research done by the College of Optometrists suggests that it is often the families who are not convinced of the benefits of an intervention, and there is plenty of anecdotal evidence to suggest that many professionals feel the same.

This is borne out by Thomas Pocklington Trust’s report (link below) quoting the RNIB who estimate that over half of older residents in care homes have some form of sight losss, yet care home residents’ co-morbidities mean that eye care interventions are overlooked or thought unnecessary.

What’s to be done?

As with so much in this world it comes back to communication. Bust those myths about it making no difference. Make it known that everyone in a care home is entitled to a free NHS eye test at least every two years. Build awareness about the importance of regular eye tests and the difference it can make to the individual’s quality of life where improvements to their sight can be made. As Suzy Webster says of her Mum after her cataract operation: “She’s a different person. She’s really got her spark back… she’s walking steadier, her mood is happier and she’s interacting with us all better.”

A look into the future

Simply slip a small device over the in-built camera on your smartphone. Turn on the Peek app, hold the phone close to someone’s eye, click and forward the picture to a trained eye care specialist.  This is the technology of the future to detect signs of glaucoma, macular degeneration, cataracts and other issues like high blood pressure. Social enterprise Peekvision claim that 80% of blindness is avoidable, and tools like theirs can replace an eye exam at a fraction of the cost. They should be shipping in early 2016 and expect it to be transforming lives in remote corners of the world… there’s a few lives waiting to be transformed right here on their doorstep. http://www.peekvision.org/

Photo by sk on Unsplash

Resources

Scie has a section on Dementia and sensory loss in their Dementia Gateway

The Age Page: Interview with Suzy Webster

Thomas Pocklington Trust: Undetected sight loss in care home

Vision2020 The Right to Sight UK (Dementia and Sight Loss Interest Group) working to increase the knowledge and information available for people living with dementia and sight loss has a useful  factsheet

Thomas Pocklington Trust: Design for Dementia and Sight Loss

The College of Optometrists’ Guidance for Professional Practice has a section ‘Examining patients with dementia or other acquired cognitive impairment’.

 

 

 

Making time to share stories

Read our exclusive interview with George Coxon – Director/Owner of Classic Care Homes Ltd and Chair of the Mental Health Nursing Association (MHNA).

Here at Care Charts UK, we are always interested in hearing about new initiatives that are helping people who are living with dementia and as such, we were delighted to find out more about a new initiative set up by George Coxon. As George explains;

“We are part of the social care world where, if we live long enough, we will be the beneficiaries of entertaining, stimulating, fun and safe 24/7 care. Our lives remain important no matter what our age or circumstances and our precious moments must be shared – it’s these moments that make us who we are.”

We recently interviewed George about this initiative; ‘10-in-10’ and how it’s already proving very successful in enhancing people’s lives.

10-in-10 is a new initiative. What exactly does it involve?

There are multiple jobs to be done by anyone working in a care home, so time is of the essence. It’s extremely important in such a busy environment to add value to the lives of our residents. Keeping them safe is obviously of the upmost importance, but it’s also vital to ensure that they have a meaningful life and to do that, it’s essential that we know well (and are known well by) those we look after. The project draws on work done by the Alzheimer’s Society in their ‘This is Me’ initiative and by you with your Remember-I’m-Me Care Charts but builds upon them further to create an ongoing series of conversations between staff and residents.

The concept is quite simple – both parties share 10 year periods of their respective lives in just 10 minutes. This makes it fun, focused and perfect for maximising time-limited situations, while capturing things we didn’t previously know about each other from the key periods of our lives, like the schools we went to, the dreams we had when we were very young, our early life friends and our favourite toys or holidays.

What was the key thinking behind the 10-in-10 initiative?

The 10-in-10 project enables us to get to know those staying with us in a focused way and in just a short period of time. It enables us to learn more about each other and ensure that we have some good-humoured, quality time. By breaking it into manageable modules we can quickly learn about  each other, capturing themes and past life moments that can then be used to assist in some of the many and varied events, occasions and celebrations  we have at Pottles Court. The initiative is highly focused on making the lives of those staying with us better, but it’s also a fun way for our staff to get to learn more about them too.

What makes this initiative different or unique?

The initiative itself is an adaptation of other ideas that I’m sure have been trialled, but by branding it with a quirky headline it achieves more focus. 10-in-10 requires a two-way exchange based on shared lives, which we believe is more beneficial than the tendency to only have a one-way dialogue. The outcomes will be part of the work we are doing with our local research colleagues and the embedding of what we describe as ‘discovery conversations’ in our care plan compilation creates an active and ‘live’ part of the life stories and life history work often seen in care homes

What has been the greatest revelation from the 10-in-10 sessions you have held?

It’s still quite early days for the initiative but we have already seen some really useful learning taking place. It’s been really powerful to hear the detail of recollections from the first 10 years of residents’ lives and this has enabled staff to get a greater sense of who they are as a person and who they were when they were in their prime. Sadly these realities are often not acknowledged in later life when we become more dependent and less able to convey the confidence and spontaneity we enjoyed in our youth. Another really useful benefit has been witnessing the levels of ability people have to articulate their stories revealing verbal skills and recall capacity that might not have appeared as apparently previously. We have been very sensitive of course in not pressuring people to remember distant memories and as expected, some do very well while others struggle a little – this is a useful part of the ongoing assessment of not just those with cognitive impairment and dementia, but also those with normal memory decline associated with growing older.

Has the initiative been easy to implement?

It’s been very easy – as with all things in life, making time is the biggest challenge so having an in-house initiative that is popular with and talked about by staff, and that forms part of supervisions has given it real status in the home.  It’s about hearts and minds, enthusiasm and embedding ideas as part of a home culture – leadership and followership as we like to see it. Ideas are for success and trying things like the ‘shared lives 10-in-10’ project is but one of many of our projects and initiatives.

To find out more about the 10-in-10 initiative, or to read about the other projects undertaken by Pottles Court, please visit http://www.pottles.co.uk or check out their blog.

 

Spread the cost of your care charts

There are hundreds of care homes who have been using their Care Charts for over three years now, and we frequently get feedback as to what good value for money they offer.

Nevertheless, we understand the constraints cashflow can impose, and we’d like to do what we can to help you incorporate Care Charts into the daily life of your organisation.

So we are delighted to offer you the opportunity to spread your payment over up to 6 months*. Your payment schedule can be set up in a matter of minutes; just email us to say what you’d like to order and over how many months, or call us on 01403 210485 to chat it through if you prefer. It won’t cost you a penny more and you can delight your staff, inspectors, residents and their families with this care-enhancing device, whilst minimising the impact on your cashflow.

*Min: £100 Max: £1,000 Max timescale: 6 months