Archive for the ‘Vision Problems’ Category

Posted on May 29, 2009 - by Nurse Virginia

Caregiver Tips: Helping your elder with Aging Vision and Alzheimer’s disease. (Part Three)

Aging vision needs much more light:

“Why are you turning the lights on already” Carl’s wife asked. “Oh, it’s going to get dark soon” He replied. This from the man who went behind her for years turning off lights when she just stepped out of a room for a minute. He wasn’t even aware of his vision problems, but he needed three times more light now than she did.

Natural sun light is always the best source of light for aging vision problems. Carl had always enjoyed wood carving, and could now be found carving in the most unusual places around the house “following the sun.” Just like a household pet that lies in the sun during the day and repositions as the sun moves through the home, Carl now follows the sun through the day.

6 Ways to help persons with diminished vision:

• Do as many errands as possible during the daylight hours.
• When you go from bright light to lower light it takes awhile for older eyes to adjust – grab a grocery cart outside the store so the elder has something to hold onto when they go from one level of light to another.
• In the home use bright lighting that reflects off of ceiling and walls to reduce shadows and dark spots.
• Be aware of providing contrasts in colors to help the elder see – white foods like mashed potatoes, cauliflower and fish on a white plate, placed on a white table cloth is a much harder meal to see than the same meal on a red plate.
• A home with a color on the windows and doorways that contrasts from the color of the walls makes it much easier for the confused person with vision loss to understand their environment.
• Avoid patterns on upholstered furniture; it’s much easier to see a solid colored piece of furniture on different colored flooring.

If the elder had a disease process that warrants the use of a white cane (see part two). The elder with Alzheimer’s disease may not be able to learn the correct use of a white cane, the sweep of the environment as they walk. But the cane can be a good visual when in public, to identify the elder as someone with decreased safety awareness and thereby increase courtesy and understanding from strangers.

A great source for information is the American Foundation for the Blind at: www.afb.org

Posted on May 22, 2009 - by Nurse Virginia

Caregiver Tips: Aging Vision, do you know what your elder with Alzheimer’s disease sees? (Part Two)

 

When you elder is confused poor vision may increase confusion.

A person with Alzheimer’s disease or another dementia will be much more confused, if they cannot see. Caregivers often take for granted being able to see what or who is around them and what is going on. But if you don’t know what your elder is seeing you are, and they are at a huge disadvantage. The person will either withdraw or behaviors will escalate.

Diseases of the eye; cataracts, glaucoma and macular degeneration are usually not painful and come on slowly. Picture walking around all day with heavy Vaseline smeared on one lens of your glasses and trying to see through that cloudy mess. That is what it is like seeing through a cataract. Add a yellow film to the lens and that is what the eye of an elderly person might look like. Add confusion to that frustration of not seeing clearly and you can have a pretty unhappy elder.

Normal aging changes of the eyes:

• clouding of vision in one or both eyes
• blurring vision in the center of the eye
• problems with focusing
• problems with night vision and the glare of headlights

Make sure when it starts to get dark you turn on adequate lighting. Make sure the elder is wearing their glasses and that they are clean. Make use of products for the elderly with vision loss.

• clocks with large numbers
• books with large print
• telephone with large numbers
• playing cards, board games with large print
• puzzles with large pieces

Regular eye exams are so important. Call the eye doctor’s office and explain that the person is elderly and what kind of dementia they have. Ask if the doctor has experience with patients with dementia. Have a clear understanding when you talk to the doctor of what the elder can see and where there may be problems with their vision.

Posted on May 22, 2009 - by Nurse Virginia

Caregiver Tips: Aging Vision, when there is a problem – looking beyond the Alzheimer’s disease. (part one)

Blaming the memory loss.

“I can’t help it, she just keeps walking away from her walker,” the caregiver said to the nurse.

She was Edna a small, 82 year old white haired woman with Alzheimer’s disease. We had tried everything – putting her name on the walker, tying ribbons to the walker, telling her all day long “Edna, don’t forget your walker.” Sometimes she remembered it, sometimes she didn’t.

We attributed all of the time she was “forgetting” to her Alzheimer’s disease. It wasn’t until the staff noticed Edna eating with her fingers, and only the food on the left side of her plate, that we became aware that something else was going on.

Sometimes the problem is aging vision as well as confusion.

The answer was there all along in her chart under the “consult” tab. Edna had been seen by her eye doctor and had Hemiopia a condition where:

• Both eyes are affected and you can see only on the right side or left side.
• One eye is affected and you can see only on the right or left with that eye
• Your vision is affected horizontally and you can only see on the top of the vision field or bottom.

Edna couldn’t see on the right side of either eye. So when utensils were put on the table on her right side she didn’t see them and she ate with her hands. Edna couldn’t see the food on the right side of the plate so she didn’t eat it. Edna didn’t see her walker when it was put on the right side of her and so she just walked away from it.

Letting the staff Get to Know Edna, changed life for her. Instead of constant reminders, that she couldn’t understand or remember the staff were now using cues to make her life easier. Now White Ribbons were hanging from the right side of the walker and they weren’t for Edna anymore, they were there to remind the staff, which side Edna couldn’t see from. Now when Edna stood up and her walker was where she could see it, on her left side, she no longer “forgot” it.

Sometimes getting to really know the elder you care for, is as simple as knowing what the doctor said.