by Michelle Cone, Senior Vice President of Training and Brand Programs at HomeWell Franchising Inc.®
Originally published by HomeCare Magazine. HomeCare® covers the HME/DME provider, home health agency and caregiver markets.
A 2016 study in JAMA Ophthalmology projects that the number of blind and visually impaired Americans will double by 2050. The reason behind this spike? For homecare providers, the answer should come as no surprise—age.
Aging is the greatest contributing factor to low vision disorders, with more than 12 million Americans aged 40 and older experiencing some level of vision impairment. At the rate the senior population is increasing, providers are facing the largest number of vision-impaired clients they have ever experienced.
For homecare providers, these predictions illuminate a compelling need and an opportunity: Older adults with vision loss need specialty care support developed explicitly to address the challenges associated with low vision. By tailoring services to clients living with low vision, providers nationwide can empower vision-impaired seniors in their communities to thrive at home and enjoy the liberties of aging in place. Simultaneously, they solidify their roles within the care continuum by helping reduce hospital readmission rates.
A More Mindful Approach
The likelihood of needing to provide care to low-vision clients is already high, as many seniors experience some degree of vision impairment. There are even estimates that one in three individuals has some form of vision-reducing eye disease by age 65. Hence, initial client home assessments typically account for potential hazards or obstructions in the hallways and other high-traffic areas of the home to prevent falls for vision-impaired clients. So, why should in-home care and home medical equipment providers develop a program specifically for low vision?
Brand programs thrive on specificity, and a well-executed low-vision program is no exception, as it can enhance the appeal of your care to potential clients and their families. This begs the question: What particular needs should a low-vision program address?
Falls pose a serious threat to the well-being and independence of older adults, as one slip can result in a severe injury and a trip to the emergency room. Each year, one in four Americans age 65 and older experiences a fall, and impaired vision more than doubles this fall risk.
For seniors struggling to see, the repercussions of a potential fall can cause a paralyzing fear and withdrawal from performing everyday tasks or their favorite hobbies. A study published in the journal “Investigative Ophthalmology and Visual Science” found that 40% to 50% of older adults with chronic eye disorders limited their activities because they feared falling, putting them at greater risk for social isolation, immobility and disability.
Vision impairment and fall risk go together, as the latter is often a direct result of low vision, but both require individual attention. Fortunately, by properly equipping a home for low-vision clients, organizations can address potential hazards in each client’s residence to prevent falls and preserve their confidence and health.
A 2020 study from the National Library of Medicine found that up to 8.6% of older adults with vision loss met the criteria for a depressive disorder. Between 10.9% and 43% reported clinically significant levels of depressive symptoms, both noticeably higher percentages than those found in the general aging population. The same study revealed that seniors with vision impairment exhibited more anxiety symptoms than those with other health conditions such as diabetes or cardiovascular problems.
Because vision loss is usually gradual, seniors and their loved ones may not be aware of how compromised their vision has become, posing a greater risk to their safety. Simply locating items around the house or enjoying activities such as gardening or cooking can become dangerous for certain older adults and consequently hinder their enjoyment and independence in living at home.
A Need for Color and Contrast in the Home
Marking areas of the home using a bright array of colors and contrasting light against dark elements can help clients navigate their homes and distinguish between household items, such as a favorite chair, and medical items, such as prescription bottles.
Color: Bright colors that reflect light are generally the easiest to see, especially vivid primary colors such as red, orange and yellow. Bright contrast tape, stickers or sticky notes in fluorescent colors can be used to mark changes in levels like stairs, identify household items like documents or bills, and warn clients of potential hazards such as doors or cabinets left ajar. Bright decorative elements like vibrant throw pillows, blankets or magnets can assist clients in locating furniture or appliances in their homes. Grab bars that are available in bright colors would also be useful to low-vision customers.
Contrast: Enhancing the contrast of light against dark or vice versa in clients’ homes has proven beneficial. Consider creating contrasting backgrounds, such as a dark switch plate behind a light-colored switch, or placing dark objects against lighter backgrounds. For example, a pale green chair can easily disappear in front of a yellow wall. Incorporating a dark blue throw blanket or slipcover can help clients identify this furniture against the yellow wall. Updating paint colors to provide more contrast is also an option, if the senior approves.
It is equally important to avoid or remove items that are transparent or too easily blend in with their surroundings, like glass items. In addition, try to avoid using patterned materials when possible, as contrasting is most effective using solid colors. This is something to keep in mind as a provider of lift chairs or other home furnishings.
Low Vision Tasks and Errands
Household tasks and certain errands, such as shopping or traveling to and from appointments, can be dangerous for low-vision clients to perform. Depending on the degree of their visual impairment, a caregiver may need to complete certain tasks or assist the client by performing any duties or steps requiring keen eyesight. These tasks can include meal preparation, laundry and light housekeeping.
While these services may fall under the category of general homecare, including and promoting them in your low-vision program helps ensure clients and their families that your caregivers and care managers are mindful of any potential needs resulting from vision impairment.
Regular eye exams are also critical to seniors since age-related macular degeneration is the leading cause of vision loss for individuals aged 50 or older. As seniors age, their risk or degree of vision impairment increases. The National Eye Institute recommends that adults over 60 receive a comprehensive eye exam with dilation every one to two years. While the exam is not to be carried out by a caregiver, it is helpful for homecare providers and caregivers to be aware of the recommended frequency of eye exams and be prepared to transport their clients to and from appointments.