Sunday, 3 August 2014

Sight loss and dementia:

Sight loss and dementia:


From Alzheimer’s Europe


The Dementia and Sight Loss Interest Group


Other causes of sight loss


•Effects of medication: such as blurred vision

•Stroke: including loss of segments of visual field, sometimes unnoticed by the person but sometimes causing serious loss of vision


 Promoting the individuals confidence in their environment.


Informal and formal carers need to provide clear, regular communication to promote the persons sense of orientation and confidence in their environment Techniques such as reality orientation and validation therapy may help.

 Reducing loneliness and isolation


People with dementia and sight loss would benefit from more one to one contact with paid carers and volunteers especially if more time could be devoted to maintaining valued pastimes.

 Managing threats to independence


People should be supported to pursue valued activities in a safe environment. Care professionals rather than family carers should initiate discussion about activities that are no longer considered safe.

 Managing visual hallucinations


Family members need guidance on managing hallucinations –this might include reassurance and non-confrontation, full explanation and distraction techniques.


 Extra respite resources such as night carers and more sessions at day centres required. Family carers also require ready access to information and advice such as that provided by RNIB and the Alzheimer’s Society.


 More services are needed that are capable of meeting both sight-related and dementia related needs. Day centres, activities and peer support would benefit people with dementia and sight loss.




Training programmes for vision rehabilitation workers should include information on working with people with dementia. Joint training of mental health and sight loss professionals would encourage the exchange of knowledge and expertise.

Good practice tips: occupation and activity

•Make enjoyed activities accessible -e.g.

•Audio transcription, talking books

•Tactile activities

•Audio labels to sort and locate personal effects

•Provide 1:1 support to explain and describe

•Assess benefits, not just risks


Good practice tips: eye tests

•Domiciliary tests at home (and in care homes) for those unable to visit an optometrist

•Appointments that are longer than usual

•Information and training about sight loss and the effect of interventions is essential for carers (family and paid)


Eye tests and screening

•People with dementia need regular eye tests and access to routine interventions, in the same way as any other person

•Optometrists lack experience of dementia

•Paid and family carers may not give priority to eye tests, spectacle wearing or other interventions

•Eye tests are not enough: information for paid and family carers is essential


Good practice tips: occupation and activity


Make enjoyed activities accessible -e.g.

•Audio transcription, talking books

•Tactile activities

•Audio labels to sort and locate personal effects

•Provide 1:1 support to explain and describe

•Assess benefits, not just risks


Good practice tips: environment


Improve lighting –make it brighter

•Use colour and increase contrast –walls to doors, furniture to walls

•No clutter –physical or visual

•Reduce glare –shade lamps, blinds

•Support route finding and orientation –use sound, smell, touch, colour


Improving models of care


Models of care need respond to both conditions, too often they may focus on one

•Sight loss should be addressed in dementia resources, and vice versa

•A sensory model of care is needed

•A network of practice could support staff in different settings and share good practice

•Care home inspections should address how well services meet the needs of people with both conditions.

•Regular assessment and diagnosis is essential, with steps to support follow on action and in particular spectacle wearing.



People with dementia and sight loss –a scoping study of models of care; Ruth Bartlett and Declan McKeefry. Thomas Pocklington Trust. 2009


This may well help many other like myself understand the problems we struggle with on a daily basis




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