Mental Health in Care Homes
The most effective care organisations take a truly holistic approach to healthcare, encompassing both mental and physical health. From our earliest years to later life, both must be looked after by people who care for us. Mental health in young people is an important subject and it’s well documented that social media has a big part to play – but rising social media use in young people is not the only trend that concerns mental health. At the other end of the spectrum, older age has its own obstacles. As we live longer and richer lives, we often require help and support from a care community for a much longer period. While many older people can and do choose to maintain their independence, some prefer the extra help that being part of a care community can bring, while others may need more direct, one-to-one assistance. Older age, and the transition to a care setting can both have their own challenges. Maintaining wellbeing when joining a care community Staff in care communities have a crucial role to play in supporting those making the transition. Any change in circumstances, especially for people with care and support needs, can be difficult on the individual’s mental health and their family, so this is an important stage in the process for care staff. My team and I believe that the key element during this stage is highly bespoke communication about and with them – all the time. That means engaging in interesting conversation about their life and things that are personal to them. We provide support and advice every step of the way – whether it’s what happens when you move in, or a form that needs filling out, we communicate the how and the why. Upon arrival we ensure there are no communication barriers and remind residents they can come to us with any worries they may have. By making sure we’re communicating effectively at every stage of transition, a difficult change becomes a well-communicated set of simple steps, meaning no one is overwhelmed. Protecting the mental health of long-term residents Maintaining and improving the mental health of our residents at Red Rose after they’ve joined us is a distinct task that requires a different approach. Building links with other residents and staff can take time but we tailor activities and conversational topics to each individual. Relationships with family can sometimes deteriorate if they are not supported and able to visit their loved one. And as people age, they may find it more difficult to take part in general activities that have been designed to bring them together. Thankfully, these issues are easily avoided with due care and attention. At Red Rose we fully support visitors coming to the home and keeping their loved one’s company. From this, we have implemented an ‘open all hours’ facility for families to come and go when is most convenient for them. The resident’s happiness is paramount to us – by putting extra effort into designing activities that are inclusive for those who are less physically able and may have poor eyesight or hearing, we can work together to combat loneliness and mental health effectively. Article by Diane Watson, Red Rose Care Community
Aqualease – aquariums for the health care sector
Aqualease have been providing aquariums within the health care arena since 2003. Including GP surgeries, dentists, residential care homes and mental health and wellbeing sites. All aquariums are expertly installed and maintained by our technicians, incorporating colour schemes, logo’s and attention to detail to create a real ‘wow’ factor to your establishment. Aquariums are known for their calming and therapeutic effects. Researchers from the National Marine Aquarium Plymouth University and the University of Exeter discovered that watching fish swim, improved mood and kept people’s attention for longer. As well as noticeably reducing blood pressure and heart rate, helping people feel instantly relaxed. Aquariums have proven benefits for dementia sufferers too, particularly in relationship to mealtime experiences. In an American study, housing an aquarium in a dining hall encouraged residents to eat, enjoy their food and help them to gain weight. For further information or to chat to one of our helpful members of staff, please contact Aqualease on 0300 30 33 145 or go to www.aqualease.co.uk Come and visit us on stand D541 at the Dementia Care Expo!
Castle View: The powerful effect of independent living
“We don’t celebrate maturity, we don’t celebrate wisdom,” commented actress Kirsten Scott Thomas (almost 60) recently in an interview with The Telegraph Magazine – but that’s exactly what happens at Castle View, the new retirement village that has opened recently in Windsor. “Our approach is to treat everyone as an individual – be they single or part of a couple,” says Robin Hughes, CEO of Castle View and the man responsible for designing and building the new independent retirement village. Residents at Castle View purchase their own homes where there are 64 apartments starting in price from £375,000. Now gaining in popularity and springing up across the country, retirement villages are seen as an excellent way to look after our ageing population while providing a really good lifestyle throughout later life. Villages generally provide a range of apartments for purchase and are designed for those aged 55 plus to live as independently as they want, with care and support close at hand should it ever be needed. These homes usually have one or two bedrooms and include a shower room/bathroom and a kitchen, with central facilities such as a restaurant, café, bar, library etc, with social events and activities arranged for the residents. “In my experience, retirement-age residents want a secure home with good basic services, plus the availability of affordable care should it ever be required,” says Robin. As with where they used to live, they want to be next to like-minded people, but are not expecting continuous cruise ship-style entertainment or unnecessary interference in their lives. “Today’s retired are fiercely independent and want to do their own thing without the intervention or support from others for as long as possible. At the same time, their ‘grown-up’ children live where their work is, often at some distance from their parents or even overseas, and so the idea of care being provided by the family or even just helping-out is less likely, while the concept of the granny annexe is increasingly being consigned to history. “Independent living in a retirement village is a ‘win-win’ for the person living there and their family who can be safe in the knowledge that their mum or dad is getting on with their life yet surrounded by kindred spirits and a caring team of staff keeping an eye out for them to ensure they are well, eating and drinking properly and generally looked after,” adds Robin. “But this older generation is also becoming increasingly discerning, and people won’t move anywhere that doesn’t meet their exacting demands, which includes being able to pursue their preferred lifestyle. Keeping fit, staying busy, active and entertained is often central to this so having a cinema, theatre, library or sports centre nearby is essential. This means that an urban location is preferred over one in the country so you can walk to where you want to get to or take a short bus ride rather than getting the car out and all the cost and hassle that involves. Castle View is like a small village within the town of Windsor.” Would you let your mother live there? Most retirement villages have arrangements in place where care can be delivered to suit, or have a care home within the complex so convalescent or respite care can be quickly accessed and the partner easily visited. Residents are also freed from the burden of worrying about looking after and paying for a large family home and garden they have long since grown out of. The ultimate benchmark for any new retirement village is ‘would you let your mother live there’ and would she be happy? Robin’s own mum, Betty, moved to Castle View 15 months ago and is very content, comfortable, living independently and enjoying many new friendships, and all at the age of 86. “We must do everything to encourage the older generation to remain independent for as long as possible and out of long term care to avoid becoming institutionalised, unless it is absolutely needed,” says Robin. “The highly beneficial effect of sociability helps counter loneliness, while having activities and events on tap stimulates the mind, all of which leads to a longer more fulfilling life, and a reduced burden on the NHS.”
Avery launches staff well-being programme
High levels of staff transience, combined with a sometimes unattractive reputation for the adult social care sector, means it is often a challenge to attract and retain high quality permanent staff. Avery knows that investing in employees, through better training, career pathways, broader and appropriate benefits packages, flexible working and pay patterns, proactive support for staff well-being and healthy lifestyle choices, plus better information and communication leading to higher staff morale and loyalty, and thus retention. The AveryOne Programme has been designed and implemented to provide genuine value-add to employees, based upon their own feedback to Avery on those features that would enhance their working experience and career opportunity. It has also become clear that this retention platform can be an effective staff attraction tool in recruitment. Adapting its approach to person-centred care for its residents, Avery has developed and launched in December 2019 an employee-centred solution to help retain staff; to better support and reward them, to enhance their personal well-being at work, to increase their job satisfaction, to boost their benefits package, and enhance their continued professional development (CPD) and career opportunities. An App for both iPhone and Android, AveryOne’s deliverables include weekly pay (quicker access to pay based on shifts worked), vouchers and coupons (helping money go further in ways that matter), a well-being focus that supports a proactive lifestyle (with health advice on-line), plus healthcare, optical and hospital plans. AveryOne – Avery looks after the people who look after its residents. Additional information Weekly Pay In 2019, Avery Healthcare was the first major care sector provider to partner with a third party to offers its employees instant access to a proportion of money or salary already earnt within the standard monthly pay cycle. The company is keen to embrace new technology wherever possible for the benefit of residents and staff, and the instant payment system gives employees greater control of their finances, and mitigates the need for them to use high interest credit such as payday loans and credit cards for when they need quicker access to funds. Very few of the staff are desk-based with access to a computer, but virtually all staff possess a mobile phone. This led Avery to implementing a mobile phone App that is compatible with both Android or Apple devices and that is quick, simple and easy to use. Discounts AveryOne offers employees instant access to discounts with hundreds of product and service suppliers, including leading supermarkets, fashion and technology retailers, restaurants, cinemas, travel companies and hotels, experience days out such as theme parks, gyms, spas and beauty services. New retailers are being added on a weekly basis, with some offering up to 60% off their recommended retail prices. Based upon research from the employees prior to this service being implemented, such benefits were high on the list of staff preferences for how their overall rewards and remuneration package could be enhanced, making their money go further in ways that they could individually choose. Well-being A key element of the App is the focus on staff well-being. It provides access to information for on-line GP services, hospital and healthcare plans, death in service benefits and eyecare discounts. It also includes a free service called Hapi Life, which offers employees proactive life advice and guidance on such things as: • managing money more effectively • nutrition and diet • work life balance • personal productivity • spiritual and religious matters • national charity days and events The AveryOne discount platform App also offers employees access to details of other core benefits such as pension schemes, training and development opportunities, as well as uniform policies. It also provides access to Avery’s website and the company’s quarterly magazine, Welcome Home. These elements within the AveryOne Programme align with other staff retention initiatives such as: • training opportunities for all staff to support their Continuous Professional Development (CPD) – from the Avery Apprenticeship Scheme to nurse revalidation and QCF Level 5 • career pathways for all categories of staff, both care and non-care – including those who wish to change direction in their career such as a carer to a trainer, or culinary staff to housekeeping • some of the longest and most thorough new recruit inductions for the sector • competitive rates of pay, continually reviewed and updated in line with the marketplace It has been Avery’s finding that in general terms an increase in staff overall well-being levels can lead to the following organisational improvements: Increased Productivity – well-being can directly improve the mental and physical health of the workforce, with staff who are motivated to complete tasks contributing more to the organisation Decreased Absence – workplaces that value well-being will experience reduced absences thanks to better health behaviours, better stress management and greater morale Improved Retention – it is more costly to continue to replace rather than retain Positive Health Benefits – an effective well-being strategy can have physical benefits as well as mental, with staff more likely to adopt and maintain healthier habits Enhanced Communication – various ways for staff to provide feedback on their working environment and experiences; through regular meetings with their line manager, anonymous staff surveys, staff group meetings, plus annual or six-monthly Personal Development Reviews (PDRs) AveryOne – Avery looks after the people who look after its residents.
Keeping your care home hygienic
Keeping your care home hygienic: Making sure residents are healthy and happy Safe hygiene practices, infection control and health and wellbeing play a major role in the care of residents and is the responsibility of all staff. In 2016, in response to the implementation of the (Care Act 2014), ‘think local, act personal’ (TLAP) carried out a survey commissioned by the Department of Health (DOH). they discovered that a proportion of people in receipt of care felt they were not respected, whilst others felt that care practices amongst staff were often ‘different’ and not comparable to others. This highlights the at times inconsistent standards from individuals and service providers. Within the United Kingdom (UK), the Care Quality Commission (CQC) carry out regulation of health and social care services ensuring they meet the required standards in relation to quality of the provision. The CQC work with the service providers, staff and service users (residents) to make improvements. Cleanliness is vital within a care home environment. A clean care home not only keeps your residents, staff and visitors safe, it also impacts on how they feel both physically and mentally. This can have a huge impact on a person’s mental wellbeing, as no-one wants to live in an environment that is unclean. This is also true for visitors and people choosing a home for a loved one, they are unlikely to select a care home that does not appear clean or smell fresh. Here at the University of Northampton, we instil this knowledge into our students from the onset with skills for practice (getting them ready for practical/placement experience). This commences with the fundamentals of personal hygiene such as handwashing techniques and effective communication. Hygiene Personal hygiene for most people is a private activity. Yet for some in a care home, due to mobility or health related issues, the resident may need assistance with the most intimate of tasks. The key here is to aid with maintaining the resident’s independence, dignity, choice and privacy ensuring you are sensitive to the person’s needs, aiming to make the experience as positive and comfortable as possible. Using good personal protective equipment (PPE) is vital to ensure the spread of infection is minimised, staff play a major role in this by ensuring they use best the latest, evidenced based practice to ensure they aim to prevent the spread of infection, e.g. wear gloves whilst providing care. It is both the responsibility of the organisation and staff to ensure that infection prevention and control (IPC) is maximised, the World Health Organisation (WHO) found that IPC is a fundamental aspect for quality health care in relation to patient safety (WHO, 2019). This can be maintained by rigorous handwashing techniques or simply by participating in regular training activities for staff, residents and/or carers/relatives. (NICE, 2014). Living in such close proximity within a care home means that infections are likely to spread. The people within the care environments are likely to have weaker immunity so are susceptible to easily transmitted infections. Residents, staff and visitors should feel safe knowing that appropriate measures are taken to ensure they are in a safe, clean and comfortable environment. Home from Home The Enhancing Health and Wellbeing Module on our foundation degree very much focuses on supporting individuals to enhance their health and wellbeing. When living in a care home the resident should feel at home. Likewise, when choosing the right environment, the choice would be made based on cleanliness and odour. Encouraging the person to bring along personal possessions can aid with the transition to long term care and helps the resident to feel valued, happy and at home in their new environment (Brownie, et al, 2014). Stigma often surrounds care home environments and offensive odours, particularly in relation to older people. A good cleaning regime from the housekeeping team and staff members can aid with ensuring good practices are adhered to in relation to cleaning and removal of waste products. There are also many products available that can aid with odour elimination such as air fresheners and scented cleaning products. Staff should ensure they attend the workplace looking presentable and treat the care environment as the residents’ place of residence, this is their ‘home’ and should be treated and respected as such. Here at the University of Northampton, we teach the students the principles around professionalism. With placement modules that provide ‘hands on’ experience with support from experts in practice. Care homes very often like to offer students employment following their placement, which is testament to the quality of the student and also to the learning experiences they have received whilst here with us and on placement. Maintaining good standards of care and ensuring staff are trained adequately is vital to ensure residents are safeguarded. During 2017-18 there were 394,655 concerns of abuse raised in relation to Adult Safeguarding, an increase of 8.2% on the previous year (NHS, 2018). Within the Faculty of Health Society and Education we are dedicated to providing the message that good, quality care matters. It is vital that our students leave us as conscientious health and social care staff that are able to deliver and celebrate good practice and challenge poor practice. Age UK (2019) Age UK factsheet 29, Finding, choosing and funding a care home. [Online]https://www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs29_finding_choosing_and_funding_a_care_home_fcs.pdf [Accessed 03/02/20] Brownie, S. Horstmanshof, L. and Garbut, R. (2014). Factors that impact residents’ transition and psychological adjustment to long-term aged care: A systematic literature review. International Journal of Nursing Studies. 51(12) pp1654-1666. CQC, (2019) Care Quality Commission – The independent regulator of health and social care in England. What we do. [Online] https://www.cqc.org.uk/what-we-do [Accessed 03/02/20] Marsden, J (2015). Keeping patients safe: a practical guide. Community Eye Health. 28 (90) 23-25 [online] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675257/ [Accessed 02/02/20] NICE (2014) NICE Quality Standard 61: Infection prevention and control (National Institute for Health and Care Excellence). [Online] https://www.nice.org.uk/guidance/qs61 [Accessed 02/02/20] NHS (2018) Safeguarding Adults, Engalnd, 2017-18, Experimental Statistics. [Online] https://files.digital.nhs.uk/33/EF2EBD/Safeguarding%20Adults%20Collection%202017-18%20Report%20Final.pdf [Accessible 17/02/20] TLAP (2017) The Care Act (2014) Survey Results. Exploring
Why is a Lasting Power Of Attorney so important?
Nicola Finbow, Head of Private Client at Clough & Willis Solicitors, discusses why care home residents should consider setting up a Lasting Power of Attorney… The daily life of a care home employee can be extremely busy, with lots of moving parts to consider to ensure the correct care is administered to all of the residents – but things can get a lot busier if a patient has an accident or falls ill and it isn’t clear who to speak to about their needs. For this reason, it’s important that care home residents and their loved ones consider setting up a Lasting Power of Attorney to ensure everyone knows who is able to make healthcare and financial decisions on behalf of the resident if a time comes when they are unable to do so themselves. What is a Lasting Power of Attorney? A Lasting Power of Attorney is a legal document that allows an individual to appoint someone they trust to take control of, or assist with, their financial or personal welfare decisions if they lose the capability to make decisions for themselves. With an ageing population, these types of agreements are becoming more and more essential to ensure that the healthcare wishes of an individual and their loved ones are adhered to. However, research by the Office of the Public Guardian from 2014 revealed that almost half (45%) of respondents had never heard of the term ‘Lasting Power of Attorney’ and, once they were told about the document, almost two thirds (61%) said they weren’t interested. There are several reasons for the lack of interest – such as, many doubting they would lose the mental capacity to make decisions of this nature, while others didn’t want to give someone else the power to make decisions for them. However for care home residents, this is more important than for most. Statistics from Alzheimer’s Society show that 70% of people in care homes have either dementia or severe memory problems and that 225,000 people will develop dementia this year, meaning that it’s important to get all of the paperwork agreed before it’s too late. If an individual no longer has the mental capacity to create a valid Lasting Power of Attorney, it becomes much more difficult for someone to authorise important financial and welfare decisions – an application to the Court of Protection would be required. These applications are much more lengthy, complicated and expensive. This can cause problems for residents and care providers, as it can mean that relatives are unable to access finances to pay for specialist care while the application is pending and the care home can be left in a difficult position as their bills start to become overdue. For the sake of protecting the best interests of care providers, residents and their loved ones, it’s recommended that all care home owners create a policy to promote setting up a Lasting Power of Attorney for all new and existing residents. Working with a solicitor can take a lot of the stress out of the process of getting the appointment in place. The expert solicitors at Clough & Willis have been providing this vital service for many years. Find out more about our Lasting Power of Attorney and Deputyship service here.
Beating the flu in care homes this winter
Influenza (commonly known as the “flu”) season is in full swing. This usually brings a chorus of sniffs and sneezes as people across the UK battle through illness. While flu outbreaks come as no surprise as temperatures drop, it has been reported that cases are at their highest level on record, and that the current rate of flu is worse than at any point last winter. This year’s flu season has been challenging for the NHS, with reports of outbreaks across several hospitals, and other illnesses such as ‘coronavirus’ putting more pressure on resources. This also comes at a time when A&E waiting times are at their worst since records began in 2004. With this in mind, contagious flu is of particular concern for care home managers. Footfall in care homes can be high, with a range of visitors, healthcare professionals and other service providers onsite, so keeping the environment clean and sanitised can understandably be a challenge for staff. However, with elderly or infirm residents who may be vulnerable to infection, it is critically important that hygiene standards don’t slip at any point throughout the year. Care home managers should make sure they have a routine cleaning regime in place and know when a specialist cleaning team should be brought in to deal with cleans outside of the norm. To ensure high hygiene standards this winter, managers should also look to schedule a deep clean of key communal areas such as the residents’ lounge and visitor waiting room, as well as their kitchens and washrooms. This could help protect residents from infection via cross contamination and reduce employee absenteeism as they fight through flu season. What is ‘flu’?The flu is a viral infection caused by various strains of influenza viruses. It can be caught at any time of the year, but is more common during the winter period, partly because we spend more time indoors when it is cold and wet, and therefore viruses can spread more readily. Despite many associating the flu with the cold weather, the main source of flu is other people. The flu virus is present in the mouth and nose of people who have the flu. When you cough or sneeze you launch thousands of viral particles such as saliva and mucus into the air – making it easy to pass from person to person in confined spaces such as communal areas. Perfect personal hygieneAn important part of a care home manager’s job is to encourage employees to take care of their own personal health and hygiene to prevent the spread of illness. With care workers being in close contact with residents every day, it is crucial that staff are fully educated on the best ways to maintain personal hygiene. One important area that managers should emphasise is hand hygiene. Cross contamination can be a particular problem in communal environments, as some diseases can live on hard surfaces such as door handles and walls, and are transmissible for several days. To minimise the spread of bacteria and viruses, hands should be washed thoroughly for 20–30 seconds using soap and water. It’s also important that staff dry their hands properly. It has been shown that damp hands spread 1,000 times more bacteria than dry hands, so it is crucial that the drying stage is not overlooked. Staff should also have access to alcohol-free sanitisers, as they provide an effective, long-lasting barrier to protect against microorganisms. Continuous training and development for both management and staff helps to ensure high standards of hygiene are maintained alongside operational efficiency. This can also help prevent unnecessary downtime in the facility, minimising disruption to the lives of residents. A clean routineIt’s essential that cleaning is carried out in care homes both proactively and reactively. Proactive cleaning involves the routine disinfection of shared contact points – such as door handles, surface tops – and communal areas. Reactive cleaning occurs when necessary. In care homes, this often takes place in response to an outbreak of illness, or when an individual presents a transmissible infection. In this case, all areas inhabited by the individual should be thoroughly disinfected. Regular deep cleans are also important. This involves conducting a thorough clean by moving all furniture away from the walls to make sure no areas are being missed from the cleaning routine. Ideally, deep cleans should be carried out at least twice a year by a professional cleaning company. They will have access to specialist multi-purpose biocidal cleaners which can decontaminate surfaces by killing bacteria, fungi, spores, yeasts and viruses. Specialist cleaning after an outbreakWhile a routine cleaning regime can help to keep infection under control, outbreaks can still occur. An outbreak of a disease, such as influenza, needs to be dealt with as quickly as possible to minimise the risk to residents. Ultra Low Volume (ULV) disinfectant fogging is a method of disinfection, carried out by a specialist, which enables the treatment of large areas in a short space of time. It works by generating a mist of disinfectant, which settles on top of, underneath and on the sides of objects, soft furnishings, furniture and hard-to-reach areas, offering maximum surface area coverage. Fogging is also fast-drying and can significantly reduce the number of pathogens present when compared to manual surface cleaning alone. It’s important that employees don’t become complacent following a visit from a professional cleaning company, as another outbreak could occur if standards are not maintained. Final thoughts With influenza on the rise, and new strains seemingly arising each year, its important than ever for care home managers to take the time now to make sure there is an effective cleaning regime in place, and that all their employees are adhering to personal hygiene best practice. Article from:Paul Casson, Technical Field Manager, Rentokil Specialist Hygiene &Jamie Woodhall, Area Technical Manager, Initial Washroom Hygiene
Screening and Treating Malnutrition in Community Care Settings
Malnutrition is a major clinical and public health problem in the UK. It’s estimated that over 3 million people are malnourished, with 93% living in the community and 1.3 million aged over 65 (1). A person is classified as malnourished if they meet a set of criteria which often includes a low Body Mass Index (BMI), significant and unintentional weight loss over a defined period of time, and/or reduced nutritional intake over a defined period of time (2). In community care settings, NICE guidelines recommend that nutritional screening for malnutrition is conducted on admission to care homes and when there is a clinical concern (3). Screening is a rapid and simple way to detect those with or at risk of malnutrition so that suitable action plans can be implemented. However, recent evidence (4) suggests that nutritional screening is not being fully implemented. Failure to screen or inaccurate scoring could lead to missed nutritional intervention which could have serious consequences for patients. Additionally, the Care Quality Commission (CQC) can prosecute health and social care providers who fail to conduct adequate nutritional needs assessments if it results in avoidable harm or risk of harm to a person using the service (5). Therefore, it’s important that all staff involved with nutrition-risk screening are suitably trained to meet the required standards for their organisation. The Malnutrition Universal Screening Tool (MUST) is the most frequently used in the UK. It’s a five-step tool which is suitable for screening adults across all care settings. It’s a scoring system that uses objective or subjective measurements to establish nutrition risk. Patients are deemed to be either low, medium, or high risk of malnutrition. For more information on how to conduct MUST screening, click here. A food-first approach is a simple way of providing enhanced nutrition to those who are or at risk of becoming malnourished. It can be useful for patients who still have a good appetite. Fortifying foods help to increase the nutritional density of the diet without increasing the volume of food consumed. Several foods which can be used to fortify the diet include:○ Double Cream○ Full Fat Milk○ Honey/Syrup/Sugar○ Butter○ Cheese○ Milk Powder○ Oils such as olive oil Additional snacks can be used to improve nutritional intake and examples include cakes, biscuits, crisps, cheese and crackers, and custard. Encouraging patients to consume nourishing drinks that provide more energy and protein than tea, coffee or water is also an effective strategy. AYMES Retail is a nutritionally-balanced, milkshake-style drink designed to help give an additional boost to those who do not require a medical prescription. It provides up to 266 calories per serving when mixed with 200ml whole milk. It’s presented conveniently in individual cartons containing 4 x 38g sachets and comes in a variety of flavours (chocolate, strawberry, banana, vanilla) to help prevent flavour fatigue. With an RRP of just £3.19, it is available to buy at pharmacies and via the AYMES website. By Harriet Smith, Registered Dietitian
Eyecare – we care!
If you are looking after elderly people in residential care, they may need assistance with mobility, self care, and medication, but is anyone helping them take care of their eyes? Older people are most at risk of eye disease, and those in residential care can easily miss out on the important routine sight test which checks on both the health of their eyes and their vision. Read on to find out how you can easily ensure your residents’ eyes are just as well looked after as their other needs. Max Halford FBDO is Clinical Lead at the Association of British Dispensing Opticians. He explains, “Eyes, like any part of the body, change as we get older but poor eyesight isn’t something we should accept. People will need to use their glasses more. They may seek better lighting for small print as they get older. However if you notice that a resident is struggling with reading or looking at the television it can be a sign that their vision has changed. If someone you care for has lost interest in reading for example, a visit to your local optician’s practice is recommended.” Everyone, however old, should have a sight test every two years, or more often if the optician recommends. You can also go back if you feel your eyes have changed in between tests. If you are concerned about how to get an elderly and frail person to the opticians, you will find that there are optical practices in most towns who provide a home visit or “domiciliary service”. Max Halford says, “If the person you are caring for is housebound the cost of this may well be covered by the NHS. If you are having difficulty locating an optician who provides this service look online for your Local Optical Committee and they will recommend opticians who specialise in care home visits.” Opticians will visit whether a single person needs eyecare, or whether you have a number of residents in need of care. Max Halford says, “It is a good idea to get the optician to visit the care home first so you can discuss the best way they can come and look after your residents.”Some people may prefer to stick with the optician they are used to: they or their family may be able to supply details. This provides the benefit of continuity of care. Max Halford says, “A visit to the resident’s own local opticians can be best as they will have the previous records. All optician’s practices have to comply with the Equality Act and welcome carers to come in and support patients whilst the eye test is being carried out”. Make sure that the optician writes down their recommendation for the person so that this can be shared amongst all those who care for the person. The recommendation can be to update spectacles, and when they should be worn. Some people may need further tests at the hospital if they have signs of eye disease and the optician can advise on this too.It is important to ensure that people wear their specs as the optician advises. Max Halford says, “If you work in a care home, there is nothing worse than finding a pair of specs and realising you have no idea who they belong to!” To avoid this he suggests, “Take a photo of the resident in their new specs to add to their record. Pop the residents initials on the inside of one of the sides in indelible pen. And if a mix up has occurred, the optician will have a record of any specs they provided!”Some people will have more than one pair of spectacles, and it can be difficult for the carer to know which specs they should wear when. Max Halford advises, “Nowadays most people get on well with varifocal or bifocal specs so one pair helps them see clearly at distance and close up. Some people prefer a separate pair of reading and distance glasses. If they do get muddled up the best way to check is to ask the resident in which pair they can see the television best- this should be the distance glasses.” You can also add “D” for distance or “N” for near in indelible pen to the side of the specs and the case they are stored in to help everyone know which pair is which. Some of your residents may have uncomfortable eyes. Dry eye is a major problem for many older people and one study compared chronic dry eye discomfort to that of angina. Do talk to the optician about this as there are a number of ways to help people. Max Halford explains, “Most people with dry eyes do have lots of tears. Very often you will see them with very watery eyes, but the quality of the tears is not good enough and they aren’t lubricating the eyes properly. Your optician or local pharmacy will be able to recommend eye drops to be used on a regular basis throughout the day- possibly every couple of hours or more- check with the optician when they visit.” There is lots more information about eyecare and older people on the Association of British Dispensing Optician’s website – or follow EyecareFAQ on Twitter or Facebook.
