Home visits can help to maintain eye care for a person with dementia

When Ken Barnes eats his dinner, he can only see one half of his plate – a symptom that’s emerged as his dementia has progressed. Each time, his wife Linda patiently turns his plate around so he knows what he’s left behind and can finish his meal. 

This is just one example of why Linda believes looking after the sight of someone with dementia is so important. 

‘If your faculties are failing, it’s difficult when it comes to understanding and working things out,’ she says. 

‘Ken has early-onset Alzheimer’s and frontotemporal dementia and his brain doesn’t always compute what he’s seeing. If he can’t see well, it makes the situation far more confusing for him.’ 

Appointment dread 

A recent trip to Ken and Linda’s optician in York seemed to scupper their hope of caring for his sight. The practitioner struggled to deal with Ken’s condition. Ken felt stressed and confused by her commands to look this way and that. 

‘She then called her manager, who was short of time and got a bit snappy,’ says Linda. ‘Ken was panicking and couldn’t process anything he was asked to do.’

Linda dreaded making another appointment but then found a home-based (domiciliary) option was available, in their case run by Specsavers. The experience couldn’t have been more different. 

‘Two ladies came into our home to see Ken and they were lovely,’ Linda says. ‘They built up a feeling of trust, meaning Ken was far more relaxed. 

‘We all sat at our kitchen table and, because Ken wasn’t being rushed, he was able to do what they asked. He even didn’t mind the torch shining in his eyes. 

‘They found out that, although he’s no longer able to read and write, Ken could recognise the letter Z. This meant they adapted the test, asking him to spot that letter.’ 

Real difference 

Continued eye care is especially important for people with dementia. If someone’s sight problems aren’t addressed, their feelings of disorientation can increase, as can the risk of falling and issues with mobility. Not being able to see clearly can make understanding and communicating with others more difficult, so they’re less able to take part in favourite activities. 

‘Having regular eye tests is an important part of helping a person to live as well as possible with dementia,’ says Simon Wheeler, Knowledge Officer at the Society. 

‘Poor vision can make dementia much harder to cope with and can even make its symptoms worse.’ 

Visual problems among people with dementia are underdiagnosed. 

‘It’s vital that people are given as much support as possible to get the right prescription for their glasses and to check for common problems, such as glaucoma, cataracts, macular degeneration and eye damage caused by diabetes,’ says Simon. 

‘The earlier these are identified, the more likely it is that the person will be able to tolerate any medical procedures that need to be done.’ 

Adapting appointments 

Unfortunately, not all opticians (people who fit glasses and contact lenses) and optometrists (those who examine, diagnose and treat eyes) know it’s possible to do a full eye test when someone has communication difficulties, including if they can’t speak.

We recommend that eye professionals include carers or family members who know the person with dementia when seeing them. 

Appointments should be longer so the person doesn’t feel rushed, or more than one can be booked. Aim for times of day when the person feels at their best. 

‘When making an appointment, tell the receptionist that the patient has dementia,’ says Simon. ‘And ask to see someone with experience of working with the condition.’ 

Eye tests can take place in care homes, day centres and at home, as in Ken and Linda’s case. 

Ask your GP or high street optician about home visits – Specsavers has a nationwide service for those who would struggle with appointments in store.

Home comfort 

Georgia Eason, Retail Director at York Specsavers Home Visits, says they’re a great way of helping people with dementia relax and feel comfortable. 

‘It can be a little distressing dealing with patients in store. There’s comfort in being in your own home.’ 

Specsavers staff are encouraged to take part in Dementia Friends information sessions, which explain different types of dementia, change perceptions about people with the condition, and give the team additional confidence. 

‘When we learn the patient has dementia, it doesn’t faze us,’ explains Georgia. 

‘If a patient finds our testing chart a bit difficult, we can make the letters a little bit bigger or point to them. Sometimes patients like to write down letters rather than reading them out.’ 

There are even ways to assess a person’s prescription that don’t need any input from them. 

‘We dispense the glasses at home as well, and go back and deliver them,’ says Georgia, ‘so they don’t have to have the stress of going into a store at all.’ 

Linda adds, ‘I’ve told lots of people the service is available at home, rather than in a small, dark clinical space that can feel claustrophobic and frightening. 

‘I’m a big believer in improving the things we can improve for people with dementia, and this is a great way to do it.’