Think sight with falls and older people Please use the accompanying notes when viewing this slide show © 2015 College of Occupational Therapists May be copied and adapted for non-commercial use by BAOT members only www.COT.org.uk

Why think sight when considering falls? Sight loss can increase the risk of falling COT’s practice guideline Occupational therapy in the prevention and management of falls in adults (2015) identifies impaired vision as an intrinsic risk factor for falls

Why link sight loss to older people? The risk of sight loss greatly increases with age. We need more light to see by as we age but how many of us realise this? www.COT.org.uk

Time for an activity! Please think for a few minutes and jot down your ideas…..what are the causes of sight loss? Then please refer to the notes for this slide for some examples. www.COT.org.uk

Linking sight loss and falls increased risk of falls and injury The risk of injury from falls and rate of hip fractures for older people with sight loss is twice as high as for sighted older people (Legood et al 2002) Falls can result in serious injury and fatality. Less serious falls can reduce mobility and independence and increase depression, isolation and fear of falling (NICE 2013)

Activity Why might someone with sight loss be more likely to fall? Spend a few minutes thinking about possible causes, then refer to the notes for this slide for examples www.COT.org.uk

Activity Look at the following four slides and consider what it would feel like to negotiate the environment with the types of visual difficulties identified. Please jot down your ideas and keep for further reflection. www.COT.org.uk

Reduced depth perception www.COT.org.uk

Poor contrast sensitivity www.COT.org.uk

Distorted lines www.COT.org.uk

Loss of peripheral vision www.COT.org.uk

Fear of falling Between 40-50% of older people with sight loss limit their activities due to a fear of falling. (Wang et al 2012) www.COT.org.uk

Accessing a vision assessment Sight loss in older people can be avoided in many cases with correctly prescribed spectacles, cataract surgery or timely treatment. www.COT.org.uk

Activity Why might other conditions mask sight loss? Take a few minutes to consider and jot down your ideas and then refer to the notes for this slide for some examples. www.COT.org.uk

Looking out for the signs of sight loss Ask questions about sight Are you able to read small print, bills, medicine? Can you recognise faces? Do you miss or over fill cups when pouring? Do you have difficulties judging steps, stairs, kerbs? Source: Visibility Consider using a tool like Pocklington's Eyes Right Toolkit www.COT.org.uk

Check the 3Cs of spectacles Clean - are the spectacles clean? Current - is the prescription up to date? Correct - are they wearing the correct spectacles for the task they are undertaking? www.COT.org.uk

Assess home hazards HOME FAST 25 items - environmental hazards throughout the home (indoor and outdoor) Westmead Home Safety Assessment: 72 items in “hazard categories”: internal/external traffic ways, general/ indoors, living area, seating, bedroom, bathroom, kitchen, laundry, footwear, medication management. www.COT.org.uk

Assess risk of falling The Falls Behavioural Scale (2003) I notice spills on the floor I use a light if I get up during the night I adjust the lighting at home to suit my eyesight I clean my spectacles When wearing bifocals or trifocals I misjudge a step or do not see a change in floor level www.COT.org.uk

What should occupational therapists consider when planning interventions for those with sight loss? Modifications to the home Lighting (TOP TIP on a home/access visit - do try the lights!) Strength and balance classes www.COT.org.uk

Please review what you have just learned and plan one action that you will take as a result of this session www.COT.org.uk