The Elders Eye Health Initative
Research suggests that there is a high incidence of vision impairment in elders living in Vancouver. 'By the age of 65, one in nine Canadians will have a visual impairment that can't be corrected with ordinary lenses. This number increases to one in four by the age of 75.' However, it is estimated that at least half of this vision loss can be improved and one quarter is preventable. Vision impairment has dramatic consequences for elders - an Australian study found that the risk of a fall doubled, the risk of depression tripled, the risk of death doubled, and ease of social functioning halved.
The Centre for Aging and Health, the Department of Ophthalmology at Providence Health Care and the BC-Yukon Divison of the Canadian National Institute for the Blind are leading the development of an Elders Eye Health Initiative to better understand and address these unmet needs. The Department of Ophthalmology will be coordinating the provision of evidence-based services to elders throughout the three phases of the initiative. The Centre for Aging and Health will provide project leadership, ensure that data collected through the phases is used in raising awareness of eye health, facilitate the use of data to inform eye health practice, and where necessary advocate for policy change. CNIB is providing a Vision Rehabilitation worker for the initiative.
The principal focus of the initiative is to understand and document the eye health needs of long term care residents in Vancouver . In addition, residents identified with a need are being referred to the appropriate services for treatment. As of December 2004, approximately 300 residents living at 7 different Vancouver facilities have been tested.
The importance of this initiative is based on the belief that a comprehensive range of eye health services are not being well used (or accessed) by Vancouver elders, particularly elders living in residential care. An Australian study found that while 77% of 200 residents assessed were visually impaired, only 16% of these visually impaired residents were under care for this problem. Extrapolation of these findings to residents in Vancouver suggests that of a thousand residents, over 700 are visually impaired and approximately 580 are not under care for these impairments. The same study suggests that there is need for better use of eye health services among elders - 20% of elders living in the community were vision impaired and of these 39% were under care.
The literature supports the effectiveness of eye health services that can prevent and treat the diseases that create low vision. Cataract surgery is successful in restoring vision in the majority of cases. While there is no cure for either glaucoma or adult macular degeneration (AMD), early detection and ongoing treatment of glaucoma can control the disease and usually preserve vision. Services for those with AMD help clients with low vision to maintain their independence. These services are available in Vancouver, but anecdotal evidence suggests they are not accessed in a timely way by elders, particularly residents.
In summary, research primarily from other countries and anecdotal local evidence suggests a significant need for eye health services among elders, particularly those living in residential care. Given the lack of Canadian-based eye related research, this initiative will result in novel Vancouver-based eye research and confirm the extent of elders' needs.