Transcript The importance of vision in preventing falls (PowerPoint)

Focus on Falls
The importance of vision in
preventing falls
Falls are the most
common cause of
people over 65 being
taken into hospital.
One in three
people in this age
group will fall every
year.
You are almost twice as likely to fall
if you are over 65 and have some form
of visual impairment. Hip fractures are
also notably more likely.
Falls are the
biggest cause of
accidental death in
people over 75 and
cost the NHS around
£2.2 billion per year.
The NICE clinical guideline on falls recommends
that multi-factorial assessments undertaken by
falls services should include investigation of
visual impairment.
National Institute for Health and Care Excellence (2013)
The assessment and prevention of falls in older people, Clinical guideline
161. London: NICE. Available from: http://guidance.nice.org.uk/CG161
[accessed 25 Feb 2013]
Vision is fundamental to coordinating movement – our
balance and postural stability are directly affected by vision.
Vision adapts gait to enable safe travel though our
environment - avoiding obstacles, negotiating steps and
stairs.
Poor balance can be caused by reduced central and/or
peripheral vision. Eye movement disorders can knock you off
balance.
Uncorrected visual loss can have a more subtle but equally
detrimental effect on falls risk. Wearing bifocal and multi-focal lenses
can increase the risk of falling.
Patients wearing glasses with an outdated or wrong prescription
(which is more common than you might think) are much more at risk of
taking a tumble.
Even a small reduction in depth perception can lead to trips over
obstacles or overstepping on stairs.
Many patients attending A&E clinics for falls or hip fractures have
correctable visual impairment but have typically not attended for
eye exams for several years.
Studies have found that between 40 and 50% of older people
with sight loss actually fear falling to the extent that they reduce
their own levels of activity. This can reduce muscle strength and,
ironically, further increases their likelihood of a fall. This completes
a bit of a vicious circle.
However, looking at it in a more positive light, evidence shows
that early cataract removal and home assessments can really help
to reduce the likelihood of falls.
http://www.profane.eu.org/
Home Safety Assessments can drastically reduce the likelihood of a fall
for people with visual impairment. Lighting and colour contrast around the
home is imperative.
For tips on home design for people with sight loss, the Thomas
Pocklington Trust have produced a number of resources. They include a
guide on levels of lighting and which bulbs to select...
Housing for people with sight loss: A practical guide to improving existing homes, Good Practice Guide 4
(3rd edition)
www.pocklington-trust.org.uk/researchandknowledge/publications/rf17
Homes and living spaces for people with sight loss: A guide for interior designers
October 2014
www.pocklingtontrust.org.uk/Resources/Thomas%20Pocklington/Documents/PDF/Research%20Publications/pocklington-forprofessionals-interior-design-guide.pdf
Choosing Energy Saving Light Bulbs
www.rica.org.uk/sites/default/files/documents/pdfs/home-tech/energy-saving-lightbulbs.pdf
There is currently no real evidence to suggest that
standard rehabilitation programmes for fallers are
effective for people with sight loss…
Northumbria, Manchester, Newcastle and Glasgow
Caledonian Universities are conducting research at
the moment which is looking to adapt exercise
programmes to improve falls prevention among older
people with sight loss. (Funded by the National
Institute for Health Research)
The cross-sector Focus on Falls
project sought to:
Outline and promote the pivotal role
that improving vision has in preventing
falls.
Produce a clearer picture of vision
testing within falls services
Support falls professionals in testing
patients’ vision and to demonstrate the
role optometrists can play in this.
Make connections between falls
professionals and optometrists to
improve continuity of care
FOCUS ON FALLS - MAIN FINDINGS
• There is variation within falls services in terms of the
frequency and method of their vision checking
• A lack of resource and capacity is key to this variation
• Most falls teams would welcome support in performing
eyesight checks
• Referral between falls teams and optometrists could
help the patient pathway and help foster clinical continuity
A quick and easy solution for non-professionals to check patients’ vision,
try using the Thomas Pocklington Trust’s “EYES RIGHT TOOL”
(available from the College of Optometrists
via [email protected])
Optometrists can play a vital role in helping
to prevent falls by detecting and
appropriately correcting sight loss,
providing the right advice as well as
ensuring spectacles are correctly centred
and of a suitable design for the patient.
Why not get in touch with a local optometric
practice or Domiciliary Eye Service (sight
tests at home)?
Visit our falls webpage for help:
www.college-optometrists.org/falls
http://www.fodo.com/resource-categories/domiciliary-eyecare