Independent Living: Integrated Health and Social Care Is Vita [If People with Sight Loss Are to Have Quality of Life

By Godfrey, Mark | New Statesman (1996), June 7, 2013 | Go to article overview

Independent Living: Integrated Health and Social Care Is Vita [If People with Sight Loss Are to Have Quality of Life


Godfrey, Mark, New Statesman (1996)


Eyesight is precious and looking after your eyes and sight is integral to individual well-being. Detecting the early signs of sight loss such as glaucoma and other eye conditions cannot be underestimated, as with many conditions, early diagnosis is important.

In the UK there are around two million people living with sight loss. Macular Degeneration is the most common cause of sight loss in the western world, and more than 500,000 people in the UK have late stage age-related macular degeneration. Prevalence roughly quadruples with each decade of life and one in 2,000 people have the condition at age 60, with this increasing to one in five at age 90. There is no cure at the present time, but treatment can slow down progress.

It is important that people with sight loss receive timely medical treatment and access the appropriate support to help regain and/or learn skills enabling them to be as independent as possible.

There is an increasing focus on reducing demand on health and social care services and improving efficiency in the light of demographic pressures and reductions in local authority funding. In social care there is an emphasis on enabling people to be self-reliant and remain as independent as possible for as long as possible. Supporting people with sight loss to regain and maintain skills for daily living is essential in promoting individual independence.

Take for example, the case of Joan. She has been diagnosed with macular degeneration, an eye condition that leads to loss of central vision. On being referred to social care by her consultant for severely sight-impaired registration, it was discovered that Joan struggled with several aspects of daily living due to her sight loss. One area of functional loss was in kitchen skills, including safety concerns in handling hot liquids. Joan had previously scolded her hand in trying to make a hot drink. She had no support at home and due to having lost her confidence, she had been limiting her liquid intake and this had led to a number of urinary tract infections.

A rehabilitation worker designed a programme with Joan that included developing safe pouring techniques. Initially the rehabilitation worker helped Joan regain her confidence by practising with cold liquids. Over time she was able to learn a range of skills including how to use her residual peripheral vision to best effect; compensatory techniques such as strong contrasts to focus her vision to the particular areas needed and to help her differentiate between objects and how to position herself to get the best lighting on the task whilst casting a minimal amount of shadow.

In addition, she developed techniques for ensuring she was able to pour water without spilling any, such as making sure the kettle spout had made contact with the edge of the cup for pouring and how to use a liquid level indicator that used audible beeps to indicate the correct water level and then the correct level of milk.

Once Joan was confident that she was able to pour the cold water properly, the techniques were then practised with boiling water. Joan is now able to make herself drinks fully independently, and in addition to other skills taught during the rehabilitation programme is able to fulfil her daily living requirements without the need for further social care support.

It is essential that an individual's skills and abilities are identified at the same time as their medical needs by GPs and consultants, and that the emphasis is on people's potential and what they can do, not what they cannot. Social care's focus on daily living skills and rehabilitation in supporting people like Joan, while only a small area, is vitally important in enabling someone to meet their nutritional needs.

Integrated care is about services and support that are shaped around the individual, with the focus being on the person and their care, and not organisations, structures and boundaries. …

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