Daily Sitka Sentinel

Expert: Vision Important for Dementia Patients

By SHANNON HAUGLAND
Sentinel Staff Writer
    When taking care of a loved one with dementia, the caregiver sometimes overlooks the importance of having the patient’s eyesight checked regularly.
    But sometimes a professional eye exam – and improving eyesight – can make a crucial difference in how the patient interacts with the world, say authorities on the care of those with dementia.
    “The biggest challenge with us as providers of care to people with dementia is their caregivers don’t understand it’s important,” said Dr. Pam Steffes, eye clinic manager at SEARHC Mt. Edgecumbe Hospital. And it’s not just eyesight: attention must be paid to the state of the patient’s other senses as well.
    To that end, Brave Heart Volunteers is sponsoring lunchtime roundtable talks on “The Senses.” (BHV has added a sixth sense – mindfulness – to sight, smell, hearing, taste and touch.)
    The next talk will be at noon Wednesday at the Pioneers Home Manager’s House, when the subject will be eyesight and Steffes will be the speaker. The series kicked off last month with a presentation and discussion on the importance of the sense of smell.
    Zack Desmond, the Brave Heart Volunteers care program coordinator, said the series was designed for anyone who wants to learn more about how to interact with people with dementia.

Zack Desmond (Sentinel Photo)

    “The emphasis is how perception changes in the various senses,” he said. “And how we can interact better with people with dementia. ... There are changes with age but it’s specific changes with people with dementia.”
    Steffes said the roundtable session on Wednesday will be dedicated to the role of eyesight in people with dementia.
    “One of the things we’re bringing to the table is the value that (eyesight) is just as important for someone with dementia,” she said. “Visual field, depth perception, all of these things play a key role – it’s just as important they have a clear perception, as best they can, of the world so they can interact as best they can. ... The value to them is essential. It plays a role in how they interact with the world.”
    She said it’s common for caregivers to think that eye exams won’t make a difference to someone with dementia, and to defer exams in favor of taking care of other issues.
    But Steffes said it does make a difference.
    “People are surprised by that, and it’s interesting how some people with dementia, they prefer to see things far away, but for others, it’s up-close,” she said. “Giving them the ability to do the tasks they enjoy improves their quality of life. ... We’ve seen people being able to re-engage after we’ve corrected their vision.”
    Desmond said many caregivers have a misconception about what is happening in the brains of people with dementia.
    “They associate dementia with memory,” he said. “It’s not that memory is dying – it’s that the brain is dying, like a liver or a heart. There’s the assumption about someone’s ability to re-engage. If they understand that there’s a way to extend the life of the brain, or give it the tools – like through improved vision – there’s an opportunity to make the life richer for the loved one.”
    Steffes said she regularly gives eye exams to people with dementia, including checking for glaucoma and macular degeneration, since people with dementia are generally elderly.
    She said when SEARHC calls with a reminder about an eye appointment for a person with dementia, a caregiver who is dealing with a host of other issues relating to this patient is faced with the question: “What’s more important? What do you want to manage?”
    “It’s a balance at that point,” Steffes said. “In general, the care providers are pretty sensitive to helping the patient have the quality of life that includes the activities of daily living.”
    The idea for the The Senses series was inspired by the work of Teepa Snow, an occupational therapist at Duke University who specializes in dementia, and has studied dementia’s devastating impact on the subject’s five senses.
    The goal in general is to improve the quality of life for people with dementia, as well as their caregivers, sponsors said.
    “It’s about seeing the person, not the disease,” Desmond said. “The disease affects how that person interacts with the world. As that’s happening, how can we better interact to bring the world to them.”
    The Senses series was led off by Sharon Sullivan, an RN who is owner of Unity Botanicals, who talked about the role of smell with patients with dementia. Snow said in an interview that people with dementia lose “protective smell,” which means they don’t understand that the smell of smoke, propane or spoiled food could indicate danger.
    Desmond said he’s hoping the series will lead to better care for people with dementia, and more informed caregivers.
    “The trends are that diagnoses are increasing,” he said. “Our population is aging. ... It’s going to be more and more relevant, not just for individuals aging but for people taking care of them.”
    Lunch will be provided at the noon discussion. Those with questions may call BHV at 747-4600.