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Nursing Home Neglect Takes on Many Forms: Patients Not Always Getting the Eye Care They Need

Jul 16, 2007 | Parker Waichman Alonso LLP

The widespread yet heavily underreported problem of Nursing Home Neglect takes on many unexpected forms, one of which being simple eye care.  Nursing homes often neglect to provide residents with even the most basic vision care.  A study conducted by the University of Alabama at Birmingham found that nearly a third of the nursing home patients it followed had never received an eye exam after being admitted to a long-term-care facility.  This occurred despite the fact that more than half of the patients in the study had some form of visual impairment.

Researchers from the university analyzed medical records from 17 Birmingham-area nursing homes.  The investigation covered a total of 380 patients age 55 and older.    In addition to examining medical records, each nursing home patient was interviewed about their use of eyeglasses and vision care.  What the study found was startling.  Even though 90 percent of the nursing home residents had health insurance, two thirds had no reference to an eye exam in their medical chart.  When interviewed, 28-percent of residents said that their last exam occurred the previous year, while 20-percent said that it had been more than two years since their last exam.  A third of patients couldn’t recall the last time they had an eye examination.

The withholding of medical care like eye exams is considered a form of nursing home neglect. Eye care can be difficult for long-term-care patients to access because they often must rely on the nursing home to provide transportation to an eye doctor. There is also a shortage of eye care professionals who serve the geriatric community.  But the Birmingham study is especially surprising because each of the nursing homes in the study had access to optometrists who visited frequently.  The study said that some nursing home staff might believe that eye care would be of little benefit to patients with cognitive problems like dementia, and that could account for the lack of available eye care services in the facilities.

Fifty seven-percent of the nursing home patients in the study suffered from visual impairment.  The researches defined visual impairment as having worse than 20/40 vision in the best eye.  This is 15 times higher than rates for adults the same age who do not live in long-term-care facilities.  While the study could not pinpoint a reason for this disparity, the researches did say that people who are visually impaired could be more likely to enter a nursing home.  Three quarters of the residents had abnormal binocular contrast sensitivity, a condition that makes it difficult for people to see the boundaries of objects.  A condition like this makes mobility difficult, and could factor into the decision to move an elderly person to a nursing home.

The data used in the study did not indicate if these visually impaired patients could be helped with treatment.  However, 37-percent of visual problems, and even 20-percent of blindness can be corrected with glasses, contacts or surgery.  It seems obvious that some of the nursing home patients followed in this study would have benefited from proper eye care.