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‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians

<p><em><a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Our <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">ageing population</a> brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss).</p> <p>Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are <a href="https://www.senseswa.com.au/wp-content/uploads/2016/01/a-clear-view---senses-australia.pdf">living with dual sensory impairment</a>.</p> <p>Combined vision and hearing loss <a href="https://doi.org/10.1177/0264619613490519">describes</a> any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is <a href="https://doi.org/10.1016/j.annepidem.2012.02.004">increasingly common</a> as people get older.</p> <p>The experience can make older people feel isolated and unable to participate in important conversations, including about their health.</p> <h2>Causes and conditions</h2> <p>Conditions related to hearing and vision impairment often <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">increase as we age</a> – but many of these changes are subtle.</p> <p>Hearing loss can start <a href="https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/highlighting-priorities-for-ear-and-hearing-care">as early as our 50s</a> and often accompany other age-related visual changes, such as <a href="https://www.mdfoundation.com.au/">age-related macular degeneration</a>.</p> <p>Other age-related conditions are frequently prioritised by patients, doctors or carers, such as <a href="https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-disease/overview">diabetes or heart disease</a>. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our <a href="https://hdl.handle.net/2123/29262">research</a> told us</p> <blockquote> <p>I don’t see too good or hear too well. It’s just part of old age.</p> </blockquote> <h2>An invisible disability</h2> <p>Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts <a href="https://doi.org/10.1080/09638280210129162">social activities and communication</a>, making it difficult for older adults to manage.</p> <p>It is underdiagnosed, underrecognised and sometimes misattributed (for example, to <a href="https://doi.org/10.1093/geronb/gbz043">cognitive impairment or decline</a>). However, there is also growing evidence of links between <a href="https://doi.org/10.1002/dad2.12054">dementia and dual sensory loss</a>. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, <a href="https://doi.org/10.1002/dad2.12054">feel happy and be safe</a>.</p> <p>A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us:</p> <blockquote> <p>There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else.</p> </blockquote> <h2>Isolated yet more dependent on others</h2> <p>Global trends show a worrying conundrum. Older people with dual sensory impairment become <a href="https://doi.org/10.1002/dad2.12054">more socially isolated</a>, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing.</p> <p>One aspect of this is how effectively they can <a href="https://doi.org/10.1001/jamanetworkopen.2020.25522">comprehend and communicate in a health-care setting</a>. Recent research shows <a href="http://dx.doi.org/10.3390/healthcare12080852">doctors and nurses in hospitals</a> aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, <a href="https://www.mdpi.com/2227-9032/12/8/852">researchers note</a>. It facilitates:</p> <ul> <li>shorter hospital stays</li> <li>fewer re-admissions</li> <li>reduced emergency room visits</li> <li>better treatment adherence and medical follow up</li> <li>less unnecessary diagnostic testing</li> <li>improved health-care outcomes.</li> </ul> <h2>‘Too hard’</h2> <p>Globally, there is a better understanding of how important it is to <a href="https://www.who.int/publications/i/item/9789240030749">maintain active social lives</a> as people age. But this is difficult for older adults with dual sensory loss. One person told us</p> <blockquote> <p>I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people.</p> </blockquote> <p>Again, these experiences increase reliance on family. But caring in this context is tough and largely <a href="https://doi.org/10.3389/feduc.2020.572201">hidden</a>. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring <a href="https://doi.org/10.1159/000507856">frustration, social isolation and depression</a> for carers too. One spouse told us:</p> <blockquote> <p>He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair.</p> </blockquote> <p>So, what can we do?</p> <p>Dual sensory impairment is a growing problem with potentially devastating impacts.</p> <p>It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers.</p> <p>We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to <a href="https://www.tandfonline.com/doi/full/10.1080/09649069.2019.1627088">navigate health care</a>.</p> <p>Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232142/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, Lived Experience Research Fellow, Centre for Disability Research and Policy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, Postdoctoral research fellow, Department of Linguistics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-keep-away-from-people-combined-vision-and-hearing-loss-is-isolating-more-and-more-older-australians-232142">original article</a>.</em></p>

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Hospice nurse explains the “very comforting” thing that happens just before death

<p dir="ltr">A hospice nurse has shared the “very comforting” thing that happens to a lot of people in the last moments of their life. </p> <p dir="ltr">Julie McFadden, a 39-year-old healthcare professional from the US, supports people who are coming to the end of their lives, going into specialised homes to make sure they remain as comfortable as possible in their final days.</p> <p dir="ltr">Throughout her career, she said more than half of those she has looked after experienced “visioning”, which is when people who are often fully lucid see deceased friends, family and pets in the moments leading up to death.</p> <p dir="ltr">“It happens most of the time at the end of their life, but they aren’t delusional,” the former intensive care nurse said on TikTok. </p> <p dir="ltr">“It’s often very comforting for the person. It’s never scary - if they’re scared, it’s likely they’re experiencing delirium or paranoia, not visioning.”</p> <p dir="ltr">“People don’t talk about it much but it’s really common and more than half of people I have looked after have experienced it.”</p> <p dir="ltr">“It’s so normal to fear death and I’ve had several patients who have expressed their fear - but then a family member came to them and they were no longer scared.”</p> <p dir="ltr">Julie went on to share a further explanation as to why people experience “visioning”, and the other-worldly power behind it. </p> <p dir="ltr">“We have no idea why this (visioning) happens and we are not claiming that they really are seeing these people,” she explained in one video.</p> <p dir="ltr">“We have no idea. But all I can tell you, as a healthcare professional who’s worked in this line of work for a very long time, (is that) it happens all the time.”</p> <p dir="ltr">“It happens so much that we actually have to educate the family and the patient about this topic before it happens so they’re not incredibly alarmed,” she added.</p> <p dir="ltr">“Usually it’s a good indicator that the person’s getting close to death - usually about a month or a few weeks before they die.”</p> <p dir="ltr">“It brings me comfort. I hope it brings you some comfort,” she concluded in her video, which quickly amassed more than 400,000 views.</p> <p dir="ltr"><em>Image credits: TikTok</em></p>

Caring

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Why we lose our hearing and vision as we age

<p>As the baby boomer generation begins to age, the prevalence of both eye and ear disease will rise exponentially, as there is a strong correlation between vision loss, hearing loss and ageing.</p> <p>The <a href="http://www.who.int/mediacentre/factsheets/fs282/en/">World Health Organisation estimates</a> that 285 million people worldwide are visually impaired, with 82% of people with blindness aged 50 and above. Australia alone will have 800,000 people aged 40 or over with low vision or hearing loss by 2020.</p> <p>As people age, they often experience a number of changes in their physical, mental and social health. Among these are eye and ear changes, and diseases that usually result in vision and hearing loss. Changes to our eyes and ears occur as a result of disease, genetic factors, “wear and tear” and environmental factors.</p> <p><strong>What happens in our eyes as we age?</strong></p> <p>There are a range of changes in our eyes that occur as a result of age. For example, over time the whites of the eyes, or “sclera”, undergo changes due to exposure to ultraviolet light.</p> <p>These changes include a yellowing or browning of the white of the eye due to fatty or cholesterol deposits in the conjunctiva – the mucous membrane that covers the eye – also related to ageing and exposure to ultraviolet light.</p> <p>Over time, changes also occur in the conjunctiva, such as a thinning of the membrane. This often results in dry eye, a condition caused mainly by reduced production of tears and reduced mucous from the conjunctiva.</p> <p>As we age, we often experience a decrease in the strength of our muscles. This is no different in the eye, and the muscles in our eyelids can become weaker over time. Reduced tone in the muscle that gives shape to our lens, as well as stiffening of the natural lens with age, causes presbyopia (inability to see near objects), necessitating the use of reading glasses.</p> <p>Eye disorders that commonly occur in older adults include:</p> <ul> <li> <p><strong>macular degeneration</strong>. This terms describes <a href="https://theconversation.com/explainer-what-is-age-related-macular-degeneration-59889">damage to the pigmented oval</a> in the centre of the retina resulting in decreased central vision and seeing fine detail. This happens as we age because of deposits of fine grains that build up in the retina.</p> </li> <li> <p><strong>Cataracts</strong>. This is a <a href="https://theconversation.com/explainer-what-are-cataracts-63699">clouding of the lens</a> that covers the eye. These are thought to be caused by breakdown and degradation of lens proteins, and are considered a part of the normal ageing of the lens.</p> </li> <li> <p><strong>Diabetic retinopathy</strong>. This is damage to the retina resulting from diabetes. Type 2 diabetes is age related and the duration and control of blood glucose levels often determine whether or not diabetic retinopathy does or does not develop.</p> </li> <li> <p><strong>Glaucoma</strong>. When <a href="https://theconversation.com/explainer-what-is-glaucoma-the-sneak-thief-of-sight-64807">glaucoma</a> occurs, the optic nerve is progressively damaged resulting in loss of the peripheral visual field.</p> </li> </ul> <p>Among older Australians, cataract is the most common eye disease and cause of visual impairment (over <a href="https://www.health.gov.au/internet/main/publishing.nsf/Content/D1A5409787D800F2CA257C73007F12F3/%24File/eyehlth.pdf">70% of people in Australia</a> aged 80 years and over have cataracts), followed by age-related macular degeneration (occurring in <a href="http://www.aihw.gov.au/media-release-detail/?id=6442464587">3.1% of older people</a>).</p> <p><strong>What happens in our ears as we age?</strong></p> <p>As we get older, we experience changes all over our body, including the ears. Commonly, people’s ears (outer ears, that is) become bigger, earwax accumulates more easily and there is more cartilage in the external ear canal.</p> <p>There is also often a stiffening of the eardrum and <a href="https://www.nursingtimes.net/roles/older-people-nurses/exploring-the-anatomy-and-physiology-of-ageing-part-6-the-eye-and-ear/1840889.article">changes to the neural</a> (nerve) system.</p> <p>These changes contribute to older people suffering from hearing loss and central <a href="https://theconversation.com/is-your-child-having-trouble-learning-they-may-have-auditory-processing-disorder-62491">auditory processing disorders</a>, in which the ear cannot properly process sounds.</p> <p><strong>How these changes affect daily life</strong></p> <p>As a result of these numerous eye and ear changes and diseases, older people typically have vision and hearing problems that include sensitivity to light and difficulty visualising distant objects or reading print.</p> <p>Hearing problems include difficulty with perceiving and discriminating sounds (including speech), understanding speech (particularly in poor listening situations such as when there is high background noise or echo), and processing auditory information.</p> <p>These difficulties interfere with older adults’ everyday functioning and participation in activities. People with sensory loss may have difficulty performing independent activities of daily living such as bathing and shopping. This means they’re more at risk of problems with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448344/">mental health and social interaction</a>.</p> <p>One of the most disabling effects of vision and hearing loss is decreased ability to communicate with others. People with severe vision loss (low vision or legal blindness) have difficulty lip reading or perceiving non-verbal cues (such as facial expression or gestures).</p> <p>Those with hearing loss have communication difficulties including difficulty perceiving sounds or following a conversation. For people with loss of both senses, communication difficulties are much worse. They can’t adequately receive a verbal message and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030176/">frequently misunderstand conversation</a>.</p> <p><strong>Management of sensory loss</strong></p> <p>Management of sensory loss requires assessment by professionals (such as optometrists and audiologists) who will recommend the appropriate management plan that may include the use of a visual or hearing device.</p> <p>Speech pathologists also play a role, with programs including speech perception training or communication programs for clients and carers.</p> <p>Early identification and intervention can help those with vision and hearing loss so the effects of these sensory losses can be minimised, improving their quality of life.</p> <p><em>Acknowledgement: Dr Julian Sack (Ophthalmologist) for his input. </em><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/chyrisse-heine-313009">Chyrisse Heine</a>, Speech Pathologist/Audiologist Senior Lecturer, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">original article</a>.</em></p>

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Vision in red! Princess Mary is all class and grace at special celebration

<p>One of Australia’s favourite royal members, the Crown Princess of Denmark, was a vision in red as she attended a special celebration on Saturday, which honoured 800 years of the Danish flag.</p> <p>The proceedings were attended by many of the Danish royal members who all looked resplendent and graceful, however Princess Mary stole the show with her classy look.</p> <p>For the event, the 47-year-old went with a splash of colour, wearing a deep burgundy dress with a pair of matching stiletto heels.</p> <p>Red seemed to be the colour of the day, with Queen Margrethe looking beautiful and elegant in a bold red jacket and matching hat.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/Byvt3mLn_xo/" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/Byvt3mLn_xo/" target="_blank">A post shared by World Royal News (@worldroyalnews)</a> on Jun 15, 2019 at 2:31pm PDT</p> </div> </blockquote> <p>Princess Mary added a beige floral hat to sit atop a chic side bun and an extra touch of glamour with diamond earrings and a matching beige clutch.</p> <p>The Tasmanian-born royal member attended the celebration alongside her husband Prince Frederik in Vordingborg, Denmark. However, multiple locations paid tribute to the special moment, including Copenhagen and Estonia.  </p> <p>The myth says Denmark’s flag fell from the sky during the battle between Danish king Valdemar and the local chieftains in Estonia in the year 1219.</p> <p>Scroll through the gallery above to see Princess Mary’s gorgeous celebration outfit.</p> <p> </p>

Beauty & Style

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5 age-related vision problems older drivers need to be aware of

<p><em><strong><span style="text-decoration: underline;"><a href="https://plus.google.com/115326292314291480106" target="_blank">Aaron Barriga</a></span> is the online marketing manager for Insight Vision Center, an <span style="text-decoration: underline;"><a href="http://www.insightvisioncenter.com/" target="_blank">Ophthalmology Center in California</a></span>. With a knack for understanding medical procedures, and an interest in eye and vision health, Aaron loves to share what he knows and what he learns.</strong></em></p> <p>Are you concerned about your safety when behind the wheel?</p> <p>What is the most important sense that you need to drive? Well, you guessed it right, the <span style="text-decoration: underline;"><strong><a href="https://www.driversalert.com/your-vision-and-its-impact-on-driving-safety/" target="_blank">impact of vision on driving</a></strong></span> is second to none. But unfortunately, your vision can deteriorate as you get older which makes it more difficult for you to see movements, people and oncoming traffic.</p> <p>Ageing affects your driving skills and your body’s reaction time so don’t put yourself as well as others at risk if you feel this way. Have a word about your eligibility to drive with your ophthalmologist.</p> <p>Here are some age-related eye and vision problems that you may face:</p> <p><strong>1. Age-related macular degeneration</strong></p> <p>This is an eye disease that harms the macula which is the center of the light sensitive retina in your eye and leads to loss of central vision. Your macula is the part of our eye that allows us to see in color and in detail. Everyday tasks like driving require the use of good central vision which is provided by the macula. Macular degeneration can reduce your central vision but doesn’t affect your side or peripheral vision.</p> <p><strong> 2. Diabetic retinopathy</strong></p> <p>This condition usually occurs with people who suffer from diabetes. This is a result of the progressive damage to the small blood vessels that sustain your retina. These damaged blood vessels then seep blood and other fluids that make the retinal tissue swell and cloud your vision. The longer the person has had diabetes, the higher the risk of developing diabetic retinopathy which can lead to blindness according to its severity.</p> <p><strong>3. Dry eye</strong></p> <p>This is a physical condition that prevents a person from releasing too little or bad quality tears. Tears help in maintaining the health of the front surface of your eyes and provides clear vision. Dry eye is a common and often chronic problem which usually occurs in older adults.</p> <p><strong>4. Cataracts</strong></p> <p>Cataracts are cloudy and opaque areas that occur in the usually clear lens of your eyes and cause blurry vision. This can be very inconvenient as it leads to decreased contrast sensitivity, increased sensitivity to glares which can make reading road signs a bit difficult. <span style="text-decoration: underline;"><strong><a href="http://www.insightvisioncenter.com/service/cataract/" target="_blank">Cataract eye surgery</a></strong></span> is the only way to get rid of cataracts.</p> <p><strong> 5. Glaucoma</strong></p> <p>This is a group of eye diseases which are usually defined by the damage to the optic nerve which leads to a loss of vision. People who have a family history of glaucoma, older adults and African Americans stand a higher chance of developing Glaucoma. Glaucoma is usually painless but you can lose your peripheral side vision over time.</p> <p>Here are some safety tips to consider:</p> <p><strong>1. Have an annual eye test</strong></p> <p>The American Optometric Association recommends getting an annual eye test if you are above 60. By having regular eye tests done, your ophthalmologist can ensure that your eyes don’t suffer from any serious eye-related changes like macular degeneration.</p> <p><strong>2. Get rid of the reflections in your eyeglasses lens</strong></p> <p>Reflections in your eyeglass lenses can cause glares and hamper your vision, especially when driving at night. You can opt to avoid the hassles of wearing glasses altogether by investing in eye surgery but make sure to speak to your ophthalmologist before you do so.</p> <p><strong>3. Drive defensively</strong></p> <p>A study conducted by the Insurance Institute for Highway Safety, about 40% of the fatal collisions of people that are 70 and above tend to happen at intersections which involve other vehicles. The common reason for these accidents was the failure to give way, particularly when taking a left turn.</p> <p><strong> 4. Avoid driving on unfamiliar routes</strong></p> <p>Research by the National Safety Council discovered that the traffic death rates are a lot higher at night as compared to daytime. A lot of ageing Baby Boomers are still driving, exposing them to the danger of getting into accidents which only increases as they age. Avoid driving in areas that you are unfamiliar with, especially if they have poor lighting, irregular twists and lack of signs.</p> <p>Are you worried about not being able to get around like you used to? You as responsible drivers and citizens need to work proactively towards ensuring your own safety as well as that of others by recognizing a drop in your ability to drive safely and seek the advice of your ophthalmologist.</p>

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Caring for someone who is vision impaired

<p><em><strong>Marissa Sandler is the CEO and co-founder of <span style="text-decoration: underline;"><a href="http://www.careseekers.com.au/" target="_blank">Careseekers</a></span>. Previously a social justice lawyer and researcher for over 15 years, Marissa is passionate about helping people live with dignity and finding innovative solutions to problems.</strong></em></p> <p>There are over 575,000 people who are blind or vision impaired currently living in Australia, with more than 70 per cent over the age of 65 and over 66,000 people who are blind.</p> <p>With stats like this it is highly possible that you may find yourself caring for a loved one whose vision starts to decrease and may unfortunately become legally blind. Here is some information that you will help you care for a person with vision loss from the beginning stages of their diagnosis.</p> <p><strong>Look for the symptoms of deteriorating eyesight</strong></p> <p>It is quite common that a person will hide their poor eyesight from loved ones, they may be embarrassed, in denial or are scared of losing their independence.</p> <p>Look out for physical symptoms including:</p> <ul> <li>Constant red eyes</li> <li>Pain in the eyes</li> <li>Blurring vision</li> <li>Sudden temporary loss of vision</li> <li>Floaters</li> </ul> <p><strong>Other symptoms could be a sign of vision problems including</strong></p> <ul> <li>Depression and anxiety</li> <li>Not wanting to go out, especially at night</li> <li>Nervous behavior in public or crowded places</li> </ul> <p><strong>Start with a conversation about sight</strong></p> <p>As soon as you think a loved one is having problems seeing it is very important that you start to talk about it.  You need to have conversations about their sight often as it will be constantly changing. Make sure you are aware of what they can and cannot see. Check in with them every few months to see what has changed.</p> <p><strong>Make the living environment as safe as possible</strong></p> <p>Use the <span style="text-decoration: underline;"><strong><a href="http://careseekers.respond.ontraport.net/safetychecklist" target="_blank">Careseekers Home Safety Checklist</a></strong></span> and do an audit on each room in the house. Specific things you should do in a home for someone with poor eyesight include:</p> <ul> <li>Making sure the home is free of clutter and unnecessary items, especially in thoroughfares.</li> <li>Make sure lighting is good throughout the house, especially on staircases.</li> <li>Light switches are at the top and bottom of the staircases.</li> <li>There are night lights, as well as easy to reach bedside lights in bedrooms.</li> <li>Arrangement of furniture and large items is consistent throughout the home, so that the layout is always familiar. The same for regularly used items in every room in the home.</li> </ul> <p><strong>A few more helpful tips</strong></p> <p><span style="text-decoration: underline;"><strong><a href="http://www.visionaustralia.org/" target="_blank">Vision Australia</a></strong></span> is the go to organization for information for anyone suffering vision loss. Here are some general tips from them for day to day interactions with people with vision loss.</p> <ul> <li>Address people who are blind or have low vision by their names so they know you are speaking to them. </li> <li>When entering a room let the person who is blind or have low vision know that you have arrived. </li> <li>Do not walk away from a person who is blind or have low vision without indicating that you are doing so - it is embarrassing and frustrating to talk to thin air. </li> <li>In dangerous situations say "STOP" rather than "LOOK OUT"</li> <li>Do not fill glasses or cups to the brim. </li> <li>When directing people use ordinary language and when describing be specific. Do not point, or say "over there". Direct people who are blind or have low vision to their left and right, not yours. </li> <li>When talking, don’t be embarrassed to use the words "look" and "see"; they are part of everyone's vocabulary.</li> <li>Describe the surroundings and obstacles in a person's pathway (remember to look up as well as down). Warn of the presence of over-hangs, such as kitchen cupboards, jutting side mirrors of cars, or trees. </li> <li>When seating people who are blind or have low vision, put their hands on the back of the chair and they will then be able to seat themselves.</li> </ul>

Caring

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How to manage poor vision while on holidays

<p>Poor vision can have a huge impact on our day to day lives, but it doesn’t mean your next holiday should remain a pipedream. With planning, preparation and patience, it’s still possible to enjoy travel. Here are four tips for managing poor vision on holidays.</p> <p><strong>1. Don’t be afraid to ask for assistance </strong></p> <p>Whether you’re talking about hotel staff or airline crew, travel employees at various points of your trip will be able to provide assistance and help make life easier for you. Don’t be afraid to ask for help – it really is part of their job and they’ll be more than accommodating. Many activity companies also have measures in place to accommodate the visually impaired.</p> <p><strong>2. Make sure you’re packed and prepared</strong></p> <p>Write a list before you go of everything you need to manage your vision problems (such as contact lenses, cleaning solutions and medication) and make sure you pack two of every item. It’s generally a good idea to keep these in separate bags in case one goes missing.</p> <p><strong>3. Leave plenty of time to make your connections</strong></p> <p>Rushing through a crowded train station can be testing at the best of time, let alone when you’re managing vision problems. If possible, try to make your movements outside peak transit hours and make sure you’ve left plenty of time to make all your connections.</p> <p><strong>4. Don’t be afraid to be ambitious</strong></p> <p>While many people would think that vision problems could seriously impact the amount of activities you could take, don’t be afraid to be ambitious in your trip planning. Many travel companies offer ways the visually impaired can enjoy their popular attractions. </p> <p><strong>Related links:</strong></p> <p><a href="/travel/travel-tips/2016/08/the-thing-you-must-check-when-using-a-hotel-safe/" target="_blank"><span style="text-decoration: underline;"><em><strong>The one thing you must check when using a hotel safe</strong></em></span></a></p> <p><a href="/travel/travel-tips/2016/08/surprising-thing-to-kick-you-off-a-flight/"><span style="text-decoration: underline;"><em><strong>The surprising thing that could get you kicked off a flight</strong></em></span></a></p> <p><a href="/travel/travel-tips/2016/08/healthy-snacks-you-can-actually-take-on-a-plane/"><span style="text-decoration: underline;"><em><strong>6 healthy snacks you can actually take on a plane</strong></em></span></a></p>

Travel Tips

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5 at-home eye exercises for better vision

<p>As we age, it’s important to take special care of our eyes. Follow these five simple at-home eye exercises for improved focus, blood circulation and more.</p> <p><strong>To regulate circulation</strong></p> <p>This one’s simple. Close your eyes for three to five seconds, then open them. Do this several times. It will help increase blood circulation to your eyes and relax your muscles. </p> <p>Another simple exercise is to focus on one point in the room, and rotate your head in a circular motion. Start with left to right, then try up and down.</p> <p><strong>To maintain clear vision</strong></p> <p>Place your palms over closed eyes and relax for one minute. Darkness is said to help strengthen the photoreceptor cells in your eyes, which in turn help maintain clear vision.</p> <p><strong>To improve vision focus</strong></p> <p>Stand near a window so your face is close to the glass. Focus on the window pane first, then allow your gaze to rest on the distance. Repeat this ten times.</p> <p><strong>To strengthen eye muscles</strong></p> <p>Sit in a comfortable position and hold out your thumb in a hitchhiking pose. Focus on your outstretched thumb and slowly bring it closer to your face, until it’s five centimetres from your nose. Move it back and forth slowly so your eyes are forced to maintain focus.</p> <p><strong>To stimulate your eyes</strong></p> <p>Try this easy eye spa: apply a hot and cold compress by draping a hot towel over your eyes, followed by a cold one. The alternating temperatures is said to cause vasoconstriction and vasodilation which should stimulate your eyes and improve blood circulation.</p> <p><strong>To control eye movement</strong></p> <p>Focus on a point on the floor and imagine a figure eight. Using your eyes, trace around the figure eight slowly. Trace it one way, then the opposite direction.</p> <p><strong>Related links:</strong></p> <p><em><span style="text-decoration: underline;"><strong><a href="/health/eye-care/2015/12/are-elderly-drivers-more-dangerous/">Does ageing make one more dangerous behind the wheel?</a></strong></span></em></p> <p><em><span style="text-decoration: underline;"><strong><a href="/health/eye-care/2015/11/first-borns-near-sightedness/">First-born children are more likely to be nearsighted</a></strong></span></em></p> <p><em><span style="text-decoration: underline;"><strong><a href="/health/eye-care/2015/11/how-often-should-you-get-your-eyes-tested/">How often should you visit your optometrist?</a></strong></span></em></p>

Eye Care

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Different vision test results – how can this happen?

<p>If you have regular eye examinations (which everyone should) you may have found that the results differed – even when the tests were taken by the same optician and in a very short time frame. If this has happened to you, don’t panic! It’s actually a very common occurrence due to a couple of different reasons.</p><ol><li><strong>Your eyes –</strong> The visual performance of our eyes varies throughout the day due to fluctuations in our hormones and blood sugar amongst other things. A test taken before the workday and after an hour on the computer will often yield a different result due to the stress that has occurred to the eye in a short period. To achieve the best result, try and schedule your test for a time when you’re relaxed, hydrated and not hungry. First thing in the morning is ideal.</li><li><strong>The conditions during your test –</strong> The conditions in which a sight test is performed can have a distinct impact on the result. You should see an experienced optician for a thorough and comprehensive test in a dark examination room without any daylight present. To ensure the best result, make an appointment with your optician and discuss any issues or questions you may have.</li><li><strong>Exterior influencers –</strong> Wearing contact lenses, taking medication and conditions like diabetes can all lead to an incorrect eye test result. To ensure the most accurate reading, let your optician know what medication you’re taking and if you suffer any medical issues. Try wearing your glasses instead of your contacts for 24 hours before your test as well if you can.</li></ol>

Eye Care

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Different vision test results – how can this happen?

<p>If you have regular eye examinations (which everyone should) you may have found that the results differed – even when the tests were taken by the same optician and in a very short time frame. If this has happened to you, don’t panic! It’s actually a very common occurrence due to a couple of different reasons.</p><ol><li><strong>Your eyes –</strong> The visual performance of our eyes varies throughout the day due to fluctuations in our hormones and blood sugar amongst other things. A test taken before the workday and after an hour on the computer will often yield a different result due to the stress that has occurred to the eye in a short period. To achieve the best result, try and schedule your test for a time when you’re relaxed, hydrated and not hungry. First thing in the morning is ideal.</li><li><strong>The conditions during your test –</strong> The conditions in which a sight test is performed can have a distinct impact on the result. You should see an experienced optician for a thorough and comprehensive test in a dark examination room without any daylight present. To ensure the best result, make an appointment with your optician and discuss any issues or questions you may have.</li><li><strong>Exterior influencers –</strong> Wearing contact lenses, taking medication and conditions like diabetes can all lead to an incorrect eye test result. To ensure the most accurate reading, let your optician know what medication you’re taking and if you suffer any medical issues. Try wearing your glasses instead of your contacts for 24 hours before your test as well if you can.</li></ol>

Eye Care

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The common vision problem you don’t hear so much about

<p>Short-sighted and long-sighted: these are commonly known terms when it comes to errors of vision. But what do we know about astigmatism? </p> <p>Astigmatism means that the eye has difficulty focusing light. In a normal eye, light comes to a single focus on the retina. This allows the eye clear sight.</p> <p>An eye with astigmatism, however, has multiple points of focus, causing details to appear more blurry. In one UK study of over 11,000 glasses wearers, 47.4 per cent were found to have some degree of astigmatism.</p> <p><strong>What are the symptoms?</strong></p> <p>Those who have astigmatism will experience blurred vision at all distances to some extent, but especially from afar. They might also experience headaches as a result. This is different from simply being near or farsighted. In fact, a person can have 20/20 vision and still have astigmatism.</p> <p><strong>How is it caused?</strong></p> <p>Astigmatism happens as a result of a misshaped cornea. Rather than the round shape a normal eye would have, an astigmatic eye is more oval shaped, which changes its ability to focus light.</p> <p><strong>Should I get tested?</strong></p> <p>During your regular routine eye exam, your doctor should check for astigmatism in the same way they would check for other vision problems. If you or your grandchildren have trouble focusing on detail, you should book an eye exam and talk to your doctor about your concerns.</p> <p><strong>How can I fix it?</strong></p> <p>While it can sometimes worsen with age, astigmatism is not a degenerative disease. As such, astigmatism can generally be corrected with glasses or contact lenses, as well as refractive surgery.</p> <p><strong>Related links:</strong></p> <p><span style="text-decoration: underline;"><em><strong><a href="/health/eye-care/2015/08/how-to-look-for-new-reading-glasses/">Read this before buying new reading glasses</a></strong></em></span></p> <p><span style="text-decoration: underline;"><em><strong><a href="/health/eye-care/2015/07/common-sight-problems/">3 of the most common threats to your sight</a></strong></em></span></p> <p><span style="text-decoration: underline;"><em><strong><a href="/health/eye-care/2015/07/exercise-can-help-eyesight/">Studies show exercise could save your eyesight</a></strong></em></span></p>

Eye Care

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What you should know about your vision and driving

<p>The myth of the bad elderly driver is just that – a myth. And research backs this up, finding that older drivers do have fewer accidents overall than younger drivers. However, research also shows that seniors have high crash rates in certain road situations, such as at intersections or at night time.</p> <p>Ageing affects your vision, but as it’s often in subtle shifts it can be hard to detect. The ability to see clearly at far distances, from the corner of your eye and at night is crucial for safe driving, and any changes, even small ones, can impact your confidence and safety when driving. Being aware of the health of your eyes and noting any vision changes in daily life is important to maintain clear vision, along with a good driving record.</p> <p>Here are the warning signs of declining vision you need to be aware of:</p> <ul> <li>Distorted vision</li> <li>Double vision</li> <li>Spots in vision</li> <li>Pain, discomfort or redness of eye</li> <li>Any loss of vision in centre or edges</li> <li>Decreased colour vision</li> <li>Reduced ability to adjust to light changes</li> </ul> <p>If you notice any changes or think you may have a problem with your vision, consult your optometrist. They can diagnose and treat any eye problems as well as help you reach the vision standards necessary for safe driving.</p> <p><strong>Related links:</strong></p> <p><em><span style="text-decoration: underline;"><strong><a href="/health/eye-care/2015/07/are-carrots-good-for-eyes/">Can eating carrots actually improve your eyesight?</a></strong></span></em></p> <p><em><span style="text-decoration: underline;"><strong><a href="/health/eye-care/2015/07/exercise-can-help-eyesight/">Studies show exercise could save your eyesight</a></strong></span></em></p> <p><em><span style="text-decoration: underline;"><strong><a href="/health/eye-care/2015/05/natural-remedies-for-tired-eyes/">6 natural remedies for tired eyes</a></strong></span></em></p>

Eye Care

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So what does 20/20 vision mean?

<p>If you’ve ever wondered what 20/20 vision actually means, we’ve got the lowdown here. When you have your eyes tested at the optometrist, they are measuring how well you can see in the distance compared to other people. Traditionally, optometrists use the Snellen eye chart, which was developed by Dutch eye doctor Hermann Snellen in the 1860s.</p> <p><strong>The Snellen eye chart</strong></p> <p>Though there are a few variations, the chart generally shows 11 rows of capital letters. As you go down from the top row, the letters become smaller and smaller.</p> <p>During your test the optometrist will ask you to keep reading down the chart until you can no longer make out the text on a particular line of letters. If you can read the bottom row (which many people can’t), then your visual acuity is considered very good.</p> <p>You may have heard of the expression “20/20 vision” and wondered what that means. The eye chart is normally placed on a wall 20 feet away from your eyes. Most optometrists don’t have rooms quite that big, so they use a combination of mirror and chart placement to simulate the 20-feet distance.</p> <p>If you have 20/20 vision you can read a letter at 20 feet that most people should be able to read at 20 feet. This is considered normal vision.</p> <p>At the other end of the spectrum, if you can only read the very top letter on the chart (it’s normally an E) your vision is considered 20/200. Meaning you can read a letter at 20 feet that people with normal vision can read at 200 feet.</p> <p>As a general rule, the 20/20 line of letters on the chart is on the fourth row from the bottom, with 20/15, 20/10 and 20/5 below that. While it’s not common for people to have visual acuity of 20/10, many animals do. Birds of prey have been estimated to have an acuity of 20/5 or even better.</p> <p><strong>The Tumbling E eye chart</strong></p> <p>There are some instances where the Snellen eye chart is not appropriate. For instance if the patient is a child who can’t yet read or might be a bit shy, another chart is used.</p> <p>A modified Snellen chart, called the “tumbling E” chart may be used instead. While it has the same scale as the Snellen eye chart, all of the characters used on the chart are variations on the capital letter “E” – where it is rotated by 90 degrees to form different shapes.</p> <p>Instead of asking them to “read” the text, the optometrist will ask the patient to show the direction of the E on their hands. The measurements have been shown to be almost the same as when the Snellen eye chart is used.</p> <p><strong>The Jaeger eye chart</strong></p> <p>When it comes to your near vision, an optometrist might use a small hand-held card called a Jaeger eye chart. This chart has short blocks of text in various type sizes.</p> <p>In the same way as the far sight tests, the Jaeger type scale allows the optometrist to measure the equivalent of 20/20 vision on the card – this is generally around 12 to 14 inches from your eyes.                              </p> <p><strong>Eye chart limitations</strong></p> <p>An eye chart can help your optometrist determine whether you need glasses or contact lenses; and it can also help the RMS decide whether you need to use eyewear while driving (or whether you can’t drive at all due to vision impairment).</p> <p>But an eye chart can’t measure things such as your peripheral vision, your depth perception, or your ability to perceive colour or contrast. They also don’t measure the health of your eye, in terms of glaucoma, fluid on the eye, dryness or the health of your retina.</p> <p>These are all looked at when you have your eye exam. Ideally you should try and have your eyes checked every one or two years.</p>

Eye Care

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Adelaide Fringe festival caters to the vision-impaired

<p>For the first time ever, vision-impaired and blind people had the chance to touch and feel the floats and costumes before the Adelaide Fringe Festival parade last night. &nbsp;</p><p>The parade, which kicked off the festival, consisted of 80 colourful floats and flocks of performers. It’s a spectacle that vision-impaired people had not been able to be part of but organisers hope that the “touch tour” would help the vision-impaired visualise the parade when they listened to it.</p><p>“It's really important because otherwise you wouldn't see anything or know what's happening,” Gloria, a vision-impaired student, told the ABC.</p><p>“It's better to have a feel because then you know what it's like instead of just hearing music,” added her friend Courtney.</p><p>Both student said that the touch tour helped them have a better idea of the parade.</p><p>“The majority of people who have a vision impairment lose their sight, so they've had sight before,” said Gaelle Mellis from Access2Arts who helped organise the touch tour.</p><p>“They might have really enjoyed going to the theatre or the Fringe parade, for example, and they think that they can't do that anymore, that that's closed off.</p><p>“What audio description does, because it's actually describing the visual elements it actually opens that experience up again.”</p><p><em>Image credit: Adelaide Fringe Facebook&nbsp;</em></p><p><strong>Related links:</strong></p><p><span style="text-decoration: underline;"><em><strong><a href="/health/eye-care/2014/11/7-habits-that-can-prematurely-age-your-eyes/" target="_blank">7 habits that can prematurely age your eyes</a></strong></em></span></p><p><a href="/health/eye-care/2015/01/signs-of-eye-floaters/" target="_blank"><span style="text-decoration: underline;"><em><strong>Why you need to be wary of eye floaters</strong></em></span></a></p><p><a href="/health/eye-care/2014/11/what-your-family-history-says-about-your-eyesight/" target="_blank"><span style="text-decoration: underline;"><em><strong>What your family history says about your eyesight</strong></em></span></a></p><p>&nbsp;</p>

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