Guidelines for Caring for Visually-Impaired Patients


Article Categories: Activities of Daily Living & CNA Skills


Many patients in long-term care or nursing homes have some type of vision disability, including blindness. According to the American Academy of Family Physicians, by the age of 65, one-third of people have some type of vision-related condition. In fact, 82% of people who are blind are over age 50.



Some of the common causes for vision loss in elderly patients include:

• Age-related macular degeneration, AMD, which causes loss in the center field of vision. Everything looks blurry and images are distorted. Patients have a difficult time reading.

• Glaucoma results from increasing pressure within the eyeball. There are no symptoms to warn a patient, so vision gradually fades. It’s the second leading cause of blindness.

• Cataracts are the “clouding” of the eye’s lens, making everything look foggy and blurry. Over 50% of patients over 75 have cataracts; it’s the #1 cause of blindness.

• Diabetic patients can develop retinopathy, damage to the retina which results in vision loss and blindness. It begins in middle age with blurriness and difficulty seeing colors.

Except for cataracts, which can be cured with lens replacement surgery, these conditions require medical management to try and slow the loss of vision. When caring for patients who are blind or visually-impaired, it’s important to learn how to help them function with dignity and as much independence as possible.

Here are some guidelines that will make your visually-impaired patients comfortable:

• Always knock when entering the room. Introduce yourself and tell what you plan to do. When you leave the room, let the patient know.

• Stand by the side of the bed or chair and face the patient when you talk. Don’t walk around as you speak; it’s confusing for the patient to try and follow your voice.

• Speak directly to the patient in a normal voice. If other people are present, don’t ask them questions the patient could answer. Avoid: “Does your mother like….?”

• When serving food, always explain what is on the plate. Use the clock face system to describe where each food is. Tell the patient where beverages or other items are. “You have chocolate pudding on the left, above your plate.”

• Guide the patient by offering your elbow and walk about one step ahead. The patient can take your arm with his fingers holding the inside of your arm, just above the elbow with his thumb resting on the outside of your arm.

• Let the patient know of any obstacles, steps, or inclines ahead. Identify doors by saying, “The door is opening away from us on the right.” Then walk through the doorway and let the patient catch it as he passes through.

• When helping the patient in the bathroom, guide her to the sink. Put your hand on the front of the sink and let her slide her hand down your arm so she can touch the sink. Then give her directions: “The toilet is to the left. When you sit, the toilet paper will be to your right.”

Getting accustomed to working with visually-impaired or blind patients takes time and practice. As you gain confidence, you will learn to anticipate what each patient requires and be able to easily help him or her throughout your shift.

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