Currently, 4% of older adults reside in long-term care facilities in the Netherlands. Nursing home residents tend to have multimorbidity that is associated with considerable disabilities and a high level of care dependency. In the Dutch adult population the highest estimated prevalence (>40%) of visual impairment (low vision and blindness) was found in the subgroup of residents in nursing homes (NHs). The aim of this study is to describe the current practice of eye care by Dutch nursing home physicians (NHPs). A digital online survey was developed to describe the eye care activities of nursing home physicians and their cooperation in this perspective with other professionals. Of 1573 NHPs present in the Netherlands, 125 (8%) responded. Results show that more than 50% of the NHPs regularly examine ‘distant vision’, ‘near vision’ and ‘the visual field’ . However, 23%, 33% and 45% almost never or never examine the ‘visual field’, ‘near vision’ and ‘distant vision’, respectively. Data regarding eye care, regularly recorded in the client files by more than 50% of the NHPs, are medical data involving ‘use of eye medication’, ‘eye disease’, and ‘eye surgery in the past’. Less commonly recorded is ‘the use of reading glasses’ as well as ‘eye pain’. Inside of the NH, (head) nurses and ward nurses (chi 2 = 309, df = 5, p = 0.000), and outside of the NH, ophthalmologists and low vision specialists are most frequently contacted about eye related issues (chi 2 = 224, df = 4, p = 0.000). Opticians are rarely contacted, and optometrists and orthoptists are ‘never’ contacted by more than 50% of the NHPs. Moreover, 50% of the NHPs noted that collaboration with external eye care professionals is ‘not structural’. This study shows that, according to NHPs, relevant visual aspects are not structurally examined and recorded in the client files. Outside of the NH, NHPs tend to have a less frequent collaborative relationship with optometrists, orthoptists and opticians compared to ophthalmologists and low vision specialists. The NHP’s role in providing eye care can be improved by development of guidelines for structural eye screening, improvement of recording in client files, and exploring plus undertaking collaboration with other eye care professionals.
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Over 40% of nursing home residents in the Netherlands are estimated to have visual impairments. In this study, light conditions in Dutch nursing homes were assessed in terms of horizontal and vertical illuminances and colour temperature. Results showed that in the seven nursing homes vertical illuminances in common rooms fell significantly below the 750 lx reference value in at least 65% of the measurements. Horizontal illuminance measurements in common rooms showed a similar pattern. At least 55% of the measurements were below the 750 lx threshold. The number of measurements at the window zone was significantly higher than the threshold level of 750 lx. Illuminances in the corridors fell significantly below the 200 lx threshold in at least three quarters of the measurements in six of the seven nursing homes. The colour temperature of light fell significantly below the reference value for daylight of 5000 K with median scores of 3400 to 4500 K. A significant difference in colour temperature was found between recently constructed nursing homes and some older homes. Lighting conditions of the examined nursing homes were poor. With these data, nursing home staff have the means to improve the lighting conditions, for instance, by encouraging residents to be seated next to a window when performing a task or during meals.
The finding of poor lighting conditions in nursing homes in combination with a high prevalence of visual problems (with cataract found to be the most common age related pathology), stretches the need of enhanced awareness of eye care by professional caregivers.
