A study published in JAMA Ophthalmology predicts that the number of Americans who are blind or visually impaired will double by 2050.1 This dramatic increase can be attributed to one major factor: age.

Aging is the primary cause of vision disorders, with over 12 million Americans aged 40 and older experiencing some level of visual impairment. As the senior population continues to grow, homecare providers are seeing an unprecedented number of vision-impaired clients.

For homecare providers, these projections highlight both a pressing need and a unique opportunity: older adults with vision loss require specialized care tailored to the challenges of low vision. By developing services that cater to individuals with low vision, providers can support seniors in aging at home while preserving their independence. This also strengthens their role within the healthcare system by helping reduce hospital readmissions.

A More Considerate Approach

The need for low-vision care is already high, as many seniors experience some degree of vision impairment. Estimates suggest that by age 65, one in three individuals will have some form of vision-reducing eye disease. As a result, home assessments often focus on identifying and addressing hazards that could lead to falls, such as obstacles in hallways or high-traffic areas. But why should in-home care and medical equipment providers create specialized programs for low vision?

Focused programs are effective because they meet the specific needs of clients, increasing their appeal to both potential clients and their families. So, what key areas should a low-vision program address?

1. Fall Prevention

• Falls are a major risk for older adults, and impaired vision significantly increases the likelihood of falling. Every year, one in four Americans aged 65 and older falls, and visual impairment more than doubles that risk.
  
  
• For seniors with vision challenges, the fear of falling can lead to withdrawal from everyday activities and hobbies, exacerbating isolation and reducing mobility. Research in Investigative Ophthalmology and Visual Science found that 40% to 50% of seniors with chronic eye conditions limited their activities due to fall fears.2 This can result in a vicious cycle of reduced activity, greater isolation, and worsening health outcomes.
  
  
• By modifying a home environment to meet the needs of low-vision clients, homecare providers can reduce fall risks and preserve seniors’ confidence and independence.
  

2. Mental Health

• A 2020 study from the National Library of Medicine revealed that up to 8.6% of older adults with vision loss met the criteria for depression, with 10.9% to 43% reporting significant depressive symptoms—much higher than in the general aging population.3 The same study also found that seniors with vision impairment experience higher levels of anxiety than those with conditions like diabetes or heart disease.
  
  
• Vision loss often develops gradually, making it difficult for seniors and their families to recognize how much sight has been compromised, which can put their safety at risk. Activities that were once enjoyable or routine, such as gardening or cooking, may become hazardous, diminishing the quality of life and independence for these individuals.
  

3. Color and Contrast in the Home

• Using bright colors and creating contrasts in the home can significantly aid low-vision clients in navigating their environments and distinguishing between everyday objects and potential hazards.
  
  
• Color: Bright, light-reflecting colors—especially primary colors like red, orange, and yellow—are easier to see. Using fluorescent-colored tape or sticky notes can help mark stairs, doorways, and other important areas. Bold decor elements like throw pillows or blankets can also help clients locate furniture or appliances more easily. Brightly colored grab bars are another useful addition.
  
  
• Contrast: Creating contrasts in lighting and background colors also benefits low-vision clients. For instance, dark-colored objects against light-colored backgrounds or light-colored switch plates against dark switches improve visibility. Avoiding transparent items or overly patterned materials also helps to prevent confusion.
  

4. Low Vision Tasks & Errands

• Certain household tasks and errands can be challenging or unsafe for individuals with low vision. Depending on the severity of their impairment, clients may need assistance with activities such as meal preparation, laundry, and light housekeeping.
  
  
• While these tasks may fall under general homecare, highlighting them within a low-vision program reassures families that caregivers are fully aware of the specific needs associated with vision loss.
  
  
• Regular eye exams are also essential, as conditions like age-related macular degeneration are common causes of vision loss among seniors. The National Eye Institute recommends that adults over 60 have a comprehensive eye exam every one to two years. Homecare providers should be aware of these guidelines and assist in arranging transportation for clients to and from appointments.
  

Low Vision in the Care Continuum

As a homecare provider, your role in the care continuum is critical, especially as the senior population continues to grow. Health care systems will rely more heavily on homecare providers to support patients and avoid hospital readmissions.

Expanding your services to include specialized programs, such as low vision care, strengthens your value both to clients and families and to the broader healthcare system. By addressing the unique needs of vision-impaired seniors, homecare providers can ensure that older adults thrive in their communities, age in place, and receive the comprehensive support they deserve.

References:

1. Varma R, Vajaranant TS, Burkemper B, Wu S, Torres M, Hsu C, Choudhury F, McKean-Cowdin R. Visual impairment and blindness in adults in the United States: demographic and geographic variations from 2015 to 2050. JAMA Ophthalmology. 2016 Jul 1;134(7):802-9.
2. Wang MY, Rousseau J, Boisjoly H, Schmaltz H, Kergoat MJ, Moghadaszadeh S, Djafari F, Freeman EE. Activity limitation due to a fear of falling in older adults with eye disease. Investigative Ophthalmology & Visual Science. 2012 Dec 1;53(13):7967-72.
3. Demmin DL, Silverstein SM. Visual impairment and mental health: unmet needs and treatment options. Clinical Ophthalmology. 2020 Dec 3:4229-51.