Eye Sight Tests & End Stage Dementia

luggy

Registered User
Jan 25, 2023
255
0
I'm sure that there are a number of very good and well run care homes out there, but I haven't yet found that to be the case in my experience during the last 3 years with mum. I'll do my best to word my post in the manner of the calm and rational person I strive to be. Deep breath, here goes.....

Yesterday, I visited mum in her care home. As I have written many times on this forum, mum is in the late stages of dementia - bed-bound, can only string 3 words together to make an out of context sentence and has no capacity. I'm her LPOA. Upon arrival in her room, I found a pair of spectacles in a case labelled with her name and 'near vision'. Mum has never had prescription glasses and used the cheap ready readers available in most High Street shops - that was way back when she could still read. After a while, a carer came into the room and I asked her about the glasses, to which she replied that the optician had visited the home and everyone had their eyes tested and some residents were issued with glasses. I asked, presumably mum will have to pay for the glasses, but the carer said she didn't know about that sort of thing.

Mum can no longer read. She's unable to engage with a book, magazine or newspaper, she cannot knit, sew, crochet or engage with any kind of activity. Mum is unable to consent to an eye test and I wasn't contacted as her LPOA. It has never occurred to me that mum, who presents as being at death's door for much of the time, would need to have an eye test with a view to being prescribed with a pair of reading glasses.

So, tomorrow I will calmly take this up with the manager and politely inform her that I have no intention of using mum's money to pay for a pair of glasses which will never be used and request that, in future, I am contacted before such decisions are made. Of course, it could be that the care home and opticians have arranged this for all residents as some kind of good will gesture, although I doubt it.

I dread visiting mum. Almost every visit generates some kind of follow up enquiry and the carers, who are all very polite and smiley, are very unwilling to discuss anything of importance.

Has anyone else come across eye tests in end stage dementia? Thanks.
 

SAP

Registered User
Feb 18, 2017
1,673
0
Not end stage but last time my mums eyes were tested the optician called me to ask if I wanted the prescription made up and told me the cost before they went a head. As it was mum refused to wear them so I decided to never to spend her money on glasses again if she won’t wear them. Doesn’t help you @luggy but it would suggest that some kind of agreement should have been reached first. Obviously the test is free but the rest is paid for.
 

sdmhred

Registered User
Jan 26, 2022
2,654
0
Surrey
Hi @luggy

I share your frustration re communications. I visited mum every day and often wasn’t told stuff. I turned up one day to find the optician present. Mum was tested in my presence and i advised she wasn’t needing any glasses these days. She had a rare disease impacting on eyes which the optician should have been made aware of in advance …but of course that hadn’t happened.

I was half expecting a bill for the sight test but thankfully that never came.

You wouldn’t have thought it was too much stress to send an email out a week prior to all families would you? Certainly management at mum’s home hadn’t had parents or OH’s themselves in care homes to appreciate that we do Like to know stuff.

If billed I would send an email back saying you will happily pay once you have seen your mum wearing glasses and reading!!!
 

nitram

Registered User
Apr 6, 2011
30,825
0
Bury
I was half expecting a bill for the sight test but thankfully that never came.
Over 60s can have a free NHS eye test every 2 years or more frequently at optician's discretion, I have an annual test because I have a slowly developing cataract.

@luggy
Perhaps optician tested eyesight and as existing glasses were correct labelled the case.
 

Chizz

Registered User
Jan 10, 2023
4,295
0
Kent
I'm sure that there are a number of very good and well run care homes out there, but I haven't yet found that to be the case in my experience during the last 3 years with mum. I'll do my best to word my post in the manner of the calm and rational person I strive to be. Deep breath, here goes.....

Yesterday, I visited mum in her care home. As I have written many times on this forum, mum is in the late stages of dementia - bed-bound, can only string 3 words together to make an out of context sentence and has no capacity. I'm her LPOA. Upon arrival in her room, I found a pair of spectacles in a case labelled with her name and 'near vision'. Mum has never had prescription glasses and used the cheap ready readers available in most High Street shops - that was way back when she could still read. After a while, a carer came into the room and I asked her about the glasses, to which she replied that the optician had visited the home and everyone had their eyes tested and some residents were issued with glasses. I asked, presumably mum will have to pay for the glasses, but the carer said she didn't know about that sort of thing.

Mum can no longer read. She's unable to engage with a book, magazine or newspaper, she cannot knit, sew, crochet or engage with any kind of activity. Mum is unable to consent to an eye test and I wasn't contacted as her LPOA. It has never occurred to me that mum, who presents as being at death's door for much of the time, would need to have an eye test with a view to being prescribed with a pair of reading glasses.

So, tomorrow I will calmly take this up with the manager and politely inform her that I have no intention of using mum's money to pay for a pair of glasses which will never be used and request that, in future, I am contacted before such decisions are made. Of course, it could be that the care home and opticians have arranged this for all residents as some kind of good will gesture, although I doubt it.

I dread visiting mum. Almost every visit generates some kind of follow up enquiry and the carers, who are all very polite and smiley, are very unwilling to discuss anything of importance.

Has anyone else come across eye tests in end stage dementia? Thanks.
Hi @luggy
For a proper outcome of an eye test, the person being tested would, in my view, have to express their view as to whether the glasses prescription being offered were OK or not. Thus, they would need to know what the glasses are for, be able to decide whether the glasses offered were making a difference to her sight and focus, then be able to say whether they're OK or no they're not OK.
Without being able to speak coherently, think rationally, I cannot see how your mum could be liable for a potential expense for which she does not have capacity in law to contract.

Thus, if you mum does not have capacity, nor ability to verbally express herself, it might well be regarded as professionally improper of a qualified optician/opthamologist to prescribe.

My OH has been short-sighted since early childhood and always wore prescription glasses/ then contact lenses / then due to early onset cataracts in her 60s she had lens implants and technically doesn't need glasses at all. However, she was told that it would be a good idea to take up the NHS free eye tests every two years to check there wasn't something else wrong with her eyes (glaucoma, macular degeneration, stigmatisms, etc). She had these tests. However my OH has had Alz for the last 6 or 7 years, Early on, she still had an eye test and could understand what was going on and why. When she had well and truly lost mental capacity and lost the mental ability to follow instructions, like sit up, sit still, look in here, try this on L eye, try this on R eye, etc etc, did know why anybody was asking her these odd things which she couldn't mentally process, the optician said I can longer carry out eye tests because she can't even express consent to have it done. The same applied to the dentist. My OH is bedbound, can't talk more than three or four words without going in noises that aren't words at all, can't concentrate / focus on anything for any length of time.
Result = no tests can be done.

I think this probably, from what you say, applies to your mum.

Yes, stay calm to be in control and confront the care home manager in the form of a friendly chat (or at least to begin with), and get them to record that for anything like that, they will contact you in advance for your consent, if appropriate.

Best wishes
 

luggy

Registered User
Jan 25, 2023
255
0
Not end stage but last time my mums eyes were tested the optician called me to ask if I wanted the prescription made up and told me the cost before they went a head. As it was mum refused to wear them so I decided to never to spend her money on glasses again if she won’t wear them. Doesn’t help you @luggy but it would suggest that some kind of agreement should have been reached first. Obviously the test is free but the rest is paid for.
Thanks @SAP I would have thought some kind of agreement or consultation ought to have taken place beforehand.
 

luggy

Registered User
Jan 25, 2023
255
0
Hi @luggy

I share your frustration re communications. I visited mum every day and often wasn’t told stuff. I turned up one day to find the optician present. Mum was tested in my presence and i advised she wasn’t needing any glasses these days. She had a rare disease impacting on eyes which the optician should have been made aware of in advance …but of course that hadn’t happened.

I was half expecting a bill for the sight test but thankfully that never came.

You wouldn’t have thought it was too much stress to send an email out a week prior to all families would you? Certainly management at mum’s home hadn’t had parents or OH’s themselves in care homes to appreciate that we do Like to know stuff.

If billed I would send an email back saying you will happily pay once you have seen your mum wearing glasses and reading!!!
Haha @sdmhred I'll remember to do just that! Not keeping relatives informed is very stressful. These things taken in isolation are one thing, but it's the constant 'drip, drip' which takes its toll.
 

luggy

Registered User
Jan 25, 2023
255
0
Over 60s can have a free NHS eye test every 2 years or more frequently at optician's discretion, I have an annual test because I have a slowly developing cataract.

@luggy
Perhaps optician tested eyesight and as existing glasses were correct labelled the case.
Thanks @nitram coorect me if I'm wrong, but I'm lead to believe that the optometrists claim back from the govt for every free test they carry out, so the more they do, the more they can claim.

Mum didn't have existing prescription glasses. The glasses I'm referring to were prescribed for the first time on the day of the optometrist's visit.
 

luggy

Registered User
Jan 25, 2023
255
0
Hi @luggy
For a proper outcome of an eye test, the person being tested would, in my view, have to express their view as to whether the glasses prescription being offered were OK or not. Thus, they would need to know what the glasses are for, be able to decide whether the glasses offered were making a difference to her sight and focus, then be able to say whether they're OK or no they're not OK.
Without being able to speak coherently, think rationally, I cannot see how your mum could be liable for a potential expense for which she does not have capacity in law to contract.

Thus, if you mum does not have capacity, nor ability to verbally express herself, it might well be regarded as professionally improper of a qualified optician/opthamologist to prescribe.

My OH has been short-sighted since early childhood and always wore prescription glasses/ then contact lenses / then due to early onset cataracts in her 60s she had lens implants and technically doesn't need glasses at all. However, she was told that it would be a good idea to take up the NHS free eye tests every two years to check there wasn't something else wrong with her eyes (glaucoma, macular degeneration, stigmatisms, etc). She had these tests. However my OH has had Alz for the last 6 or 7 years, Early on, she still had an eye test and could understand what was going on and why. When she had well and truly lost mental capacity and lost the mental ability to follow instructions, like sit up, sit still, look in here, try this on L eye, try this on R eye, etc etc, did know why anybody was asking her these odd things which she couldn't mentally process, the optician said I can longer carry out eye tests because she can't even express consent to have it done. The same applied to the dentist. My OH is bedbound, can't talk more than three or four words without going in noises that aren't words at all, can't concentrate / focus on anything for any length of time.
Result = no tests can be done.

I think this probably, from what you say, applies to your mum.

Yes, stay calm to be in control and confront the care home manager in the form of a friendly chat (or at least to begin with), and get them to record that for anything like that, they will contact you in advance for your consent, if appropriate.

Best wishes
@Chizz very well said. I'll commit some of what you have written to memory for future reference, should it be required!
 

nitram

Registered User
Apr 6, 2011
30,825
0
Bury
Thanks @nitram coorect me if I'm wrong, but I'm lead to believe that the optometrists claim back from the govt for every free test they carry out, so the more they do, the more they can claim.
Correct
Mum didn't have existing prescription glasses. The glasses I'm referring to were prescribed for the first time on the day of the optometrist's visit.
Sorry, I thought they were
the cheap ready readers available in most High Street shops - that was way back when she could still read
left over from when she used them.

NHS tests are free for over 60s, free provision of glasses requires an Optical Vouchers
 

CAL Y

Registered User
Jul 17, 2021
650
0
Hi @luggy
For a proper outcome of an eye test, the person being tested would, in my view, have to express their view as to whether the glasses prescription being offered were OK or not. Thus, they would need to know what the glasses are for, be able to decide whether the glasses offered were making a difference to her sight and focus, then be able to say whether they're OK or no they're not OK.
Without being able to speak coherently, think rationally, I cannot see how your mum could be liable for a potential expense for which she does not have capacity in law to contract.

Thus, if you mum does not have capacity, nor ability to verbally express herself, it might well be regarded as professionally improper of a qualified optician/opthamologist to prescribe.

My OH has been short-sighted since early childhood and always wore prescription glasses/ then contact lenses / then due to early onset cataracts in her 60s she had lens implants and technically doesn't need glasses at all. However, she was told that it would be a good idea to take up the NHS free eye tests every two years to check there wasn't something else wrong with her eyes (glaucoma, macular degeneration, stigmatisms, etc). She had these tests. However my OH has had Alz for the last 6 or 7 years, Early on, she still had an eye test and could understand what was going on and why. When she had well and truly lost mental capacity and lost the mental ability to follow instructions, like sit up, sit still, look in here, try this on L eye, try this on R eye, etc etc, did know why anybody was asking her these odd things which she couldn't mentally process, the optician said I can longer carry out eye tests because she can't even express consent to have it done. The same applied to the dentist. My OH is bedbound, can't talk more than three or four words without going in noises that aren't words at all, can't concentrate / focus on anything for any length of time.
Result = no tests can be done.

I think this probably, from what you say, applies to your mum.

Yes, stay calm to be in control and confront the care home manager in the form of a friendly chat (or at least to begin with), and get them to record that for anything like that, they will contact you in advance for your consent, if appropriate.

Best wishes
👍
 

Alisongs

Registered User
May 17, 2024
709
0
Hi @luggy

I share your frustration re communications. I visited mum every day and often wasn’t told stuff. I turned up one day to find the optician present. Mum was tested in my presence and i advised she wasn’t needing any glasses these days. She had a rare disease impacting on eyes which the optician should have been made aware of in advance …but of course that hadn’t happened.

I was half expecting a bill for the sight test but thankfully that never came.

You wouldn’t have thought it was too much stress to send an email out a week prior to all families would you? Certainly management at mum’s home hadn’t had parents or OH’s themselves in care homes to appreciate that we do Like to know stuff.

If billed I would send an email back saying you will happily pay once you have seen your mum wearing glasses and reading!!!
Love it!
 

Jessbow

Registered User
Mar 1, 2013
5,872
0
Midlands
Very many rpofoundly ddisabled people have glasse prescribed, without the ability to have ever strug two words ogether- imagine those say, with cerebal palsy and alike

a decent optomotrist can make a judgement as to a persons sight without the patients imput, as long as they have co-operation
 

luggy

Registered User
Jan 25, 2023
255
0
Very many rpofoundly ddisabled people have glasse prescribed, without the ability to have ever strug two words ogether- imagine those say, with cerebal palsy and alike

a decent optomotrist can make a judgement as to a persons sight without the patients imput, as long as they have co-operation
Good point @Jessbow but mum has late stage dementia and, therefore, is unable to consent, cooperate and understand what a pair of glasses are used for - unlike those with Cerebral Palsy and the like. The care home should have contacted me on this matter, but they did not, and now it seems that mum is liable for the expense of a pair of glasses she is unable to use.
 

Jessbow

Registered User
Mar 1, 2013
5,872
0
Midlands
Good point @Jessbow but mum has late stage dementia and, therefore, is unable to consent, cooperate and understand what a pair of glasses are used for - unlike those with Cerebral Palsy and the like. The care home should have contacted me on this matter, but they did not, and now it seems that mum is liable for the expense of a pair of glasses she is unable to use.
I didnt mean your mum particually. I would feel just like you- id refuse to pay too. About as much use to mum as a pogo stick!
 

luggy

Registered User
Jan 25, 2023
255
0
I didnt mean your mum particually. I would feel just like you- id refuse to pay too. About as much use to mum as a pogo stick!
Haha, pogo stick! I'll keep that one up my sleeve for future reference too.
 

Sirena

Registered User
Feb 27, 2018
2,403
0
A similar thing happened when my mother was in her care home, at that time she had moderate dementia, but fortunately I was asked about it.

The optician visited the care home, and then rang me and to say my mother needed bifocals, it would really help her to read books again (that would have been a miracle). £150, did I want to proceed with that? I said no thanks. She already had reading glasses, which she never used. When I visited, I mentioned it to the care home manager who laughed and agreed. As Jessbow says, as much use as a pogo stick!
 

My Mum's Daughter

Registered User
Feb 8, 2020
773
0
At the time, Mum was mobile, had her own optician and was up to date with her eye tests. The home were fully aware of this and I have a chain of emails as proof.

Then Mum "lost" her glasses and as she wore them all the time, I fail to see how the carers missed them not being on her nose. As we all know, these "lost" items have a habit of turning up a few days later so I took no immediate action.

A few days later, Mum's in their mobile optician's chair having an eye test that she didn't need or qualify for. I only found out when the home called to ask if she qualified for a voucher towards a new pair of specs. Mum's prescription is far from standard so even buying the cheapest frames, the bill would have been well over £100.

"Lost" glasses were back on her nose a few days later.
 

luggy

Registered User
Jan 25, 2023
255
0
Just a little update for information - I spoke with the manager of mum's CH, who was extremely apologetic that I had not been contacted. The upshot is that the glasses are free and 'lessons have been learned' - that old chestnut again.

I looked up 'General Opthalmic Services' on GOV.UK and the fees payable to optometrists for NHS domicillary visits is £39.04 for the first 2 eye tests, then £9.77 for the third and subsequent tests. They can claim up to £71.40 for the issue of a pair of single vision lenses. So, the claim they have made for mum, and quite possibly a few of the other residents, was completely unnecessary.
 
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luggy

Registered User
Jan 25, 2023
255
0
At the time, Mum was mobile, had her own optician and was up to date with her eye tests. The home were fully aware of this and I have a chain of emails as proof.

Then Mum "lost" her glasses and as she wore them all the time, I fail to see how the carers missed them not being on her nose. As we all know, these "lost" items have a habit of turning up a few days later so I took no immediate action.

A few days later, Mum's in their mobile optician's chair having an eye test that she didn't need or qualify for. I only found out when the home called to ask if she qualified for a voucher towards a new pair of specs. Mum's prescription is far from standard so even buying the cheapest frames, the bill would have been well over £100.

"Lost" glasses were back on her nose a few days later.
@My Mum's Daughter sounds like a bit of a racket going on !