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AFBAmerican Foundation®
for the Blind

Expanding possibilities for people with vision loss

Recognizing and Responding to Medical Issues of Older Clients Who Are Blind or Visually Impaired

By Audrey Demmitt, R.N., VisionAware Support Group Advisor

man holding emergency bag on lap

There are a variety of concerning health events that can come up when working with and caring for older persons. Many older individuals live alone and are struggling to stay in their own homes and maintain their independence. They may lack family and community support, financial resources, and access to medical care and information which puts them at greater risk for falls, accidents, food scarcity and poor nutrition, and rapidly declining physical and mental health. If you are a service provider, you are in a unique position to observe and monitor your elderly consumers in their home environment and help them find needed resources and support.

Many older adults have multiple medical conditions and may take many medications, which can result in health events and even crises. When working with older persons, it is important to have a thorough psycho-social assessment, medical history, and medication list on hand. Other important information includes emergency contacts, allergies, current medical conditions, and insurance information, in case of emergency transport to the hospital. Reviewing this information will help you identify special needs and the potential for health problems of your elderly client.

Take time to review specifics with the client and ask questions such as "When was the last time you experienced low blood sugar?", "What do you do to treat it?", "What is the purpose of this medication?", "Do any of your medications cause side effects that bother you?"

It would also be helpful to do a baseline assessment of the client’s physical appearance, mental status, breathing status, mobility, and their living environment. Make a note of anything that concerns you and watch for changes. Carry a copy of their health form to include emergency contact, allergies, medical conditions, medications, and insurance information in case of emergency transport to the hospital.

A Word About Universal Precautions and Standard Precautions

"Universal Precautions" means you consider every client as a possible carrier of contagious diseases which can be contracted through contact with blood or body fluids. Standard precautions are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. Hepatitis, AIDS, pertussis, MRSA and other infections are very real threats. Older persons who live in assisted living or who have had a recent hospitalization may carry infections.

Good hand-washing practices can prevent the spread of infection to yourself and others. Avoid contact with contaminated articles and surfaces which may harbor germs. Use barrier gloves and other personal protection equipment if you are likely to have contact with blood or body fluids when teaching and rendering care. You may want to create a bio-hazard kit containing latex-free gloves, 4x4 gauze, CPR barrier face-mask, and band aids to carry with you.

What Medical Emergencies Are Common with Older Adults?

The most common reasons for older persons to visit the Emergency Room are heart attacks, strokes, and falls and injuries. But there are other serious symptoms to pay attention to if you are a professional or caregiver. Fever, increased pain, adverse drug reactions, sudden changes in mental status, and distressed breathing can also signal medical emergencies. Due to increased age, a weakened immune system, multiple medical diagnoses, and other factors, an older person's health status can change very quickly and dramatically, leading to a number of urgent medical issues as follows:

Heart Attack
Stroke
Diabetic Emergencies
Urinary Tract Infections
Depression in Older Adults

Be Alert and Observant

Professionals who work with older persons can help prevent untoward health events by being alert and observant to changes in the older adult. By knowing some basic information, you may be able to refer your client to needed help. And in some situations, you may even save a life by acting quickly and knowledgeably in an emergency.

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