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Learn
About Vision Loss
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Understand different terms and phrases related to vision loss.
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Find Services
for Seniors Near You
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You may not realize how many helpful services are available.
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Talking to your patient about losing vision is something that all doctors dread. You are trained to give the good news about what you can do to save vision or restore sight. But you can't do that for everyone and the situation is worsening with the dramatic growth in numbers of older persons with macular degeneration. Also, most people fear vision loss and the process of adapting to it has been likened in the literature to the grief process of dying such as the 5 stages of grief that Elisabeth Kubler-Ross developed: denial, anger, bargaining, depression, and acceptance.
The good news is that there are some things that you can suggest that will help your patient adjust to vision loss. And as your patient's trusted doctor, you may be the only person who can deliver that news and have it hit home.
Here are some ideas to help:
Setting the Stage
- First, create a quiet setting in which you can talk to the patient and his/her family members (if your patient is comfortable with having the family in the room).
- Recognize that talking to patients may take some time but that your time and patience may be the best "treatment" that you can offer your patient.
- Also think about how you feel about vision loss and come to terms with your own feelings. Expect that you may have strong emotions yourself. You may feel like you have "failed" the patient because you have not been able to preserve his/her vision. Also, if you consider vision loss to the absolute worst thing that can happen to your patient, this will come across in your discussion.
- Familiarize yourself with resources in your community that can help your patient cope with vision loss and take back control of their lives. (link to AFB directory)—such as low vision resources, vision rehabilitation services, support groups, talking book programs, etc. You may want to talk to representatives of these resources ahead of time so you are familiar with what they offer and have a comfort level in referring your patients. Develop a relationship with them.
Talking to Your Patient
- Encourage your patient to involve his/her family in the discussion.
- Tell your patient about your diagnosis or findings matter of factly.
- Allow time for your patient and family members to absorb the information and to ask questions.
- Create hope, not despair. Often patients only hear the message "there is nothing more I can do" and stop listening. You can be the bridge to helping them continue to have productive lives and work through their feelings.
- Talk slowly and patiently. Do not rush your patient.
- Give your patient and family members a chance to talk.
- Listen and acknowledge that both your patient and family members will have strong emotions about loss of vision and what it means—such as anger, sadness, denial, and even fear.
- Don't let a patient go out the door without hope and connection to additional help.
- Give your patient and family members some information to take with them. You may want to print materials from afb.org/seniorsite/eyecare portal that you feel would be useful and/or have information available in your office about local resources.
- Encourage your patient to take advantage of these programs. Cite examples of patients who have been helped by these services or discuss role models with whom they may be familiar such as a local person with vision loss who is well known in the community.
- But remember that your patient may be in such a state of shock over your diagnosis that he or she may not hear what you have to say at first.
So...
- You may need to followup with your patient. Call or schedule him or her for another visit. Ask if he/she has any further questions and determine if he/she has followed through on your recommendations.
- Address issues that may be of concern—such as driving, taking medications, reading, living alone, and working.
- Keep brochures handy in your office so it is easy for your patients to find information about resources that will help. They may be too embarrassed to ask or to tell you that they lost the ones you gave them.
Other Suggestions
If you are in a busy practice and do not have the time to talk at length with your patient, you may want to consider having one of your staff members take on this job—but only after you have broken the news and given them some hope. As their physician, you can make the most impact.
Make sure that your staff is psychologically prepared to talk to patients and aware of the resources that he/she can offer the patient.
Develop relationship with local vision rehabilitation resources and ask them to be in your office once or twice a month to meet patients that you have referred to them.
Consider creating an audio or video that your patients can take home with them that covers the points you would cover in a one-on-one session. Your words of comfort, hope, and encouragement may make a real difference in their lives.
Work with a local grief counselor to offer a support program.
Other Resources:
www.mywhatever.com/cifwriter/library/eperc/fastfact/ff11.html
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