Low vision and diabetes in older people living in residential care homes
AuthorsDarwesh, Nizam Muhammad
health care assistants training
residential care home
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AbstractBackground: Worldwide one in twelve people are living with diabetes and one in two people do not know they have diabetes. Currently large numbers of the older people live in residential care homes in the UK, and up to one in four older people living in residential care homes present with diabetes. Low vision is one of the complications associated with diabetes in older people. In those aged 75 and over, one in five, and in those aged over 90, one in two people are affected by low vision and they are at an increased risk of developing other eye diseases. Within 20 years of diagnosis nearly all people with Type 1 and almost two thirds of people with Type 2 diabetes (60%) have some degree of diabetic retinopathy. Aims and Objectives: This study aimed to investigate the issues and problems faced by older people living in residential care homes with low vision and diabetes; to evaluate health professionals’ knowledge and understanding of the impact of low vision associated with diabetes in older people living in residential care homes; and to develop an educational toolkit which aimed to educate health care assistants about low vision and diabetes. Methods: This study is an exploratory investigation of older people living in residential care homes with low vision and diabetes. Adopting an open-ended qualitative approach using focus groups, interviews and a health professional’s survey, 116 participants were involved. These included GPs, ophthalmologists, nurses, optometrists, health care assistants and older people with low vision and diabetes. The data was analysed thematically. The educational toolkit was developed in the second part of this study, and 20 healthcare assistants were trained using this toolkit. Their knowledge was tested before the training, immediately after the training and one month after the initial training. Following Kirkpatrick’s model, the skills and practical use of the educational toolkit was assessed using an open-ended qualitative approach. Results: The results found that many older people and the health care assistants had the perception that low vision was a normal ageing process and could not be rectified. The study found that there was evidence to suggest that eye health was not considered to be a priority; instead, it was considered to be a natural part of the ageing process. The results found that 82% of the HCAs had not had any training in the area, and more than half of the nurses and GPs did not have sufficient knowledge of low vision and diabetes. After training, however, their knowledge was increased. This suggested that low vision and diabetes toolkit training could be used to educate healthcare assistants on a regular basis. The study also found that knowledge does decline over time, and therefore regular training for HCAs is required in order to maintain eye health and diabetes in older people, as well as improving their quality of life. Conclusion: In the research findings it was found that 50% to 70% of low vision was preventable or treatable if detected in its early stages and could be avoided by simply wearing appropriate spectacles, or possible surgery. However, in order to identify these 50% to 70% with low vision, everyone concerned should be able to recognise the signs and symptoms of preventable low vision, particularly health care assistants, as according to this study, health care assistants spent large amount of time in the residential care homes compared to the other health professionals.
CitationDarwesh, N.M. (2015) 'Low vision and diabetes in older people living in residential care homes'. PhD thesis. University of Bedfordshire.
PublisherUniversity of Bedfordshire
TypeThesis or dissertation
DescriptionA thesis submitted to the University of Bedfordshire in partial fulfilment of the requirements for the degree of Doctor of Philosophy
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