Which of the following should the nursing assistant do when working with a resident who has a visual impairment?

1. Tielsch J, Javitt J, Coleman A, et al. The prevalence of blindness and visual impairment among nursing home residents in Baltimore. N Engl J Med. 1995;332(18):1205–1209. [PubMed] [Google Scholar]

2. Mitchell P, Hayes P, Wang J. Visual impairment in nursing home residents: The Blue Mountains Eye Study. Med J Aust. 1997;166:73–76. [PubMed] [Google Scholar]

3. Crews J, Campbell V. Vision impairment and hearing loss among community-dwelling older americans: Implications for health and functioning. Am J Public Health. 2004;94(5):823–829. [PMC free article] [PubMed] [Google Scholar]

4. Owsley C, McGwin G, Scilley K, et al. The visual status of older persons residing in nursing homes. Arch Ophthal. 2007 July;125(7):925–930. [PubMed] [Google Scholar]

5. Tay T, Wang J, Kifley A, et al. Sensory and cognitive association in older persons: Findings from an older Australian population. Gerontology. 2006;52:386–394. [PubMed] [Google Scholar]

6. Ferrell B. The management of pain in long-term care. Clin J Pain. 2004;20(4):240–243. [PubMed] [Google Scholar]

7. Black SA, Rush RD. Cognitive and Functional Decline in Adults Aged 75 and Older. J Am Geriatr Soc. 2002;50:1978–1986. [PubMed] [Google Scholar]

8. Resnick H, Fries B, Verbrugge L. Windows to their world: The effect of sensory impairments on social engagement and activity time in nursing home residents. J Gerontol B Psychol Sci Soc Sci. 1997;52B(3):S135–S144. [PubMed] [Google Scholar]

9. Whitson H, Cousins S, Burchett B, et al. The combined effect of visual impairment and cognitive impairment on disability in older people. J Am Geriatr Soc. 2007;55:885–891. [PubMed] [Google Scholar]

10. Owsley C, McGwin G, Scilley K, et al. Impact of cataract surgery on health-related quality of life in nursing home residents. Br J Ophthalmol. 2007;91:1359–1363. [PMC free article] [PubMed] [Google Scholar]

11. Dreer L, McGwin G, Scilley K, et al. Development of a nursing home vision-targeted health-related quality of life questionnaire for older adults. Aging Ment Health. 2007;11(6):722–733. [PubMed] [Google Scholar]

12. Owsley C, McGwin G, Scilley K, et al. Effect of refractive error correction on health-related quality of life and depression in older nursing home residents. Arch Ophthal. 2007;125(11):1471–1477. [PubMed] [Google Scholar]

13. Ke KM, Montgomery A, Stevenson M, et al. Formal and informal care utilisation amongst elderly persons with visual impairment. Br J Ophthalmol. 2007;91:1279–1281. [PMC free article] [PubMed] [Google Scholar]

14. Wang JJ, Mitchell P, Smith W, et al. Incidence of nursing home placement in a defined community. Med J Aust. 2001;174(6):271–275. [PubMed] [Google Scholar]

15. Brod M, Stewart AL, Sands L, et al. Conceptualization and Measurement of Quality of Life in Dementia: The Dementia Quality of Life Instrument (DQoL) Gerontologist. 1999;39(1):25–35. [PubMed] [Google Scholar]

16. Steinberg E, Tielsch J, Schein O, et al. The VF-14. An index of functional impairment in patients with cataract. Arch Ophthal. 1994;112(5):630–638. [PubMed] [Google Scholar]

17. Linder M, Chang T, Scott I, et al. Validity of the visual function index (VF-14) in patients with retinal disease. Arch Ophthal. 1999;117:1611–1616. [PubMed] [Google Scholar]

18. Ware JJ, Sherbourne C. The MOS 36-item short-form health survey: I. Conceptual framework and item selection. Med Care. 1992;30:473–483. [PubMed] [Google Scholar]

19. Age-Related Eye Disease Study Research Group. Cognitive Impairment in the Age-Related Eye Disease Study. Arch Ophthal. 2006;124:537–543. [PMC free article] [PubMed] [Google Scholar]

20. Busse A, Sonntag A, Bischkopf J, et al. Adaptation of dementia screening for vision-impaired older persons: Administration of the Mini-Mental State Examination (MMSE) J Clin Epidemiol. 2002;55:909–915. [PubMed] [Google Scholar]

21. Klein R, Klein B, Linton K, et al. The Beaver Dam Eye Study: Visual acuity. Ophthalmology. 1991;98(8):1310–1315. [PubMed] [Google Scholar]

22. Real FJ, Brown GC, Brown HC, et al. The effect of comorbidities upon ocular and systemic health-related quality of life. Br J Ophthalmol. 2008;92:770–774. [PubMed] [Google Scholar]

23. American Academy of Ophthalmology Preferred Practice Patterns Committee. Comprehensive adult medical eye evaluation. San Francisco: American Academy of Ophthalmology; 2005. Preferred Practice Patterns Guidelines. Available at: http://www.aao.org/ppp. [Google Scholar]

24. Comprehensive Adult Eye and Vision Examination. St. Louis: American Optometric Association; 2005. American Optometric Association Consensus Panel on Comprehensive Adult Eye and Vision Examination. Available at: www.aoa.org/documents/CPG-1.pdf. [Google Scholar]

25. Snyder L, Pyrek J, Smith K. Vision and mental function in the elderly. Gerontologist. 1976;16(6):491–495. [PubMed] [Google Scholar]

26. Teresi J, Morse AR, Holmes D, et al. Impact of a vision intervention on the functional status of nursing home residents. J Vis Impair Blind. 2005;99:96–108. [Google Scholar]

27. de Winter L, Hoyng C, Froeling P, et al. Prevalence of remediable disability due to low vision among institutionalized elderly people. Gerontology. 2004;50:96–101. [PubMed] [Google Scholar]

28. Deremeik J, Broman A, Friedman DS, et al. Low vision rehabilitation in a nursing home population: The SEEING Study. J Vis Impair Blind. 2007;101(11):701–714. [PMC free article] [PubMed] [Google Scholar]


Page 2

Demographics of the Study Enrollees by Impairment Group

Impairment Group
CharacteristicNo
Impairment
VisionImpairment

Only

CognitiveImpairment

Only

Vision andCognitive

Impairments

p
N=82
(21.5%)
N=51
(13.4%)
N=102
(26.7%)
N=147
(38.5%)
Age, y0.02
  60–6915 (18.3)7 (13.7)7 (6.9)10 (6.8)
  70–7931 (37.8)20 (39.2)24 (23.5)46 (31.3)
  80–8930 (36.6)17 (33.3)50 (49.0)65 (44.2)
  90–995 (6.1)7 (13.7)20 (19.6)26 (17.7)
≥1001 (1.2)0 (0.0)1 (1.0)0 (0.0)
Race/Ethnicity0.002
  African American11 (13.4)8 (16.0)35 (34.3)45 (30.6)
  White71 (86.6)43 (84.3)67 (65.7)102 (69.4)
Sex0.02
  M22 (26.8)3 (5.9)17 (16.7)30 (20.4)
  F60 (73.2)48 (94.1)85 (83.3)117 (79.6)
Education<0.0001
  Grade school3 (3.7)2 (3.9)37 (36.3)61 (41.5)
  Some high school24 (29.2)10 (19.6)21 (20.6)27 (18.4)
  High school graduate34 (41.5)19 (37.3)26 (25.5)41 (27.9)
  Some college11 (13.4)16 (31.4)14 (13.7)9 (6.1)
  College graduate6 (7.3)3 (5.9)2 (2.0)1 (0.7)
  Graduate or2 (2.4)1 (2.0)0 (0.0)1 (0.7)
professional degree
MMSE score*--
  27–3035 (42.7)15 (29.4)0 (0.0)0 (0.0)
  24–2647 (57.3)36 (70.6)0 (0.0)0 (0.0)
  20–230 (0.0)0 (0.0)51 (50.0)50 (34.0)
  16–190 (0.0)0 (0.0)28 (27.4)53 (36.0)
  13–150 (0.0)0 (0.0)23 (22.5)44 (29.9)
No. of medical conditions, mean (SD)5.9 (2.9)6.1 (2.9)5.2 (2.9)5.5 (3.1)0.24