The population in the United Kingdom (UK) and other developed countries is ageing. Due to improved health care and living conditions life span is steadily increasing. It is expected that by 2033 the number of individuals aged over 85 will double reaching around 3.2 million or 5% of the total population (Office for National Statistics (ONS), 2009). With this increase in life expectancy comes a new burden on health care; increasing life span also leads to increasing numbers of age related illnesses. In the UK, 69% of people aged over 85, and 48% of those over 75 have a disability or limiting long standing illness (Department for Work and Pensions, 2009). Sight loss is one of the most common disabling conditions in the ageing population. As individuals age they are more likely to experience sight loss which affects one in five people over the age of 75 and one in two people over the age of 90 (Access Economics, 2009)
Pocklington’s commissioned research using the English Longitudinal Study of Ageing (ELSA) showed that, on measures such as general health, participants with less than good vision consistently score lower than those with good or excellent vision (Department of Epidemiology and Public Health, University College London, 2006). In addition, the experiences of people with sight loss reported in a recent Wandsworth LINK survey of service users at Pocklington Court and the Balham Resource Centre highlight many of the daily challenges being faced by people with sight loss when trying to manage their general health. Service users talked about the difficulties of: reading medical letters and medication labels, handling tablets, especially when they are all the same shape and colour (white), extracting tablets from blister packs or weekly pill boxes, using eye drops, identifying everyday symptoms of ill-health, waiting for someone else to contact their GP or hospital for them, insufficient time allowed by GPs when service users attend for minor illnesses, securing home visits by community services staff (such as chiropodist), especially when a Guide Dog is present, and the impact of hospital cancellations or re-arrangements of appointments.
The RNIB campaign ‘Losing Patients’, which began in 2009, built on a range of similar findings from research commissioned by RNIB from the Picker Institute (RNIB, 2009). The campaign focuses on the need for accessible health information. While important, this is only one element of the difficulties that face people with sight loss in managing their general health.
We are keen to adopt an inclusive definition of health and the management of general health within this study and refer to the WHO’s definition as our starting point: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. Rather than focusing on ill health and on particular conditions for which medication are required, we take a holistic definition of health; we want to elicit what older adults understand by the term “general health” and what falls under the remit of “managing general health” for them.
Aims and objectives
The aim of this research is to understand older people’s experience of living with vision impairment and its impact on their quality of life in order to determine the nature of care and support needed to manage their general health. To achieve this we have three broad objectives:
- To determine how older people manage their general health, i.e. how their vision impairment impacts on their ability to manage their health
- To identify the barriers and facilitators that older people encounter in relation to managing their health
- To determine the priorities of older people with vision impairment and to identify techniques they develop for managing their health