Nursing home

Manual assists ODs’ care options for nursing home patients

People are living longer than ever—life expectancies have nearly doubled this past century-but aging is still a fact of life.

The health care industry, as a whole, faces a significant challenge in caring for an increasing number of elderly patients, and optometry is no different. As more elderly enter nursing homes, a newly updated manual from AOA offers members a leg-up in navigating this tightly regulated area of need.

Optometrists can use this manual to better understand how they can contribute to the eye care needs of our growing elderly population.

Medicine has added another age descriptor to nomenclature, the "old-elderly"-those ages 85 or older will increase from 1.5 percent of the U.S. population in 2000 to 4.5 percent by 2050. Furthermore, reports indicate the 65-and-older population will surpass the 15-and-younger group by 2030, growing to more than a fifth of the U.S. population.  

"Not only are we getting older, but we have a higher population of the old-elderly," says William A. Monaco, O.D., Ph.D., M.S.Ed., a practitioner focused in nursing home settings. "We're healthier and living longer, and as a result we have to change our thinking to be able to deal with the incredible costs associated with having people survive with chronic illness. You're dealing with a huge, well-defined problem."  

Guidance for navigating nursing home care
It's a problem addressed in the pages of the AOA's manual, Optometric Care of Nursing Home Residents, originally published in 1998 with the intent of providing optometrists an understanding of the diagnostic and management elements needed for evaluation and care of this growing segment of the patient population.  

Just updated to reflect current trends in nursing home care, the comprehensive, 57-page manual covers a range of topics and goals for optometrists to consider when treating this area of specialized care, including:

  • General overview of nursing home facilities, such as types of services, staff and statistics;
  • Benefits to joining the professional care team;
  • Access to residents, including reimbursements, regulations, and coding and billing;
  • The role of optometric care in the nursing home setting;
  • The optometric consultant's clinical responsibilities;
  • General ethical considerations;
  • Basic instruments and equipment for nursing home practice; and,
  • Resident evaluations and examinations, records and forms.

Dr. Monaco, part of the OD group that updated the care manual, says a major goal of the manual is to provide optometrists a guide for working alongside these facilities' multidisciplinary care teams.

"Optometrists can use this manual to better understand how they can contribute to the eye care needs of our growing elderly population," Dr. Monaco says.

Expanding care
Optometric care in the nursing home setting can be difficult and highly scrutinized work, says Rebecca Wartman, O.D., AOA Third Party Center member tasked with leading the manual work group.  

Speaking from personal experience, Dr. Wartman says the level of documentation required for routine care can be daunting, but a goal of the updated manual is to better streamline optometrists' integration into care facilities.

"[The nursing home] population will be far more elderly, and far more in need of care and treatment of disease than what people imagine," Dr. Wartman says. "There are some highly functioning people in nursing homes, and we've got to make sure they're cared for."  

Find more information about adult vision care over 60 years of age at the Patients & Public section of, and access the free care manual here.

May 28, 2014

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