My husband has worn glasses since he was a child, and is almost blind without them (near sighted). He has some glaucoma now and the eye doctor does tests (his pressure is down to 13 with the prescription eye drops which is great) but he can't tell the doctor "which is better, A or B" any more. Hubby says his sight hasn't changed, but the doctor can't check his vision any more. Do any of you have any suggestions?
Mary, I don't have any suggestions for you other than to get a very very patient optometrist to do the testing. We have had to change several because we have had trouble with this A or B or 1 or 2 thing for many years and I don't have AD!
We were finally able to choose another place for eye exams (insurance co. dictated previously where we had to go). On the new patient form I filled out for DH it asked about health conditions and meds. I pointed to the word Alzheimer's as I handed back the form to the receptionist. She was fantastic. And she alerted the doctor privately. He was patient, and slowed down the pace of his exam. The next time we went, when the glasses came in the other receptionist told me she is caregiver to her FIL when she isn't at work. It felt good to know they all had an understanding.
That is all I can suggest. That you ask them over the phone if they have any experience with AD patients. A few years ago for my Dad I asked that ahead of time and learned the doctors father has AD, and he and one of his assistants do once a month Nursing Home days where they go to clean lenses, re-fit glasses, replace nose pads, and repair frames. Boy, did I feel lucky. When we went back to this docs office to pick up Dad's glasses I parked in front of the door so I could open it and ask if they were running on time, as I didn 't want to get Dad out in the rain, into his wheelchair just to go in and sit. Well, the optician said, "Oh, don't bother him to get out in this weather, I'll just fit them out there." What a sweetie. Like drive through service.....LOL
A while back, I heard that they've developed a technique that can be used to fit glasses to children too young to communicate well. It had to do with focusing a light on the back of the eye, and seeing which lenses brought the back of the eye into focus properly, if I recall correctly. I wonder if that is very widely available, and could be used for AD patients.
Does anybody have any idea what I'm talking about? or how to find an ophthalmologist who can do it?
I am the caregiver to my grandmother (as well as my husband) and she is having vision problems. I spoke with the eye doctor I use and she said she knows how to work with someone who has dementia. She said she proceeds as she would with a child who can't read or even speak well yet, and if all else fails "I take a picture of their inner eye and then I can tell what prescription they'll need". I was worried about getting my 94 yo grandmother in the chair and wanted them to test her from her wheel chair, but their chair's arms raise out of the way, and it swivels to any angle necessary for me to assist my grandmother in getting into it. Her appt is April 10 so I'll learn more about this then.
To bring up another aspect of eye exams, my wife (stage 5) may have to have cataract surgery within a year. I am very concerned that she will not remember to be careful of the eye while it heals. Has anyone had experience with cataract surgery?
My wife M needs cataract surgery also. I know she wouldn't remember the surgery and would get into trouble in the post operative stage. I discussed post operative care with her eye doctor and he didn't have a solution either. He then recommended no surgery because of the post operative care problem.
Is there a way to safely get a cataract patient with AD through the post operative stage?
I am with the rest of you. Before I made an appointment, I asked the receptionist if the doctor had experience with patients that have dementia. Yes was the answer so I made the appointment. When the day came, the doc started to give my wife the eye exam and knowing what was coming, Kathy just sat in the chair confused. I did my best to help direct my wife what to do which did not help. The doctor was absolutely no help and stopped the exam. So much for asking if the doctor could do an eye exam for Kathy. I sure hope I don't get a bill from him because we will surly have some words.
I too carried my husband in for a check-up. He was so confused and they couldn't finish the exam. The Dr. came and told me to just forget it.That was a year ago, I asked the medical Dr. about it and he said you have probably done all you can do. I just want him to have everything he needs.
The responses that I've gotten so far on the Alzheimers Association discussion forum:
deeplysaddened: I'm sorry I dont know about that, but maybe you could call a few in your area and see if they do this proceedure. I wish you the best of luck and am thinking of you.
vjh: I would check with other local opticans. I know that there is a machine to read a persons eyes to determine the script. I think my eye doctor uses it, and then follows it up with the a or b business, but it would be a good start.
Maral51: I do think they have some test for people who can't read. My son had it done when he was younger.
SueGall: At my dad's optometrist, they have a machine that checks the script, but then do the eye chart test. When my dad started his chart the last time, he could not read the big E at the top of the chart. The doctor stood next to the chart and talked to my dad about focusing, and he had my mom stand on the other side of the chart. He was able to get to the fourth line! Go figure. He can't see worth a hoot - can hardly see the food on his plate. Doctor thinks it is part of the AD, not so much eyesight. So even if the machine measures his eyesight, it might not make a difference. Good luck.
I'll keep checking to see if anyone else responds anything more definitive.
Two years ago, was the last eye exam my husband had. It was very hard to get him through that one, so, I know we will probably not try again. He was very confused and also my DH has trouble talking, which made it almost impossible to get his vision assessed. We did finish the exam and I bought him a new pair of prescription glasses, but, he does not want to wear his glasses anymore. He will take them off and want to hold them. We have lost them numerous times. He used to love to wear ball caps, but, does not want anything on his head anymore. Everything changes as we go thru AD.
Now, one other thing that really worries me is that it is impossible to get him to sit in the Dental Chair at the Dentist office. In fact, there are very few dentists that will take AD patients, so, now I am just keeping his teeth really clean and hoping for the best. Two years ago, my dentist was cleaning my husband's teeth and in the middle of everything, he just tries to get up out of the chair and gets very agitated. My DH is now in a Nursing Home and cannot walk anymore and is totally dependent, so, that would make it even harder to transfer him into the dental chair. Plus, sometimes when you are brushing his teeth, he will clamp down on the toothbrush and will not let go. The CNA's also help me with keeping his teeth clean. Like we all know it is just the challenges we run into with AD.
I also want to make sure my DH has everything he needs and is very comfortable, but, some of the obstacles you run into while accomplishing this is very trying. I love him with all my heart and will keep trying for as long as this journey takes.
Once they get to a certain point with AD, there are no clear answers. We all just do the best we can for our loved one.
Thank you all for your comments. I appreciate your advice and your sharing your "adventures" regarding the same. This website and all of you are really such a big help! Thank you again!
I had cataract surgery last summer. My husband, who has dementia, was the one who put the drops in my eyes for up to 4 times a day for weeks on end. At one point I was doing 4 different drops in one eye and 2 different drops in the other. I had them lined up for him because it all confused him. I actually bought a second bottle of one of the drops even though I didn't really need to so I would have separate drugs for each eye.
I had a plastic piece over my eye when I slept for the first few days so I wouldn't touch it in my sleep, and I wore it for the first 24 hours. You can only do the surgery if you are sure she won't pull that plastic thing off, or if the doctor can come up with a way to make it stay on even if she isn't cooperating. At this point, where my husband is right now, he could do the surgery because he would cooperate and because they don't put you to sleep, just give you stuff to keep you calm and make sure you don't hurt.
My husband won't wear his hearing aids any more, which he absolutely needs, but he will wear his glasses. At some point he probably will give those up too. I think he may be having problems with his automatic toothbrush, but at this point I'm not sure because I only just discovered that he might have a problem.
When my husband required eye surgery in 2006 I requested it be done with local anesthesia since I had heard there can be repercussions from being completely out, with more memory loss because of that. At first the surgeon was hesitant, but then did as I requested and it all came out just fine. Well, fine in that he could have become legally blind and now can read with one of those vision boards that looks like a computer. My husband has always been a reader and still enjoys it even if he doesn't recall most of it.
frand ... there have been a number of threads about anaesthetics on the Alzheimers Assoc web site. There are three general categories of anaesthetics: local, general administered by inhalation, and general administered intravenously. There is little known for sure (although some studies are beginning to be funded), but all the information to date indicates that the inhaled anaesthetics may be a problem. It appears that general anaesthetics which are given intravenously do NOT have the same potential to cause or exacerbate AD. So if your husband requires surgery where he absolutely HAS to have a general, ask for intravenous.
my husband wore contacts for 40yrs and had more than 4sets of expensive hearing aides. even while still practicing as a lawyer. he lost all contacts and all hearing aides many times so i opted not to use either. believe it or not everyone is amazed 10yrs into the AD he can still read without glasses now and we just speak into the other ear a little louder. not using any extras at this point as he puts things in his mouth too. as far as dentists this is a tricky one, he hasnt been in yrs due to the same reasons above. i dont know what they will do if there is a major problem. probably use laughing gas or such to knock them out? i wont take him unless its major at this point. i sure worry about even cavities though they can hurt..there is no correct way to work this out! divvi
Mary, you've stumped even the Alzheimers Assoc experts:
"Thanks for posting this question here but unfortunately we do not have information about such a procedure. I would encourage you to contact an ophthalmologist directly with this question. I did locate the customer service number for the American Academy of Ophthalmology which is 415-561-8540.
Sunshyne, thank you for trying! I guess he'll let me know when he can't focus, then maybe we'll try to see if he can take the test for children too young to read. I appreciate your thoughtfulness!
Mary, I tried posting again, since I hadn't gotten a lot of answers, plus I thought I might have been limiting the responses by asking about the type of test I remembered hearing about. Latest set of answers:
lucy123:
The last time I took my mom to the eye doctor, it was the same thing - she just didn't understand what he was asking her to do.
Fortunately, my mom's prescription hasn't changed significantly over many years, so her doctor was fairly confident based on that and whatever information he DID get that her prescription hadn't changed.
My mom does see an opthamologist rather than an optometrist, and I think this makes some difference. He tends to see more older patients and others with more complex issues than the average person. I realize chances are good you already see one since your husband has glaucoma. If not, I would recommend it.
Has your husband's doctor indicated he can't determine your husband's prescription, or are you assuming he won't be able to?
When you consider that some very young children and many non-verbal developmentally disabled adults wear glasses, there must be SOMEHOW doctors are able to give an "educated guess" about what the prescription should be. I don't know exactly what this is based on, but clearly it's possible.
I've wondered this same thing about other folks with AD. I'll be interested to read more responses.
lostnow:
I wondered the same thing with my mom, her glasses were falling apart and she needed new ones-hadnt had an exam in a few years. I ended up just getting the same prescription she had last time in some very nice frames that looked like they could take a beating. Ended up a waste of money and worry though--she stopped wearing them about a month later. Until that point she wore them around her neck all the time and they just caught the crumbs. But I do think they can tell alot just by looking these days...not sure.
Cheyena:
O I wish I knew the answer to this one!
My DH has the same problem, cant read, can barely see the pictures in a magazine. he said he needs his glasses. What happened to his old ones? He twisted them up in a fit one afternoon, stomped them and then they disapeared. Later he told me he threw them away! Walmart had some reading glasses for abt 30.00. I bought those, he said they were great for close up. He asked where I got them, I told him, next thing I know, they were twisted and stomped and he said they were no good. Sigh. I know he needs glasses. He was near sighted for yrs, then ended up needing Bi-focals. Now he has no glasses. I thought abt trying to find his prescription from the store he got his last prescription from, but thats been abt 3 yrs now. I wonder if they would still have it?
I did contact the Eye Dr at walmart, explained the situation, and she said that she could give him a test that could help alittle, but of course, if you cant say A is better than B, how will that work out? I guess its worth a try, so Glasses for DH is on my ToDo List.
lucy123:
Cheyena-
It won't "solve" your problem, but if non-prescription reading glasses help your husband at all, you can get them for lots less than $30 a pair. I've even seen them at many $1 stores.
For that price, you may be able to afford a few temper tantrums!
If you do take him to try and get a prescription, maybe you can ask his regular doctor if he can suggest an eye doctor with training or experience with patients with special needs.
I've gotten glasses myself at Wal-Mart, and I like them fine because they're quick and cheap. But I don't think I'd expect anyone I've ever seen there to have any idea about how to deal with a patient like my mom.
Just a thought.
Also, if you figured out where you got the old ones, called and explained your situation, MAYBE they would be cooperative and give you the prescription. Legally, I don't think they are bound to do it. Lots of places WON'T give out your prescription EVER, and I don't think anyplace usually does it after a year.
BUT if you were really, really nice and explained your difficulty, maybe...
NDuke:
When dad misplaced his glasses about a year and a half ago, the doctor couldn't get the right responses out of him either. Most eyes don't change DRASTICALLY within a few years time, so I just had him give me a prescription for the lenses and we went to pick out his frames. I got the kind that you can twist and turn and practically tie into a knot before they break! And... sure enough they broke so I had to get a new earpiece. But he could see well out of them. Still can. It may not be perfect, but it's a LOT better than he can see without any glasses at all. I didn't get him bifocals, though. He doesn't read anyway.... had stopped reading the newspaper by then too.
I'll let you know if anyone else comes up with ideas.
I have exactly the same problem with my Jim. I have taken Jim faithfully to the eye Doctor almost each 4 months, the Doctor has had to do each step of the exam in small steps, I do think because they just don't take the time they should with a dementia patient and of course it gives another office visit to the Doc. I do plan this time when we go to tell the Doctor that I am unsure if Jim will be able to even make another visit to him and I want him with his educated guess to give us a new prescription, it has now been five years, with me taking him repeatedly and he has not been able to read A or B in the last year. I want a new one even if it is just a step above what we have. I will let you know what he says. I kept asking how they check for a person when they can no longer tell them what the chart says, the Doctor kept telling me they had instruments to be able to check, then when it came to the point Jim cannot tell them they say I will just have to watch by the way he acts. This diease is killing me.
My ADLO has worn glasses all her life, and wouldn't even take them off for the last three years. Now that she has gone to a home, she frequently walks around with no glasses. It bugs the heck out of us, because we know she is almost blind without them. BUT the caregivers there say it is not unusual for ADs to stop using their glasses, due to the way the messages are being received in the brain. We don't even know what the eye is registering. If they can't process speech and hearing and memories, it's not out of the realm of possibilities that the eye doesn't get mesages either. If it doesn't bother them, maybe let it go?
My DH has worn his glasses for almost 12 years now and would also never take them off. But, he is now in a home and we are experiencing the same thing. I will put his glasses on him and he may wear them, but, then again, sometimes he just takes them off and will either hold them or we find them on the floor. He just doesn't want to wear them any longer, so, I think it is just best to let it go. I do not know any other way to handle it. The CNA's periodically try to put them on him, but, if he does not want to wear them, well, they do not force the issue. My DH is in Stage 6 of Alz., so as we all know so many things change for them.
My husband, who is at a much earlier stage, has basically given up his hearing aids. Reading about what is happening at a later stage with glasses, I understand much better what is going on. Understanding makes things easier to accept.
My husband is going to an opthamologist and has been for many years. He wants to see him again in four months. I think that I'll take him and see if he does the same thing on the chart next time. Even if he does, I'll have to take him for the glaucoma tests after that. I appreciate hearing from everyone. Knowing I'm not alone in this in comforting.
We went to the eye doctor yesterday (opthamologist) and my husband couldn't read enough of the letters on the chart to get a meaningful result. The tech then tried the pictures that they use for children--he couldn't identify them either. However, when the doctor came in, he said he has a machine that could do the reading, used it, and said that my husband's eyeglass prescription hadn't changed. So for those of you who are facing this problem, when making an appointment, I would discuss the problem and ensure that the doctor has equipment that can do the job if reading the chart is impossible.
P. S. The doctor also skipped the part where they put different lenses in front of the patient and ask, "which is better, A or B", etc.
Marilyn, on an update from my entry of March 18, 2008. we went back in four months and the same thing occurred that happened with your husband. My husband has to have drops in his eyes daily, but otherwise, no going to the eye doctor, no more tests.
There comes a time when you just have to accept that we have done all we can for them.
I remember at one point in time the eye doctor suggested we just skip the bifocal part of the lenses....he was no longer reading and didn't need the magnification. It wasn't too long after that my husband started taking off his glasses and twisting them so badly that the lenses would pop out. I kept taking them in for repair and finally it dawned on me that he obviously didn't want to wear them any longer.
My DH had cataract surgery on both eyes in January. He was given a choice of lens implants. He could get standard lenses that did not correct vision or lenses that did make corrections to his vision. Our insurance would pay for the standard lenses, but to get the corrective ones we had to pay the difference in cost, about $2000 per lens. It was really expensive but we decided to get them, because of all I had read on this site about difficulties with eye exams and with keeping track of glasses at later stages of the disease. Thank you, everyone!
DH cannot read without glasses but recently started claiming he has never needed glasses. Now he will pick up a magazine and look at it for a while but I guess he just looks at the pictures.