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Alcohol and Vision Loss


 

 

Alcohol consumption does not usually lead to vision loss, but there is some evidence that smoking may (1). And many people who drink heavily, also smoke.  In the Seniors' Health Study, seniors who had alcohol problems also had twice the rate of vision loss as seniors in the general senior population.

 

New research suggests that there may be some health benefits to moderate alcohol consumption for some types of vision loss. It has been suggested that small amounts of wine may help stave off age-related macular degeneration (AMD). Age-related macular degeneration is the leading cause of blindness in people over age 65. (2)

 

According to the new study, people who had consumed two to 12 glasses of red or white wine per year (in other words, very low drinking) cut their chances of developing AMD almost in half, compared with those who reported consuming no alcohol. This is in line with other studies that have suggested that low levels of alcohol consumption may reduce the risk of heart disease.

 

On the other hand, new research also indicates that heavy drinkers, or adults who consumed at least four drinks a day, were about 6 times more likely to develop symptoms of late age related macular degeneration over a 10-year period. And those who reported that they were heavy drinkers in the past were more than twice as likely to develop late related macular degeneration.  Current smokers were also more likely to develop the disorder,  researchers report in the October 1st issue of the American Journal of Epidemiology. (3)

 

 

However, alcohol consumption is not recommended for seniors who have diabetes, partly because of the increased risk of strokes and partly because of the risk of diabetic retinopathy (see the section on Alcohol and Diabetes).

 

 


 

Adapting to Vision Loss

Vision loss  can have a  significant impact on an older person's life. The Canadian National Institute for the Blind (CNIB) notes that there are several factors that affect a person's reaction to vision loss (4):

Seniors often say they’ve been told after being diagnosed with age-related macular degeneration that their eye condition is not currently treatable or preventable, and therefore nothing can be done. That simply is not true.

The CNIB, for examples, notes there are many ways to help people to find ways to keep their independence, to thrive in a sighted world. "With guidance in improving lighting, using magnifiers and developing coping techniques, most vision-impaired people can preserve self-esteem and independent living skills."

 


 

Understanding the Effect of Vision Loss on the Senior's Life


 

Drinking can become a coping strategy for some people experiencing vision loss in later life, and more particularly, for coping with the social isolation that can accompany vision loss.

It is important for service providers to understand what the vision loss means to the senior on a practical and emotional level. It can mean loss of sense of self–identity and loss of certain cherished activities. It often means restriction or loss of driving. That, in turn, means that senior may need help learning alternate ways of doing things and getting around. For someone who has never taken a bus, and now must do so with limited vision, the world becomes a serious challenge. There may be tendency for the senior to withdraw and to have reduced contact with the rest of the world.

Some seniors in these circumstances find it very difficult to be around other people. For example, a shopping centre suddenly becomes a threatening place, where people (or more accurately, the shadows of people) seem to dart from nowhere. Everyday activities like reading the telephone book can become increasingly frustrating. Banking, particularly with the increasing number of automated teller machines, can be overwhelming at times. *

 

* On a positive note, audio banking machines are slowly becoming available in some communities.

 


 

Vision Loss in the Context of Treatment for Alcohol-related Problems


 

Helping a senior who is experiencing vision loss and who also has an alcohol problem can be challenging and promising. There are a number of important things to remember.

 

(1) Help the person adapt and adjust to these vision changes.

 

There numerous practical problems the senior needs to adapt. He or she may need help to overcome some of these obstacles in living before being able to reduce or stop drinking.

 

Vision loss can also easily lead to grieving and depression. The person may need collateral help with both issues.

 

(2) Take a hard look at  your agency or program for policy and systemic barriers that leave out people with vision problems or other disabilities from being able to utilize your services. Then work to remove those barriers.

 

Most existing treatment approaches are based on the idea that the person can see and read. Review of the residential treatment and supportive recovery programs in the Lower Mainland of British Columbia in 1997, for example, indicates they relied heavily on videos, written materials and written exercises. One program lasting 28 days, for example, required participants to view 14 videos on alcohol related issues.

 

It is essential to have alternate formats available for seniors for ANY material, whether that is for prevention or intervention. Alternate formats can include large print, audio cassettes, and Braille. While it is stating the obvious, if audio cassettes are used, make sure the person has a cassette player; understands how to operate it; and can physically operate it (some people with severe arthritis can't).

 

Using handouts in a group? Blow up the size of the handouts that you give out to legal size.

 

 

(3) Provide materials in alternate formats and plain language.

 

Even for seniors whose sight has not changed, it is important to have written material in a large print,  easy-to-understand format. This cannot be stressed enough. (For suggestions on Communicating In Print With and About Seniors, see www.hc-sc.gc.ca/seniors-aines/pubs/communicating/pdf/comsen_e.pdf)

 

Data from Statistics Canada indicates that in 1996, 36.8% of seniors in Canada reported having received less than grade nine education, and another quarter of Canadian seniors had attended but did not graduate from high school.(5) Lower levels of formal education affects many seniors' level of functional literacy. Throughout Canada, the level of functional illiteracy is much higher among older adults compared to younger adults, and it significantly affects their ability to receive and understand written information. Moreover, a large numbers of seniors do not know that their literacy abilities may not be adequate to get and understand the health information they need most. (5)

 

(4) Be supportive and understanding.

 

Linking seniors to the resources to help them adapt, is not necessarily going to  mean they will want to use them, in the beginning (or sometimes, at all). Vision loss  (and blindness) can generate a very personal reaction. It is important to realize that some seniors will have strong negative attitudes about disability and people with disabilities (even if that person is himself or herself). Years ago, people with disabilities were treated with pity or seen as a family shame.

 

Our ignorance of what it is like to live with a disability, our lack of care or understanding can create unreal expectations, or at  the other end of the spectrum, can lead  to patronizing  behaviour.

 

(5) Be an advocate.

 

As more and more of the population moves into their 60s, 70s, and 80s, vision loss will probably be more common. The resource needs for seniors will grow, but the available resources may not keep pace, unless people advocate for these resources. Do not expect service organizations to take on this advocacy role.

 

 


 

References

  1. Wine May Decrease Risk of Age-Related Blindness (5/9)* Virginia Watson c.1997 Medical Tribune News Service, NYT-05-12-97
  2. Archives of Ophthalmology, October 1996. Netherlands study on age-related macular degeneration and smoking.
  3. Klein, R.,  Klein, B.  Tomany, S. & . Moss, S. (2002) Ten-Year Incidence of Age-related Maculopathy and Smoking and Drinking: The Beaver Dam Eye Study,  Am. J. Epidemiol. 156: 589-598.
  4. Canadian National Institute for the Blind, "Living With Vision Loss: A Handbook for Caregivers". (see Website below)
  5. Educational Attainment and Literacy Levels,  Statistical Snapshot of Canada's Seniors, No. 9, Health Canada, see: www.hc-sc.gc.ca/seniors-aines/pubs/factoids/en/no9.htm
  6. P. Roberts and G. Fawcett. At Risk: an analysis of health and literacy among seniors. See: www.statcan.ca/english/freepub/89F0104XIE/high3.htm
 

Links and Resources on Vision Loss

Living With Vision Loss: A Handbook for Caregivers

This handbook is intended to help make day-to-day life better for the older members of society who cope with vision loss. It was developed through consultation and collaboration with blind and visually impaired seniors, community representatives and the staff of the Canadian Institute for the Blind www.cnib.org/  (located under "Pamphlets and Publications") .

 

General Interest Internet Articles on Vision Loss: 

Helping People Cope, by Roderick Jamer, Canadian Association of Retired Persons.

See: www.50plus.com/ArticleFull.cfm?objectid=6ED9F8FC-D82E-11D3-B62E009027DE53E4&Section=Health&catName=

 

Information on Age Related Macular Degeneration, University of Ottawa Eye Institute,  Ottawa Hospital. See:

www.eyeinstitute.net/subfiles/amd/index.htm

 

Page last updated Friday April 29, 2005

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