Sight loss and loneliness

Care homes exploring alternative activities to tackle isolation can benefit residents with sight loss, study finds

Research suggests care homes that draw on wider community resources can enable better engagement 

Care homes exploring alternative activities for residents with sight loss, including from their wider communities, may help to head off loneliness and isolation, a study has concluded.

The project found that care homes can focus too narrowly on efforts to integrate sight-impaired people into existing in-house activities, which could lead to staff effectively taking over.

Researchers noted that homes making use of community assets – for instance local volunteers and faith-based organisations – seemed to be in a position to offer more meaningful opportunities for participation.

“We found that care homes run many social activities, and staff try their utmost to be as inclusive as possible. Yet we also found the involvement of residents with sight loss could seem almost contrived, with the meaning of the activity becoming lost,” said Dr Mark Wilberforce of the University of York, one of the research team.

“There’s plenty of interest within social care at the moment around assets-based practice and making the most of community strengths,” Dr Wilberforce added. “But there isn’t enough linking up of care homes with communities – we need to explore how to make that work.”

Different experiences

The study was based around surveys of 85 care home managers as to their approach towards residents with sight loss, defined as an impairment that cannot be corrected with eyewear. Most of them worked in medium-sized private homes that largely house self-funding residents.

Forty-two care home residents experiencing sight loss were also assessed as to their isolation and loneliness, with 18 – aged between 66 and 98 – subsequently taking part in more detailed interviews.

The majority of residents were not dissatisfied with their levels of wellbeing, even where they lacked social contact. The study found – as others have done – that the mere absence of social contact does not necessarily equate to an individual feeling lonely.

While some people were lonely – with around a quarter recording assessment scores indicating significant loneliness – others were happy with relative solitude. Still others preferred more contact but were reconciled to their circumstances and did not consider it a ‘problem’ that needed to be rectified.

Where residents with sight loss did experience loneliness, there were indications that this was experienced somewhat differently than by their peers.

Some, for instance, felt unable to access various rooms or activities with confidence – even with the help of a carer – for instance, because they felt unable to choose who to sit near without making an explicit announcement.

Another specific contributory issue was around background noise, which poses a significant barrier for people relying solely on their hearing to interact.

Internal focus

Care home managers who participated in the study said they were aware of the range of challenges involved in maintaining sight-impaired residents’ engagement within their facilities.

Most assessed new residents’ vision via a specialist service, and arranged follow-up appointments. But one in six said they had no in-house resources to assist people with sight loss, and more than half (60%) did not provide vision impairment training to staff.

Managers acknowledged that action was not always taken to address residents’ issues, because care homes’ busy environment tended to get in the way.

Following on from this finding, the research team has produced online and visual resources including a list of simple tips for staff to help maintain residents’ engagement.

Most managers also looked mainly within the home when considering how to promote social engagement between residents with sight loss.

It was this factor that led in some cases to ill-judged attempts to integrate vision-impaired residents into activities that had little meaning or value to them.

But, the study found, many people’s most valued contacts and networks remained outside the care home environment.

It recommended that further research be carried out to explore the value of local volunteers and other community assets to support more purposeful engagement in care homes.

Full summary findings

NIHR SSCR (2020) Isolation and Loneliness in People with Sight Loss in Care Homes (the INSIGHT project), Research Findings 120, NIHR School for Social Care Research, London.

Further information

This study was funded by the NIHR School for Social Care Research and undertaken by the Social Policy Research Unit at the University of York.

The findings were completed before COVID-19 and have been published to support NIHR SSCR’s requirement that findings from all completed studies are made publicly available.