Many of us don’t give much thought to how we go about our day, running on a sort of autopilot based on many years of routine.
We haven’t needed to worry about how to tie our shoes, what is required to get into a vehicle or any number of day-to-day activities since we were little kids learning how to do these things for the first time.
If you’re like me and wear glasses and contacts, you are also familiar with the series of machines and steps required to figure out what prescription lens you will need to be able to see clearly.
Again, this isn’t something that requires a lot of thought. The optometrist and the techs are good about explaining each step, so all we must do is follow along.
Add dementia to the mix, and this seemingly “no-brainer” activity becomes a lot more complicated.
My first encounter with how difficult the eye doctor’s office could be came when I was caring for my mother, who at the time was in her 80s. Not only was my mother seriously nearsighted, but she also had cataracts and a condition called blepharospasms, which are spasms of the eyelid. Her eyelids would close and not want to open again.
By the time my mother came to live with me, she had already given up on trying to deal with the eyelid issues. For years she had had Botox injections in her eyelids to get rid of the spasms, and after a while the shots stopped working.
Then Mom developed vascular dementia, which not only affected her thinking, but I’m pretty sure it also impaired her visual processing. She would complain of seeing double, and she also saw things that weren’t there.
This made trips to the eye doctor a real adventure. One could never be sure what she would throw at the optometrist.
What I learned in those years was that the eye doctor doesn’t necessarily need a person to be able to read that row of letters on the eye chart to know what prescription to use. For that, I was thankful, especially when my mother would arrive at the eye doctor’s office in one of her feistier moods.
I’ve been reflecting on all of this again recently. Tony and I just had our annual visit to the eye doctor last week.
Last year, Tony, who is in the middle stages of early onset Alzheimer’s disease, was still able to read out the letters on the eye chart. Granted, it was touch-and-go for a lot of it, but our optometrist was patient and kind as he tried to figure out what she was asking him.
Like my mother, Tony has his own additional layer of challenge in the vision department. When he was 5 years old, he was struck in the eye by a rock that had been put into a mudball. He lost the vision in that eye. It’s one more thing Tony’s eye doctors have had to deal with.
As Tony’s disease has progressed, he has had more and more trouble with following commands. Something simple like “scooch your chair closer to the machine” is met with silence and … nothing. Repeating the command usually has no effect, either.
It’s not that Tony wants to be uncooperative. No, he’s more than happy to be helpful with the techs who are trying to administer these tests. He just doesn’t understand.
That requires me to try to get Tony to cooperate. Sometimes I can, and sometimes I can’t.
Thank goodness everyone in the office is willing to work with him. But trying to get someone who doesn’t understand what you want to put his eye up to a machine, hold still and open his eye wide enough to take a photo was almost an impossible task.
Still, eye doctors have ways around these seemingly insurmountable hurdles. After doing what she was able to do, our eye doctor was able to tell me that Tony’s vision had remained stable.
I was more than a little thankful for that. Picking out glasses with someone who has dementia or Alzheimer’s can be another challenge entirely.
Been there, done that too.
• Joan Oliver is the former Northwest Herald assistant news editor. She has been associated with the Northwest Herald since 1990. She can be reached at firstname.lastname@example.org.