Access to primary eye care for people living with dementia: a call to action for primary care practitioners to 'think vision'.

Marianne Piano, Bao Nguyen, Flora Hui, Constance Dimity Pond
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Abstract

Access to allied health services offers significant benefits for people living with dementia, yet access is currently fragmented and inconsistent. The 2023-2024 budget allocated AU$445million to further enable general practice-led, multidisciplinary teams, with integrated care located within practices, including employment of allied health professionals. Such team care models are recognised by The Royal Australian College of General Practitioners as vital to delivery of high-quality care for older adults. They are especially relevant for over 250,000 Australians who live with dementia in the community. However, not all allied health professionals are currently based within general practices. Future, sustainable general practice-led models of multidisciplinary care that connect patients with external allied health providers could be considered for a comprehensive and collaborative approach to care. Our focus is on people living with dementia, who are at greater risk of preventable vision impairment. Poor vision and/or ocular health can be detected and managed through regular eye examinations, which are predominantly delivered by community-based optometrists in Australia, in a primary care capacity. However, people living with dementia are also less likely to have regular eye examinations. In this paper, we highlight the value of ensuring access to primary eye care services as part of post-diagnosis dementia care. We illustrate the important role of primary care practitioners in building and sustaining connections with allied health professions, like optometry, through effective referral and interprofessional communication systems. This can help break down access barriers to dementia-friendly eye care, through promoting the importance of regular eye tests for people living with dementia.

痴呆症患者获得初级眼科护理的途径:呼吁初级保健从业人员 "思考视觉"。
获得专职医疗服务对痴呆症患者大有裨益,但目前获得这些服务的途径分散且不一致。2023-2024 年预算拨款 4.45 亿澳元,用于进一步扶持由全科医生领导的多学科团队,在诊所内提供综合护理,包括聘用专职医疗人员。澳大利亚皇家全科医师学院认为,这种团队护理模式对于为老年人提供高质量的护理服务至关重要。对于超过 25 万在社区生活的澳大利亚痴呆症患者来说,这种模式尤为重要。然而,目前并非所有的专职医疗人员都在全科诊所工作。未来,可以考虑采用由全科医生主导的可持续多学科护理模式,将患者与外部专职医疗服务提供者联系起来,以提供全面、协作的护理服务。我们的重点是痴呆症患者,他们更有可能出现可预防的视力损伤。视力低下和/或眼部健康问题可以通过定期眼科检查来发现和处理,在澳大利亚,眼科检查主要由社区验光师以初级保健的身份提供。然而,痴呆症患者也不太可能定期进行眼科检查。在本文中,我们强调了作为痴呆症诊断后护理的一部分,确保患者获得初级眼科护理服务的价值。我们通过有效的转诊和跨专业沟通系统,说明了初级保健医生在建立和维持与联合医疗专业(如验光配镜专业)的联系方面所发挥的重要作用。这有助于通过宣传痴呆症患者定期进行眼科检查的重要性,打破痴呆症患者获得眼科护理的障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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