Systematic barriers letting down older Australians, MDFA report

Currently, only 10-15% of people with low vision access services, which the report noted was in part a result of inadequate distribution and a lack of coordination amongst low vision services.It also listed educational shortfalls and poor collaboration between different service providers as exacerbating issues.The report, “Low Vision, quality of life and independence: A review of the evidence on aids and technologies”, which is based on collective data from Australian government and private institutions, argued aside from systic barriers, individual inaction and educational shortfalls were other contributing factors.Systic barriersProduced in collaboration with The George Institute for Global Health, the report also stated that Australia’s low vision sector has predominantly been the realm of NGOs.This has led to limited public and private support, with low vision services that often operate in isolation to clinical services.{{quote-A:R-W:450-I:2-Q: Low vision aids ranging from a simple magnifier or specialised lighting, through to adaptive technology, can transform the lives of people with sight loss, helping th to live to fulfill, independent lives. -WHO:Ms Julie Heraghty, CEO of MDFA}}A further consequence is a service delivery syst that varies by state and individual organisation, leading to some jurisdictions experiencing an overall shortage of services.It also contends that the current model of low vision care is fragmented, lacks collaboration, and underutilises the potential of primary and secondary optometry to relieve already stretched ophthalmic services.“Few private optometrists provide low vision services and the number of patients seen by these optometrists is small,” the report says.“Also GPs lacked awareness of the services provided by low vision organisations and the value of those services for patients.“Factors such as this may be attributed to the tendency of low vision NGOs to focus attention on their blind clientele, rather than generate a broader awareness of the services they provide.”Other systic barriers listed include a lack of confidence among optometrists to provide low vision support services, and inadequate runeration for the time needed to conduct assessments and prescribe low vision aids.Individual barriersAccording to the authors, patients often don’t perceive thselves as having low vision, even in cases where moderate or severe VI is present.This self denial may result in avoidant coping behaviour, which can also be linked to a patient’s belief that their vision probls are out of their control or unsolvable.These perceptions were identified as a major barrier to low vision service uptake, and were backed up by a 2011 study that found 37% of patients declined a referral to a low vision service, based on the believe that it was not needed or would not help.Meanwhile, patients with mobility probls – thought to be 74% of those requiring assistance – said distance from services and the use of public transport or taxis were other obstacles.Cost, education, contributing factors{{image3-a:r-w:400}}A number of programs exist that are designed to improve living conditions for those with vision probls and blindness, however, prohibitive costs and a lack of awareness has led to th being underutilised, especially by the elderly.The authors attributed this to a poor understanding of both the term and definition of “low vision”, as patients could perceive thselves as being either visually impaired or blind, rather than somewhere in between.Meanwhile, another study quoted in the report found that 34% of failed referrals spoke a language other than English, suggesting that language and cultural appropriateness may also present a barrier to access.Possible solutionsMs Julie Heraghty, CEO of MDFA, said that “low vision aids ranging from a simple magnifier or specialised lighting, through to adaptive technology, can transform the lives of people with sight loss, helping th to live to fulfill, independent lives. “Currently, the vast majority of people in Australia with sight loss have great difficulty affording or accessing these aids. This needs to change,” Heraghty said.To address the situation the MDFA recommends increased investment in research and development of vision-related technologies; establish a nationally-funded program to enhance existing government mechanisms and subsidy in private health insurance coverage.Heraghty pointed out that, “while successive governments are to be commended for subsidising registered sight-saving drugs to avoid vision loss, unfortunately, many older Australians who are vision impaired or blind, are repeatedly missing out on the support they most need – low vision aids and technologies”.The MDFA estimates the initial cost of a federally funded program to be around $30 million per year with a suggested annual allowance of between $667 and $2,400 per person per annum, depending on vision assessment.Heraghty added that these recommendations are “financially achievable” and that the MDFA will urge the Minister for Health to also focus on many older Australians who are not covered by the National Disability Insurance Sche (NDIS) to entitle th with the same level of support.