What I have learned

“My job is kept interesting by continuing to build my skills”

Clare Pearce, optometrist and practice director of Pearce and Blackmore Opticians, and Ingrid Patterson, Dementia Friendly communities coordinator, on ensuring accessible eye care and the importance of expanding skills


When were you introduced to the Dementia Friendly scheme? What made you want to complete this as a practice?

Clare Pearce, optometrist and director of Pearce and Blackmore Opticians (CP): I was originally introduced to the Dementia Friendly scheme in 2020 through an initial phone conversation with Ingrid. It started the ball rolling but as our practice was navigating the COVID-19 pandemic, it wasn’t until early in 2021 that we resumed contact and began taking steps towards our pledge to become Dementia Friendly. I feel really passionate that optometry, and healthcare in general, should be accessible to everyone and I knew that it was something I wanted to incorporate into my business. No one deserves to get second-rate care.

What has the process involved for the team, and as a practice?

CP: The process began with a telephone conversation with Ingrid about what we felt was important in a patient journey through the practice and what would be difficult for a patient with dementia to experience. Ingrid then shared a checklist that I was able to use to go through the practice and highlight areas of improvement, for example clear signage and good lighting.

Following that, we put together a pledge document which had action points that we agreed to implement as a business to make the practice a more Dementia Friendly place. These action points for our practice included simple things like getting name badges in black writing on a yellow background, to more time-consuming things like making cue cards to give to patients during their time in the practice to aid their understanding of what is happening. Ingrid then delivered some online training so each individual staff member became a Dementia Friend.

I feel that as I offer more services, I see a wider range of patients and that variety in my day-to-day working is so interesting – I love it

Clare Pearce, optometrist and director of Pearce and Blackmore Opticians

How does this build into your wider plans for the practice?

CP: Becoming a Dementia Friendly practice is great for the business as carers and people with dementia can specifically search for Dementia Friendly places and our practice will now feature. I want my practice to be a place where patients and carers can feel that their individual needs are met and they can still receive the best care.

How might the skills from this training be applicable within your clinical role as an optometrist?

CP: Communication is such a key part of any optometrist’s job and it has to be adapted to each patient that sits in your chair. Having the opportunity to know how to specifically adapt your communication for a patient with dementia and their carer has been great. Having the training has also given me the confidence to be examine patients with dementia.

How important is it to you to continue developing your practice through further training and development?

CP: I am motivated to continue to develop my skills and build my practice because we never finish learning. My job is kept interesting by continuing to build my skills and those skills then directly benefit my patients. As the sole optometrist at my independent practice, the clinical services that we offer comes down to the skills I have built up. Balancing work, my family and studying is a challenge, but one that brings professional reward.

I am accredited with the Wales Eye Care Service, which offers emergency eye care and examinations for patients who are in a high-risk category of sight loss. As my practice is in a medical centre, being qualified to offer this service means that I can work effectively with the adjacent GP and pharmacy practices to largely keep patients within primary care. I have recently become a low vision accredited practitioner and I’m excited to be able to offer this service to my low vision patients as it means that I do not have to refer them to another practice. Part of what I love about having an independent practice is the continuity of care I can offer and that will always include those patients who are sadly losing their sight.

Becoming a Dementia Friend and pledging to make my practice a Dementia Friendly business came from a similar motive. I want to be able to continue seeing my patients in an environment that is appropriate and comfortable for them. I feel that as I offer more services, I see a wider range of patients and that variety in my day-to-day working is so interesting – I love it.

Cue cards and Clare
Following the Dementia Friendly business scheme, Clare Pearce designed cue cards to use in practice to support communication with patients who have a diagnosis of dementia

In addition to continued training, how important do you feel it is to broaden your skillset in areas beyond clinical practice?

CP: I’m really passionate that optometry is accessible to everyone regardless of their ability, language or position. Over 10 years ago, I began to put this into practice and went to college to learn British Sign Language (BSL) and am now, although not interpreter level, able to perform a sight test in the language. Being aware of ways we can work towards making our profession accessible is the first and most important step. For example, I wouldn’t expect everyone to be able to perform a sight test in BSL but for an optometrist to be deaf aware is, in my opinion, really important. The same goes for being dementia aware. Just to be told or reminded about ways we can aid communication is vital.

People living with dementia and their carers have told us that optometry is one of the sectors that they rely on for good healthcare

Ingrid Patterson, Dementia Friendly communities coordinator for Cardiff and Vale

What does the process for becoming a Dementia Friendly business involve?

Ingrid Patterson, Dementia Friendly communities coordinator for Cardiff and Vale, (IP): Being a Dementia Friendly business is about enabling people living with dementia and the people caring for them to feel that their needs are understood and supported as part of their everyday life.

It is an approach through which communities, local businesses and organisations, and key individuals such as carers, family members and friends, come together to enable people to live well for as long as possible within their chosen community.

The Dementia Friendly business process supports local businesses in Cardiff and Vale to become more welcoming and accessible for people living with dementia and their carers. It’s a straightforward but meaningful process, whereby Marie Curie provides support and resources produced by the Alzheimer’s Society to enable businesses to create a Dementia Friendly action plan. Businesses choose the actions that they will take and then sign a pledge as a commitment. They are then presented with a certificate and a pledge sticker.

How did you tailor the training to the optometry-specific audience?

IP: People living with dementia and their carers have told us that optometry is one of the sectors that they rely on for good healthcare and so people want to feel reassured and that their needs can be understood and supported when they go for eye care and tests. Using the feedback that people with a diagnosis of dementia have given us, we are approaching local businesses, such as Cardiff and the Vale optometry practices, with the offer of being supported to become Dementia Friendly.

We use the bookcase model to illustrate the impact of dementia on somebody’s memory when they come in to have their eye test, linking with history and symptoms. We also highlight the importance of simple communication for somebody living with dementia. Patient information cards were introduced to practice with pictures as well as words to support effective, simplified communication. Good patient-centred communication is key, such as the simple but meaningful action of communicating directly with the patient, and not just to their carer.

The way that the patients were supported to use the practice was also key. Some actions that came as a result of our Dementia Friends information session with the practices was the opticians chose to present a smaller selection of glasses as a way of supporting people to make more of an informed choice, and introducing wayfinding signage that's dementia friendly.

What do you feel it means for people with dementia to be able to access services like optometry that are part of the Dementia Friendly Communities in Cardiff and Wales?

IP: I think that it is key for optometry specifically, because it’s so important that a good standard of healthcare should be accessible to everyone, irrespective of having a health condition. I think what the business pledge scheme enables is a mechanism of building communities where people are aware and supportive of the needs of people living with dementia and their carers.

It’s a way that local optometrists can come together to support their patients, not only to continue to use their services, but to remain connected and active by continuing to use their local services for as long as possible.

Why might optical practices want to consider becoming Dementia Friendly, and why particularly now?

IP: People living with dementia have told us they need confidence to continue using their local services, particularly following periods of lockdown. They have reported feelings of anxiety and fear and also isolation, and I think lockdown exacerbated these experiences. People have told us that they gain reassurance by seeing pledge stickers displayed in local windows. For example, seeing Pearce and Blackmore Opticians display their Dementia Friendly stickers means that people feel they can go somewhere where their needs will be understood and supported.

Opticians have told us that small changes can make a big difference and that their businesses have benefited. The Dementia Friendly process has enabled engagement with new patients and clients, and their staff have gained confidence.

We’re looking to connect with more optometry practices across Cardiff and the Vale, so if people are interested in finding out more they can get in touch via email. 

I think people often hear about Dementia Friends but not necessarily the Dementia Friendly business pledge scheme, and it’s lovely if we can make these changes at a business level as well as at an individual level.

More details on the Dementia Friendly programme in Cardiff and Vale can be found on the Dementia Friendly Cardiff website. 

To read more about dementia awareness training, take a look at OT’s article with Raj Gill on rolling out training across two practices.