How do you put eye drops in an elderly person? A comprehensive caregiver's guide

According to the CDC, vision loss is one of the top 10 causes of disability in the United States, with a significantly higher prevalence among older adults. Learning how do you put eye drops in an elderly person is a vital skill for caregivers, helping to ensure proper treatment and maintain a senior's eye health effectively and with minimal stress.

Quick Summary

Successfully administering eye drops to an elderly individual requires a calm approach and the right technique. Caregivers can use a standard method by creating a lower eyelid pocket, a closed-eye corner method for those with difficulty keeping their eyes open, or various assistive devices to ensure accurate and comfortable application.

Key Points

• Start Calmly: Wash your hands and explain the process clearly and calmly to reduce anxiety and resistance.

• Position for Stability: Have the person lie down or sit with their head tilted back and stabilized, which can increase accuracy.

• Try Two Methods: For cooperative seniors, use the standard open-eye method; for uncooperative or anxious individuals, try the gentle closed-eye corner method.

• Consider Assistive Tools: If dexterity or coordination is an issue, eye drop guides or bottle squeezers can help ensure the drops land correctly.

• Ensure Proper Absorption: After applying the drop, have the person close their eye gently and press the inner corner to prevent drainage.

• Consult a Professional: If you face persistent difficulty or notice signs of infection, do not hesitate to contact a doctor or pharmacist for further guidance.

Understanding the Challenges of Administering Eye Drops

For many caregivers, administering eye drops can be a source of frustration, especially when the elderly person is uncooperative, anxious, or has mobility issues. Seniors may experience a range of physical challenges that make the process difficult, including:

• Decreased Dexterity: Conditions like arthritis can make it hard to hold and squeeze a small eye drop bottle.
• Tremors or Shaky Hands: Involuntary movements can cause drops to miss the eye entirely.
• Anxiety and Fear: Many people have an involuntary flinching or blinking response when something approaches their eye, which can be heightened by age-related anxiety.
• Dementia or Cognitive Impairment: A person with memory loss or dementia may not understand why they need the drops and resist the process.
• Vision Loss: Poor eyesight can make it difficult for the senior to track the bottle and help guide the process.

The Importance of Patience and Communication

Before you begin, remember that patience is paramount. Rushing the process can increase anxiety and make the individual less cooperative. Explain each step in a calm, clear voice. Tell them exactly what you are doing and why. Using a reassuring tone can significantly reduce a person's stress and resistance.

The Standard Method for Cooperative Patients

For an elderly person who is able to cooperate, this is the most common and effective method.

1. Prepare the Environment: Choose a quiet, well-lit area. Have the eye drops and a clean tissue ready. Ensure your hands are washed thoroughly with soap and water to prevent contamination.
2. Position the Patient: Have the person lie down or sit comfortably in a chair with their head tilted back. Placing a rolled-up towel under their neck can provide support and keep their head stable.
3. Secure the Eyelid: With one hand, gently pull down the lower eyelid to create a small 'pocket' or 'pouch' for the drop. Instruct the person to look up towards the ceiling, away from the dropper tip.
4. Administer the Drop: Hold the eye drop bottle about an inch away from the eye with your other hand. Use the heel of your hand to rest on the person's forehead for extra stability. Squeeze the bottle gently to release a single drop into the eyelid pocket. Do not let the dropper tip touch the eye or eyelashes.
5. Post-Application Care: Instruct the person to close their eye gently—not squeeze it shut—and press lightly on the inner corner of their eyelid near the nose for about one minute. This is called punctal occlusion and helps the medication absorb into the eye rather than drain away. Blot any excess liquid with a clean tissue.

The “Corner Method” for Anxious or Resistant Patients

If the elderly person has difficulty keeping their eye open, this closed-eye technique can be a gentler, less intimidating alternative.

• Preparation: As with the standard method, wash your hands and gather your supplies. Have the person lie back or tilt their head back.
• The Drop: With their eye gently closed, place one or two drops of the medication in the inner corner of the eye, where the eyelids meet the nose.
• The Blinking: Ask the person to slowly open their eye and blink gently. The drop will roll into the eye as they blink.
• Absorption: Have them keep their eye closed for a minute or so after the drop has gone in to allow for absorption. Pressing on the inner corner is still a good practice.

Comparison of Eye Drop Application Methods

Feature	Standard (Open-Eye) Method	Corner (Closed-Eye) Method
Patient Comfort	Can cause anxiety; relies on cooperation.	Less intimidating; useful for sensitive or resistant individuals.
Application Accuracy	Very high if the patient is steady.	Good, though some drops may be lost.
Speed	Quick, assuming the patient cooperates.	Slightly slower, as it relies on blinking.
Caregiver Skill	Requires a steady hand and patient reassurance.	Requires less precise aiming, focusing on placement.
Best For	Cooperative seniors, those with good head control.	Anxious or uncooperative patients, those with tremors.

Assistive Devices for Easier Application

Several tools are available to help simplify the process, especially for those with limited dexterity or poor hand-eye coordination.

• Eye Drop Guides: These devices fit over the eye and hold the bottle in place, directing the drop precisely onto the eye. They remove the need for steadying the hand.
• Bottle Squeezers: These gadgets are designed to make squeezing the bottle easier for individuals with arthritis or weak hands.
• Magnifiers: Some devices come with built-in magnifiers to help the caregiver see the eye more clearly.

When to Seek Professional Guidance

While these techniques work for many, some situations require professional assistance. If the elderly person is consistently resistant, becomes agitated, or if you suspect they are not receiving the full dose of medication, it's time to speak with their doctor or pharmacist. A professional can offer personalized advice or recommend alternative treatment methods. A caregiver should also contact a healthcare provider immediately if the person's eye becomes red, swollen, or produces discharge, as this could indicate an infection.

Conclusion

By approaching eye drop administration with patience, communication, and the right technique, caregivers can make the process more comfortable and effective for an elderly loved one. Whether using the standard method, the gentle corner technique, or an assistive device, the goal is to ensure the medication is delivered accurately and without causing unnecessary stress. For more detailed instructions on safe eye care practices, you can refer to authoritative resources on the topic, such as AARP's Guide to Using Eye Drops. Mastering this skill is a crucial part of providing compassionate and competent senior care.

Frequently Asked Questions

What if the elderly person blinks and the drop doesn't go in?

If they blink and you are unsure if the drop was successful, it's generally safe to try again. The eye can hold only one drop at a time, so any extra will simply run out.

How do you put eye drops in an elderly person with dementia?

For someone with dementia, patience is critical. Approach them from the front, maintain eye contact, and use simple, reassuring language. The closed-eye corner method is often less frightening. You can also try distracting them with a song or story.

Is it okay to put eye drops in a person's eye while they are asleep?

No, it is not recommended to put eye drops in a person's eye while they are asleep. The sudden sensation could startle them and cause agitation. Wait until they are awake and more cooperative.

What if the elderly person has shaky hands and wants to do it themselves?

Encourage their independence while providing support. You can help by steadying their arm or suggesting an assistive device like an eye drop guide, which can give them the confidence and stability to do it themselves.

How long should I wait between different types of eye drops?

If an elderly person is prescribed more than one type of eye drop, you should wait at least 5 to 10 minutes between applications. This prevents the first medication from being washed out by the second.

What if the bottle tip touches their eye or eyelashes?

If the dropper tip touches the eye or eyelashes, the bottle has become contaminated. Do not use that bottle again to avoid introducing bacteria into the eye. It is safer to discard it and open a new, sterile bottle.

Can I use cold eye drops to help with application?

Yes, some caregivers find that refrigerating the eye drops (if the medication allows) makes them feel colder, which helps the person feel exactly when the drop enters the eye. This can sometimes make the process easier to track.