View from the front room: Variety is the spice of life

When I tell people I do domiciliary they often have quite a negative view of it. They tend to think all the customers are old and have dementia, and that it’s a difficult day.
In fact, it’s very varied. Not all of our customers are old – we see disabled children, and young people with agoraphobia who can’t leave the house. We do see customers with dementia, but we also see people who’ve just had a hip replacement, for example, and can’t get out.
One of the lovely things about domiciliary is that the customers are almost always pleased to see us. That’s very rewarding.
I’ve worked in domiciliary for three years now. Prior to that I worked in a small independent practice for 15 years. It was the same thing every day and I couldn’t see my career progressing. I needed a change.
Then I started doing some domiciliary work with a colleague – going to see a few of our customers who couldn’t come into the shop anymore. I was a bit apprehensive about it beforehand, but I loved it. It was a totally different dynamic to store work. In the shop I did tests every 20 minutes from nine to five and didn’t really connect with the customers at all. But with domiciliary you’re invited into someone’s home, so it’s a lot more personal. You get to know the person, rather than just doing the test.
My colleague left and joined Specsavers as a domiciliary director, and three years ago I joined him as an employed optometrist and became optometric director a couple of years ago. I’ve never looked back.
I’m never bored now. The variety is amazing. Some visits are very rewarding. Recently I saw a man in his 50s who had serious mobility issues and hadn’t been out for years. For some years he’d thought he was going blind, but was too scared to call us. When I finally got to see him, I was able to tell him that it was just cataracts and could be sorted out fairly easily.
Other visits are very sad. Today I was chatting with a customer about her family, and she told me her daughter, who lived in Australia, had died. She hadn’t heard from her for a while and only found out that she’d died because a relative told her after seeing it on Facebook.
Loneliness is a problem for a lot of our customers. We are very aware of our responsibility to show kindness to them, as sometimes the only contact they have with the outside world is with people like us who are paid to see them.
At Christmas, we saw a lovely old gentleman whose wife had died. He lived on his own, had no family, and couldn’t get out due to arthritis. We tested his eyes, had a lovely chat, looked at photos of his wife and of his time in the war and he showed us his sloe gin bar. We couldn’t join him with the sloe gin, unfortunately. But it felt good to connect with somebody on a personal level rather than just going in, doing the test and leaving. He was a character I’ll always remember.
One of the things I enjoy about domiciliary is the challenge of thinking outside the box. You’ve got to be adaptable, because from one appointment to the next you can’t predict what the environment will be like. As soon as you walk in, you’re assessing where you need the customer to sit, or if they can move, or where you can put things. Some customers are lying down in bed, which is a bit of a challenge. You have to find somewhere to put the chart/iPad – we often use walking frames as chart stands. In some houses there are items on every surface and you have to step over things.
It’s quite different to working in store. In store, if you saw some pathology you’d have to refer. But in domiciliary, you have a discussion with the customer about going to hospital and quite often they’ll say, ‘I understand what you’re saying but I’m elderly, I’ve had enough of hospitals, it’ll be too traumatic and I’m not going.’ And you’ve got to respect their decision.
I don’t think I could go back to high street practice now.