Social Networks May Shape Visually Impaired Older Adults' Occupational Engagement: A Narrative Inquiry

Age-related vision loss (ARVL) has been shown to interfere with older adults' occupational engagement. The primary purpose was to examine the role social networks play in facilitating/constraining engagement in desired occupations for older adults with ARVL. This study adopted a constructivist narrative methodology. Five older adults, ≥ 60 years of age with ARVL, participated in three virtual interviews, which were coded using thematic analysis. Three overarching themes were identified: (a) Diverse Social Networks Fulfill Different Occupational and Psychosocial Needs, (b) Retaining a Sense of Independence through Seeking Reciprocity in Social Relationships, and (c) Community Mobility and Technology Support as Essential for Preserving Social Relationships. Findings broaden understandings of how informal/formal social networks are involved in shaping visually-impaired older adults' adaptation to ARVL and related occupational changes. Findings may help improve the quality and delivery of low-vision rehabilitation services to optimize their contribution to occupational engagement.

The impact of combined age-related vision loss and dementia on the participation of older adults: A scoping review

INTRODUCTION

There are a growing number of older adults with combined age-related vision loss (ARVL) and dementia. Existing literature shows the pervasive impact that both diagnoses have separately on the participation of older adults, however, little is known about the societal participation of older adults with both conditions. As such, the aim of this scoping review was to explore the combined impact of ARVL and dementia on the participation of older adults, with a specific focus on highlighting strategies that help mitigate the impact of ARVL and dementia on participation.

METHODS

This study utilized a scoping review, informed by the framework by Arksey and O'Malley [1]. Two researchers independently ran a total of 62 search terms across four categories in six databases (PubMed, CINAHL, Scopus, Embase, Medline, PsycINFO), with an initial yield of 2,053 articles. Grey literature was also included in this scoping review and was retrieved from organizational websites, brochures, conference proceedings, and a Google Scholar search. The application of study inclusion criteria resulted in a final yield of 13 empirical studies and 10 grey literature sources.

RESULTS

Following detailed thematic analysis of the empirical and grey literature sources, four themes emerged regarding the impact of combined ARVL and dementia on the participation of older adults including: 1) Managing the pragmatic aspects of a dual diagnosis; 2) Diverse approaches to risk assessment and management; 3) Adopting a multi-disciplinary approach to facilitate care and; 4) Using compensatory strategies to facilitate participation.

CONCLUSIONS

The four themes highlight the challenges older adults with these combined diagnoses experience, which limit their opportunities for meaningful participation. Given the scarcity of research on this topic, future research should identify the type of ARVL and dementia diagnoses of study participants, conduct qualitative research about the lived experiences of older adults with a dual diagnosis, and broaden the geographic scope of research.

Experiencing visual impairment in a lifetime home: an interpretative phenomenological inquiry

Lifetime home standards (LTHS) are a set of standards aimed at making homes more accessible. Previous research, however, indicates that LTHS do not adequately meet the needs of those with sensory impairments. Now, with visual impairment set to increase globally and acknowledging the recognised link between quality of dwelling and wellbeing, this article aims to examine the experiences of visually impaired people living in lifetime homes. The objectives are to investigate existing lifetime homes and to identify whether LTHS meet occupants' needs. Qualitative semi-structured interviews were carried out with six visually impaired people living in homes designed to LTHS in Northern Ireland. Collected data was analysed using interpretative phenomenological analysis identifying three super-ordinate themes: (1) living with visual impairment; (2) design considerations and (3) coping strategies. A core theme of balance between psychological and physical needs emerged through interconnection of super-ordinate themes. Although there are benefits to living in lifetime homes, negative aspects are also apparent with occupants employing several coping strategies to overcome difficulties. Whilst residents experience negative emotions following visual impairment diagnoses, results suggest that occupants still regard their homes as key places of security and comfort in addition to then highlighting the need for greater consideration of specific individual needs within general guidelines.

The Environmental Production of Disability for Seniors with Age-Related Vision Loss

To date, attention to the environmental production of disability among older adults with age-related vision loss (ARVL) has been limited. This critical ethnographic study aimed to reveal the ways in which environmental barriers produced and perpetuated disability for 10 older adults with ARVL. A modified version of Carspecken's five-stage approach for critical ethnography was adopted with three methods of data collection used, including a narrative interview, a participant observation session, and a semi-structured, in-depth interview. Findings revealed how disability is shaped for older adults with ARVL when they encounter environmental features that are embedded within an ageist and disablist society. These findings are illustrated via presenting analysis of three commonly discussed activities: shopping, eating, and community mobility. Our discussion suggests that addressing the environmental production of disability requires inclusive social policy, advocacy, and a focus on education in order to develop and sustain age and low-vision-friendly environments.

Reshaping understandings of disability associated with age-related vision loss (ARVL): incorporating critical disability perspectives into research and practice

PURPOSE

In this paper, we have sought to stimulate a critical dialog regarding the ways in which disability has been largely conceptualized and studied in literature addressing age-related vision loss (ARVL). We suggest an expansion of this largely biomedically informed research area to include alternative frameworks, namely critical disability perspectives.

METHOD

To demonstrate the potential contributions of adopting a critical disability approach to enhance understandings of ARVL, this article outlined the primary tenets of the biomedical and social models of disability; the key aims, emphases, and assumptions of critical disability perspectives; and provided examples of how such an approach would lead to new research foci in the study of ARVL.

RESULTS

The paper highlighted four qualities of critical disability perspectives that future ARVL research should ascribe to, including (a) a focus on interdependence over traditional notions of independence; (b) a broader conceptualization of 'normalcy'; (c) the influence of language as a means of describing or labeling disabled persons; and (d) the influence of the socio-political environment in the creation and sustainment of disability.

CONCLUSIONS

This paper encouraged the incorporation of critical disability perspectives to provide new ways of conceptualizing, researching, writing about, and practicing in relation to ARVL. Implications for Rehabilitation The application of critical disability perspectives to expand the boundaries of low vision research can broaden low vision rehabilitation services (LVRS) in ways that more effectively attend to environmental features shaping and perpetuating disability for clients with age-related vision loss (ARVL). Low vision research, informed by critical disability perspectives, would inform a shift away from the exclusive focus on independence towards an acknowledgment of interdependence. The integration of participatory research approaches in ARVL research could generate new insights to inform rehabilitation by enhancing space and respect for the stories and knowledge of older adults aging with vision loss. Greater attention in low vision rehabilitation should be paid to how older adults' experiences of disability are tied to both the environmental context in which they exist and by the limitations caused by their impairment.

Understanding the occupational performance experiences of individuals with low vision

Introduction

Occupational therapy practitioners who provide interventions for adults with low vision need to understand challenges with occupational performance from the individual’s perspective in order to implement effective treatment. The purpose of this study was to understand self-described occupational behaviors of persons with low vision.

Method

This qualitative study included semi-structured interviews regarding the occupational experiences of 22 individuals with varying levels of vision impairment. Transcribed data were organized according to the areas of occupation reported in the American Occupational Therapy Association’s Practice Framework.

Results

Participants described occupational performance of activities of daily living, instrumental activities of daily living, and leisure. Within each area of occupation, participants reported lighting, contrast, familiarity, and organization within the environment as facilitators or barriers to participation. Participants with increased vision loss relied heavily on assistive devices, task simplification, and others to perform desired occupations.

Conclusion

The information obtained in this study can assist practitioners in selecting more effective interventions to increase the independence and safety of individuals with low vision.

Factors That Influence the Occupational Engagement of Older Adults with Low Vision: A Scoping Review

Introduction:

Prior research has provided occupational therapists with an understanding of the negative impact of low vision on self care, leisure and productivity. In order to guide future low-vision rehabilitation services, an understanding of the factors that influence the occupational engagement of older adults with age-related vision loss (ARVL) is also needed.

Method:

A scoping review of the literature was conducted in order to identify those factors that have been shown to influence the occupational engagement of older adults with ARVL, and to identify future research needs.

Findings:

As identified in this scoping review, five types of factors were shown to influence occupational engagement for older adults with ARVL including: demographic variables, emotional components, behavioural components, diagnostic components, and environmental aspects.

Conclusion:

Although findings pertaining to personal factors can inform practice, few studies explored the influence of environmental factors on occupational engagement. Given that occupation is a result of person-environment transactions, it is important that future research more fully explores environmental influences in order to enable occupational therapists to deliver services that optimize the occupational performance of seniors with ARVL.