With increasing longevity among populations, age-related vision and hearing impairments are becoming prevalent conditions in the older adult populations. In combination dual sensory loss occurs. Dual sensory loss is becoming a more common condition seen by clinicians and previous research has shown that 6% of non-institutionalized older adults had a dual sensory impairment, whilst 70% of severely vision-impaired older adults also demonstrated a significant hearing loss. Decreased vision and/or hearing acuity interferes with reception of the spoken message and hence people with sensory loss frequently experience communication breakdown. Many personal, situational and environmental triggers are also responsible for communication breakdown. Limited ability to improve communication performance frequently results in poor psychosocial functioning. Older adults with sensory loss often experience difficulty adjusting to their sensory loss. Depression, anxiety, lethargy and social dissatisfaction are often reported. Sensory loss, decreased communication performance and psychosocial functioning impacts on one's quality of life and feelings of well-being. Rehabilitation services for older adults with age-related sensory loss need to accommodate these difficulties. Improved staff education and rehabilitation programmes providing clients and carers with strategies to overcome communication breakdown is required. A multidisciplinary perspective to the assessment and remediation of older adults is recommended.

Self-report of hearing loss is insensitive to age effects and does not provide a reliable basis for estimating prevalence of age-related hearing loss, although may indicate perceived hearing disability.

Objective: To assess the effectiveness of a coach-led motivational interviewing (MI) intervention in improving glycaemic control, as well as clinical, psychosocial and self-care outcomes of individuals with type 2 diabetes mellitus (T2DM) compared with usual care.

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ObjectiveThe objective of this study was to explore the decision-making processes and associated barriers and enablers that determine access and use of healthcare services in Arabic-speaking and English-speaking Caucasian patients with diabetes in Australia.Study setting and designFace-to-face semistructured individual interviews and group interviews were conducted at various healthcare settings—diabetes outpatient clinics in 2 tertiary referral hospitals, 6 primary care practices and 10 community centres in Melbourne, Australia.ParticipantsA total of 100 participants with type 2 diabetes mellitus were recruited into 2 groups: 60 Arabic-speaking and 40 English-speaking Caucasian.Data collectionInterviews were audio-taped, translated into English when necessary, transcribed and coded thematically. Sociodemographic and clinical information was gathered using a self-completed questionnaire and medical records.Principal findingsOnly Arabic-speaking migrants intentionally delayed access to healthcare services when obvious signs of diabetes were experienced, missing opportunities to detect diabetes at an early stage. Four major barriers and enablers to healthcare access and use were identified: influence of significant other(s), unique sociocultural and religious beliefs, experiences with healthcare providers and lack of knowledge about healthcare services. Compared with Arabic-speaking migrants, English-speaking participants had no reluctance to access and use medical services when signs of ill-health appeared; their treatment-seeking behaviours were straightforward.ConclusionsArabic-speaking migrants appear to intentionally delay access to medical services even when symptomatic. Four barriers to health services access have been identified. Tailored interventions must be developed for Arabic-speaking migrants to improve access to available health services, facilitate timely diagnosis of diabetes and ultimately to improve glycaemic control.