Problems identified by dual sensory impaired older adults in long-term care when using a self-management program: A qualitative study

Abstract

ObjectiveTo gain insights into the problems of dual sensory impaired older adults in long-term care. Insights into these problems are essential for developing adequate policies which address the needs of the increasing population of dual sensory impaired older adults in long-term care.MethodsA qualitative study was conducted in parallel with a cluster randomized controlled trial. Dual sensory impaired older adults in the intervention group (n = 47, age range 82–98) were invited by a familiar nurse to identify the problems they wanted to address. Data were taken from the semi-structured intervention diaries in which nurses noted the older adults’ verbal responses during a five-month intervention period in 17 long-term care homes across the Netherlands. The data were analyzed using descriptive statistics and qualitative content analysis based on the Grounded Theory.FindingsThe 47 dual sensory impaired older adults identified a total of 122 problems. Qualitative content analysis showed that the older adults encountered participation problems and problems controlling what happens in their personal environment. Three categories of participation problems emerged: (1) existential concerns of not belonging or not being able to connect with other people, (2) lack of access to communication, information and mobility, and (3) the desire to be actively involved in care delivery. Two categories of control-in-personal-space problems emerged: (1) lack of control of their own physical belongings, and (2) lack of control regarding the behavior of nurses providing daily care in their personal environment.ConclusionsThe invasive problems identified indicate that dual sensory impaired older adults experience great existential pressures on their lives. Long-term care providers need to develop and implement policies that identify and address these problems, and be aware of adverse consequences of usual care, in order to improve dual sensory impaired residents’ autonomy and quality of life.

Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial

“…Overall, treatment delivery was fair. When compared with the findings of the parallel study analysing the problems addressed with the SMP-DSI, 45 we observed differences in treatment delivery: problems in controlling personal space were addressed to a greater extent than were the problems requiring behavioural involvement of others. Of the problems in controlling personal space, 27 of the 44 (61.3%) were fully addressed using all five SMP-DSI steps.…”

“… 44 In addition, we analysed the collection of problems addressed with the SMP-DSI in this cRCT; these were reported in a second separate qualitative study. 45 …”

The Challenge of Being Present and Inclusive: Chaplains’ Experiences With Providing Existential Care to Older Persons With Acquired Deafblindness

“…Caregivers can counteract this feeling of incoherence over time through a combination of emotional and practical support (Olesen and Jansbøl, 2005). Roets-Merken et al (2017) describe a category of existential challenges when becoming deafblind, implying thoughts like being stupid, forgotten, and not being significant anymore. As well, to orientate oneself is one of the most affected abilities when becoming deafblind.…”

“…The need for existential care appears explicitly in older age because of prevalent physical and mental decline and the awareness of the increasing likelihood to die (McFadden, 2013). A life with deafblindness is often accompanied by identity crises, implying an existential feeling of loneliness (Gullacksen et al, 2011), disconnection from others (Roets-Merken et al, 2017), and the world (Prause et al, in press), as well as questions about one's value (Johansson, 2017). Therefore, access to existential care appears to be an essential concern for older persons with acquired deafblindness.…”

Screening for Vision Impairments in Individuals with Dementia Living in Long-Term Care: A Scoping Review

“…As individuals age, there is not only increased risk of vision loss and cognitive decline, but there are often additional declines in other sensory functions, including hearing [11,[44][45][46][47]. The studies reported within this scoping review primarily focused on visual impairment, but it is likely that a large number of the participants in the reviewed studies also experienced age-related hearing loss.…”