Shifting from Compensation to Participation: A Model for Occupational Therapy in Low Vision

Abstract

Critical review Introduction Life for adults aged 65 years and older has changed dramatically over the years. Since individuals are living longer, today's healthy older adult spends approximately a third of his or her life in retirement (Bass-Haugen et al 2005). Most of these older adults are not sedentary: they spend about 4 hours a day outside the home, engaging in shopping, driving, cultural and sporting events, volunteering, travelling, and visiting family and friends (Horgas et al 1998). Additionally, many older adults do not retire abruptly but, rather, remain in or return to the workforce (Bass-Haugen et al 2005). These social, leisure and productive occupations maintain quality of life, self-efficacy, and physical and mental health (Stevens-Ratchford 2005). However, activity engagement decreases in the presence of health conditions such as low vision, which have an impact on daily functioning (Bass-Haugen et al 2005). Of the estimated 314 million people with visual impairments worldwide, approximately 82% are above the age of 50 years (World Health Organisation 2009). These individuals are in need of unique rehabilitation treatment plans to enable their occupational engagement. People with low vision generally do not have significant impairments in basic activities of daily living (ADL) such as self-care because, over time, they have learned habits and routines that come naturally and do not require the use of intensive visual skills. Rather, low vision has an impact on instrumental activities of daily living (IADL), the tasks involved in managing home, work, leisure and family care. Many older adults enter long-term care because of physical disabilities that impede their ability to complete self-care. However, otherwise healthy older adults with low vision tend to lose their ability to age in place due to difficulties with IADL. They may misread a medication label or leave their oven on because they cannot see the dial. Research supports these claims, with participants reporting independence in ADL but significant disability in leisure, work, social and mobility activities

Older Adults Recently Diagnosed with Age-Related Vision Loss: Readjusting to Everyday Life

“…To be able to live the everyday lives that these individuals value, rehabilitation services should meet the different, complex challenges that vision loss creates. Rehabilitation programs described by Eklund and DahlinIvanoff (2006), Rees et al (2010), and Schoessow (2010) have all focused on practical problem solving and emotional reactions to vision loss. Our findings more specifically indicate that services and rehabilitation programs should also concentrate on how vision loss can influence interactions between individuals and social environments, particularly regarding how to appear and be seen by other people.…”

Screening for sensory impairment in older adults: Training and practice of occupational therapists in Quebec

“…Sensory loss can have devastating effects on an individual, both at the level of occupational performance (Markowitz, 2006; Perlmutter et al, 2013; Schoessow, 2010) as well as psychologically and socially. Specifically, older adults with age-related vision loss are more likely to experience depression (Rovner, Casten, Hegel, Leiby, & Tasman, 2007; Rovner & Ganguli, 1998), social isolation (Saito, Kai, & Takizawa, 2012), and reduced quality of life (Renaud et al, 2010).…”

Broadening the Vision: The Education and Training Needs of Occupational Therapists Working with People with Sight Loss

“…The question therefore needs to be addressed in the UK as to whether occupational therapists here should embrace this key position of emerging practice within the field of visual impairment (Schoessow 2010). With the call for the profession to seize opportunities (Clark 2009) and challenge professional boundaries by investigating Broadening the vision: the education and training needs of occupational therapists working with people with sight loss opportunities in emerging roles and non-traditional settings (Alsop 2006, Scott 2007), the answer to this question is perhaps already apparent.…”