The findings provide evidence that ADL and IADLs require different skills and are associated differently depending on numerous variables. As the incidence of people living with vision loss is increasing to epidemic proportions due to an aging population, understanding the relationship between vision and participation in meaningful activities has important implications.

This research shows that care partners want to retain social participation and provides support for the importance of addressing the socio-emotional needs of care partners of people with a chronic disease. Interventions that guide care partners to take care of their spectrum of needs may lead to healthier, positive relationships. Implications for rehabilitation The focus of rehabilitation is often on the person diagnosed with the chronic condition. Living with and caring for someone with a chronic illness, such as Parkinson's disease, can lead to limitations in activity and social participation for the care partner. Including care partners in the rehabilitation process is key to helping maintain their health and well-being. Learning caregiving and self-management strategies may help care partners support their loved ones while staying socially engaged.

This systematic review examined evidence regarding the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in leisure and social participation for older adults with low vision. We identified and reviewed 13 articles that met the inclusion criteria. Four themes related to interventions to improve leisure and social participation emerged from the literature review: using a problem-solving approach, delivering a combination of services, providing skills training, and making home visits and environmental adaptations. The strongest evidence supports using a problem-solving approach to improve leisure and social participation for older adults with low vision. Evidence was moderate supporting the delivery of a combination of services, either by one professional or through an interdisciplinary approach. Results for the effectiveness of skills training and home visits and home adaptations were mixed. Implications for practice, education, and research are discussed.

Introduction Vision loss influences both basic and instrumental activities of daily living. There is limited information, however, on the relationship between vision loss and leisure activities. The research presented here was part of a larger study that aimed to understand the importance of participation in leisure activities for those with vision loss. This article focuses on one key theme that emerged from the data: the challenge of engaging in leisure activities outside the home for older adults with vision loss. Methods Semistructured interviews and participant observation were used to collect data from 26 adults aged 70 years and older with vision loss. Only those who perceived themselves to be in good or excellent overall health, separate from vision loss, were included. Results Themes that emerged related to limited leisure activities outside the home included both personal and environmental factors, such as challenging physical environments, struggling to “get there,” feelings of vulnerability, having decreased energy, and lacking assertiveness. Discussion The results indicated that vision loss is a key factor that limits one's ability to engage in out-of-home activities. There is a mismatch between environmental and personal factors that prevents participation in many activities. Although it appears that the participants chose not to engage in leisure activities outside the home because the activities were not within their competence, it is clear that these decisions were neither easy nor desirable. Implications for practitioners Therapists who provide services to older adults with vision loss should work with their clients to explore ways to facilitate participation in leisure activities in the community. Advocating for features that increase access and participation, addressing safety, exploring ways to conserve energy, and practicing assertive communication are all important components of a comprehensive vision rehabilitation program.

key words: visual impairment, participation, activity ABSTRACT Engaging in leisure activities is related to successful aging. Because there are an increasing number of older adults living with vision loss, many of whom struggle to engage in leisure, the aim of this study was to understand the meaning behind leisure activities for older adults who are living with vision loss. Twenty-six individuals with a visual acuity of 20/70 or worse participated in semi-structured interviews and allowed for the observation of engagement in a leisure activity of choice. Three themes regarding leisure and vision loss emerged: a shift in relationships, the influence of vision loss on time use, and achieving meaning through leisure as an important outcome. Discussion focused on implications for practice, emphasizing a need to understand the meaning of an activity to achieve leisure participation outcomes, and the importance of finding ways to enable older adults with vision loss to engage in leisure occupations.