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

Abstract

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.

Self-regulation when using a mobility scooter: The experiences of older adults with visual impairments

“…When looking at the need for self-regulation by IVI who use scooters, many of the barriers are similar to those experienced by IVI as pedestrians. These barriers include poorly maintained footpath infrastructure, difficult road crossings and the threat of embarrassment (Blaylock et al., 2015; Brouwer et al., 2008; Gallagher et al., 2011; Laliberte Rudman et al., 2016; McGrath et al., 2017; Montarzino et al., 2007). The need to improve community mobility conditions seems obvious, and is also supported by a range of other studies into the experiences of pedestrians with visual impairment, powered mobility device users and older pedestrians (Blaylock et al., 2015; Brouwer et al., 2008; Fomiatti et al., 2014; Gallagher et al., 2011; Laliberte Rudman et al., 2016; McGrath et al., 2017; May et al., 2010; Montarzino et al., 2007; Mortenson et al., 2015; Wilton and Davey, 2007).…”

“…Barriers to community mobility for IVI include the inability to drive or access public transport, a lack of confidence and difficulty navigating poorly designed or maintained footpaths (Brouwer et al., 2008; Wilton and Davey, 2007). To facilitate their mobility, IVI report self-regulation strategies as pedestrians that relate to driving self-regulation strategies, such as carefully planning routes and travelling at a slower pace (Brouwer et al., 2008; Gallagher et al., 2011; Laliberte Rudman and Durdle, 2008; McGrath et al., 2017; Montarzino et al., 2007). However, IVI have a higher rate of physical impairments than their non-sight-impaired peers, compromising their ability to walk as a means of transport (Crews et al., 2006).…”

Current Practice in Low Vision Rehabilitation of Age-related Macular Degeneration and Usefulness of Virtual Reality as a Rehabilitation Tool

“…As the leading cause of acquired visual impairment in the Western world, AMD is responsible for 8.7% of all blindness worldwide. In individuals aged 65 to 75 years, AMD prevalence ranges between 9%-25%, and over 80% of those affected become legally blind after age 70 [1][2][3][4][5][6][7][8]. In France, AMD affects 8% of the population, and its frequency increases with age: 1% of people aged 50 to 55 years, 10% of those 65 to 75 years, and 25% to 30% of persons aged over 75 suffer from AMD [1,6,[9][10][11].…”

“…As individuals lose their central vision and the ability to discriminate between fine spatial details, they become less autonomous in performing basic activities of daily living (ADLs, e.g., walking, feeding, dressing) as well as instrumental activities of daily living (IADLs, e.g., taking medications, independent mobility, managing money). This predisposes them to low self-esteem and it is correlated with a three times greater risk of developing depression [3,[5][6][7][8][9][10]. Additionally, AMD patients are twice as likely to fall and four times more likely to fracture a hip [4,6,7,9,[10][11][12][13][14][15][16][17][18].…”

“…This predisposes them to low self-esteem and it is correlated with a three times greater risk of developing depression [3,[5][6][7][8][9][10]. Additionally, AMD patients are twice as likely to fall and four times more likely to fracture a hip [4,6,7,9,[10][11][12][13][14][15][16][17][18]. Significant social and economic ramifications will thus ensue as the proportion of older adults in the general population continues to rise [1,[19][20][21].…”