Barriers and Facilitators That Influence Social Participation in Older Adults With Dual Sensory Impairment

Abstract

Introduction: The proportion of older adults with combined acquired vision and hearing impairments (referred to as Dual Sensory Impairment/DSI) is growing, and their unique care needs are beginning to receive increased attention. Considering the age-related demographic shift, one million older adults in Canada are expected to experience DSI by 2036, and evidence suggests that DSI is associated with communication difficulties, cognitive decline, depression, functional decline, and participation challenges. Given that the goal of sensory rehabilitation is to improve participation, the study explored perceived contextual barriers and facilitators of social participation among older adults with DSI to better understand their lived experience. Methods: The International Classification of Functioning, Disability and Health (ICF) was used as a framework to identify and describe the contextual factors (environmental and personal) that influence the social participation of older adults with DSI. Sixteen older adults with DSI (mean age = 86 years, SD = 7; 9 female; registered with an urban sensory rehabilitation organization) were interviewed using a semi-structured qualitative interview guide. Interviews were audio-recorded, transcribed, and then analyzed using a content analysis approach. Results: Environmental factors, such as societal attitudes toward disability, access to technology aids, and availability of transportation services emerged as the most important factors influencing participation. The onset and type of the impairments and attitude toward one's disability were important personal factors affecting the participation. The availability of social support and the use of assistive devices (e.g., magnifiers, glasses, and hearing aids) were reported to be facilitators. In contrast, the inaccessibility of the built environment and the cost and limited availability of accessible transportation were key barriers to their social participation.

International Classification of Functioning, Disability, and Health in adult and older users of audiology services

“…These findings corroborate an international study that used the ICF to describe how environmental and personal aspects influence the social participation of older adults with dual sensory disabilities (sight and hearing). As a result, the availability of social support and the use of assistive devices, such as HA and glasses, were reported as facilitators for the social participation of the population studied 33 . Another international study -whose objective was to investigate the relationship between hearing loss self-management and the benefits and satisfaction of HA users -verified that participants who reported better self-care with the effects of hearing loss in the aspects of social participation and emotional well-being reported less difficulty to hear in noisy environments and greater satisfaction with the HA.…”

Device abandonment in deafblindness: a scoping review of the intersection of functionality and usability through the International Classification of Functioning, Disability and Health lens

“… 17 37 59 64 Technologies for vision impairment were the following: talking clock or watch, 60 62 talking calculator, 62 talking scanner, 62 white cane, 17 64 braille technology 37 64 and different types of magnification devices. 64 In addition, mainstream technologies that could be connected or incorporated to overcome barriers unique to combined vision and hearing impairment were explored: tablet computers, 64 videophone technology together with 22-inch television monitor, 58 braille display notetaker connected via Bluetooth to an iPhone, 61 63 and global positioning technology linked to a smartphone and apps. 65 Aside from the use of braille, only one study made references to a haptic feature of a device, mentioning the vibrating functions available with certain smartphones.…”

“…59 60 62 64 Research methodologies included qualitative, 17 37 58 63-65 quantitative 59 60 62 and mixedmethods approaches. 61 Deafblindness was defined using medical model quantitative thresholds based on visual acuity and pure-tone audiogram measurements, [60][61][62][63][64] self-institutional identifiers 17 37 58 65 or questionnaire responses. 59 Two studies 61 63 made reference to the Nordic Definition of Deafblindness, 66 while one study 17 referred to the European Parliament' Written declaration on the rights of deafblind people, describing deafblindness as a unique disability.…”

“…Technologies for hearing impairment were the following: personal amplification system, 60 telephone amplifier, 60 hearing aids. 17 37 59 64 Technologies for vision impairment were the following: talking clock or watch, 60 62 talking calculator, 62 talking scanner, 62 white cane, 17 64 braille technology 37 64 and different types of magnification devices. 64 In addition, mainstream technologies that could be connected or incorporated to overcome barriers unique to combined vision and hearing impairment were Open access explored: tablet computers, 64 videophone technology together with 22-inch television monitor, 58 braille display notetaker connected via Bluetooth to an iPhone, 61 63 and global positioning technology linked to a smartphone and apps.…”

“…62 Furthermore, access to and availability of technical support emerged as a variable that became relevant when problems arose with device use in the field, 61 63 with the need for support in these situations often being fulfilled by friends or family 17 as well as by the availability of support through government services. 64 on September 4, 2021 by guest. Protected by copyright.…”