Low vision rehabilitation services: Perceived barriers and facilitators to access for older adults with visual impairment

Abstract

Introduction The aim of this study is to describe the barriers and facilitators to accessing low vision rehabilitation services in Massachusetts, USA, and determine differences between communities with and without existing low vision rehabilitation services for older adults with visual impairment. Method A sample of older adults with visual impairment ( n = 64) from both communities participated in the study. Barriers and facilitators to accessing the services were explored through focus groups and prioritized during one-on-one interviews, which allowed for comparison between communities. Results Twelve themes were identified: (a) bureaucracy and funding (public policy); (b) public awareness and stigma (community); (c) services available, knowledge of providers, care coordination, transportation (organizational); (d) people and lack of awareness of family/friends (interpersonal); and (e) income, health status, knowledge, self-advocacy, and time (individual). Conclusion This study provides insights into the perceived barriers and facilitators of accessing low vision rehabilitation services for older adults with vision impairment living in Massachusetts, USA. Key findings indicate the need for improved awareness of these services at the provider and consumer level, coordinated care, increased education on the efficacy of occupational therapy low vision rehabilitation services, client-centered care provided when the client is ready to accept services, and service provision that addresses sociodemographic factors.

Barriers and facilitators in the referral pathways to low vision services from the perspective of patients and professionals: a qualitative study

“…According to a social ecological approach of health promotion, health is a function of an individual and his/her environment. It can be used to identify the factors that contribute to a certain health-problem on individual, interpersonal, organizational, community and public-policy level and was recently used by Kaldenberg [ 25 ] in a similar study.…”

“…From the perspective of eye care professionals, insufficient time in the ophthalmic practice, lack of knowledge and experience, and lack of funding for LVS devices seemed to hinder referral [ 23 , 24 ]. From the patients’ view, self-advocacy, good communication with the professionals and social support by family and friends were some of the identified facilitators [ 22 , 25 ]. Following referral guidelines was a facilitator identified by professionals [ 26 ].…”

“…However, Khimani, Redmon [ 32 ] and Sarika, Venugopal [ 33 ] recently showed that investigating both point of views can be beneficial as it generates a broad perspective, which contributes to a better understanding about factors influencing the referral pathways to LVS. Furthermore, earlier studies were mainly conducted in countries with no systematic national provision or financial coverage of LVS and/or with a low income, such as the United States [ 25 , 28 , 32 ], Australia [ 30 , 31 ], Canada [ 23 ], India [ 29 , 33 ], Colombia [ 34 ] and Ghana [ 35 ]. As a consequence, insights to referral barriers and facilitators are particularly lacking from high-income countries in general with different types of healthcare and coverage systems.…”

Social Networks May Shape Visually Impaired Older Adults’ Occupational Engagement: A Narrative Inquiry

“…To date, existing research regarding social networks and ARVL has primarily focused on the impact social networks have on the emotional and psychosocial wellbeing of individuals with ARVL ( Papadopoulos et al, 2014 ; Reinhardt, 2001 ), as well as the challenges ARVL imposes on maintaining existing, or building new, social networks ( Wang & Boerner, 2008 ). The link between visually impaired older adults’ social networks and occupational engagement has been less researched, with a few notable exceptions ( Kaldenberg, 2019 ; McGrath & Astell, 2016 ). These studies have focused on visually impaired older adults’ ADLs, IADLs, as well as some limited aspects of social life, including interpersonal interactions and community/civic engagement.…”

Special issue: Low vision rehabilitation

“…Despite the many benefits and impressive outcomes of low vision rehabilitation, many older adults experience barriers to services (Matti et al., 2011). Kaldenberg (2019), in an article applying qualitative methodology, investigated the barriers and facilitators to low vision rehabilitation services for older adults with visual impairment living in the northeastern USA. Results of this study identify multi-level factors for consideration in improving access to occupational therapy and low vision rehabilitation services.…”