Amanda Jean Mohler, Peggy Neufeld, Monica S. Perlmutter; Factors Affecting Readiness for Low Vision Interventions in Older Adults. Am J Occup Ther 2015;69(4):6904270020. https://doi.org/10.5014/ajot.2015.014241
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© 2020 American Occupational Therapy Association
OBJECTIVE. We sought to identify factors that facilitate and inhibit readiness for low vision interventions in people with vision loss, conceptualized as readiness for change in the way they perform daily activities.
METHOD. We conducted 10 semistructured interviews with older adults with low vision and analyzed the results using grounded theory concepts.
RESULTS. Themes involving factors that facilitated change included desire to maintain or regain independence, positive attitude, and presence of formal social support. Themes related to barriers to change included limited knowledge of options and activity not a priority. Themes that acted as both barriers and facilitators were informal social support and community resources.
CONCLUSION. This study provides insight into readiness to make changes in behavior and environment in older adults with vision loss. Study findings can help occupational therapy practitioners practice client-centered care more effectively and promote safe and satisfying daily living activity performance in this population.
Occupations done less often, changed in the way they are completed, completed with difficulty or less enjoyment, or dropped
Moving laundry upstairs
Using public transportation
Asking a family member to drive
Repeated mention of a valued activity, such as driving or reading, at multiple points in the conversation
“Reading my Bible is very important.”
“TV . . . is not a high priority. I don’t watch much television, period.”
“I am not as interested in using the computer.”
Brief mention of a prior interest in playing poker
Desire for independence
Lack of someone available to help make the change
Activity not a priority
Desire to maintain or regain independence
Presence of formal social support
Limited knowledge of options
Informal social support
It was about 9–10 years ago that I hit a certain point in my life and I just said, “You know, the heck with this ‘oh, me’ stuff. Look at all the other people with challenges much worse than yours.” So, I think from that, once I acknowledged my vision loss, and once I got through the grieving process, things were easier.
In the meat department, I can’t see, and there is a wonderful gal there. I like certain $5 chicken breasts. . . . She’ll pick those out for me.
I have someone with me at all times [shopping], but if I didn’t, I would go up to the service desk and get a helper. You know, [in] a lot of your stores, you can do that—go up and ask for assistance.
It was pretty abrupt when I couldn’t drive. . . . I had volunteers from friends and church members that drove me to and from work.
I am on the planning committee. The chairman of the committee gives me a ride.
I don’t use the computer. I have never learned. I could learn that, and I may because I would like to be able to. It just seems like a big step to take.
When we first came here, I did not know that the society [low vision support group] existed.
I decided not to mark my keyboard because I am not very interested in using the computer anymore.
I have not learned to use a bus or public transportation, and I really do not have much interest in public transportation.
He [her husband] found these ugly metal things [hand rails], and I said, “Get those off of there. I don’t want those. . . . I don’t want those ugly things.”
My aesthetic side—I did not like those [contrasting door handles].
I functioned pretty much thinking I had a perfect body that operated perfectly.
I was raising four kids and working and so forth, and I don’t think I thought of what was wrong.
I went to San Diego and visited my mother in the adult retirement facility. . . . She looked at me when I got out of my sister’s car and said, “Put that thing [white cane] away. You do not need it here.”
I wanted to get a better light in the stairwell going to the basement, and my husband says, “We are going to, we are going to,” but he doesn’t.
My daughter takes me shopping. I will say, “I want Cracker Barrel extra sharp cheese,” and she will . . . buy some other brand that was cheaper. I don’t get the groceries that I used to.
A lot was told to me at the [community low vision agency] about those machines [CCTVs]. I think it was through the [agency] that I realized that was available and how helpful it was.
They [community low vision agency] are great. We play games. . . . We had crafts. . . . We have a book club. It is a way of getting out and being with people instead of being home all the time.
Occupational therapy practitioners’ attention to factors that facilitate or inhibit a client’s readiness for change can enhance the client’s willingness to modify the way he or she performs valued activities.
Assessment of drive for independence, positive attitude, formal and informal social support, and access to and availability of community resources can inform occupational therapy intervention goals and methods to facilitate readiness for change in older adults with low vision.
Effective client-centered occupational therapy requires practitioners to consider clients’ readiness to adopt changes in the way they perform activities and to modify interventions accordingly.
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