Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Dr. Jan Polgar

2nd Supervisor

Dr. Bert Chesworth

Joint Supervisor

Abstract

The purpose of this dissertation was (i) to investigate the prevalence of older Canadian adults living with coexisting vision and mobility impairments, and (ii) to describe how disability associated with both impairments relate to health status, activities of daily living, physical activity participation, assistive technology use, and health care services. These goals were achieved by using mixed methodology approach.

The first manuscript was based on secondary analyses of the 2006/2007 National Population Health Survey (NPHS). The results of the secondary analysis of the NPHS revealed that approximately 3% of the Canadian population over the age of 65 was living with coexisting vision and mobility impairments. Also, older adults with both conditions required more assistance with activities of daily living and they reported the lowest levels of physical activity participation compared to those living with one or no impairment.

The second part of the core component was based on secondary analyses of the 2006 Participation and Activity Limitations Survey (PALS). The PALS was specifically designed for individuals who reported they were living with a disability. As a result, a greater proportion of respondents indicated the presence of both target conditions – approximately 15% of older Canadians who reported having a disability were living with coexisting vision and mobility impairments. The analysis of the PALS data revealed that older adults with both impairments required more assistance with activities of daily living and they reported a higher use of assistive technology; however, there was a higher level of unmet needs for vision related assistive technology.

The final manuscript consisted of in-depth interviews conducted to add the personal perspective of older adults with both impairments, and to expand and clarify the quantitative findings. The analyses of the transcripts revealed four main themes among participants:

(i) the meaning behind vision, mobility, and coexisting impairments;

(ii) adaptation of desired activities;

(iii) external support for engaging in activity; and

(iv) internal support for engaging in activity.

The results of this dissertation contribute knowledge about living with coexisting vision and mobility impairments and offer a starting point to guide rehabilitation services for clients with multiple impairments.

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