Ageing with a unique impairment: a systematically conducted review of older deafblind people's experiences

Should genes for non-syndromic hearing loss be included in reproductive genetic carrier screening: Views of people with a personal or family experience of deafness

Many commercial reproductive genetic carrier screening (RGCS) panels include genes associated with non-syndromic hearing loss (NSHL), however little is known about the general acceptability of their inclusion. Although some couples wish to avoid having a deaf child, there are effective interventions and supports available for deafness, and no consensus on whether it is appropriate to reproductively screen NSHL genes. This study explored views of people with personal experience of deafness regarding carrier screening for genes associated with NSHL. We interviewed 27 participants; 14 who identified as deaf and 13 hearing parents of a deaf child. Thematic analysis was undertaken on transcripts of interviews. The findings reveal the complexity of attitudes within these groups. Some vacillated between the wish to support prospective parents' reproductive autonomy and concerns about potential harms, especially the expression of negative messages about deafness and the potential loss of acceptance in society. While some participants felt carrier screening could help prospective parents to prepare for a deaf child, there was little support for reproductive screening and termination of pregnancy. Participants emphasized the need for accurate information about the lived experience of deafness. The majority felt deafness is not as severe as other conditions included in RGCS, and most do not consider deafness as a disability. People with personal experience of deafness have diverse attitudes towards RGCS for deafness informed by their own identify and experience, and many have concerns about how it should be discussed and implemented in a population wide RGCS program.

Psychological and social consequences of deafblindness for siblings: a systematic literature review

The onset of deafblindness profoundly impacts both the individual with this condition and the individual's family, including siblings. While current studies have primarily focused on the impact felt by parents or spouses, the distinct experiences of siblings have received comparatively less attention. This systematic review addresses the existing research gap regarding the psychological and social consequences experienced by siblings of individuals with deafblindness. A comprehensive search was conducted across multiple electronic databases, including PsycINFO, PsycARTICLES, Dissertations & Theses (on ProQuest), ERIC (Education Resources Information Center), International Bibliography of the Social Sciences (IBSS), Sociological Abstracts, Google Scholar, PubMed, and Cairn Info. Seven studies were identified as meeting the eligibility criteria for inclusion. The review revealed that siblings of individuals with deafblindness face psychological and social challenges, including emotions such as feelings of neglect, resentment, embarrassment, jealousy, and anxiety. Siblings also grapple with communication difficulties, contributing to feelings of exclusion and insecurity. In addition, these siblings take on significant responsibilities within the family and encounter obstacles in forming relationships outside the family. These findings underscore the need of interventions to improve the well-being of siblings of individuals with deafblindness by addressing their psycho-emotional needs and promoting positive social interactions. These findings align with studies conducted on siblings of children with other disabilities. However, additional research is crucial to investigate overlooked dimensions, particularly positive factors like coping mechanisms and resilience, that may influence the mental health and social experiences of these siblings.

Quality of Life in Deafblind People and Its Effect on the Processes of Educational Adaptation and Social Inclusion in Canary Islands, Spain

Deafblindness is a unique and complex disability. Research on the needs and quality of life are scarce; as well as the lack of adequate knowledge, training and lack of qualified professionals to serve this group. All this justifies the sense and interest of this study. This study is derived from the project with reference 2020EDU04. Design: The study is descriptive, cross-sectional and quantitative-qualitative research design was conducted. Objectives: Know and analyze the needs of adult deafblind people in order to contribute to improving their quality of life. Method: Sample of 16 adults with double sensory loss (hearing and vision) residing in the Autonomous Community of the Canary Islands (Spain) was used. Instruments: The FUMAT Scale was used to measure personal development; self-determination; interpersonal relationships; social inclusion; rights of deafblind people; emotional well-being; physical well-being and material well-being. In addition, a semi-structured interview is conducted. Results by dimensions: Personal development: The professionals did not have specialized training to provide an educational response. Physical well-being: 68% of the sample had other health problems associated with deafblindness. Interpersonal relationships: 100% of the sample reported communication problems in the family environment. Social inclusion: They reported difficulties in accessing educational and leisure activities. Material well-being: In general, they stated that they have the material resources necessary for their daily lives. Self-determination: they consider that they have decision-making capacity in basic aspects of daily life. Rights: Deafblind people state that they have limitations in exercising their rights. Based on the interviews, it was observed that the people with the greatest difficulties in daily life are those who presented the greatest visual commitment. Conclusion: The etiology does not determine the quality of life of deafblind people, but communication conditions interpersonal relationships and personal development, and therefore their quality of life.

A salutogenesis approach to ageing with impairment: the managing and coping experiences of older people ageing with deafblindness

An understanding of the psychosocial impact of deafblindness on older people is impoverished by a dearth of research in the field. Particularly limited are studies adopting a salutogenesis perspective, in which older deafblind people's coping capacities are explored. Much research focuses on vulnerability to unfavourable outcomes, which may perpetuate negative stereotypes of deafblind people as passive and dependent. Identifying deafblind people as a vulnerable group gives rise to misunderstanding of the impairment, perceptions of incapability and neglect of deafblind people's agency. This paper draws on data from the first United Kingdom-based study of vulnerability from the perspectives of older adults ageing with deafblindness. Findings presented here relate to participants’ experiences of managing and coping with their felt vulnerability and ageing with deafblindness. The study adopted interpretative phenomenological analysis (IPA) as its qualitative approach. In-depth semi-structured interviews were undertaken between October 2014 and July 2016 with eight participants, aged between 48 and 83 years. Data were analysed using an iterative six-step IPA process. Three superordinate themes were identified: taking action to protect self; psychological coping strategies; and accessing and using care and support. Participants’ managing and coping strategies, and the care and support they value, respond to elements identified as generating felt vulnerability. Professionals should seek to bolster coping capacity and provide support in ways valued by those ageing with deafblindness.

Prevalence of Individuals with Deafblindness and Age-Related Dual-Sensory Loss

Introduction

The authors of this paper have compiled a report on the prevalence of deafblindness and dual-sensory loss based on the review of existing estimates. The purpose is to inform readers of the importance of using consistent, well-researched definitions and survey questions in future prevalence studies.

Methods

Articles were extracted through ProQuest and EBSCOhost, online library databases of Cambrian College and Laurentian University. Keywords search included “deafblindness,” “dual-sensory impairment,” “dual-sensory loss,” “age-related,” “congenital,” “acquired,” and “prevalence.” Additionally, the authors conducted a search with Google for research reports and Google Scholar for other relevant peer-reviewed articles.

Results

This review provides a current overview of prevalence estimates of deafblindness and age-related dual-sensory loss around the world, examining 19 articles or reports published over the last 20 years (2000–2020) in 18 countries, including the European Union (consisting of 8 countries). In line with the prevalence estimates by the World Federation for the Deafblind global report 2018, the review indicates an estimated 0.2–2% prevalence of dual-sensory impairment and underscores varying ranges of prevalence among populations, studies or countries, age groups, and types of deafblindness. The review highlights that the prevalence of deafblindness or dual-sensory loss was often not comparable across studies, but it is clear that the prevalence of dual-sensory impairment increases with age. The studies varied in methods (e.g., population surveys, cross-sectional, and longitudinal studies).

Implication for practitioners

The review provides evidence of varying ranges of prevalence rates. Future prevalence studies may benefit from consistent definitions, standard data-collection tools to do better comparisons across countries, and identify factors that predict higher or lower prevalence rates among populations and age groups.

Optimizing Evaluation of Older Adults With Vision and/or Hearing Loss Using the interRAI Community Health Assessment and Deafblind Supplement

Purpose: Service providers must identify and assess older adults who have concurrent vision and hearing loss, or dual sensory impairment (DSI). An assessment tool suitable for this purpose is the interRAI Community Health Assessment (CHA) and its Deafblind Supplement. This study's goal was to explore this assessment's administration process and to generate suggestions for assessors to help them optimize data collection.

Methods: A social worker with experience working with adults who have sensory loss, who was also naïve to the interRAI CHA, administered the assessment with 200 older adults (65+) who had visual and/or hearing loss. The assessor evaluated the utility of the instrument for clinical purposes, focusing on sections relevant to identifying/characterizing adults with DSI.

Results: Suggestions include the recommendation to ask additional questions regarding the person's functional abilities. This will help assessors deepen their understanding of the person's sensory status. Recommendations are also provided regarding sensory impairments and rehabilitation, in a general sense, to help assessors administer the interRAI CHA.

Conclusions: Suggestions will help assessors to deepen their knowledge about sensory loss and comprehensively understand the assessment's questions, thereby allowing them to optimize the assessment process and increase their awareness of sensory loss in older adults.

Cognitive Impairment in Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Scoping Review Protocol

Introduction: As the prevalence of age-related sensory impairment increases, more evidence emerges on the association between uni-sensory and cognitive impairment (CI) in older adults. However, the link between CI and concurrent hearing and vision impairment (referred to as dual sensory impairment/DSI) is not well-understood, and this combined effect may be additive or multiplicative. Moreover, the existing evidence on CI in older adults with DSI is scattered and limited. Through this systematic scoping review, we aim to map existing evidence on CI in older adults with DSI, and to summarize what is known about the prevalence, incidence and risk factors of CI, and tools used to screen or assess CI in older adults with DSI. Methods and Analysis: We will use the Joanna Briggs Institute framework to perform the review. Eleven databases [MEDLINE, CINAHL/EBSCO, EMBASE, Mednar, WorldWideScience, PsycEXTRA, OAIster, OpenGrey (SIGLE), Global Health, PsycINFO, and Web of Science] and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) will be searched. Study selection will be completed using Covidence, and data will be extracted using an a priori data extraction tool. To be included, studies had to be peer-reviewed, had older adults with DSI as the focal population, and are related to CI. Data will be presented using a narrative summary with emphasis on implications for future research and practice. Discussion: Reliable cognitive screening is of the utmost importance for prevention and treatment of CI within DSI population. The study findings will have significant implications for health services delivery and policy research. The summarized findings on the prevalence, incidence, associated risk factors, and CI screening and assessment tools will inform geriatric care. The review will also document knowledge gaps on CI in the DSI population and identify areas of interest for future studies. Ethics and Dissemination: The scoping study, being a review of existing documents, does not require ethics approval. The findings will be disseminated with relevant stakeholders using knowledge translation activities such as scientific presentations and publications. We intend to use the findings to conduct a Delphi study to evaluate which CI tools are suitable for older population with DSI.

Psychosocial determinants associated with quality of life in people with usher syndrome. A scoping review

Background: In Usher syndrome, deafness is congenital and blindness is acquired. Therefore, the progressive loss of one of the two senses forces individuals with this syndrome to reorganize their everyday tasks and relationships, creating new strategies to communicate, access information, and move within a given space. This reorganization can interfere with the subjects' capacity to build a good quality of life.Methods: We conducted a scoping review of both peer-reviewed and gray literature, to identify existing evidence of the role of psychosocial determinants on the quality of life of people with Usher syndrome.Results: Twenty-one references met the inclusion criteria. Findings suggest that people with Usher syndrome seem to adjust their life habits to their condition, maintaining hope for the future, and believe in their capacities to accomplish their goals in spite of the various difficulties they encounter. However, this scoping review highlights a lack of research on adaptive strategies, as well as a lack of knowledge concerning the integration of the syndrome in one's identity, the relations to caregivers, and the specificities of the psychotherapeutic support. More information on these topics would enable better-adjusted social, psychotherapeutic, and medical responses.Implications for rehabilitationUsher syndrome, a rare genetic disease, leads to deafblindness, a cluster of related multiple sensory disabilities. People with Usher encounter several obstacles in their daily life. It is also difficult to adapt to the progressive loss of hearing and sight.This paper proposes a scoping review: we identify the main adaptation strategies used by people with Usher Syndrome in order to become autonomous in spite of these obstacles. In becoming more autonomous, they come to a better quality of life.We summarize the most frequent adaptation strategies (at school, work, leisure, interpersonal relationships, etc.) to help programs aimed at rehabilitation for people with Usher syndrome, and to find unexplored research perspectives (e.g., psychotherapies).

Aetiologies of acquired deafblindness in a national sample

The present study provides an overview of aetiologies and co-morbidities of acquired deafblindness in a Danish national sample of 514 individuals above 50 years of age identified with acquired deafblindness. Information was obtained from a survey and a register. The most frequent aetiology of vision loss was age-related macular degeneration (55.4%). The most frequent aetiology of hearing loss was presbycusis (53.7%). The most frequent aetiology of acquired deafblindness was the combination of age-related macular degeneration and presbycusis (41.5%). However, among the younger participants (50–59 years of age), Usher syndrome was the most common aetiology (62.5%). The aetiologies of acquired deafblindness are many and constituted by several different combinations of hearing and vision loss aetiologies. The most frequent aetiologies are age related.