Aim was to explore the health-related quality of life (HRQoL) and related factors among older adults with visual impairment (VI). A total of 39 independently living subjects aged ⩾65 years (83 ± 6.5), referred to the Low Vision Center of the Oulu University Hospital, Finland during one year participated in the study. The participants had low vision or blindness as defined by the World Health Organization (WHO). The 15D, a generic HRQoL instrument, was used to assess the HRQoL, and an ophthalmic examination was performed to assess vision. A population-based control group ( n = 1074) was available for comparison. The mean 15D index scores for the participants and the control group were 0.768 ( SD = 0.089) and 0.827 ( SD = 0.044), respectively, ( p < .002). In the dimensions of move ( p < .05), see ( p < .001), breath ( p < .05), usual activities ( p < .001), depression ( p < .05), and distress ( p < .05), the study participants scored statistically significantly lower than the control group. However, the participants had better mental function scores (0.856 vs 0.773, p < .05). Among the participants, there was no difference in the 15D by gender (men 0.755, women 0.774, p > .05), habitation (alone 0.768, with someone 0.770, p > .05), or age ( r = –.084), nor did the extent of low vision appear to affect the 15D index in this material. The older adults with VI had poorer 15D index score than Finnish population of equal age, but they scored better in the dimension of mental function. Mental skills may indeed be crucial for independent living despite VI.
Visual impairments (VI) burden particularly the aging population globally. To ensure healthy aging despite disability, the health care systems must provide effective low-vision rehabilitation services (LVR) for those in need. Low-vision rehabilitation counseling (LVRC) requires specialized multidisciplinary teamwork and has not been studied in detail among the elderly. This study aims to provide a comprehensive picture of individual LVRC actions and introduce a LVRC classification to use for attempts to improve the LVRC processes. This study employed a qualitative follow-up design. Data describing the individual LVRC processes in a prospective cohort of elderly patients with VI ( n = 39) were collected individually over 2 years during the years 2016–2019. The data were analyzed through deductive content analysis. The analyzed LVRC provided assistive devices, services, and home modifications, but problems related to independent movement in the living environment, psychosocial burdens, adaptation to disability, and learning new compensatory skills received less attention. To ensure effective LVRC, the multiprofessional team providing the rehabilitation should emphasize goal-setting and continuous assessment. LVRC should be seen as a process of adaptation, adherence, and learning. LVRC should support and promote older adults to participate and function to their full potential in the modern society, which includes utilizing digital technologies.
This study describes the self-estimated functional ability of older adults with visual impairments (VI) living at home prior to and after 24 months of individual low vision rehabilitation (LVR) according to the International Classification of Functioning, Disability and Health (ICF) framework. The LVR was carried out according to regular standard of care in Finland. The study provides knowledge that is relevant for improving both LVR as well as other services for older adults living with VI. Thirty-nine older adults with VI initially participated in the study with 28 remaining for the follow-up at 24 months of LVR. Data were collected by an orally administered questionnaire including items from the Oldwellactive Wellness Profile instrument. Data were analyzed using the marginal homogeneity test, and the outcomes were divided into four categories according to the ICF framework. Comparisons between the baseline and 2-year follow-up revealed statistically significant decreases in daily functions, including going outdoors ( p = .011), washing oneself ( p = .016), taking care for personal hygiene ( p = .046), dressing ( p = .034), preparing meals ( p = .041), and doing heavy housework ( p = .046), following 2 years of received LVR. A statistically significant increase in the need for help was also observed during the study period ( p = .025). The independence of older adults with VI decreased, and the need for external services or help increased during 24 months after the onset of receiving LVR. Visual problems were shown to widely affect functional ability. Activities and participation dimension together with loneliness are most affected and need attention in individual LVR.
We are witnessing an emerging digital revolution. For the past 25–30 years, at an increasing pace, digital technologies—especially the internet, mobile phones and smartphones—have transformed the everyday lives of human beings. The pace of change will increase, and new digital technologies will become even more tightly entangled in human everyday lives. Artificial intelligence (AI), the Internet of Things (IoT), 6G wireless solutions, virtual reality (VR), augmented reality (AR), mixed reality (XR), robots and various platforms for remote and hybrid communication will become embedded in our lives at home, work and school. Digitalisation has been identified as a megatrend, for example, by the OECD (2016; 2019). While digitalisation processes permeate all aspects of life, special attention has been paid to its impact on the ageing population, everyday communication practices, education and learning and working life. For example, it has been argued that digital solutions and technologies have the potential to improve quality of life, speed up processes and increase efficiency. At the same time, digitalisation is likely to bring with it unexpected trends and challenges. For example, AI and robots will doubtlessly speed up or take over many routine-based work tasks from humans, leading to the disappearance of certain occupations and the need for re-education. This, in turn, will lead to an increased demand for skills that are unique to humans and that technologies are not able to master. Thus, developing human competences in the emerging digital era will require not only the mastering of new technical skills, but also the advancement of interpersonal, emotional, literacy and problem-solving skills. It is important to identify and describe the digitalisation phenomena—pertaining to individuals and societies—and seek human-centric answers and solutions that advance the benefits of and mitigate the possible adverse effects of digitalisation (e.g. inequality, divisions, vulnerability and unemployment). This requires directing the focus on strengthening the human skills and competences that will be needed for a sustainable digital future. Digital technologies should be seen as possibilities, not as necessities. There is a need to call attention to the co-evolutionary processes between humans and emerging digital technologies—that is, the ways in which humans grow up with and live their lives alongside digital technologies. It is imperative to gain in-depth knowledge about the natural ways in which digital technologies are embedded in human everyday lives—for example, how people learn, interact and communicate in remote and hybrid settings or with artificial intelligence; how new digital technologies could be used to support continuous learning and understand learning processes better and how health and well-being can be promoted with the help of new digital solutions. Another significant consideration revolves around the co-creation of our digital futures. Important questions to be asked are as follows: Who are the ones to co-create digital solutions for the future? How can humans and human sciences better contribute to digitalisation and define how emerging technologies shape society and the future? Although academic and business actors have recently fostered inclusion and diversity in their co-creation processes, more must be done. The empowerment of ordinary people to start acting as active makers and shapers of our digital futures is required, as is giving voice to those who have traditionally been silenced or marginalised in the development of digital technology. In the emerging co-creation processes, emphasis should be placed on social sustainability and contextual sensitivity. Such processes are always value-laden and political and intimately intertwined with ethical issues. Constant and accelerating change characterises contemporary human systems, our everyday lives and the environment. Resilience thinking has become one of the major conceptual tools for understanding and dealing with change. It is a multi-scalar idea referring to the capacity of individuals and human systems to absorb disturbances and reorganise their functionality while undergoing a change. Based on the evolving new digital technologies, there is a pressing need to understand how these technologies could be utilised for human well-being, sustainable lifestyles and a better environment. This calls for analysing different scales and types of resilience in order to develop better technology-based solutions for human-centred development in the new digital era. This white paper is a collaborative effort by researchers from six faculties and groups working on questions related to digitalisation at the University of Oulu, Finland. We have identified questions and challenges related to the emerging digital era and suggest directions that will make possible a human-centric digital future and strengthen the competences of humans and humanity in this era.
