Living with fear: the lived experience of community mobility among older adults with low vision.

This secondary analysis of data drawn from a descriptive phenomenological study explored how older adults with low vision experience and manage community mobility. Participants included 34 urban and rural older adults, age 70 years and older, who were not using low-vision-rehabilitation services. The findings convey a core element of the experience of community mobility for participants: living with a pervasive sense of fear regarding one's body and way of being. Participants continually gauged risks associated with mobility and engaged in risk avoidance and management strategies. Community mobility was often restricted by participants because of perceived risks, leading to reduced participation in a range of physical, social, and other types of activities. Further research on environmental factors mediating community mobility and on strategies effective in maintaining mobility among seniors with low vision is essential to optimize participation, health, and service delivery.

Shaping knowledge regarding occupation: examining the cultural underpinnings of the evolving concept of occupational identity.

BACKGROUND/AIM: Within occupational therapy and occupational science, knowledge regarding occupation-based concepts is in the process of being developed, disseminated and acted upon internationally. It is critical to reflect on the forces shaping the ways in which this knowledge is being constructed. METHOD: In this paper, the ways in which cultural assumptions and values have influenced the evolving concept of occupational identity are examined through applying Kluckhohn and Strodtbeck's framework of cultural variations in values to two contemporary conceptualisations of occupational identity. RESULTS: The analysis demonstrates the ways in which values most consistent with Western culture are embedded within and dominate these contemporary conceptualisations of occupational identity, emphasising a future orientation, achievement-based doing, individual choice, and mastery of individuals over nature. CONCLUSIONS: This paper points to conceptual boundaries within which occupational identity is currently being shaped and points to alternative possibilities in the hope of prompting dialogue and research that looks at this concept in more diverse ways. Heightened sensitivity to the influence of culture on the shaping of occupation-focussed knowledge will serve to strengthen and enrich the growth of the evolving body of knowledge pertaining to occupation, and foster culturally sensitive research and practice.

Positive aging and its implications for occupational possibilities in later life.

BACKGROUND: There is a growing emphasis in academic, policy and popular literature within Western societies on positive discourses of aging. Although such discourses appear to be consistent with central beliefs of occupational therapy, particularly with respect to the health-promoting potential of occupation, critical social gerontologists are raising concerns about how such discourses are being shaped in relation to consumer culture and the rise of neoliberalism. METHOD AND PURPOSE: Literature examining the emergence and evolution of positive aging discourses was reviewed and reflected upon using an occupational perspective. RESULTS: Positive aging discourses are being shaped in ways that limit occupational possibilities and promote occupational injustices. CLINICAL IMPLICATIONS: Occupational therapists need to consider ways to enact discursive, practice and policy changes that enable aging persons with diverse abilities and resources to pursue occupations that fulfill needs and promote health.

Holding on and letting go: the perspectives of pre-seniors and seniors on driving self-regulation in later life.

Although decisions related to driving are vital to well-being in later life, little is known about how aging drivers who do not experience a medical condition that requires driving cessation regulate their driving. This exploratory, qualitative study used focus groups with 79 such community-dwelling individuals to examine driving self-regulation from the perspective of pre-senior (aged 55-64) drivers, senior (aged 65 years or over) drivers, and senior ex-drivers. Themes resulting from inductive analysis addressed the importance of driving, mechanisms of self-monitoring and self-regulation, people who influenced decision making, and opinions regarding licensing regulations. A preliminary model of the process of self-regulation that highlights intrapersonal, interpersonal, and environmental influences on why, how, and when aging drivers adapt or cease driving is presented. The model identifies areas for future research to enhance understanding of this process, including the effectiveness of self-regulation. Findings suggest that increased public awareness of issues related to driving and aging could assist aging drivers, their families, and their family physicians in optimizing driving safety for this population. Since a near accident or accident was seen as the only factor that would lead many informants to stop driving and few informants planned for driving cessation, there is a need for interventions that help aging drivers make the transition to ex-driver in a timely and personally acceptable way.

Quality of life for people with physical disabilities: a new instrument.

This article describes the development and validation of the Quality of Life Profile for Adults with Physical Disabilities (QOLP-PD). This new cross-disability instrument is grounded in a well-developed conceptual framework. It reflects the underlying assumption that quality of life issues are the same for people with and without disabilities, although adults living with chronic physical disabilities may address those issues somewhat differently during the course of their daily lives. This instrument was developed on the basis of in-depth interviews, item review and refinement, and pilot testing with adults who have chronic acquired and life-long physical disabilities. Preliminary validation studies were carried out in separate studies with two Canadian samples for which separate results are reported. In Study 1, interviewer-administered items were completed by a cross-disability sample from a large city in Ontario (n = 27). In Study 2, self-administered items were completed by adults with spinal cord injuries from urban and rural Saskatchewan (n = 40). Alpha coefficients for the QOLP-PD ranged from 0.67-0.97 (Ontario sample) and from 0.84-0.98 (Saskatchewan sample). Validation coefficients are also reported. Although the samples were small, the psychometric properties of the instrument are generally sound. Future research directions are discussed.