Background: This study investigated the trajectories of decline in individual instrumental activities of daily living (IADL) with aging and the effect of hearing loss, vision loss, or dual sensory loss on these trajectories in community-living frail older persons. Method: This longitudinal population-based study was conducted in 9,319 community-living frail Dutch persons aged 60 years and older. Self-reported hearing loss, vision loss, or dual sensory loss and nine IADL were assessed in 15 studies of the Dutch National Care for the Elderly Program (The Older Persons and Informal Caregivers Survey Minimum Dataset). Probabilities of limitations in IADL, odds ratios (per 5 years) for binary, and rate ratios (per 5 years) for score outcomes were calculated using mixed logistic and negative binomial models with age as the underlying timescale, stratified by sensory loss, and corrected for confounders. Results: At baseline, the number of IADL limitations was higher in dual sensory loss (2.00 [interquartile range 1.00–4.00]) and vision loss (2.00 [interquartile range 1.00–4.00]) compared to no sensory loss (1.00 [interquartile range 0.00–2.00]) or hearing loss (1.00 [interquartile range 0.00–3.00]). Trajectories of individual IADL showed an increase in limitations in all IADL with age. Household tasks, traveling, shopping, preparing a meal, and walking showed the most rapid decline. Handling finances, traveling, and walking followed a different pattern of decline based on sensory loss status. Conclusions: The age effect on limitations in IADL appears to be similar across all types of sensory loss, with the exception of handling finances, traveling, and walking. At baseline, persons with self-reported sensory loss had higher levels of self-reported functional limitations. Trajectories depict a decline in IADL competence with age.
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Survivors of father–daughter incest often suffer from complex trauma and sensory insensitivity, making it difficult to decipher the sensations in the body and experience body ownership, self-location and agency. This case study illustrates how sensory focused, Trauma-Centred Developmental Transformations can help restore or develop a bodily self, desensitize fear-based schemas, revise deeply buried beliefs and extend repertoire.
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Europeans are living longer than ever in history, because of the economic growth and advances in hygiene and health care. Today, average life expectancy is over 80, and by 2020 around 25% of the population will be over 65. The increasing group of older people poses great challenges in terms of creating suitable living environments and appropriate housing facilities. The physical indoor environment plays an important role in creating fitting, comfortable and healthy domestic spaces. Our senses are the primary interface with the built environment. With biological ageing, a number of sensory changes occur as a result of the intrinsic ageing process in sensory organs and their association with the nervous system. These changes can in turn change the way we perceive the environment around us. It is important to understand these changes when designing for older occupants, for instance, care homes, hospitals and private homes, as well as office spaces given the developments in the domain of staying active at work until older age.
MULTIFILE
This project aims to develop a measurement tool to assess the inclusivity of experiences for people with varying challenges and capabilities on the auditory spectrum. In doing so, we performed an in-depth exploration of scientific literature and findings from previous projects by Joint Projects. Based on this, we developed an initial conceptual model that focuses on sensory perception, emotion, cognition, and e[ort in relation to hearing and fatigue. Within, this model a visitor attraction is seen as an “experienscape” with four key elements: content, medium, context, and individual. In co-creative interviews with experts by experience with varying challenges on the auditory spectrum, they provided valuable insights that led to a significant expansion of this initial model. This was a relevant step, as in the scientific and professional literature, little is known about the leisure experiences of people with troubled hearing. For example, personal factors such as a person’s attitude toward their own hearing loss and the social dynamics within their group turned out to greatly influence the experience. The revised model was then applied in a case study at Apenheul, focusing on studying differences in experience of their gorilla presentation amongst people with varying challenges on the auditory spectrum.Societal issueThe Netherlands is one of the countries in Europe with the highest density of visitor attractions. Despite this abundance, many visitor attractions are not fully accessible to everyone, particularly to visitors with disabilities who sometimes are not eligible to ride due to safety concerns, yet when eligible generally still encounter numerous barriers. Accessibility of visitor attractions can be approached in various ways. However, because the focus often lies on operational and technical aspects (e.g., reducing stimuli at certain times of the day by turning o[ music, o[ering alternative wheelchair entrances), strategic and community-focused approaches are often overlooked. More importantly, there is also a lack of attention to the experience of visitors with disabilities. This becomes apparent from several studies from Joint Projects, where visitor attractions are being visited together with experts by experience with various disabilities. Nevertheless, experience is often being regarded as the 'core product' of the leisure sector. The right to meet, discover, develop, relax and thus enjoy this core product is hindered for many people with disabilities due to a lack of knowledge, inaccessibility (physical, digital, social, communicative as well as financial) and discrimination in society. Additionally, recreation entrepreneurs still face a significant gap in reaching the potential market of guests with disabilities and their networks. Thus, despite the numerous initiatives in the leisure sector aimed at improving accessibility on technical and operational fronts, often people with disabilities are still not being able to experience the same kind of enjoyment as those without. These observations form the pressing impetus for initiating the current research project, tapping into the numerous opportunities for learning, development and growth on making leisure offer more inclusive.Benefit to societyIn total, the current project approach comes with a number of enrichments in terms of both knowledge and methodology: a mixed-methods approach that allows for comparing data from different sources to obtain a more complete picture of the experience; a methodological co-design process that honours the 'nothing about us without us' principle; and benchmarking for a group (i.e., people with challenges on the auditory spectrum) that despite the size of its population has thus far mostly been overlooked.
