Atul Jaiswal is a CIHR Health System Impact post-doctoral fellow in Vision Science in the Wittich Vision Impairment Research Laboratory at the School of Optometry, University of Montreal, Canada, in collaboration with the research partner organization “the Institut Nazareth et Louis-Braille (INLB),” Montreal. His scholarship aims to advance the knowledge in the field of combined vision and hearing impairment [referred to as dual sensory impairment (DSI) or deafblindness] and generate evidence to inform global health and rehabilitation care practice. His postdoc work aims to explore ways to prepare the Canadian healthcare system to meet the needs of older adults with DSI by addressing the barriers to health services and health information during and post COVID-19. He obtained his Ph.D. in Rehabilitation Science from Queen’s University, where his thesis focused on identifying ways to enhance the participation of individuals with DSI in society. He is also a recipient of the MITACS Accelerate Fellowship to pursue a research study on how best to integrate vision loss rehabilitation in the Canadian healthcare system. He is a trained occupational therapist as well as a rehabilitation social worker with experience of more than ten years in the field of disability rehabilitation. He received a gold medal during his Master’s degree in Disability Studies and was instrumental in initiating a successful advocacy campaign for people with disabilities. At Queen’s, he delivered his TED talk on “Novel applications and considerations of Wearable technologies” in the field of healthcare and rehabilitation at TEDxQueensUSalon 2017.
Healthcare inequities for older Canadians with vision and hearing loss during COVID-19 pandemic: A qualitative study
Atul Jaiswal, Wittich Vision Impairment Research Laboratory, Université de Montréal, Canada
Walter Wittich, Shreya Budhiraja, Samuel Côté, Peter Holzhey and Norman Robert Boie, Wittich Vision Impairment Research Laboratory, Université de Montréal, Canada
Sangeetha Santhakumaran, McGill University, Canada
Abinethaa Paramasivam, Ryerson University, Canada
Marie Savundranayagam, Western University, Canada
Claude Vincent and Edeltraut Kröger, Université Laval, Canada
Evidence indicates that older adults with concurrent hearing and vision loss (dual sensory loss/DSL) often experience poorer health and challenges accessing health services. With the increasing prevalence of sensory loss among older adults, health care systems are being challenged to adapt health and rehabilitation services to meet their distinct care needs. These challenges in access to health services may have exacerbated during COVID-19 for older adults with DSL due to pandemic-related physical distancing regulations that restrict access to interpreter or communication support from informal caregivers. The objective was to explore the experiences of access to healthcare services and health-related information for older adults with DSL in Canada.
Following a qualitative descriptive design, we conducted semi-structured interviews with 33 older adults with DSL. Data collection took place in Ontario and Quebec between September 2020 and June 2021. Discussions were audio-recorded using Zoom, transcribed, and managed using NVivo Pro. Data were analyzed using a thematic analysis approach.
Findings from interview data indicate that older adults with DSL experience barriers to healthcare that are linked to inaccessibility and communication challenges in the interactions between older adults with DSL and healthcare providers, especially when using tele-healthcare. For example, they reported that they faced communication breakdowns due to a lack of communication support during the care process, and healthcare staff do not have enough time and flexibility in their schedule and lack the necessary training to accommodate their communication needs. Older adults with DSL reported challenges in access to health information and often had to rely on informal caregivers who were not easily available in the pandemic. In cases where they accessed health services in a clinical setting, they reported having difficulties following social distancing requirements in the clinical setting and navigating the physical layout of the clinical setting without any support. Moreover, older adults with DSL expressed a negative impact of the pandemic on their mental health, such as feeling depressed and socially isolated.
This qualitative study indicates healthcare inequities for older adults with DSL and documents significant barriers they face when accessing health services and health-related information in Canada. This study calls for more research to find concrete solutions to overcome these healthcare inequity-related challenges for this population. The findings emphasized that the tele-healthcare model has inherent challenges in delivering care to older adults with DSL and underscored the need to accommodate their communication and accessibility needs. Training of healthcare professionals on DSL-specific communication and accessibility needs is much needed to meet the care needs of older adults with DSL in Canada.