Using the iPad to Facilitate Daily Activity Among Older Adults With Low Vision: A Pilot Study

PURPOSE: The purpose of this pilot research was to evaluate the effectiveness of an iPad training program and small-group instruction in the use of the iPad to enhance the performance of daily occupations by older adults with low vision (LV).

RATIONALE: Current LV rehabilitation typically includes training in the use of multiple task-specific devices for the completion of daily activities. The average older adult with LV uses more than seven devices (Fok, Polgar, Shaw, & Jutai, 2011) that are often abandoned as visual status declines (Mann, Goodall, Justiss, & Tomita, 2002). The iPad may be a useful alternative because it offers increased font size, improved contrast, and text-to-speech options for older adults with LV. Additionally, it is a cost-effective, normative device usable for multiple purposes and has the ability to adapt as visual status declines.

DESIGN: We used a multiple–case study–design pilot study to investigate the change in iPad use and occupational performance before and after a group iPad training program. The program focused on connecting to family and friends, performance of daily tasks, and meeting personal goals.

PARTICIPANTS: Five White women ages 49–81 yr participated in a 10-wk iPad training group. All were legally blind as a result of LV diagnoses including macular degeneration, glaucoma, retinitis pigmentosa, cataracts, and others.

METHOD: Each participant completed a pretest (Time 1 [T1]) and posttest (Time 2 [T2]) assessment immediately before and after the program using the Canadian Occupational Performance Measure (COPM) and an iPad use survey developed specifically for the program. Three months after completion of the program, the participants completed the iPad use survey again (Time 3 [T3]).

ANALYSIS: We analyzed the data from each participant individually using descriptive statistics due to the small sample size, the range of visual diagnoses of the participants, and their unique personal goals.

RESULTS: Four of the 5 participants improved their performance and satisfaction in identified goals on the COPM. Each increased the use of the iPad during daily activity throughout the program and 3 mo after program completion. Example activities included reading books, taking notes in class, listening to music, reading recipes, information gathering, and managing electronic mail.

Specifically, Participant 3 improved performance and satisfaction with applying makeup using the iPad, with COPM ratings of 1/1 at T1 and 7/8 at T2, respectively, using a 10-point rating scale. Likewise, Participant 4 reported improved performance and satisfaction in photography, with COPM ratings of 2/1 at T1 and 10/5 at T2.

Although all continued to use the iPad and integrated it into daily activity, 2 participants decreased the amount of use from T2 to T3. Each participant reported enjoying learning new applications that could apply to their daily lives.

DISCUSSION: The iPad when accompanied with appropriate training has the potential to be a viable assistive device for older adults with LV. Further research with larger sample sizes is necessary to refine education and training methods and determine tasks with which tablet technology is most effective.

IMPACT STATEMENT: This pilot research will assist in providing an evidence base for contemporary LV rehabilitation for older adults with LV to participate in meaningful occupations with the assistance of mainstream, multipurpose technology.

References

Fok, D., Polgar, J. M., Shaw, L., & Jutai, J. W. (2011). Low vision assistive technology device usage and importance in daily occupations. Work: A Journal of Prevention, Assessment and Rehabilitation, 39, 37–48. http://dx.doi.org/10.3233/WOR-2011-1149

Mann, W. C., Goodall, S., Justiss, M. D., & Tomita, M. (2002). Dissatisfaction and nonuse of assistive devices among frail elders. Assistive Technology, 14, 130–139. http://dx.doi.org/10.1080/10400435.2002.10132062