Module 2

Understanding Psycho-Social Transitions and How These Relate to Employment of Older Persons Who Are Visually Impaired

Learner’s Goal:

  To understand the psycho-social transitions older persons experience as they age and encounter visual impairment and how these relate to working.

  Learner Objectives:

  At the end of the module, you will be able to describe some of the psycho-social transitions older persons experience including personal losses and the challenges they present in coping with everyday life.

  You will be able to describe the role of the family in dealing with these transitions and the challenges they present.

  You will understand the role work can play in helping older persons cope with psycho-social transitions.

A. Understanding Psycho-social Transitions Older Consumers with Visual Impairments May Experience

1. The losses and challenges associated with age-related vision problems can be both real and perceived.

  An older person who has recently lost vision may have experienced a variety of other losses, recently or concurrently.  It is important for the counselor to know and understand what the older person has been experiencing.  The older consumer who is ready for work has more than likely gone through a period of adjustment, but may still be dealing with some of these issues.

·        Decreased independence or feeling the need to depend on someone else for everything.

·        Reduced ability to move about in familiar or unfamiliar environments.

·        Inability to drive a car.

·        Decreased control over one’s life; for example, feeling unable to do anything or find anything in the environment, having to wait for others to complete tasks such as reading mail, going shopping.

·        Loss of control over the physical environment such as the inability to locate things.

·        Diminished access to written material and information in general, feeling cut off from the world.

·        Decreased privacy such as needing someone to read one’s personal mail, assist in paying bills.  

·        Loss of anonymity or obscurity; for example, feeling stared at when using a cane, a sighted guide, or a magnifier.

·        Decreased ability to read or respond to letters.

·        Loss of opportunity for non-verbal communication such as being unable to see gestures and non-verbal feedback.

·        Diminished feelings of self-confidence, adequacy, self-esteem and self-worth.

·        Loss of roles and responsibilities and value in society such as work, volunteerism, feeling unable to carry out traditional roles in the home such as carrying out garbage, cleaning house, etc.; not being able to help others in some meaningful way.

·        Lessened opportunities for productive activity such as volunteerism, involvement in recreational pursuits.

·        Loss of social network, or feeling cut off from friends, feeling out of the mainstream of life.

·        Decreased financial security due to loss of employment, increased costs of living due to disability.

·        Loss of sense of being whole or feeling as though part of one’s self is gone.  (Orr, 1998)

 2.  Psycho-social Transitions Associated With the Aging Process.

Some of the transitions and challenges associated with the aging process are similar to those related to vision loss such as:

• Diminished social network of all ages, feeling isolated or segregated (such as moving into senior housing).

• Loss of roles such as work or volunteer.

• Decreased financial security.

•  Diminished control over one’s life.

• Loss of self-confidence and self-reliance.

• Decreased physical and/or psychological mobility.

• Diminished self-worth or self-esteem.

• Loss of a sense of being whole.

3.  Other Psycho-social Transitions Associated With Growing Older

·        Death of spouse or significant other.

·        Loss of siblings, neighbors, friends and peers (note this refers to physical loss not distancing or psychological loss which may occur as a result of loss of vision)

·        Decreased geographic proximity to children and grandchildren.

·        Diminished health due to chronic disease or acute illness.

·        Decreased physical capabilities such as hearing, mobility (Orr, 1998).

  B. Understanding Family Relationships and Peer Support

  1. Role and Involvement of Family members

  “A strong body of evidence has been amassed documenting the important and supportive role played by the family in the lives of older people and... in the rehabilitation of disabled older people, including those who are visually impaired” (Silverstone, 2000, p. 160).

  In the early stages of visual impairment, family members may not recognize that there may be a problem.  Those living with the older family member experiencing vision loss are more likely to experience stress related to the older family member’s reaction to vision loss such as severe depression (Silverstone, 2000). The older person who is working may feel he/she has to give up working.  Family members may or may not support the older person in this decision making process.

  Involvement of family members in the vocational rehabilitation process is difficult.  The Rehabilitation Act calls for development of an individualized plan which emphasizes client choice and self-determination.  However, the counselor should be acutely aware of the role that family members play and be ready to provide appropriate interventions if needed.

  Major family situations to which counselors should be attuned:

  a. The older person’s concern about his/her vision loss is greater than that of the family, or he or she does not want the family involved.

b. The family of the older person is concerned with the vision loss but does not perceive a crisis.

  c. The family is experiencing a crisis in relation to the older person’s vision loss and often experiences a great deal of stress (Silverstone, 2000, p. 166).

  2. Counselor interventions can include:

·        assessment of the family situation

·        distribution of educational materials

·        educational forums

·        support groups

·        open houses for families

·        individual or family group meetings

·        family counseling (Silverstone, 2000).

  If family members choose not to be involved or are unavailable, older consumers with visual impairments can still benefit from individual counseling or group support meetings where family issues are discussed.  The main thrust of this approach is to enable the older person to understand that he/she has control of his/her own life but that it is “ok” to seek help from family members or peers (Silverstone, 2000).

C.  Role of Work in Helping the Older Person Cope with Transitions and Challenges of Aging and 

Visual Impairment

  Although the older person may experience psycho-social transitions and lack of family support, this does not mean he/she is not a viable candidate for employment. In fact, going back to work or remaining on the job can help the older person deal with the challenges these transitions present by providing the following:

·                    additional income

·                    opportunity to be with others

·                    sense of self-worth

·                    opportunity to learn new skills

·                    health insurance and/or other benefits

·                    something worthwhile to do

  Learning Activities–You may try these activities to practice what you have learned.

1. Take each psycho-social transition associated with vision loss.  Write down an example which comes to mind of someone in your life who has experienced similar transitions and how he or she was affected.

2. Take each psycho-social transition associated with aging.  Write down an example which comes to mind of someone 

in your life who has experienced similar transitions and how he or she was affected.

Congratulations!

You have finished Module 2.

Now go on to the key points section to review what you have learned.

  Key Points

1.         Older persons experience a number of real and perceived losses as a result of the aging process.

2.         Some of these psycho-social transitions are similar to those experienced as a result of losing vision.

3.         The family of the older person can be a positive or a negative force in the older person’s adjustment to challenges associated with aging and vision loss.

4.        Work can help the older person to deal with these challenges by providing something worthwhile for the older person to do.

  Self-Check

  You will find a self-check section at the end of each module to allow you to find out what you have learned and help you identify sections you may need to review before moving on to the next module.

Please answer each True or False and check Appendix A for answers.

____1.            Loss of roles and responsibilities and value in society such as work or volunteerism  is a major psycho-social transition experienced by older persons with vision loss.

____2.             Research indicates that families have little or no effect on the adjustment of the older person to vision loss.

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