People with visual impairments rely on countless assistive devices—from magnifiers to audiobook players to electronic notetakers—to get through the day. These gadgets help them perform tasks like cooking, texting, and completing work assignments.
But having so many devices can be problematic, says Jennifer Kaldenberg, a clinical associate professor of occupational therapy. Some people get overwhelmed by the sheer number of tools—and how to use them. Even devices that could make a big difference to someone’s well-being often end up collecting dust.
Since 2015, Kaldenberg has been studying whether a single Apple iPad can successfully replace a drawerful of devices. She trained a group of four older women with various degrees of visual impairment—caused by eye conditions such as macular degeneration, optic neuritis, and corneal transplantation—to use the tablets for everything from connecting with family to reading books to managing medications, then monitored how that influenced their lives.
“Once they had the basics down, we wanted to help the women with their specific goals or interests,” says Kaldenberg. “One of the women, for instance, stated that she hadn’t worn makeup in five years and she just really wanted to do that independently and feel good.”
They introduced her to Camera Zoom. The app, which allows users to zoom in while looking at themselves, proved more helpful than the regular magnification devices the participant had been using. “She was able to zoom in on her eyes and put on her mascara,” says Kaldenberg. “Seemingly simple things like this were very meaningful.”
The study, conducted with Stacy Smallfield, an associate professor of occupational therapy and medicine at Washington University in St. Louis, Mo., found the iPad successfully replaced many of the devices these women commonly used for their day-to-day tasks. And the iPads didn’t suffer the same fate as many other short-lived or discarded assistive devices. Five years after joining the study, the women were still using them every day.
Empowering People with Low Vision
Kaldenberg specializes in working with people with visual impairments and has devoted her teaching—training occupational therapy and optometry students on successful therapy interventions—and research to improving their lives. Advocating for the elderly is another important component to her research, and the iPad study is just one example of that.
She’s previously examined other occupational therapy interventions that can be used to improve the leisure and social participation of older adults with low vision, who are at a higher risk for social isolation. She and her coresearchers looked at 13 studies that tested various interventions and determined the best type was a problem-solving approach, in which practitioners help their clients define barriers to participating in social and leisure activities, work with them to set realistic goals, and then come up with solutions to those barriers. For instance, practitioners can consult with their patients to find ways to make activities like going out to dinner or seeing a movie with friends more feasible and enjoyable. Kaldenberg has also studied ways to incorporate vision intervention into daily practices at nursing homes to limit fall risk, and how occupational therapists can assist in productive aging for people with low vision.
She even considers further implications for her research on the iPad: “There are a lot of studies nowadays looking at social isolation and loneliness in older adults,” says Kaldenberg. “Beyond this study, the iPad could be looked at as a tool to address that.”
Group Training As Intervention
Kaldenberg says the findings of the iPad study challenge the stereotype that older adults can’t learn new technology. She also hopes it highlights the benefits of group training, which is often overlooked.
“A lot of times, intervention is done one-on-one, but we found that this group structure was really helpful,” she says. In particular, the women wound up learning from each other. “They were finding different strategies that might be helpful. Somebody would say, ‘Oh, I tried it this way, and this way works better.’ Having those multiple perspectives was really helpful.”
Kaldenberg plans to expand her research to include participants with a greater diversity of backgrounds and a wider breadth of diagnoses. Among the issues she hopes to explore are barriers such as Wi-Fi cost and access, and whether lower-cost tablets can be as effective as an iPad.
“We started this study to see if we could have a meaningful impact on older adults,” says Kaldenberg. “And I think we saw how one device—instead of having a drawer full of devices—can help them perform tasks more efficiently and effectively in their everyday lives.”