INTRODUCTION

In recent years, social rehabilitation of elderly people with disabilities has been recognized as one of the key tasks of gerontological theory and practice [1, 3, 7, 9–12, 14, 15]. Meanwhile, visual impairments are among the leading causes of disability in old age [2, 8]. The demographic trends that took place, in particular in Russia, associated with an increase in the absolute number of the blind and visually impaired elderly people and their share in the social group of visually impaired people in general, led to the formation of an age structure that characterizes the state of deep demographic old age by the beginning of the 21st century. Demographic aging is associated with the reduction of the rehabilitation potential of the blind and visually impaired, both at the population and at the individual level [5].

Consequently, elderly people with disabling visual impairments represent a specific target group of social rehabilitation who require special theoretical and methodological approaches [13].

Meanwhile, in typhlology, the target settings of social rehabilitation of the blind and visually impaired are viewed through the prism of their lifestyle [4]. In light of this, in order to determine meaningful and target guidelines of social rehabilitation work with elderly visually impaired people, it is of fundamental importance to understand the characteristics of their lifestyle, especially since in terms of quality and lifestyle they, according to the results of a special study, reveal significant specificity [6]. We pursued the corresponding goal in a pilot experiment, using a comparative study of the lifestyle characteristics of elderly people with and without visual disabilities.

MATERIALS AND METHODS

Forty people at ages of 60–88 years took part in the experiment as respondents: 20 visually impaired people registered with the St. Petersburg regional organization of the All-Russian Society of the Blind who were the experimental group, and 20 elderly people without visual disabilities who acted as the control group. A comparative analysis of the socio-demographic indicators of the respondents (age, marital status, income, number of children, and type of residence) did not reveal significant differences between the experimental and control groups, which indicates their comparability.

The author’s questionnaire was used in the experiment. It included a total of 43 closed-ended questions and was successfully tested earlier on a large-scale sample of visually impaired people, but within the framework of an empirical study that did not imply the implementation of a comparative plan [5].

The questionnaire materials were processed in two ways. In the cases where the respondent was asked a question that allowed the choice of only one of the proposed answer options, the analysis was based on percentages characterizing, in proportion, the number of research participants holding certain positions on this issue. If the respondent could use several presented answer options at once, then a type of rating indicator was used that reflects the relative importance of each of the options. The rating was calculated by dividing the total number a given answer by the total number of survey participants; thus, the corresponding value could fall within the range of 0–1 points.

The statistical significance of the revealed differences was assessed using the φ* criterion, that is, Fisher’s angular transformation.

RESULTS AND DISCUSSION

Visually Impaired Seniors: Position in Society

The position of the visually impaired elderly in society is characterized in a subjective sense, first of all, by the fact that they have a more pronounced feeling of a negative attitude of society towards the elderly than their peers with intact vision: this opinion is shared by 75% of the blind and visually impaired respondents versus 50% of respondents who do not have vision disabilities; this difference is statistically significant (φ* = 1.65, p ≤ 0.05). At the same time, visually impaired elderly people categorically deny the existence of such a negative attitude to the same extent as elderly people without disabling visual impairments; the corresponding position is taken by 10% of the subjects in each of the groups of respondents.

At the same time, according to the blind and visually impaired elderly, society underestimates the usefulness of the elderly. Visually impaired respondents see such usefulness, first of all, in the upbringing of grandchildren and great-grandchildren: this answer has the highest rating: 0.6. The benefit to society for the blind and visually impaired elderly people is largely associated with the transmission and support of family traditions, as well as with the fact that older people are useful as an example of leading an active life style (0.5).

Meanwhile, according to older people who do not have visual disabilities, the usefulness of older people in society is determined primarily by doing housework and raising grandchildren and great-grandchildren (0.7), as well as continuing socially significant work activities (0.6). In turn, the visually impaired elderly people value the function of mentoring (0.3 and 0.2, respectively) somewhat higher than the respondents without disabling visual impairments.

In addition, and this is important considering that fact that the social status of older people is determined subjectively and by the extent to which they identify with current trends in the social and cultural life of the country, blind and visually impaired respondents, for example, are less positive than their peers with intact vision in assessing the changes that have occurred in the field of culture and art, as well as in the life of the country as a whole (70 and 50% versus 75 and 60%, respectively); in relation to culture and art, a statistically significant trend (φ* = 1.30, p ≤ 0.10) is likely. Thus, in terms of the perception of the social status of older people, visually impaired elderly people feel underestimation of their usefulness by the public, but at the same time they have a clear idea of the role they play in public life, which is associated with raising grandchildren and great-grandchildren, demonstrating an example in the implementation of an active life, and support of family traditions.

Elderly Visually Impaired People: The Preservation of the “Spiritual Core” of the Personality

According to the results of the survey, approximately the same proportion occurs of those who continue to be interested in their previous professional activities among elderly people with and without visual disabilities; however, among the blind and visually impaired, it is still somewhat less (45%) than among those with normal vision (50%). At the same time, both the visually impaired elderly and the elderly with intact vision are overwhelmingly convinced that their moral principles and values have stood the test of time; among the visually impaired, this conviction is even more pronounced (95 versus 90%, respectively). Thus, the subjective stability of their moral and ethical sphere is obvious.

In addition, elderly people with vision impairments generally have a high preservation of the social circle “inherited” from the sphere of their previous labor activity; this, according to the survey, is characteristic of 70% of the blind and visually impaired respondents, while in relation to respondents with normal vision, the value of this indicator is 65%.

Meanwhile, after the termination of work, visually impaired elderly people, as well as elderly people who do not have such a disability, primarily began to devote more time to physical exercise and maintaining health (0.55). While for the visually impaired elderly the next most important activity is associated with a hobby, as well as, in general, with the acquisition of new habits and interests (0.25), for elderly people who do not have visual disabilities, this is mainly dacha farming, household chores, and raising grandchildren (0.40), which is twice as high as the corresponding rating for the blind and visually impaired (0.20). Moreover, in the latter case, the nature of the differences indicates the possible presence of a statistically significant trend (φ* = 1.39, p ≤ 0.082).

At the same time, after the end of their labor activity, the attitude towards religion remained unchanged for the majority of elderly visually impaired people; moreover, 15% of the respondents have increased interest in religious issues, while among elderly people without disabling visual impairments only 10% of the survey participants noted that they began to attend church after retirement.

At the same time, elderly visually impaired people generally hold a more skeptical opinion about the significance of their life and spiritual experience than their peers with intact vision: among the blind and visually impaired respondents, this experience is considered valuable only by 65%, while among those with normal vision it is 80%.

The priorities in the preferred use of their accumulated life experience are also different, although for the elderly, both with and without visual disabilities, the priority in this sense is the transfer of life experience through the parenting of grandchildren and great-grandchildren. However, in the elderly blind and visually impaired, this attitude is significantly less pronounced (φ* = 2.35, p ≤ 0.01) than in those with normal vision (0.45 and 0.80, respectively).

Moreover, other ways of disseminating their life experience are also relevant for the visually impaired, participation in events with the involvement of veterans (0.35), its use in personal life, transferring to youth (0.15), and broadcasting national and religious traditions of young people and the expression of their worldview and understanding of life in creativity (0.10). For elderly people without visual disabilities, the transfer of life experience through the parenting of grandchildren and great-grandchildren is the dominant and practically the only way to demand it. Thus, visually impaired elderly people do not confine themselves to the transfer of life experience only on the scale of the family micro-society.

Meanwhile, the greatest stability of the “spiritual core” of the personality of the visually impaired elderly is found in the aspect associated with the preservation of their care of their appearance. Thus, assessing themselves in the context of the corresponding question of the questionnaire, 90% of the blind and visually impaired participants in the survey indicated that they care about their own appearance and its attractiveness. According to their information, 80% of the surveyed elderly people who do not have visual disabilities worry about their appearance.

Thus, in terms of the preservation of the “spiritual core” of the personality, visually impaired elderly people are characterized by a more pronounced orientation toward social interaction than older people without disabling visual impairments, and a variety of activities to disseminate their life experience.

Elderly Visually Impaired People: Inclusion in Social and Cultural Life

The initial characteristic of the level of involvement of the visually impaired elderly in social and cultural life is primarily the sharply limited opportunity for their independent access to the relevant social institutions. Thus, according to 75% of the blind and visually impaired respondents, their health and mental state does not allow them to visit public institutions and cultural institutions on their own, while out of sighted participants in the survey, only 20% speak in a similar vein; these differences are statistically significant (φ* = 3.69, p ≤ 0.001). At the same time, elderly visually impaired people show a greater interest in books, television and radio broadcasts, visiting public and cultural institutions than their normally seeing peers (70 versus 55% of the sample, respectively). Thus, a conflict of possibilities and desires occurs in elderly people with visual impairments that can affect their mental well being.

At the same time, differences in preferences in the field of art are found in older people with and without visual disabilities. As evidenced by the results of the survey, among the elderly visually impaired the greatest interest is attracted by pop concerts (0.70), movies (0.50), and theater performances (0.45), as well as exhibitions in museum, television series, and radio performances (0.35). For older people with normal vision, the priorities are related to films (0.45) and exhibitions in the museum (0.40).

At the same time, elderly people with visual disabilities, to the same extent as elderly people with intact vision, show an interest in domestic politics (95% of respondents each). However, the policy of other states is of interest to the elderly blind and visually impaired, in general, somewhat less than to elderly people with normal vision (50% of respondents versus 70%); the nature of the differences here indicates the possible presence of a corresponding significant trend (φ* = 1.30, p ≤ 0.10). A similar and, moreover, an even more pronounced tendency (φ* = 2.26, p ≤ 0.012) is also found in terms of political activity itself: participation in elections is relevant only for 35 and 70% of visually impaired respondents and people with intact vision, respectively.

As for the celebrated holidays as certain indicators of the activity of public life, the most popular among the visually impaired elderly are family (0.85) and state (0.80) holidays, as well as church holidays, which are celebrated by 40% of the blind and visually impaired respondents. For older people who do not have vision disabilities, the nomenclature of corresponding priorities is similar, but family holidays are more significant for them (95%), and state and church holidays, are less important (0.65 and 0.25).

The visually impaired elderly provide their involvement in the modern information process primarily through communication with people (0.9 points), as well as with television (0.85 points), radio (0.80 points), and books (0.50 points). In contrast, such media as newspapers and magazines are not popular with them (0.20 and 0.25, respectively). Meanwhile, for seniors with normal vision, the most popular source of information is books (0.50 points), which turn out to be more significant as information sources or channels than communication with people and radio (0.45), as well as newspapers (0.40). Thus, the need occurs for communication with other people (φ* = 3.25, p ≤ 0.001), as well as the general focus on obtaining information, especially from television and radio broadcasting sources (φ* = 2.77, p ≤ 0.002).

In general, in the aspect of the inclusion of elderly visually impaired people in social and cultural life, a number of features of their lifestyle, which are expressed in a certain imbalance between their desires and opportunities in the corresponding sense, as well as in a contradiction between a high interest in politics and an unwillingness to manifest real political activity, are revealed. At the same time, interpersonal communication plays a leading role in the integration of the visually impaired elderly into the information space and variety concerts are the most attractive cultural events for them.

Elderly Visually Impaired People: The Need for Novelty and Expansion of the “Spiritual Space”

The need for the elderly visually impaired for novelty and expansion of “spiritual space” is characterized, according to the survey, by the fact that 65% of the blind and visually impaired respondents note their desire to learn something new; this indicates that their cognitive activity is quite pronounced on the whole, although the corresponding indicators for normally seeing respondents have slightly higher values (70%).

In turn, visually impaired elderly people reveal a more intense (0.45) need for mastering a computer and the Internet than their peers without disabling visual impairments (0.35), as well as the need for classes on handicrafts and creativity (20 and 10%, respectively).

Educational needs are almost equally reduced in both elderly visually impaired and elderly people without such a disability: this involves training in courses or in vocational education institutions (0 and 0.05 respectively), the study of foreign languages (0.10 in both samples) or certain areas of science (0.05 in both groups of respondents).

At the same time, as shown by the results of the survey, the spheres in which the visually impaired elderly have insufficient impressions are direct communication with art (0.50), communication with nature and trips to other cities and countries (0.45), as well as walking around the city (0.40). For elderly people with preserved vision, these are trips to other cities and countries (0.60), communication with nature (0.35), communication with friends and children, and walking around the city (0.25), while the lack of direct communication with art is noted by only 20% of the respondents. Thus, the comparative dissatisfaction with the need of the visually impaired elderly in communicating with art is clearly revealed; this that comes to the fore for them in the sphere of social and cultural activity.

At the same time, according to the results of the survey, elderly people with and without visual disabilities have the same experience of tourist trips (85%) and would equally like to participate in them at the present time, if they have the opportunity (70%). However, the goals of such trips are somewhat different: for the blind and visually impaired respondents, the priority is primarily associated with the health-improving format of rest (0.55) and only then with the cultural and educational aspects of the trip (0.45), while for those who see normally, the opposite is true (0.30 and 0.55, respectively). At the same time, the differences regarding the recreational format of rest indicate the possible presence in this case of a statically significant trend (φ* = 1.62, p ≤ 0.053). The need to visit memorable places is expressed in older people of both categories in almost the same way (0.25 and 0.20).

Thus, in terms of the need for novelty and expansion of the “spiritual space,” visually impaired elderly people, in contrast to elderly people who do not have vision disabilities, experience a pronounced deficit in communication with art, and the purpose of their trips is primarily health improvement and improvement of well being. At the same time, they are distinguished by a pronounced need to master such modern types of activity as the use of computer technology and the Internet.

Elderly Visually Impaired People: Creative Activity

The creative activities of the elderly visually impaired, as shown by the results of the survey, have a specific manifestation in the social sphere and in the sphere of art.

In the social sphere, the activity of the elderly blind and visually impaired is realized only within the framework of home improvement (0.50 points) and cooking (0.40 points). The same types of activities as sewing (0.05 points), embroidery (0 points), and flower cultivation (0.10 points) are not popular with the visually impaired, which seems quite consistent taking into account the extremely limited availability of these types of activities with deep visual impairment.

All types of social and household activities, except for embroidery (0 points), cooking (0.45 points), sewing (0.35 points), flower cultivation (0.30 points), and home improvement (0.30 points) are in demand for normally seeing respondents almost to the same degree. Moreover, in relation to sewing, the differences that are found are statistically significant (φ* = 2.57, p ≤ 0.004), and in relation to flower cultivation and home improvement, significant trends (respectively φ* = 1.63, p ≤ 0.052 and φ* = 1.30, p ≤ 0.10) are likely.

Meanwhile, artistic and creative activity is reduced both in the elderly visually impaired and in their normally seeing peers (0.30 points and 0.40 points, respectively). However, a significant part of the visually impaired respondents (45 versus 40% of the normally seeing respondents) noted that such classes would be attractive to them if they were organized near their place of residence. Thus, the socio-organizational aspect of the creative activity of the visually impaired elderly is revealed and is associated with the need to have appropriate rehabilitation work at the place of residence.

This would be all the more important since the leading motives for engaging in creative activities for the visually impaired elderly are associated with the ability to escape from everyday worries (0.40), to realize their abilities (0.30), experience the joy of creativity and communicate with people close to one’s interests (0.25), and bring the joy of creativity to others (0.20). In contrast, earning additional income through art (0.15), participation in the creation of a new one (0.10), and gaining recognition of young family members (0.05) actually do not motivate artistic and creative activity for elderly people with visual disabilities.

Thus, the creative activity of the visually impaired seniors is generally reduced both in qualitative and quantitative terms. At the same time, visually impaired elderly people are especially limited in terms of social and domestic activity; however, they see the main purpose of artistic and creative activity in the distraction from everyday worries.

Visually Impaired Seniors: Social and Cultural Communication

In terms of social and cultural communication, it is important that visually impaired elderly people feel loneliness to a lesser extent than their normally seeing peers: 20% of the blind and visually impaired and only 15% of the normally seeing respondents note the lack of such a feeling.

However, visually impaired older people assess the degree of understanding of the life views and beliefs of older people by their relatives and friends generally more pessimistically than older people with intact vision. Thus, while 35% of the blind and visually impaired respondents doubt whether their relatives and friends share their views, only 10% of respondents with normal vision experience have such doubts. Consequently, visually impaired elderly people feel psychologically “distanced” from their family members. Similarly, according to the estimates of 25% of the sample of the visually impaired, relatives and friends do not share their hobbies in the field of art, while in the sample of normally seeing seniors this opinion is held by only 15%.

It is noteworthy in this sense that in the transfer of cultural experience, visually impaired elderly people are focused not only on family, but also on friends, and to a greater extent than elderly people without such a disability do. Thus, while blind and visually impaired respondents would equally like to discuss watched films and read books with family members and friends (0.65 points), respondents with normal vision definitely give priority to family members in discussing what they read and watched (0.65 points), and not to friends (0.40 points), and these differences indicate the possible presence of a statistically significant trend (φ* = 1.60, p ≤ 0.055).

In turn, visually impaired elderly people are also involved in family affairs to a lesser extent than elderly people without disabling visual impairments and this participation itself is largely passive. The point is that, according to the results of the survey, participation in family affairs is expressed among elderly people with visual disabilities primarily in thinking about problem situations in the family (0.55 points) and obtaining information about the affairs of all family members (0.50 points), and only then, in providing material assistance to family members and performing some household duties (0.45 points); participation in family councils is a very rare form of involvement in family life (0.25).

Respondents with eyesight participate in family affairs primarily by performing some household duties (0.80 points); they also know about the affairs of all family members (0.70 points), help family members financially (0.65 points), and think about problem situations in the family (0.55 points). Respondents of this category participate in family councils quite rarely, but not as much as respondents with visual impairments, in 35% of cases. At the same time, in relation to the performance of household duties, the revealed differences have a statistically significant character (φ* = 2.35, p ≤ 0.008), and in relation to the dedication to the affairs of family members and the provision of material assistance to them, the presence of a significant trend (respectively, φ* = 1.30, p ≤ 0.10 and φ* = 1.28, p ≤ 0.11) is likely. Thus, visually impaired elderly people have limited and in a sense inactive involvements in the affairs of their families.

For the communicative characteristics of elderly people with visual disabilities, they define joint holidays with friends as their preferred forms of communication (0.60 points), collective attendance at cultural events and discussion of what has been read and viewed (0.40 points); communication with grandchildren and great-grandchildren is only in the next place among the chosen forms of communication (0.35 points). However, this difference is also significant in the choice of seniors without visual disabilities (φ* = 2.26, p ≤ 0.012); communication with grandchildren is the dominant communicative form (0.70), although attending holidays with friends is just as significant for them as for the visually impaired respondents (0.60 points).

Thus, visually impaired elderly people are more focused on communication outside the family microsociety than elderly people with normal vision. At the same time, in addition to direct personal communication, older people with and without vision disabilities prefer communication on phone (1.0 and 0.95, respectively), and not by correspondence (0.15 in both samples). As for the finally preferred formats and places of communication, according to the results of the survey, the range of preferences for the visually impaired appears to be somewhat wider, giving an unconditional priority to communication in a narrow circle, for example, in an apartment (80% of the responses); they are also ready to communicate in a small group, but in crowded places, and even in nature and in a church, while respondents who see normally exclusively choose the option of communicating in a narrow circle, in an apartment in 100% of the cases.

Thus, the visually impaired elderly as subjects of social and cultural communication are focused on the meso- and macrosociety. At the same time, generally, while not feeling lonely, they nevertheless perceive themselves to be distanced from their family members, who do not fully share their life views, beliefs, and hobbies in the field of art and culture; their preferred forms of communication are often associated with collective activities.

CONCLUSIONS

Elderly visually impaired people are characterized by a high degree of interest in social contacts and a wide range of methods of inclusion in social life: there is a pronounced breadth of interests and hobbies, a desire to obtain new information and dissemination of life experience, and a focus on social interaction. However, social contacts of the blind and visually impaired are more superficial; their alienation takes place in family social relations. At the same time, visually impaired seniors are distinguished by their immersion in family interactions, an orientation towards supporting allied people, and participating in the upbringing of children.