Sensory impairment is independently associated with numerous negative health outcomes in older adults, including cognitive decline, dementia, falls, and functional decline and loneliness. Once considered benign aspects of aging, recent literature has emphasized the public health importance of sensory impairment. As the United States population ages, these numbers are expected to increase. A small and often overlooked subset is those with dual sensory impairment, concurrent hearing and vision impairment, which affects 1 in 9, or 11.3%, of Americans 80 years or older. Similarly, estimates suggest that hearing impairment, defined as a mild or greater hearing loss using World Health Organization criteria, impacts 38 million Americans and increases in prevalence with age such that two-thirds of Americans over age 70 years.
In the United States, vision impairment impacts approximately 14 million individuals 12 years and older, of which approximately 3 million would remain impaired even with refractive correction. Vision and hearing impairment are highly prevalent, chronic conditions which disproportionately affect older adults. In light of the current COVID-19 pandemic, as hospitals limit visitors to reduce the spread of infection, arrangements should be made to ensure that the communication and transportation needs of those with sensory impairment are not neglected. Healthcare accompaniment is common for persons with sensory loss and healthcare systems should consider accommodations for and leveraging accompaniment to improve healthcare for persons with sensory impairments. A secondary analysis suggests communication needs as the primary reason for accompaniment among persons with hearing loss, while those with vision impairment were more likely to indicate transportation needs. Those with vision impairment and dual sensory impairment had 2.139 (95% confidence interval =1.605–2.850) and 2.703 (CI = 1.549–4.718) times the odds of reporting accompaniment to healthcare visits relative to those without sensory impairment. ResultsĪfter excluding observations with missing data, 10,748 Medicare beneficiaries remained representing a 46 million total weighted nationally representative sample, of which 88.9% reported no sensory impairment, 5.52% reported hearing impairment, 3.56% reported vision impairment, and 0.93% reported dual sensory impairment. Adjusted odds of reporting accompaniment to healthcare visits and given reasons for accompaniment among United States Medicare beneficiaries with self-reported sensory impairment (hearing, vision, and dual sensory impairment) were examined. These cross-sectional analyses included data from the 2015 Medicare Current Beneficiaries Survey and survey weighting provided by Centers for Medicare and Medicaid Services.
This piece aims to determine the use of accompaniment in healthcare interactions by persons with sensory impairment. Millions of older adults in the United States experience hearing, vision, and dual sensory impairment (concurring hearing and vision impairment) yet little research exists on their needs in interactions with the healthcare system.
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