Bridging the Social Gap Through 'Conscious Caring': A Constructivist Grounded Theory of the Art of Caring for Older Adults With Dual Sensory Impairment.

aimThe aim of this study was to develop a conceptual understanding of the role of caring for older adults with combined vision and hearing impairment (DSI).

backgroundDual sensory impairment (DSI) impacts both listening and speechreading communication, function and social participation, meaning that older adults often require support and care to 'age in place' successfully. Family carers play a key role in supporting older adults with DSI to maintain social and physical health. DESIGN/

methodsThis qualitative study uses Charmaz's constructivist grounded theory (GT) methodology. Data were collected between 2017 and 2019 and analysed using constructivist GT methods. Lengthy interviews with eight family carers of older adults living with DSI explored personal histories of DSI, relationships with families, social networks and health care professionals.

resultsThis study demonstrates that caring in this context is predominantly social and 'invisible'. To reduce the social effort of their family member with DSI and to maintain their own self-identity, family carers adopted a 'conscious caring' approach. This is conceptualised as an approach to caring that supports family carers to access resources embedded in their social networks by bridging the gap between the dyad and their broader, more diverse social networks.

conclusionThis study identifies that a reduction in both close and broader social networks limits personal, social and psychosocial resources and impacts the capacity of the dyad to renegotiate their roles, create and maintain their individual and shared social networks and successfully transition to living with DSI. IMPLICATIONS: There is a gap in the literature regarding the impact of sensory impairments on complex communication, health and social care needs of older adults and the role that family carers play. Registered nurses require complex communication skills to support older persons with DSI during health and social care interactions. A better understanding of DSI itself, as well as understanding the key role family carers play in integrating care for their family member, is crucial to delivering person-centred care. IMPACT: This study addresses a growing social gerontological issue and identifies the role that family carers play in integrating health and social care for their family member with DSI. Better professional recognition of DSI and increased visibility of the challenges of living with DSI could help address barriers to effective communication between service providers, formal care support staff and those with DSI. Integrating family carers into care teams is critical to improving health and social care experiences for both caregiver and care receiver. NO PATIENT OR PUBLIC INVOLVEMENT: This study did not include patient or public involvement in its design, conduct, or reporting.