This is the third and final of three linked Expert series articles from Guide Dogs examining factors impacting on the mobility of people with sight loss. Here, Dr. Lorna Marquès-Brocksopp, Research Associate at Guide Dogs, explores holistic well being and its relationship with mobility and rehabilitation.
Guide Dogs’ aim is to not rest until people who are blind or partially sighted can enjoy the same freedom of movement as everyone else. Guide Dogs’ strategy clearly sets out how we will work towards this goal, supporting our clients through their individual mobility journeys. Our work is multi-faceted: from supporting someone with a new diagnosis, helping them and their families adapt emotionally to their sight loss, to working with other organisations and ensuring that our clients receive the right mobility service for their particular circumstances. As such, our work is not only directed at the individual, micro-level, but at structural, macro-level factors which may hinder or facilitate the freedom of movement which every one of our clients has the right to enjoy. Our work therefore is not only directed at the goals of our own strategy, but addresses the ten outcomes of Seeing it My Way.
Whilst freedom of movement may overtly indicate a focus on mobility and the physical, tangible elements of client health, we are learning through our research that the journey towards mobility touches many different areas of an individual’s wellbeing. This view is supported in the wider literature on the multidimensional nature of health, which increasingly underlines the importance of a holistic approach to address how well people feel. Indeed, the concept of ‘wellbeing’ has received significant interest in public policy and discourse of late. This is evident in the fact that the term features strongly in relation to initiatives and programmes both within and external to Guide Dogs as a community of practice. Furthermore, recent research has begun to consider the ‘holistic’ nature of wellbeing: the importance of addressing not only the physical (eg mobility) but the interrelated emotional, social, and spiritual factors which enable us to feel ‘well’.
Concepts: Bodily processes and systems.
Relation to sight loss: Aetiology of eye conditions including visual acuity and field; mobility and functionality.
Concepts: Thoughts and feelings; connectedness with oneself.
Relation to sight loss: Resilience (self-esteem, confidence); empowerment (autonomy, self-control); positively perceived emotions (happiness, optimism).
Concepts: Connectedness with others (humans and other species) and the external environment.
Relation to sight loss: Friendships and peer support; employment and education; human−animal bond and animal-assisted interventions.
Concepts: Sense of meaning and purpose in life; living in accordance with one’s values; connectedness to oneself and others.
Relation to sight loss: Spirituality as a ‘buffer’ or coping mechanism for adjusting to or living with sight loss; finding meaning in life following a diagnosis of sight loss.
The question, therefore, is how we can help those people who are blind and partially sighted receive more holistic, person-centred services and support. We have learnt through previous research that people with sight loss are not a homogenous group: Each individual will have their own needs and preferences, and as such it can be argued that they should receive their own individually-tailored package of support. Whilst objective measurements of physical health are a useful starting point (eg visual acuity), research tells us that more can be learned by taking a subjective approach to addressing client need by understanding the whole of their wellbeing. In practice, when we talk about physical health and mobility, this means considering not only how an individual uses their remaining vision and how they feel about this, but how they use all their physical senses.
Furthermore, research suggests that positive outcomes in physical health are both directly and indirectly linked to enhanced emotional and spiritual wellbeing: successful rehabilitation often depends upon if an individual feels they have the confidence and motivation to succeed and if they believe that embarking on rehabilitation will bring their lives meaning and purpose. In addition, research also suggests that holistic approaches to orientation and mobility underline the use of not only physical and sensory skills, but emotional and cognitive capacities as well. As such, Stage 2 of Guide Dogs’ strategy - The Mobility Journey - underlines how a client may need time and space to reflect on their sight loss and support for the ongoing feelings they may experience. There is a growing awareness, therefore, of the need to address how clients feel spiritually, socially and emotionally in order for them to feel ready to work with service providers in selecting the most appropriate mobility service for their needs.
Future research may wish therefore to consider whether and how different types of support consider not only mobility, but the emotional, social and significantly, spiritual wellbeing of individuals living with sight loss. Such research may consider how individuals can be helped to find meaning and purpose in life, and in turn a sense of spiritual wellbeing, which has been found to lead to improvements in how well an individual feels physically, emotionally, and socially.
For further information, please contact Lorna Marques-Brocksopp, Psycho-Social Research Associate, Strategy and Research Team at: [email protected]
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