Sensory impairments among older home care clients and associations with functioning, falls, and received care time
Thesis event information
Date and time of the thesis defence
Topic of the dissertation
Sensory impairments among older home care clients and associations with functioning, falls, and received care time
Doctoral candidate
Master of Health Sciences Tiina Pesonen
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Health Sciences and Technology
Subject of study
Nursing Science
Opponent
Professor Riitta Suhonen, University of Turku
Custos
Docent Satu Elo, University of Oulu
Nearly half of home care clients aged over 65 have impaired vision or hearing – even mild sensory impairments are associated with decreased functioning
Impaired vision and hearing are common among older home care clients, and their effects are evident in daily life. According to a doctoral dissertation conducted at the University of Oulu, even mild sensory impairments are associated with decreased functioning, falls, and received care time. These associations are stronger in more severe sensory impairments and in cases of dual sensory impairment. Better identification and management of sensory impairments could support older adults’ ability to live at home.
The findings are based on the doctoral dissertation of MHSc Tiina Pesonen, which examined sensory impairments and functioning among home care clients using register-based data. Functioning was assessed from physical, cognitive, and psychosocial perspectives. Cognitive functioning includes, for example, memory and decision-making ability, while psychosocial functioning covers loneliness and depressive symptoms.
The results showed that certain sensory impairments, such as moderate or severe vision impairment and dual sensory impairment, may accelerate cognitive decline. The risk of falling was particularly increased among home care clients with both impaired vision and cognition. At the same time, they had a significantly greater need for assistance with daily activities than other home care clients.
Associations were also found between sensory impairments and received care time. Impaired vision was associated with longer care time, whereas dual sensory impairment was unexpectedly linked to shorter care time. This finding raises the question of whether the received care time corresponds to older adults’ actual service needs.
Need for improved identification and management of sensory impairments
The study highlights the importance of regular assessment of vision and hearing and referral for further examinations when needed. Previous research shows that a significant proportion of sensory impairments can be treated or managed, for example with assistive devices. However, the results suggest that not all sensory impairments among home care clients are necessarily identified or managed.
Sensory impairments should also be taken into account in service planning. Appropriate support can help older people cope more safely in everyday life and live as full a life as possible in their own homes.
Pesonen’s doctoral dissertation consisted of three sub-studies using data from the national Resident Assessment Instrument database. Sub-study I examined the association between sensory impairments and functioning among home care clients (n = 7,013) over an 18-month period. Sub-study II investigated the relationship between previously identified risk factors for falls, impaired vision and cognition, and falls among home care clients (n = 26,353). Sub-study III examined the association between sensory impairments and the amount of care received among home care clients (n = 1,477).
The findings are based on the doctoral dissertation of MHSc Tiina Pesonen, which examined sensory impairments and functioning among home care clients using register-based data. Functioning was assessed from physical, cognitive, and psychosocial perspectives. Cognitive functioning includes, for example, memory and decision-making ability, while psychosocial functioning covers loneliness and depressive symptoms.
The results showed that certain sensory impairments, such as moderate or severe vision impairment and dual sensory impairment, may accelerate cognitive decline. The risk of falling was particularly increased among home care clients with both impaired vision and cognition. At the same time, they had a significantly greater need for assistance with daily activities than other home care clients.
Associations were also found between sensory impairments and received care time. Impaired vision was associated with longer care time, whereas dual sensory impairment was unexpectedly linked to shorter care time. This finding raises the question of whether the received care time corresponds to older adults’ actual service needs.
Need for improved identification and management of sensory impairments
The study highlights the importance of regular assessment of vision and hearing and referral for further examinations when needed. Previous research shows that a significant proportion of sensory impairments can be treated or managed, for example with assistive devices. However, the results suggest that not all sensory impairments among home care clients are necessarily identified or managed.
Sensory impairments should also be taken into account in service planning. Appropriate support can help older people cope more safely in everyday life and live as full a life as possible in their own homes.
Pesonen’s doctoral dissertation consisted of three sub-studies using data from the national Resident Assessment Instrument database. Sub-study I examined the association between sensory impairments and functioning among home care clients (n = 7,013) over an 18-month period. Sub-study II investigated the relationship between previously identified risk factors for falls, impaired vision and cognition, and falls among home care clients (n = 26,353). Sub-study III examined the association between sensory impairments and the amount of care received among home care clients (n = 1,477).
Created 12.5.2026 | Updated 13.5.2026