Older men's experiences of living with severe visual impairment

Background. Little is known about how men react to their health and illness experiences. Lack of information about the lives of older men is unfortunate considering the anticipated growth of the older male sector of society and the fact that older men age differently than older women. One health-related experience common to many older men is severe visual impairment caused by macular degeneration, a chronic eye disease that affects central vision. Understanding the health experiences of older men is imperative if nurses are to provide quality care to this growing segment of society. Aim. The purpose of this study was to gain an understanding of the experience of severe visual impairment from the perspective of older men with macular degeneration. Method. A phenomenological approach was used to investigate the experience of severe visual impairment in eight older men with macular degeneration. Data were gathered through audiotaped interviews and analysed using a modified Giorgi method. Findings. The resultant general structural description revealed six central themes: (1) older men's lives were circumscribed by what they could and could not see and could and could not do, (2) cherishing of independence, (3) creation of strategies, (4) acknowledgment of the progression of visual impairment, (5) confrontation of uncertainties, scepticisms, and fears about their diagnosis and treatment, and (6) persistence with hope and optimism. Conclusions. A thorough nursing history and assessment must be completed, including information about the progression of the visual impairment, strategies used for living with visual loss, and presence of other health problems that may complicate life with visual impairment. Nurses must be aware that older men with macular degeneration are often sceptical about their diagnosis and treatment. Therefore, careful education and clear communication are essential.