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"The most pathetic person in the world is someone who has sight but no vision."

—Helen Keller, American author, political activist, and lecturer (1880–1968)


By the end of this chapter, readers will be able to:

  1. Explain the relationship between sensory changes that occur in older adults with resultant physical and behavioral compensation.

  2. Discuss the age-related changes of the eye and its support structures and of the visual pathway.

  3. Describe the auditory system changes associated with aging, particularly as they relate to the reception of speech sounds.

  4. Identify common age-related changes that occur in taste, smell, touch, temperature, and pain perception.

  5. Relate sensory deficits common in older adults to functional performance and lifestyle issues.

  6. Identify how interprofessional teamwork may help older adults improve functional performance and address lifestyle issues.

Clinical Vignette

Shirley Rosen is 75 years old. She retired at age 62 from her position as a receptionist at an office within walking distance from her home. When her husband died 5 years ago, she returned to part-time work at her previous place of employment and shares a position with another woman who works part-time. When the weather permits, Mrs. Rosen walks the two blocks to work; otherwise, she drives herself to work. Mrs. Rosen's coworkers notice that she frequently asks people to repeat themselves when on the telephone and that she is often squinting when looking at the computer. Sometimes Mrs. Rosen wears a wool jacket during the summer months because she finds the office too cold with the air conditioning. Judy Johnson, a long-time friend, has noted that when they go out to lunch Mrs. Rosen takes small bites of her food, does not eat all her meal, and seems to have lost pleasure in eating. Often, when Judy makes a comment to Mrs. Rosen, she will smile and nod her head, but this response does not match Judy's comment. Judy wonders if Mrs. Rosen is developing dementia.

  1. How does the social and physical environment of an older adult (such as Mrs. Rosen) support or hinder function in the context of pain or sensory changes due to aging?

  2. What is the role of context (cultural, personal, temporal, virtual), occupational justice (American Occupational Therapy Association, 2014), and health and wellness and how are these affected by sensory changes due to aging?

  3. How might a hearing impairment influence how others perceive an older adult's (such as Mrs. Rosen) cognitive and psychological health?

  4. How might impaired sensory conditions affect dietary choices and, consequently, overall health?

Our bodies receive sensory information about the physical world through generalized and specialized sensory receptors. These receptors begin functioning in utero in most cases, and, beginning in early adulthood, start a slow and progressive decline (Cech & Martin, 2002). The "senses" (vision, hearing, touch, taste, smell) or systems of sensation send information via a sensory modality in the peripheral nervous system ...

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