**Background:** The population of older adults in the United States is increasing, with an estimated 22 million informal caregivers in 2014. Among caregivers of older adults, 23% care for individuals with visual impairments (13% with only visual impairments, 10% with both visual impairments and dementia). Caregivers of individuals with both dementia and visual impairment spend 1.7 times more hours providing care than caregivers of those without either disability, and have 3.2 times as many valued activities affected. Despite the specific challenges of caring for older adults with visual impairments—including assisting with reading, transportation, financial management, and medication—little research has focused on interventions for this population. The purpose of this study was to pilot a multimodal virtual intervention to improve quality of life and well-being for unpaid caregivers and their care recipients with visual impairments.
**Methods:** Participants were recruited through social media, personal invitations, and caregiver-serving organizations across the United States between May and July 2021. Inclusion criteria: unpaid caregivers of adults with visual impairments over age 30, care-recipients diagnosed with visual impairment by a medical practitioner, and internet access with basic computer literacy. The final sample included 12 caregivers and 8 care-recipients (20 total). Caregivers had a median age of 56.5 years (IQR 28.5), were predominantly female (66.7%), white (58.3%) or African American (33.3%), and 75% provided more than 8 hours of care per day. Care-recipients had a median age of 71 years (range 40–95), were 58.3% female, and had various visual impairments including far/short sightedness (25%), total blindness (16.6%), macular degeneration (16.6%), and color blindness (16.6%). The 10-week virtual intervention was delivered over Zoom for one hour per week. Activities were chosen based on caregiver pre-study survey responses and included tai chi, yoga/chair yoga/blind yoga, gardening, de-stressing techniques, meditation/safari meditation, music/singing, dancing/ballroom dancing, nutrition, birding, numismatics (coin collecting), and workshops on packing suitcases and cooking. Facilitators included college professors, a tai chi expert, a yoga instructor, a nutrition expert, an expert in activities for visually impaired adults who is blind, and a participant who served as co-facilitator. Caregivers completed pre- and post-intervention surveys including the Satisfaction with Life Scale, Living Arrangement and Indicators of Social Interaction survey, EQ-5D, Perceived Change Index (PCI), and Geriatric Depression Scale (GDS). Two focus groups (5–7 participants each) were conducted post-intervention. Quantitative data were analyzed using descriptive statistics in SPSS v27; qualitative data were analyzed using qualitative description methodology with independent coding by three authors.
**Key Results:** Due to the small sample size, inferential statistics were not possible. Descriptive comparisons showed that 21.7% more caregivers reported being satisfied with their life at post-intervention compared to pre-intervention. Other improvements included: feeling of helplessness improved (23.3%), feeling of being overwhelmed improved a lot (11.7%), ability to understand care recipient's behavior improved a lot (10.0%), and having no problems with mobility (16.4%). Some measures remained constant or worsened: feeling full of energy (−10.0%), ability to manage day-to-day caregiving improved a lot (1.7%), having no pain/discomfort (−3.3%), and anxiety or depression (+25.0%). Five major themes emerged from focus group interviews: (1) Time for self (escape from caregiving duties, opportunity for self-care), (2) Barriers (technology challenges with Zoom, time constraints, opportunity costs), (3) Learning opportunities (acquiring skills to manage caregiving challenges, plans to continue using lessons learned), (4) Quality of life (perceived improvement with expectation of continuity beyond the study), and (5) Social support (sense of community, particularly valuable during the COVID-19 pandemic). All participants who began the study completed it with high attendance.
**Clinical Implications:** This pilot study demonstrates the feasibility of a virtual, participant-informed multimodal intervention for unpaid caregivers of older adults with visual impairments. The combination of recreational activities (tai chi, yoga, gardening, music) and practical skill-building (cooking, packing) appeared to address both stress reduction and the specific challenges of caring for someone with vision loss. The qualitative findings highlight that caregivers value dedicated time for themselves, social connection with peers facing similar challenges, and practical strategies they can integrate into daily life. The high retention and engagement suggest that participant choice in activities is important for adherence. However, the small sample size (n=12 caregivers), lack of control group, and technology barriers limit generalizability. Future research with larger samples is needed to determine statistical effectiveness and to separate caregiver and care-recipient experiences. Given that 23% of caregivers for older adults serve those with visual impairments, and these caregivers face disproportionate burden, accessible interventions like this one could fill an important gap in support services.