Visual Search Behavior During Toileting in Older Patients During the Action-Planning Stage

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Human-Computer Interaction

Background:

• Visual search is crucial for daily actions like target selection.
• Toileting is a frequent, high-risk activity in rehabilitation, yet visual search during this task is understudied.
• Understanding gaze patterns during toileting can inform rehabilitation strategies.

Purpose of the Study:

• To quantify visual search behavior during the approach phase of toileting in older inpatients.
• To investigate the relationship between gaze patterns and functional independence in toileting.
• To identify visual strategies associated with safe and unsafe toileting in a rehabilitation setting.

Main Methods:

• Twenty geriatric inpatients (≥65 years) in a rehabilitation ward participated.
• Eye tracking (Tobii Pro Glasses 2) recorded gaze behavior from toilet room entry to the toilet bowl.
• Functional independence was assessed using the toilet-Functional Independence Measure (toilet-FIM) at discharge.

Main Results:

• Longer gaze time on the toilet seat correlated with greater toilet-FIM independence (β = 0.446).
• Prolonged gaze towards the toilet rim (β = -0.839) and right handrail (β = -0.621) were linked to lower independence.
• Visual search patterns explained 71.5% of the variance in toilet independence (adjusted R² = 0.715).

Conclusions:

• A seat-oriented gaze suggests effective motor planning for safe toileting.
• Gaze fixation on the toilet rim or handrail may indicate compensatory strategies due to reduced independence.
• These findings enhance understanding of older adults' motor planning and spatial perception during toileting.