Mobility training for the older blind: a common sense approach - Orientation and Mobility for Blind People

American Rehabilitation, Autumn-Winter, 1997 by L. James Witte

The biggest obstacle and older individual who is blind faces in developing independence in general and mobility in particular is not the learning of the necessary skills but the sparsity of rehabilitation services available to this population. This situation frustrates both the individual and the agency involved, as they struggle to meet a need with inadequate resources. Because of this problem, any discussion of mobility training for the older blind must first explore both the needs of this group and the barriers to meeting those needs, before discussing the techniques involved in providing that training.

People over 65 make up from 60 to 70 percent of the blind and severely visually impaired population. This age group is also the fastest growing group. This population needs and can benefit from sound rehabilitation training. Such programs for blind persons of any age are built on the premise that most tasks that need to be accomplished in any walk of life do not require vision. A blind person can participate fully in the community if he or she learns the appropriate alternative techniques of blindness. The validity of this approach has been demonstrated repeatedly as the number of successful blind people who have participated in these programs increases.

Advanced age alone does not negate an individual's ability to learn. In society at large, many senior citizens participate in elder hostels, pursue second careers, or become involved in volunteer work--all of which require the ability to learn. Like their sighted peers, older individuals who are blind can also learn and can benefit from the training of a good rehabilitation program, as evidenced by the competencies developed by those who have already received such training.

The need of the older blind for training in alternative techniques is not being met. The rehabilitation literature has discussed this problem over the past 30 years. However, no solution has been agreed upon. As a result, a large number of older blind people in many locales are simply not getting a "fair shake." Two major barriers preventing this are:

* the federal laws and regulations pertaining to rehabilitation, and

* the amelioration of the condition of the blind on one hand, and an artificial shortage of professional workers in some fields of rehabilitation on the other.

Federal Laws and Regulations

Historically, older blind persons have experienced difficulty in securing training services when such individuals are not pursuing employment. Rehabilitation agencies serving blind people typically administer rehabilitation programs that focus on employment. Some separate state agencies for the blind have offered older blind persons a wide range of services, such as a library, access to aids and devices useful to the blind, radio-reading programs, and perhaps some effort at employment through a home industries program. But these services, valuable as they are, have generally been thought of as more ameliorative than rehabilitative. In addition, there has often been some "bootlegging" of home teaching services, including mobility training, to persons like the older blind whose vocational goal was probably ephemeral. Even then, such home teaching in many states did not include mobility training because of the policy of some agencies to hire only mobility teachers with master's degrees in orientation and mobility (O&M). Because the number of instructors possessing such credentials was small, these states were unable to hire enough mobility instructors to meet the needs of blind people, including those who were older.

In 1978, the Federal Government made some effort to serve the older blind population. Federal funding for what came to be known as "Centers for Independent Living" enables some agencies serving the blind to formalize separate programs for blind people, including the elderly, who are not pursuing vocational goals. Independent living centers initiated by state agencies for the blind take different forms. In some places, individuals come to a central location to receive instruction in a wide range of blindness techniques. In others, the centers send out itinerant teachers to work with blind persons in their communities. In still other instances, agencies contract with others for the provision of rehabilitation services to the older blind. In any case, the development and continuing existence of these centers represents a national recognition of the needs of older blind people and a commitment to meet those needs.

Not all of these centers can offer mobility training, however. Those programs tied to the requirement that only O&M practitioners with a master's degree can provide such training find themselves limited by a shortage of qualified staff. Consequently, the elderly blind get the "leftovers" of such training--if they are lucky enough to get anything at all. Agencies that did not require graduate level training in mobility of its staff did not experience this problem.

There was an additional and unexpected benefit to locating an independent living program within a separate state agency for the blind. Common public attitudes and misconceptions about blindness, when adopted by newly blinded people themselves, can be devastating. Many such persons, at any age, have a tendency to "sell themselves short." Training in the more open-ended approach of independent living can help such persons overcome their lack of self-confidence. Many of these students, including the older blind, have eventually found themselves wanting to expand their goals beyond independent living and were able to easily transfer to the vocational rehabilitation program available in the same agency.