The White Cane: A Tool for Fall Prevention
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Fear of falling is a significant concern for many older adults, particularly those with low vision, who understandably feel more anxious about tripping or stumbling over curbs. Sadly, this often leads to them staying home, fearing a fall could result in serious injury.
What many don’t realize is that a white cane is an incredible tool for those with some remaining vision, not just for individuals who are totally blind. If someone has some sight but does not always trust their vision, the cane can help detect obstacles and elevation changes and alert others to the fact that the person does not see well.
Orientation and mobility (O&M) specialists can help people find the right mobility aid and provide specialized training on how to travel safely, efficiently, and confidently in their neighborhood and beyond. Here are a few scenarios where using this valuable tool can contribute to peace of mind and help people with blindness or low vision maintain their quality of life.
Detecting Obstacles and Elevation Changes: Meet Mrs. Morimoto
Mrs. Morimoto, a vibrant and upbeat woman in her 60s, lives with glaucoma. Her shrinking field of vision makes her see the world as if looking through a cardboard tube. While she retains significant usable central vision, allowing her to read street signs, admire gardens, and recognize friends on her walks, her “tunnel vision” means she can easily miss objects at her feet or brush against low hedges.
Mrs. Morimoto used to enjoy a brisk walk every morning but now walks very slowly and cautiously. Her back aches from bending over to scan the ground ahead nervously. Sometimes, she’s so focused on the sidewalk that she misses a tree branch at head height. Moreover, her intense concentration on her path keeps her from looking up and enjoying the scenery.
Mrs. Morimoto always thought a white cane was for people with no vision, so she was very surprised when her ophthalmologist said she would be an excellent candidate for one. She began working with an occupational and mobility (O&M) specialist at a local vision center. Over time, Mrs. Morimoto learned to trust the cane to detect obstacles and drop-offs in her path so that she could focus her vision elsewhere.
The O&M specialist also taught her how to scan for traffic at intersections, maximizing her usable vision and keeping her safe. After receiving O&M training, Mrs. Morimoto could, once again, walk upright with her head held high. Her pace increased, and as her posture improved, her back felt better. Once again, she could look around at the scenery. Instead of staring down at the sidewalk, she can smile and wave at the kids running around the schoolyard on her daily walks.
Mr. Alvarez is a 73-year-old active gentleman living with macular degeneration. He enjoys meeting friends at the senior center and singing in the church choir. Living in the city, he has always been able to walk or take public transportation.
With the help of extra lighting and low vision optical devices he purchased from a low-vision clinic, Mr. Alvarez can read mail, pay bills, and remain independent at home. One day he missed a curb and twisted his ankle on the way home from church. He became very anxious about going out, particularly on cloudy days. Mr. Alvarez contacted his eye doctor at the low vision clinic, who put him in touch with an O&M specialist.
Mr. Alvarez learned that macular degeneration often results in loss of contrast sensitivity. In other words, objects in the foreground seem to blend into the background if they are similar colors. For example, someone with macular degeneration would have difficulty seeing the edge of curbs or spotting a gray planter on a concrete patio. Loss of contrast sensitivity is often more pronounced in dim light, so cloudy days, darkened stairwells, or dimly lit restaurants and lobbies are more of a challenge to navigate.
The O&M specialist taught Mr. Alvarez to scan ahead for potential objects or drop-offs in his path and then use his cane to verify what he suspects may be there. If a dark patch appears on the sidewalk as he nears an intersection, he relies on his long white cane to explore, ensuring his eyes remain on traffic and signals.
It can tell him if he needs to avoid a gaping hole, step over a puddle, or walk over a harmless shadow. The cane helps him judge the depth of a curb or determine how big a step he needs to take off the city bus onto the sidewalk. Mr. Alvarez is delighted this valuable tool gives him the freedom to enjoy his favorite activities.
For Identification Purposes: Meet Mrs. Gould
The fashionable 92-year-old Mrs. Gould still loves going to the bustling downtown shopping area with her daughters. Because she has diabetic retinopathy, an O&M specialist trained her family members to be effective guides. Her daughters know not to pull her by the hand but instead offer her an arm to hold onto. Using human guide techniques, they can pass through doorways smoothly, go up and down stairs safely, and help Mrs. Gould into a chair with dignity and grace.
However, Mrs. Gould has recently become more uncomfortable in crowds as her vision has worsened. She worries that baby strollers will knock her over and is very embarrassed when she accidentally bumps into someone. Her O&M specialist introduced her to a white cane used for identification purposes. This “ID cane” is thin, lightweight, foldable, and easy to grasp.
While Mrs. Gould occasionally sweeps it across the floor to check for obstacles, she primarily relies on it to communicate with others she doesn’t see well. People are more likely to get out of her way, and when she does bump into someone, they are quick to offer apologies first.
Mrs. Gould used to worry that her acquaintances would think she was rude or standoffish because she could no longer recognize them on the street. The cane reminds her friends to identify themselves when they greet her. Since she has been using this simple tool, Mrs. Gould is much more relaxed and continues to look forward to her outings.
Consider a White Cane
The long white cane is an essential tool for people who are blind and many with low vision. Please don’t stop going out because you worry about falling! As an Orientation and Mobility Specialist, I have witnessed firsthand how this simple device can restore freedom and independence. Use the APH ConnectCenter’s Directory of Services to find local support and training resources. Discover how a white cane can positively impact your life!
Cane travel when Blind or Low Vision on VisionAware
Orientation and Mobility: Tips for Getting Around when Blind or Low Vision
Acknowledgments
An unfolded long cane photo is a Wikimedia Commons file used in accordance with the Creative Commons Attribution 3.0
An identification cane photo is a Wikimedia Commons file used in accordance with the Creative Commons Attribution 3.0