This is the first of the three interviews announced in January. .
This week, how a compassionate and caring rehab teacher works with clients who are often stunned by their loss of good sight. He is asking his clients to use a white and red cane and go out into traffic! How can he help us and our families find the trust?
Next week March 17, Bob mcgillivray a long established Low Vision specialist discusses the newest developments in magnifiers, video magnifiers, telescopes and more.
March 24, Vicki Vogt, Reader Advisor at the Perkins Talking Book Library gives details of access to TV listings, described TV shows and movies , and a new accessible menu from Comcast.
Joe Kolb trains clients with vision loss in getting around; and young mobility professionals in the art and psychology of helping them. He has been doing it for more than thirty years.
The interview and observation of a new client
Hannah Fairbairn (HF): How do you start the teaching process?
Joe Kolb (JK): I start with an interview. In the course of asking questions I can understand what their needs are, but they may not understand themselves, because they are so new to it all. I take the interview and my assessment, and the next time I say:
“Based on talking to you and observing you, these are the things I recommend.” Then they make the decisions. It is very important that the client makes his or her own decision.
HF: When I lost nearly all my sight, and a mobility teacher came to train me, I was not very invested in the training. I was in a state of denial.
JK Well Hannah my sense is that you might not be ready for the cane. I want to have a call from you after you have used the cane 3 times. If you would like to be able to get out on your own. You just have to use it!
HF: So the client has to initiate the phone call.
Having a white cane in your hand
JK: Probably the most difficult thing for many people is the thought of using the white cane. Just having it in your hand in that first session! So I say:
Let me ask you a question. It is a question that people sometimes find very hard to think about
How do you feel about using a white cane with red markings? I like the people who are very frank. They say immediately, “There is no way!” Then I say: “Perhaps this is not a good time for you. Just know that you are increasing your risk of accident and injury, such as tripping on a tree root, missing a curb, or bumping into someone.”
HF: Do clients often want to get you involved in training the family??
JK: All the time, the family is adjusting as well, and some of them do not adjust well. Part of my job is to persuade, and search for the middle ground between the client and the family. It can be very tricky. As the instructor I often have to bring the expectations down, because unspoken expectations can be the breeding ground of resentment. You have to get a sense of where the family and the client are, and where they need to be. It takes diplomacy.
HF: When we are new to vision loss, we are often very confused. We hardly know ourselves any more.
JK: That’s where the art comes in! Trying to get across a sense of what is reasonable. Is it reasonable to expect your wife to drive you everywhere. No! She is getting worn out. It is affecting your relationship. The resentment and the tensions can be so great!
Little ways of saying things
As the instructor you have to have an appreciation of the dynamics and the probable thought processes of the client and his family. You have to find little ways of saying things that might help them move in a different direction. This is the soft skills in being a teacher. It is how you work it that makes the difference. Somehow you have to build up a cheery trusting relationship that gets past the denial.
The great marble block of fear
JK: Part of what is going on here is dealing with fear. Think of fear as being a solid block of marble. What you are doing as the instructor is chipping away day by day like a sculptor. You are chipping away the fear.
Confidence is the Mobility Cocaine
Tools in your tool box
JK: after the person has learned some mobility skills, I say, “You are going down a road that is marked by surprises. But now you have tools in your toolbox.”
HF: So what is the most important tool?
JK: Confidence is the mobility drug, the mobility cocaine! Even the decision to go out the door takes confidence.
HF: I remember standing in the hallway fighting down panic. Even the front steps seemed like a cliff.
JK: The confidence of the instructor is definitely transferable to the client, so the instructor needs a very calm confident manner. When it is the right time I say, “Okay I have been watching you. I think you are ready to have me walk on the other side of the street.”
HF: The training wheels are coming off!
JK: It is all about the sequencing of the instruction. You gradually hand over the initiative.
How long is mobility training
HF: How long does it take for someone, say a senior to be trained?
JK: It depends how often the instructor can get there. If I can see the person every week, it might be a couple of months on average. Not of course during the winter, we are not doing much outside yet.
It is easy to misjudge your skill level
HF: Training must vary too with how the person is adjusting to his loss of sight?
JK: Some people overstate their abilities and try to do things they are not trained for. They do not know where their skill level ends and where the instructor or family is providing information.
HF: I remember the shock when I realized that my husband had given me a lot of audio commentary. I was not really independent much of the time, and I was so scared to ask for assistance
Asking for assistance on the street
JK: People who are introverted, quiet and passive find this so hard. I say, “Put yourself in the middle of the sidewalk with your body blocking the way. Open your mouth and ask!” It is a big hurdle.
JK: When in doubt do not do it! There are always intersections that are bigger and trickier than your skill level. At a distance hearing cannot provide the certainty of vision. Even the weather, the sounds of rain or wet streets can mush with traffic noise.
Training someone who has no vision
HF: Do you think differently when you have a person with no functional vision?
JK: If the person has no vision, and his cane skills are not at a certain level, he is going to get hurt! Even with perfect cane skills he may get hurt from head level obstructions. For a younger person my job is to make sure that I take her cane skills to as high a level as possible. She has to know when she has come to her limit.
The story that keeps Joe working
HF: In all your years of experience what is one story that inspires you to keep working?
JK I had a client called Betsy with some remaining vision. She was in her thirties and had dropped out of school some years before. She was struggling with being a visually impaired person carrying a red and white cane.
For her final exam she decided to travel by herself to Neiman Marcus in downtown Boston. She did a fabulous job. She and I were giddy with her success.
Then she suddenly said, “I can’t go in there. I am afraid of what people will think!”
So I said, “DO you mean to tell me that for the past four months you have worked tooth and nail learning everything. You have done all that work and now you are scared to go in. Is that what you are telling me?”
Then I said, “If you cannot do it for yourself, do it for your instructor.” So she goes in, makes a quick purchase at the cosmetics counter and comes out again. The next week she goes off into life.
A couple of years later I get a letter. She is at the University of Wisconsin, participating in all these support groups and about to graduate.
She said, “I realized that I did not have to be afraid of what people thought of me.”
For more information about Joe’s career and achievements,