Vision Health Resources
Step by Step: A How-to Manual for Guiding Someone With
Vision Loss
Most people with vision loss are able to travel independently – they
work, shop, do their banking and visit friends just like anyone else. But
there may be times when a sighted guide comes in handy: for example, in
crowded situations like office parties, at street crossings, in unfamiliar
places, or when people who have recently lost their sight are first learning
how to get around.
Whether you are encountering someone with vision loss as a family member or
caregiver, as a staff person in a nursing home or hospital, or even as a
friend or co-worker, this manual will provide the skills and confidence you
need to guide someone comfortably, respectfully, and safely.
Step 1: Introduction
When approaching a person with vision loss, the guide initiates the
greeting. Identify yourself (“Hi Mike, it’s Lucy.” or “Hello there, my name
is John.”) and then ask if assistance is desired. If so, gently touch the
back of the person’s hand with your own as a signal for her to take your
arm. If no assistance is needed, you can simply wish the person a good day
and move on.
Step 2: Basic Sighted Guide Technique
The person with vision loss will take your arm just above the elbow with
her fingers on the inside of your arm and her thumb on the outside – this is
a very natural way for the two of you to be connected. Never take the
person’s arm or hand, or try to push or pull her along. Not only is this
considered rude, it is also a much more difficult method of navigation for
the person you are guiding.
The person may have a preference as to whether she holds your left or right
arm; either way is fine. Usually she will take the lead and indicate which
side she prefers. The person’s grip will typically be firm enough to
maintain contact with you, but relaxed enough to be comfortable.
Hold your arm naturally in a straight, relaxed position at your side. The
person you are guiding stands to your side about half a step behind you. Her
arm will also be relaxed, with the elbow bent at about 90 degrees, and held
close to her body.
Take care not to stand too close together or too far apart: too close feels
uncomfortable and may make you trip over each other. Too far away means you
take up too much space. Walk at a normal pace. The guided person will feel
your motion and follow along comfortably.
When approaching any irregularities in terrain, for example, stepping from a
concrete sidewalk onto grass, let the person know ahead of time.
Step 3: Providing More Support
There may be times where you’ll be guiding somebody who needs a bit more
support. In this case, you’ll want to stay closer together, and the person
may hold your arm a bit more tightly. She may even put an arm through yours
and rest her hand on top of your forearm for maximum stability. In this
case, bend your arm at the elbow, at a 90 degree angle, to provide this
support.
Step 4: Switching Sides
Sometimes you may need to switch sides when opening doors, using
handrails on stairways, or for a change of pace. Here you’ll learn how a
person with vision loss switches from the guide’s left side to the guide’s
right side.
First, the person with vision loss places her left hand on the guide’s arm,
directly above her right hand or “grip hand.” Now she is holding onto the
guide with both hands.
She will let go with her right hand and bring her left hand gently across
the guide’s back until she connects with the guide’s right arm above the
elbow. Now she can take a small step over to the guide’s right side and
resume the normal sighted guide position.
You both might want to practice this technique while standing still – soon
you’ll be able to do it while walking.
Step 5: Narrow Areas
In spaces where it’s awkward to walk side-by-side (narrow pathways,
doorways, and in crowds), you will need to walk almost directly in front of
the person you are guiding.
To get ready for this, move your guiding arm backwards and position it
diagonally behind your back. This signals the narrowness of the space.
The person with vision loss will then straighten her gripping arm and step
directly behind you. Now you’re in single file, one full pace apart. Her arm
will be fully extended to prevent her from stepping on your heels.
When you’re finished negotiating the narrow space, bring your arm back and
resume the normal guiding stance. The person you are guiding will pick up on
this signal and move back into the standard position, one half-pace behind.
Step 6: Going Through Doors
Tell the person with vision loss when you are approaching a door, and
describe it and the direction it opens (the side with the hinge). For
example, you can say something like “We’re approaching a door opening to the
left and toward us. It’s a large wooden door with a doorknob.”
The person with vision loss will switch sides if necessary so that she is on
the same side that the door opens. You are responsible for opening the door
(if it is not already open), but for safety reasons she will take charge
after that. Once she has made hand contact with the door, it is her
responsibility to hold it open until you have both cleared the doorway, and
then to close it if necessary.
If the person you are guiding is unable to control the door (e.g., if the
person is elderly and the door is heavy), you should take responsibility for
holding and closing it.
Step 7: Stairs and Curbs
Tell the person with vision loss when you are both about to climb up or
down stairs or curbs. Approach these squarely – never at an angle – and come
to a full stop before you proceed up or down.
For stairs, the person may need to switch to the side with the handrail. You
should tell her where the handrail is in relation to her body (“There’s a
metal handrail on your left.”). She will then grasp the handrail and locate
the first step by sliding one foot forward until the step is detected.
To begin, you step down (or up) one step, then both of you will proceed
together in rhythm. As the guide, you will always be one step ahead.
Step 8a: Taking a Seat
This technique is used for approaching a seat from the front.
Bring the person with vision loss directly in front of her seat, with her
knees almost touching it. Let her know that she is in front of a seat, and
what type of seat it is (e.g. couch, bench, rocker, office chair with
wheels, etc.). You should also tell her if the chair has arms or any other
unusual features.
The person with vision loss examines the seat with one hand to determine its
characteristics (soft? stable?) and see if there is anything on it. She will
then turn around and sit down.
Step 8b: Taking a Seat at a Table
In this case, you will be approaching a chair from the back.
Place your own hand on the back of the chair, and tell the person you are
guiding that you are at a chair pushed in to a table. She will then move her
gripping hand down your arm until she is touching the back of the chair. At
this point, you should step away. Next, she will locate the table with her
free hand, which helps her judge how far to pull the chair out, and sit
down.
Step 8c: Row Seating
This procedure is used for places such as auditoriums and concert halls.
First, walk in the usual guiding position to the row where the seats are
located. Stop there, let the person know you have arrived at the row, and
maintain the guiding grip. You should lead, so you may need to switch sides
so you can enter the row first.
Now, proceed by side-stepping together along the row – turn your bodies as
needed so as not to step on other patrons! When the person’s vacant seat is
reached, let her know. She will back up until she feels the seat against the
back of her knees, and then sit down.
When it is time to leave, you should stand up first and, if necessary, pass
in front of the person with vision loss to be in a position to lead out. The
person with vision loss will grip your arm, and both of you will side-step
out together until you are in the aisle.
Step 9: Getting into a Car
Most people with vision loss can get into a car on their own if given
proper cues and information.
First, tell the person which direction the vehicle is pointing (“to your
left”), and place the person’s grip hand on the door handle. Guide her other
hand to the roof above the top corner of the door – this is important to
help avoid bumped heads. At this point, she can open the door and get seated
safely in the car on her own.
If more physical assistance or verbal information is needed – for example,
with seatbelts, canes or packages – you can provide this.
Once the person is seated in the car, it is important to clarify who will
close the door – ask before you slam!
Step 10: Going Your Separate Ways
When it comes time to take leave of each other, be sure to tell the
person you are guiding that you are about to go. “Goodbye, Andrea. I’m
heading off now!” will usually do the trick. Make sure she left at a
tangible reference point, such as a wall, facing a particular direction, or
even in the company of other people. Not only is this courteous, but it also
means she will not be left stranded in an open space talking to someone who
has already moved on.
Assisting People with Guide Dogs
As always, first ask the person if she would like some assistance. The
person may want to take your arm, with her dog accompanying both of you. Or,
she may instruct her dog to find and follow you as you walk ahead. Or she
may simply ask for directions and proceed on her own.
If she would like your assistance as a guide, offer your arm by making
contact with the back of her hand as usual. The person may have a preference
about which arm she chooses, depending on how she normally positions her
dog.
If she wants to instruct her dog to follow you, walk a few paces ahead and
provide verbal directions as you go (“we’re going to be taking the next
left”). The person with vision loss will instruct her dog.
If she just needs directions, give them as clearly as possible, using
specifics such as “Turn right at the next corner” rather than saying
something vague such as “stop over there.”
You should never pat a guide dog, unless permission has been given by its
owner.
Assisting People who are Deafblind
Deafblindness is a combination of both hearing and vision loss; it
affects everyone differently. Many individuals who are deafblind have some
hearing and can see a small percentage. Others have no hearing or vision.
People who are deafblind use various methods of communication, for example
visual sign language and tactile (touch) communication methods such as
print-on-palm or two-hand manual. Each person will have a preferred method
of communication, which provides an important source of information about
the outside world. This information helps the person get a sense of where he
is and what is around him – a process known as “orientation.”
When acting as a sighted guide for a deafblind person, follow the usual
sighted guide procedure, but instead of verbally offering your assistance,
you can initiate the greeting by lightly touching the person’s hand or
shoulder. It is important that you maintain contact until your presence is
acknowledged. Otherwise, the deafblind person may think your touch was
accidental.
A deafblind person may respond in a number of ways indicating how he prefers
to communicate. If the person has some degree of hearing, he may respond
with “Who are you?” If this happens, identify yourself and offer assistance.
The person may also use communication cards, large print notes,
print-on-palm, voice, sign language, tactile finger spelling or the two-hand
manual alphabet to communicate. If you don’t know the method that the person
uses, try the print-on-palm method, which is simple to use and understood by
many people who are deafblind. Print large capital letters right into the
palm of the person’s hand with the tip of your index finger, pausing between
words. You can print something like “HI (pause) I AM JIM (pause) NEED HELP?”
As a guide it is very important that you remain aware that the person cannot
hear; he may not hear environmental sounds, a siren, traffic, or even your
voice.
To compensate for the hearing loss, the person will rely on his sense of
touch, and the movements and direction of the guide. At times it may be
necessary to gently place the person’s hand on an object, such as a chair or
railing. Instead of saying, “The railing is on your left,” you may gently
guide or place the person’s hand there.
The universal sign for an emergency is an X on the back. In an emergency,
such as a fire, draw a large X with your finger, covering the person’s
entire back. This should alert him that he should follow you. You are now
his sighted guide and responsible to guide him to safety. Provide a more
detailed explanation if possible as soon as you are both out of danger.
If you are guiding a deafblind person, try not to leave him alone. If it is
necessary to leave for a few minutes, make sure the person knows where he is
and when you will return, and have him wait in a safe area, such as on a
bench.
If you regularly come into contact with a deafblind individual, and would
like to receive more information about the ways people who are deafblind
communicate, please contact CNIB in your community.
Safety Tips:
Keep these guidelines in mind to make navigation easier and safer for
anyone who has vision loss
- Push chairs into a table when vacating them.
- Keep all doors completely open or closed.
- Keep cupboard doors closed.
- Don’t move furniture around in the home or office of a person with
vision loss without informing her first
For further information about sighted guide technique, or about any
aspect of vision loss, contact
CNIB in your community.