Three sequential studies investigate the professional practice of the rehabilitation worker in delivering Orientation and Mobility (O&M) training to older visually impaired people. The first study explored through in-depth, face-to-face interviews (n=17) professionals’ views of the relevance of O&M training to visually impaired people. Analysis of the findings suggested that the prevocational training of the rehabilitation worker equipped them with techniques that in the majority of cases required substantial adaptation to meet the needs of their predominant client group (older people). Emerging evidence of a gap between rehabilitation worker training and their practice prompted a second study to establish expert views of what constituted good practice in O&M with older people. Utilising a Delphi method, an expert panel (n=5) produced detailed descriptions of the elements of good practice (family; mobility aids; public transport; assessment; orientation; sighted guide; the individual; road crossing; the public; the senses) that they considered to be essential for effective O&M intervention with older people. This framework provided the structure for the third study which explored – through telephone interviews (n=29) with practising rehabilitation workers – how their experience of practice aligns with the expert view of ‘good practice’. A grounded analysis of the data uncovered how the rehabilitation worker adopts a common sense, pragmatic approach to the application of their practice. Whilst this enables them to draw directly from the expertise of their client, there is a lack of the underpinning knowledge they require to be confident that this practice is effective. Appreciating that the practising rehabilitation worker develops skills and abilities in order to deliver O&M that meets the needs of older visually impaired people, recommendations are made for the development of their pre- and post-vocational training.
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Rehabilitation workers’ perspectives of orientation and mobility training with older visually impaired people