A report, Home Cure, published earlier this year by the think tank Demos, amongst other things, called for a more holistic and long-term approach to reablement services so that people are supported, not just to manage in their own homes, but also to engage with the community.
Engaging with the community – shopping, meeting with friends, using leisure facilities, taking part in activities, using public transport, simply getting out for a breath of fresh air – is one of the biggest challenges deafblind people face. Services that address that challenge are a must if deafblind people’s quality of life is to improve.
One solution is for deafblind people to have one-to-one support from a communicator-guide. That’s not what reablement is about – it’s about people developing ways to manage without support from another person. It’s about acquiring skills to find our way, stay safe, detect what’s happening around us, communicate with the general public and cope with all of the things that can happen when we’re out and about. It’s what has, more traditionally, been called orientation and mobility training.
Reablement services are typically provided for just six weeks. I know of many deafblind people who have had one orientation and mobility training session a week for just six weeks. They learnt the motor skills of how to move a long cane and have learnt one or two routes but are unable to get out and about. They did not have the time to develop the cognitive skills, such as problem solving if they veer off course, have to deviate from the route they learnt or want to find their way to a different location, or simply interpreting the tactual information coming through the cane. They have not had time to develop ways of communicating with the general public, transport staff or of soliciting ad-hoc assistance or of handling inappropriate attempts to help. And perhaps most importantly, they have not had time to develop a belief and confidence that they can get out and about without support from another person. Once the six weeks was up, that was it and they have been left unable to get out and about by themselves.
The barriers to deafblind people engaging with the community are complex and different for each person. For many deafblind people there will always be a need for support from communicator-guides or intervenors. However, with the right training, training that enables them to develop all of the motor and cognitive skills and the confidence they need, more deafblind people would be able to get out and about by themselves more of the time. That training has to be for a long enough period of time and to be provided by people who understand the complex barriers faced by, and the complex skills needed by, deafblind people.
Liz Ball is the Campaigns Involvement Officer at Sense