Part 3 · Mind, senses and communication
When the person sees little or nothing
Content under professional review before publication.
1Make the home safe and predictable
The problem
With little sight, the familiar home turns into an obstacle course: furniture that appears suddenly, steps that cannot be seen, rugs to trip on.
What is happening underneath
Low vision is not only blurred sight. Often it is loss of contrast, of side vision, or of the eye adapting to light. A flat floor or a clear glass on a pale table can be almost invisible to the person.
Step by step
- Keep a fixed order: every item always in the same place, and do not move the furniture without telling them.
- Add contrast: a colored plate on a pale cloth, a dark strip on the edge of each step, a light switch that stands out from the wall.
- Mind the light: good, even lighting with no dark patches and no glare. A light left on at night on the way to the bathroom prevents falls.
- Remove tripping hazards: loose rugs, cords, low stools. Leave doors either fully open or fully closed, never halfway.
- Announce changes: if you moved something or there is a new object in the path, tell them and guide their hand to it.
What you must never do
- Never rearrange the furniture without telling them: they learn the home by heart, and a change makes them fall.
- Never leave doors or drawers half open or objects in the middle of the path.
- Never say "it is over there": use clear references, on your right, on the table.
When to ask for help
Sudden vision loss, eye pain, or new flashes or spots is an emergency: seek care at once. For existing low vision, the ophthalmologist and vision-rehabilitation services help make the most of what the person can still see.
2Guiding them when walking
The problem
Taking someone with little sight by the arm and pushing them forward frightens them and throws off their balance. There is a simple, safe way to guide.
What is happening underneath
The person feels safe walking half a step behind you, feeling your movement, not when pushed into a space they cannot see.
Step by step
- Offer your arm: let them hold your elbow with their hand. You walk half a step ahead and your body shows the way.
- Announce what is coming before, not on top of the obstacle: "one step up", "now we go down", "a door on the left".
- At stairs, stop, say whether you go up or down, and let them feel the first step and the handrail with their hand.
- To seat them, place their hand on the back or arm of the chair: with that they orient themselves and sit safely.
- If you must leave them a moment, leave them touching something firm: a wall, a table, a chair.
What you must never do
- Never push them from behind or pull them by the arm.
- Never leave them standing in an open space with nothing to hold.
- Never move their cane or lead them by the cane: it is their point of reference.
When to ask for help
An orientation and mobility instructor can teach them to move safely, with or without a cane. Ask the doctor or the rehabilitation service.
3Communicating and protecting dignity
The problem
People often treat someone who cannot see as if they also could not understand: speaking louder, deciding for them, or talking about them in front of them.
What is happening underneath
Not seeing is not the same as not hearing or not thinking. What protects dignity most is to keep treating them as the capable person they are.
Step by step
- Identify yourself when you enter the room ("hi, it is Ana") and say when you leave, so they do not talk to an empty room.
- Speak in a normal voice and address them directly, not through another person.
- Before touching or helping, say what you are about to do: "I am going to take your arm", "your glass is on your right".
- Describe what helps: where the food is on the plate, like a clock face (meat at 6, potatoes at 12), who came in, what is on the table.
- Keep their things always in the same place and within reach, and tell them if you moved something.
What you must never do
- Never touch them suddenly without warning: it startles them.
- Never talk to them like a child or raise your voice for no reason.
- Never decide or answer for them when they can do it themselves.
When to ask for help
If low vision is isolating or saddening them, tell the doctor. Low-vision services and support groups help a great deal, both the person and the caregiver.
What about the home?
This library is free. iliapp.com is a professional service that assesses the home to make it safer.
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