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White Canes, Buses, Trains and Automobiles: Factors that Limit the Mobility of Older Adults with Vision Loss

Thank you to AFB guest bloggers Neva Fairchild, National Aging and Vision Loss Specialist, and Pris Rogers, Special Advisor on Aging and Vision Loss.

Professionals in the transportation field understand that transportation should be individually customized so that people have a variety of choices to meet different needs. I might take a bus to one place, Uber to the next and occasionally paratransit. Everyone should have these choices and be able to access transportation on their own schedule, not someone else’s. We want a multi-modal system that allows everyone to live and travel where they want…” (AFB Project VISITOR Phase Two Report)

The American Foundation for the Blind (AFB) has identified transportation as a critical barrier to the ability of people who are blind or visually impaired to access the necessities of life—medical services, food, employment, and socialization opportunities. In response to the concerns brought up at listening sessions, conferences and correspondence, AFB recently completed Project VISITOR, consisting of an environmental scan of the available literature plus additional research to inform and provide direction to its advocacy and research work in this arena.[1] Although this research was conducted prior to the outbreak of the coronavirus pandemic, it is clear from AFB’s post-pandemic research that COVID-19 has added exponentially to the transportation concerns that people with vision loss already were experiencing. [2]

AFB’s Project VISITOR research had two phases: 1) a survey of 32 U.S. organizations that provide vision rehabilitation services to identify current promising practices, challenges, and solutions related to transportation for older people with vision loss;[3] and 2) telephone surveys of 81 older adults with low vision who live in urban, urban cluster (populations over 50,000 but less than 250,000) and rural areas.

In the Phase 1 study, some of the identified challenges mirror the challenges facing all older adults, such as a lack of affordable and convenient transportation options in their communities.

Of particular importance to the vision rehabilitation and independent living professionals who participated in the survey is their reported lack of knowledge about the modes of transportation available in the communities they serve. Since these professionals train their clients to use transportation services, not knowing what services are available has the effect of limiting their clients’ transportation options.

Other major concerns identified in the Phase 1 study include:

  • Limited funding for Orientation and Mobility (O&M) services which teach individuals with vision loss to use a long white cane and other skills to travel safely. Nationally, due to lack of trained O&M specialists and to funding for services, older people with vision loss often receive very limited O&M instruction, which impacts their use of available public transportation. (Note: O&M specialists receive graduate degrees in the discipline and are certified by professional organizations. Many states require this certification to hire them).
  • Public transit options that often do not meet the needs of older people, particularly older adults with vision loss who also have other disabilities.
  • A concern that “with the rise of Uber and Lyft, regular bus service and paratransit services may decrease.”

The Phase 2 survey of individuals with vision loss revealed that just under a third of participants in urban and urban cluster areas traveled daily, whereas only 8% of rural participants did so. Forty percent of urban or urban cluster participants reported that lack of transportation prevented them from doing what they needed or wanted to do, while 58% of those from rural communities reported this limitation. However, even in areas where transportation options exist, individual respondents reported that they:

  • Often do not know what options exist.
  • Sometimes lack the foundational skills (e.g., O&M training) needed to travel safely and independently when using these options within their communities; and
  • May have given up using some of the transportation options available because they are either too expensive or too inconvenient.

Barriers to Paratransit Identified by Respondents

Many older adults with vision loss qualify for paratransit services. The barriers experienced by the 81 respondents in the Project VISITOR survey are, in many instances, similar to barriers encountered by other older adults and people with disabilities who rely on paratransit, including:

  • The amount of time required to schedule trips in advance.
  • Lack of available services to meet the demand in the community, especially in rural areas.
  • Lack of affordable transportation alternatives.
  • Lack of flexibility (e.g., hours and days of operation).
  • The need to reach destinations outside the geographic area served by a local program.
  • The amount of time spent in a vehicle that is picking up and dropping off others.
  • The cost, access to and/or knowledge of how to use a smartphone.

Transportation Challenges Unique to People with Vision Loss

Survey respondents with vision loss also experienced a number of unique challenges, such as:

  • How do you know when your vehicle/driver arrives for pick-up?
  • How can you know that the vehicle has reached your destination?
  • Once you exit the vehicle, how will you locate the entrance of the office/store at your destination?
  • Can you get sighted assistance from drivers of rideshare services, for example, to ensure that you are at the right entrance to the shop or office where you are going?
  • Safety concerns about using rideshare or volunteer ride programs

Implications for Older Adults with Vision Loss

For people losing vision later in life, lack of vision rehabilitation services, especially orientation and mobility (O&M) training, can lead to increased risk of falls and lack of confidence to travel independently. Not knowing what transportation services are available, lack of knowledge of how to use those options and fear of traveling with vision loss can exacerbate the problem, leading to social isolation and depression.

It is clear from AFB’s efforts to shine a light on the transportation experiences of older adults with vision loss that much work remains to be done to create flexible transportation solutions that meet their needs, particularly for those who are new to vision loss, individuals who have not received specialized training in living with vision loss, and those who live in rural areas. The barriers to transportation mobility run the gamut from systemic issues such as no service in the community, to individual challenges such as lack of knowledge of transportation options and income constraints, to transportation providers’ lack of understanding and knowledge of the specialized needs of older people with vision loss. The American Foundation for the Blind offers a number of resources (listed below and at to help fill gaps in your knowledge. Please remember that inclusion of older people with vision loss in your planning and advocacy efforts will be of great benefit when tailoring appropriate transportation options.

For additional information:

White Paper on Improving Transportation Systems for People with Vision Loss

Project VISITOR Phase One Report

Project VISITOR Phase Two Report

Flattening Inaccessibility-Part 1 and Flattening Inaccessibility-Part 2: NADTC Blog Posts


[1] AFB’s Project VISITOR research was supported by Volkswagen Group of America, Inc., Mobility-as-a-Service Team, Engineering and Innovation Center California.
[2] See blog posts, Flattening Inaccessibility, Parts 1 and 2, on the NADTC website.
[3] Independent Living for Older Individuals who are Blind (OIB) programs are operated by state rehabilitation agencies and funded by the Rehabilitation Services Administration, Office of Special Education and Rehabilitation Services, U.S. Department of Education.

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