Monthly Archives: February 2014

The Importance of Landscaping, Greenery and Green Spaces

For the audio version go to http://youtu.be/T1lt6Ni7fx0  —–

Landscaping is often overlooked when streetscape accessibility is being discussed, but it is an important component of an inclusive environment. In addition to adding to the attractiveness of streetscapes, landscaping can offer shade and improve air quality. Landscaping, such as trees bordering a sidewalk, can provide directional cues to people with visual impairments, as well as act as a safety measure, creating a buffer between pedestrians and automobiles. Grassy areas are essential for people who rely on guide, service, and/or therapy dogs, as the dogs require areas to relieve themselves.

Accessible Streetscape

There are challenges when selecting the appropriate landscaping. The landscaper must ensure that the roots will not become a tripping hazard or affect the stability of the surface. They must consider the growth of the branches or bushes and ensure they don’t interfere with the path of travel. It is important for landscapers to avoid plants or trees with thorns as they can flatten the tires of mobility aids.

Landscaping has also been shown, in multiple studies, to be useful as a tool for people with certain medical issues; two examples are Attention Deficit Disorder and dementia. It has been shown that spending time each day near greenery benefits children with ADD. And, for some, symptoms of ADD can be reduced within green spaces. Likewise, green spaces have been shown to be of benefit for people with dementia. Studies have shown that exposure to environments with greenery can reduce negative and violent behaviour in patients with dementia in long term care facilities. Many long term care facilities are looking to landscaping to help reduce agitation, lessen fear, and increase positive feelings.

In addition to benefiting patients, landscaping has been proven to be of benefit to staff within medical settings; increasing patience, lessening frustration, and improving emotional and mental health. Spending time in green spaces can help to lower heart rates and blood pressure. Studies have shown that landscaping can help with burnout rates for staff as well as for caregivers. Having available landscaping and/or green spaces in medical settings offers a place to relieve stress in a very emotionally intense environment.

Having greenery, green spaces and/or landscaping near schools has been shown to help alleviate mental stress and fatigue. It has been shown to act as a positive distraction, benefitting mental, physical, and emotional health.

As more studies demonstrate the benefits of landscaping, facility designers are taking green spaces more seriously. They are recognizing that landscaping has a proven benefit to built environments, as well as to those who use the facilities.

Relaxing Green Space

Landscaping has an obvious aesthetic appeal, but less obvious is the effect it has on the accessibility of a space. Green spaces are part of creating inclusive communities. Greenery can be beneficial to the physical accessibility of a space as well as to how people respond emotionally and mentally to that space. Human well being is intimately connected with the environment that surrounds us. Ensuring we don’t lose sight of green spaces in urban settings is vital to our health, comfort, happiness and overall quality of life.

Interacting with a Person Who Uses a Wheelchair

For the audio version go to http://youtu.be/c9AhBbY0euA —–

For many people interacting with someone who has a disability can be a stressful and daunting prospect, especially if they have had little or no previous experience. While it is important to utilize the following steps it is also vital that you keep in mind that you are not alone in feeling hesitant during these interactions, so be patient with yourself, give yourself room to learn and to be led, and your interaction will be a success.

The first step is to position yourself directly in front of the person who uses a wheelchair. Don’t stand to the side, as some people in wheelchairs are unable to twist their bodies. Others are able to turn their bodies but doing so causes pain, which can negatively affect their ability to communicate and interact. If there is a seat handy you can sit but there is no need to crouch.

Greet the person as you usually greet people. If you are comfortable doing so shake hands. Some may not have full arms or hands or they may have a prosthetic. If you are comfortable shaking what they have than do so, but don’t do anything you are not comfortable doing. It is also your own choice as to whether or not you wish to lighten your grip. If you are unsure about shaking a person’s hand ask first.

Respect their personal space. Typically personal space is no less than 18 inches (46cm); an arm’s length is an easy way to measure personal space. Mobility aids are an extension of a person’s personal space and one should never touch a mobility aid without first asking for and then receiving permission. Do not lean on a person’s wheelchair or put your hand on any part of the wheelchair or try to move it without first asking for and then receiving permission. People in manual chairs are often moved without people asking for their permission which robs the person of their independence, and it is a violation of their personal space.

Speak in your normal voice directly to the person with whom you are conversing. If there is someone accompanying the person with the wheelchair, and they are a part of the conversation, communicate with them but do not direct your attention or conversation solely to that person. And do not ask that person questions regarding the person with the wheelchair. Assume the person with the wheelchair can speak for themselves unless otherwise told.

If you are unsure about proper terminology ask them for guidance. The same rule applies for assistance. If you are unsure whether they need assistance, ask them.They will best know what they need, and if, or how, you can help.
People with disabilities are often called “courageous”, “inspirational”, “brave”, and/or “special” but steer away from these words. You may be amazed at how people with disabilities have adjusted but using a wheelchair is their reality and most people with disabilities will tell you that they have adjusted to the barriers life has thrown their way, much like you having adjusted to barriers within your own life.

Remember that in all interactions intention rules. There are those who use all the right words and mean it in all the wrong ways, and there are those who say all the wrong words and mean it in all the right ways. It is fairly easy to recognize when people have good intentions, and most people with disabilities understand that people can be nervous or unsure about how to interact so they tend to go by the overall intention of the conversation or interaction. If your intention is good the interaction should be a success.

The Importance of Sidewalk Surfaces

For the audio version go to http://youtu.be/Okfj5IXT6wE —–

Many people walk on sidewalks without giving a thought to the surface, but for people with mobility devices such as wheelchairs, scooters and walkers, or people with wheeled devices like strollers or wheeled grocery bags, sidewalks surfaces are incredibly important to the usability and mobility of their community. Far too many communities focus on the aesthetics of sidewalks and disregard the universal design of the surface.

One way to assess the usability of sidewalks is to look at how many lines, or joints, there are on the sidewalk surface. The more joints in a sidewalk the rougher the ride it is for someone with a mobility device. Every line that a person rides over causes a jolt to the body. When one relies on a mobility device to get around their neighbourhood or community these jolts to the system add up over the day, and can cause considerable discomfort or pain. Sidewalks should have as few joints as possible, with minimal deepness of joints, and be made with a flat, non-slip surface.

Another way to assess usability of a sidewalk is to listen to the noise a mobility aid makes while traveling over it. The noisier the ride the harder it is on the body. Imagine a surface of cobblestones which have a lot of joints and do not connect together with a flush fit. You can hear the inaccessibility as a mobility device bounces around on this surface. If, on the other hand, you listen while someone in a mobility aid travels over sidewalks that have continuous, hard, smooth surfaces you will hear very little noise.

Many communities build streetscapes with aesthetics in mind before usability. This can lead to people with mobility aids bypassing the sidewalk and using the road and/or bike lanes. This is not only extremely dangerous but it is also frustrating to cyclists and drivers who need the space and who worry about injuring pedestrians. There are others with mobility devices who are unable to leave their homes because there are no accessible, safe, comfortable sidewalks. They have the means to transport themselves, via their mobility aid, but the sidewalks are not made with them in mind, which isolates them in their own community.

It is sometimes difficult to explain the importance of accessibility issues to those who have not had first-hand experience but in this case there is a parallel many people without mobility devices will have experienced, which explains why properly made, nod-decorative, and safe sidewalks are necessary. Think of rumble strips. How many of us have been in a vehicle on a highway when the car veers off the main path of travel and onto the rumble strips? These strips cause a quick jolt which grabs the attention of the driver to remind them to get back on course. The jolt that the driver experiences from the rumble strips is very similar to the jolts that people with mobility devices experience on sidewalks. Two big differences being that those with mobility aids are expected to continue to drive on these rumble strips (or sidewalk surfaces) and that they often have bodies more susceptible to pain and/or discomfort. Ask yourself, would you want to drive on rumble strips all the time? Especially if you have issues with pain? The fact is that people with mobility aids are expected to travel over surfaces similar to rumble strips in communities across our province, and it is an expectation that needs to stop.

These are examples of sidewalks that are not ideal.

These are examples of sidewalks that are not ideal.

While decorative surfaces can add to the aesthetic appeal of a community they make the streetscapes less universally accessible. There are, however, ways of incorporating decorative bricks and paving stones without causing accessibility concerns. One way is to place them off the main path of travel. Paving stones and bricks can be used as decoration on the border of the path of travel, which not only adds to the attractiveness of the sidewalk but it also adds to the safety as it creates a buffer zone between the pedestrian and the roadway, and it acts as wayfinding, indicating to people with visual impairments the location of the path of travel.

It is vitally important to create communities where the environment does not disable the person’s ability to participate in their community. Sidewalks are one of the most important parts of universally accessible streetscapes. In addition to mobility devices and strollers it is also important for people with visual impairments, agility issues, and small children. Having a stable, solid, flat, non-slip surface makes the community more open, inviting, and pain-free. With a growing number of older adults and the booming mobility aid market we must make streets that are usable, comfortable, safe and as painless as possible for all types of pedestrians. We must ensure their safety by keeping pedestrians on the sidewalk and off the roads. And we must ensure that those who have transportation, by way of mobility devices, can use them, and not become cut off to the outside world due to a lack of accessible sidewalk surfaces.

These are examples of ideal sidewalks.

These are examples of ideal sidewalks.

Chronic Pain

For the audio version go to http://youtu.be/P2HR6a4KgWQ —–

Sixteen to twenty percent of the Canadian population lives with chronic pain, yet there remains a lot of confusion and misinformation about what chronic pain is and how it affects a person’s life.

Unlike an acute injury, whose onset is sudden and which is typically better within a six month period, chronic pain lasts far longer, sometimes for years or a lifetime. Chronic pain can originate from an injury, an accident, surgery, repetitive movements, an infection, or trauma. For some the origin of their pain has recovered or healed but pain signals are still firing. For others their chronic pain can occur without the person being aware of the originating incident, making it difficult to diagnosis and treat.

Chronic pain affects every facet of a person’s life. It impacts a person’s ability to be a fully functioning, productive part of their community. Chronic pain can affect social lives, careers, recreation, finances, and a sense of self-worth. It can cause problems with sleep, memory, concentration and energy. It can cause depression, anxiety, and a loss of identity. Unfortunately the pain is often made worse by the emotional toll of how the chronic pain has negatively affected one’s life, which traps the person in a cycle from which it is hard to break free.

Many people with chronic pain struggle to maintain their jobs. Some are unable to convince their employers that they need a change in duties, or modifications in their workload or schedule. This forces them to find other employment or go on disability. Others are unable to work at all.

For many people their chronic pain does not have any visible signs. This often leads to people doubting the legitimacy of their pain. The struggle of hearing skepticism and doubt on a constant basis from outer sources, including those within the medical profession, can be frustrating and isolating. In the face of the constant doubt it is incredibly challenging to keep in mind that only you know what your own body feels.

Oftentimes people live with chronic pain for years without getting a diagnosis which can further lead to doubts about the validity of the pain. For many trying to find a diagnosis and a way to control the pain becomes a full-time job. There can be long waits to see specialists and get tests. For many people with chronic pain the revolving door of specialists and tests can last for three years or more before diagnosis. This experience can be a roller coaster of emotions which makes living with chronic pain even harder as it becomes all encompassing. Desperation to return to the life once lived keeps them focused and dedicated to finding a diagnosis and, hopefully, a treatment plan. This dance within the medical system can use up all the remaining reserves of energy a person has when living with chronic pain, sometimes leaving no energy left for family, friends, and the rest of what makes for a well-balanced life.

While we in Canada are fortunate that we are covered by our medical system for many things there are a lot of medically necessary treatments and medications which are not covered. This leads to the high cost of life with chronic pain. The costs of the medications, treatments, and parking at hospitals and medical buildings is often beyond what one can afford, which causes stress that can worsen one’s pain which continues the ongoing cycle. In addition, many have their ability to work, and earn income, negatively affected, if not cut completely. Many people with chronic pain go on disability. This journey through the medical system is often harder to navigate, and more financially draining, for someone with chronic pain who lives outside of the Lower Mainland where many of the doctors and specialists are located. These people have the added costs of transportation and in some cases accommodation for medical appointments. Some have to drive three hours or more for appointments which can be limiting as some with chronic pain can no longer drive or handle that long of a trip. There is an inequality to proper treatment for people with chronic pain depending on where you live in our province.

There has also been enormous cuts over the past few years about what the government covers, and so people are often unable to try treatments because the cost is too high. There are a lot of people with chronic pain who live under the poverty line who have to decide between medications, treatments, housing, food, and transportation costs on a monthly basis. The emotional toll of not having enough money to try something that might get you back on the road to recovery is devastating. Unfortunately on top of these costs we live in a society where people feed off the desperation of those with chronic pain and so there is no shortage of “cures” and “miracles” that cost a pretty penny and very rarely live up to the hype.  Yet people with chronic pain can feel, and be told, that if they don’t try everything they aren’t completely investing in getting better. It takes a while to learn to research, to be discriminating and to not jump at every possible treatment that comes one’s way. When one so very desperately wants to be better it can be hard to pass up anything, even if it has only a tiny chance of working.

We, as Canadians, need to improve our awareness and knowledge about chronic pain. As stated on the website of the Canadian Institute for Relief of Pain and Disability: “The Canadian health system does not adequately support most people with chronic pain. Effective chronic pain management programs, services, and drugs are not always available or accessible to all Canadians. And while guidelines about how best to manage chronic pain have been developed, they are not fully supported by the current health system.” (http://www.cirpd.org/painmanagement/chronicpain/pages/default.aspx)

If you are a person living with chronic pain please know you are not alone. Know that there are others who understand what it is to live with very real pain on a daily basis, and to have it affect every part of your life. Seeking out others with chronic pain can help, there are support groups as well as online communities. It does help to speak to others who, while not sharing your identical experience, share a lot of commonalities with your journey. Speaking with people who live with chronic pain can sometimes relieve stress in that you realize you are not alone or crazy. Sometimes others can help you discover coping mechanisms, stress relief methods, ways to manage your pain and information about the promises of research. It is a hard journey. There is no magic pill or miracle cure that can rid one of chronic pain. There are, however, ways to manage expectations, relieve stress, find support, learn to constructively communicate with, and support, yourself and to understand how to communicate your needs to loved ones.