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Inclusion: A Community Life For All (Episode 8)

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In this podcast episode, Bethany Hartropp and Sophie-Anne Scherrer, both Occupational Therapists working with the Disability Programs Specialized Services at the CBHSSJB, talk about inclusion and accessibility. We all have different abilities, sometimes because of age, health conditions or injury. This podcast talks about strategies for staying active and having roles in our family and communities when we or our loved one need extra help to do this.

Download our Inclusion Fact Sheet

References

Bruijn, P., Regeer, B., Cornielje, H., Wolting, R., van Veen, S., & Maharaj, N. (2012). Count me in: Include people with disabilities in development projects – A practical guide for organisations in North and South. Veenendaal: LIGHT FOR THE WORLD. https://www.light-for-the-world.org/sites/lfdw_org/files/download_files/count-me-in-include-people-with-disabilities-in-development-projects.pdf

Centers for Disease Control and Prevention (2020). Disability Inclusion. https://www.cdc.gov/ncbddd/disabilityandhealth/disability-inclusion.html

Goering, S. (2015). Rethinking disability: the social model of disability and chronic disease. Current reviews in musculoskeletal medicine8(2), 134-138.

HCMA Architecture and Design. (2020). Rick Hansen Foundation Accessibility Certification Cost Comparison Feasibility Study. https://www.rickhansen.com/sites/default/files/downloads/20200115-rhfac-final-report-full-v3.pdf

Rohwerder, B. (2015). Disability inclusion: Topic guide. Birmingham, UK: GSDRC, University of Birmingham. https://gsdrc.org/topic-guides/disability-inclusion/barriers-to-disability-inclusion/

Townsend, E. A., & Polatajko, H. J. (2007). Enabling occupation II: advancing an occupational therapy vision for health, well-being & justice through occupation. Ottawa. ACE.

World Health Organization (2002). Towards a common language for Functioning, Disability and Health – ICF. https://web.archive.org/web/20181018004751/http://www.who.int/classifications/icf/en/

World Health Organization (2011). World Report on Disability. https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:36324d3d-b7b9-480e-b06d-cfda0f1e3f5f#pageNum=1

Image

Salvation Army (2020). Be Bold: From Equality to Equity on International Day of the Girl. https://www.salvationarmy.org.nz/BeBold

Resources on accessibility and inclusion

In Eeyou Istchee

CBHSSJB staff can reach out to Disability Programs Specialized Services for support in increasing local accessibility and inclusion.

To place funding request for a project for people under 18 years old in your community, contact the DPSS Jordan’s Principle team.

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This podcast is produced with the support of the Cree Board of Health and Social Services of James Bay and Jordan’s Principle.

 “NISHIIYUU AND ME” by artists from Whapmagoostui and the N’We Jinan project. Permission to use the music was generously provided by David Hodges/N’We Jinan. You can listen to the track on SoudCloud here or buy/stream it on Apple Music .

“Forever” by DJ Arrow. Permission to use the music was generously provided by Jason Swallow. You can listen to the track on SoundCloud here.

Disclaimer

The information provided on this website is for information only and is not a substitute for professional medical advice, assessment and evaluation. We encourage our readers to seek and consult qualified health care professionals for answers to personal medical questions. Read the full disclaimer.

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TRANSCRIPT: Inclusion: A Community Life For All (Episode 8)

Sophie-Anne Scherrer

Waachiyaa. My name is Sophie-Anne Scherrer

Bethany Hartropp

Waachiyaa. My name is Bethany Hartropp.

Sophie-Anne Scherrer

And today we are going to talk about the importance of making sure that everyone is able to participate in the life of their community, the challenges, barriers that they may face in doing that, and a few possible solutions.

Bethany Hartropp

Sophie-Anne, it is so good to be here and discussing this topic of accessibility and inclusion with you. As I know it is very close to both of our hearts.

Sophie-Anne Scherrer

Yes, this is a really important topic. As occupational therapists, our role is to help people do what is important for them in their life. So we work around this topic everyday. People with various health conditions often face more barriers than others when participating in regular activities and working on achieving their life goals. And those barriers are often more related to their environment than to their own personal challenges.

Sophie-Anne Scherrer

Dana Lawlor and myself recorded a podcast episode on disabilities previously, which people can access online. It explains how the environment someone lives in can help or limit, what they can do in their life. Today, we will talk more about the importance of finding ways to help everyone with or without disabilities to participate in the regular activities of their community.

Bethany Hartropp

Sophie-Anne, this makes me think about the story of Sydney. And Sydney she was a woman with a great sense of humour. She loved to spend time with family and friends, and she enjoyed being outside and going to camp. She was born with a condition that meant she had to use a wheelchair. So her home was adapted with a ramp and with equipment for her. But some things remained extremely difficult, so winter was always hard with a wheelchair because wheelchairs do not move easily through snow. And when she was a child, her parents would often carry her. And many places in the community were not accessible, such as school and friend’s homes. When she went to camp, her family brainstormed to make the cabin more accessible for her, and also things like the canoe and ATV so that she could participate in activities that she enjoyed with everyone. Everyone at Camp has roles that fit their abilities and Sydney was no exception to this. She was a very good listener and one of her jobs was to listen to the radio and keep track of what was going on in local camps. Her friends enjoyed her company so they found ways to meet and spend time with her and they would choose places where a wheelchair could go like outside or at her home. Even when she could not do the activity her friends were doing, she would go and hang out with them. And this was really important to her as a teenager and a young woman.

Sophie-Anne Scherrer

So, Bethany, this is a nice story. Sydney, her family and her friends have all made sure that she would take part in the group’s activity. They found creative ways for her to be with her loved ones in different contexts, and they found roles in which she contributed to everyone’s wellbeing.

Bethany Hartropp

Exactly. She told her friends and family what she wanted to do. And then they problem solved together. And this is what inclusion is all about.

Sophie-Anne Scherrer

Awesome. Now that we have seen an example of how inclusion can look like in someone’s life, let’s take a look at a formal definition so we can see how it applies to different situations. The Center for Disease Control says that disability inclusion is about including people with disabilities in everyday activities and encouraging them to have roles similar to their peers who do not have a disability. So basically it means that everyone should be able to take part in the same everyday activities and should be able to take on the same roles whether or not they have difficulties in their body or their mind. And by roles, I mean things that you identify yourself with. Personally, I am a daughter, a sister, a partner. I’m a worker. I’m a friend. Some people can also be students. They can be community members, spouses or parents or anything else. If I had a disability, it would still be important to me to be able to do the things that a daughter, a partner, a worker, a friend do. So to achieve this, we have to offer everyone the support they need to engage in social activities, in using services, moving around the community, having relationships and enjoying other day to day activities.

Inclusion is about understanding what challenges people are facing and making sure everybody has the same opportunities to participate in every aspect of life as much as they wish.

Bethany Hartropp

So what you are talking about is a bit like the difference between equality and equity, Sophie-Anne.

Sophie-Anne Scherrer

Yep. That’s it.

Bethany Hartropp

So what we know is that we cannot give the same support to everyone and expect that they will all succeed in the same way. Some people need more support or different support than others. Just like in this image. So for people who are listening, we have a first picture describing equality where we see three people watching a game over a wooden fence.

A tall person can see without any help. A short girl cannot see over and a person in a wheelchair cannot see at all either. So they were all given a square block of the same height. This is a picture describing equality. All of them have received the same support to try to help them out no matter what their needs were. But this is not helpful to any of them. Too much for the tall person. Not enough for the short girl. And the wheelchair cannot get onto the square block. For everyone to see the game, we need equity and this is the second picture we need to figure out with the people at the game what would work best for them. So the second picture shows the tall person standing on the grass. The short girl on two blocks. And the person in the wheelchair at the top of a ramp. Yay! Now everyone can see if we want everyone to have the ability to participate. We have to think about the help they need. If we give everyone the same help, like on the image of equality, it may be too much help for some people. And it may. It may not be enough help for other people.

Sophie-Anne Scherrer

Yes, totally. So we need to look at the intensity of the help we are giving. So how much help we’re giving. But we also need to be looking at what type of help we’re giving so we can see in the image that the tall person does not need a block to stand on and does not need a ramp.
However, what would happen if we had what we call an invisible disability so difficulties that we don’t see what would happen if, for example, he had trouble understanding the time and showing up to the game on time. Maybe he would need support to remember when to get there or to organize his schedule to be there to attend the game.
He could have trouble understanding what the game is about and may need someone to explain what the game is about to him. So sometimes the difficulties people have are not visible, but they still need help that is adapted to the challenges they face.

Bethany Hartropp

Sophie-Anne, this is a really good point. We often do not know about invisible health conditions unless we are told that they are just as powerful in someone’s life and within the family as a physical health condition. As we mentioned at the beginning of this podcast, often for people who need extra support in their activities, the biggest barriers in participating in the life of their community are related to their environment, and that is a problem everywhere in the world. The World Health Organization has identified the main barriers and I’m going to list some of them, and then we are going to discuss possible ideas to overcome them together. So first, the person does not get enough help and support from others. The second barrier is that the person does not get the right services or adapted equipment. The third is programs. Events and activities have not been planned. Thinking about how to include people with disabilities from the start, fourth barrier is community members may not feel comfortable interacting with people with disabilities and so may avoid it because we’re not sure how to do this. And the fifth barrier is a lack of physical accessibility.

Sophie-Anne Scherrer

Okay. Wow. I know it’s weird to say this, Bethany, right after you named a lot of barriers. But what I’m realizing there is that all the barriers you just named are mainly related to how other people act, the decisions that are made and how the environment is built.

Bethany Hartropp
Yes.

Sophie-Anne Scherrer

So to me, this is great news because it means that we all have the power to change some of it by becoming more curious about people with disabilities and their needs and by finding ways to help them out. Am I right?

Bethany Hartropp

You are right.

Sophie-Anne Scherrer

Huh? Okay, then let’s talk about different ideas to get over these barriers.

Bethany Hartropp

Absolutely. So a few things to consider. Firstly, some of the ideas that we’re about to talk about might already be in place in a community. If not, these are things that could help and that people listening to this podcast could try. Also, things do not have to be big to have a large impact on a person’s quality of life. So the first barrier that we talked about and the second the first one is that the person does not get enough help and support from others. And the second talked about having the right services or adaptive equipment. So to respond to these two, we’re going to talk about them at the same time. The first step is to state what is needed. If you are a person who needs support to participate in your community’s life as much as possible. Speak for yourself and say what you would like. Tell people around you if you want to participate to do an activity, attend an event, have a job, go to school, etc. It is the first step to being included. Speak out with your family and friends, your community organizers, health care providers, the band council. Help others understand what kind of support you need and how you see it being put into place best for you. Ask questions if anything is unclear. You are the specialist of yourself.

Sophie-Anne Scherrer

And for people who are friends or family members of someone with a disability or someone who has different needs for support. Keep in mind that you have an important role to play. Sometimes it’s difficult for the caregiver or for the person to speak, as they may be so busy trying to manage their day to day life with all the barriers that they face, that they may feel too tired to start advocating asking for more support for themselves. So if you know someone in that situation, you may be well placed to advocate for them. Talk to them first, because we sometimes we can assume that we know what someone needs, but we’re not in their shoes. So talk to them and their caregivers, confirm their needs and confirm that they’re okay with you asking for that. And then you can ask for what they need and help your community put in place to support that. With help, you can be part of that solution. And for everyone who are struggling to get the support you or a loved one needs, we know how much having to ask all the time can be frustrating. But change only happens when we continue to fight this battle. You have a very important role to play in this, but it should not all be on your shoulders. So for those of you listening to this podcast, who are in the position to make decisions, we know you receive a lot of requests and have to make hard decisions. So when you receive requests for support like this, please take the time to listen with an open heart and try to put yourself in the shoes of the other person who is facing all those barriers, stopping them to live a full life.

Bethany Hartropp

Okay. So we have just talked about two barriers Sophie-Anne, ideas for getting support from both people and services. And the third barrier we had brought up was accessing programs, events and activities. So if you organize events and activities in your community, having the idea of accessibility and inclusion is a great start. You will be more aware, planned them to be accessible for people with disabilities. So some strategies and tips for this are share the details schedule of the activity beforehand so people can plan. Using pictures can help with this. If you would like ideas on how to, there is information on the Disability Programs website and having the detailed schedule can really help a lot of people. So if there are several activities and an event for example, this may help with people planning which parts they’re going to come to at an event, what they’re going to stay for. So, for example, if there’s a gathering and there is a meal and then some games after and someone is really good at playing the games, but they have a hard time sitting down and eating the meal. Then if they know what the gathering is about, they might skip the meal but come to the games after. If someone in another family is not good with loud noises, then they might come for the meal. and plan for leaving early so that they don’t stay for the games. So having the activity, the event schedule in advance can be very, very useful for people to plan and figure out how they’re going to participate. Having a quiet space like a hallway or just an area available for people to take a break is also very useful. Another strategy is to make sure that the space is set up so that if somebody is in a wheelchair, there is space for the wheelchair to move. Because wheelchairs take up a lot more space. So making sure that the space between tables and chairs for the wheelchair to get in and also to spin around because the wheelchair with the footrests. It takes a lot more a lot more space. Asking for volunteers to accompany people to the event. This could be talking with the person or the family if needed, beforehand to know what the person actually needs.

Sophie-Anne Scherrer

Okay. But Bethany, I have a question for you.

Bethany Hartropp

Mm hmm.

Sophie-Anne Scherrer
When attending community events is challenging for someone, and there needs to be adaptations like the ones you just described. And I know there’s other adaptations, too. You just named a few examples, but there are other things that can be done as well. So when there needs to be those adaptations, wouldn’t it be better to just create a separate event for people with similar challenges, like an event just for people with autism or for people with using wheelchairs, for example?

Bethany Hartropp

Oh, good question. So offering separate programing is necessary and useful in some situations to offer a very safe environment to learn new skills or to give a chance to interact with people who experience similar challenges. However, helping someone with a health condition or who has any type of needs attend a regular community event benefits everyone. The person and the family will get to enjoy some well-needed social time. The community will get to spend time with that person and will get to know them personally as another human being. Rather than only seeing differences and as people outside of the family are more comfortable interacting with the person, that person can have more friends and more social network. The family has more support and the community may see how the person can participate in other events and other gatherings. For example, most communities have groups that are specifically designed for elders, and elders meet at certain times. The group is for them and the activities are designed for them. The elders also attend community gatherings and both benefit from the gatherings and contribute to them for elders to attend. There are sometimes volunteer drivers to get to the location, a ramp, so wheelchairs, extra space between tables, a microphone to help. If people cannot hear properly. These are all simple strategies that help elders participate in the gathering.

Sophie-Anne Scherrer

Yeah, that makes a lot of sense. So just to summarize, to make sure I understood well what you said, making the effort to organize events that anyone can go to will help everyone from community members who can become more comfortable interacting with each other, to caregivers who become less isolated, and to people with different needs who get to live a fuller life. And the solution are often quite simple and don’t cost much. Just like the ones you mentioned, oftentimes we just need a little bit of teamwork and creativity to put them into place. Did I get this right?

Bethany Hartropp

Yes, that’s right. Yeah. So moving on to that fourth area of when community members may not be comfortable interacting with people with disabilities. We may avoid interactions because we’re not sure how to do this. So a few pointers for people. If you are not sure how to interact with someone, ask them or their caregiver what they need to feel comfortable and how they usually communicate. People will usually, often answer this question very easily and very simply, and they’ll be happy to answer this question. And also, the more we are in contact with a variety of people, with different communication systems, the more we become comfortable with our interactions. For more communication tips and strategies. There is information on the disability program’s website. Feel free to look it up for some ideas.

Sophie-Anne Scherrer

Yes. And then moving on to the fifth barrier, which is the lack of physical accessibility. But first, let’s imagine a community where there is all the support and services needed. Community members are comfortable interacting with people who have disabilities and events. Programs and activities include everyone. That seems like the ideal scenario. Right?

Bethany Hartropp

Right.

Sophie-Anne Scherrer

So. Well, what if in this scenario some people are not able to get out of their houses because there are stairs at the front? What if they cannot get around their community because it is too hard to push their wheelchair through snow or sand? What if they cannot stay in an activity for too long because the toilets in the public buildings are not adapted for them? There may be really nice programs in this community, but people would not be able to get to them. That is what physical accessibility is about. So people who take decisions in community could consider the following that it’s it’s quite important to think about building houses, streets and public buildings that are accessible to everyone. We have had the Provincial Accessibility Guidelines in the resources section of this podcast to help with this.

Bethany Hartropp

So, Sophie-Anne, sometimes people ask how many houses should be accessible in a community and what would you answer to that?

Sophie-Anne Scherrer

All of them. Because people visit each other. Making one house accessible means that the person will be stuck at home if the other houses are not accessible. And plus, people develop disabilities not the according to the World Health Organization. Most of us will face disability at one point in our life. It’s sad to say this, but it’s something that we need to deal with. And it’s not necessarily that we’re all going to face something permanent, but we might have a disability for a short moment, a temporary disability, and plus we all grow older. And by growing older, we develop some more difficulties in our body that may make it more difficult for us to get around. I want to share something I read recently with you. I think you’ll appreciate it as well. There’s been research to look at the the cost of building a house that is accessible from the start and it is estimated to cost anywhere from 0 to 2% more than the regular house.

Bethany Hartropp

It’s almost the same price. Oh, my gosh.

Sophie-Anne Scherrer

Yep, it could be the same price. Yeah. Sorry.

Bethany Hartropp

No, I’m just, that is fantastic. It’s that it’s not like super, super, super more expensive. And also, I’m just thinking about the cost of all the adaptations and how much they cost to put in afterwards when a house has been built and then somebody needs those adaptation is made after from a ramp to an adapted bathroom to. Sometimes I’ve had friends where an elevator has been put in a home or like it’s incredibly expensive to put that in after. But to make a home accessible from the beginning and it’s like it’s almost the same price or it is the same price. That’s, that’s fantastic. That’s really good news. And it makes me think, too, of the story we shot at the beginning of Sydney and how she was at home, and she had very few places to go to in her community and how, because they were not accessible from the beginning and how that would have been great for her if she could have gone to friends, homes because they were accessible for their families from the beginning too.

Sophie-Anne Scherrer

So to recap, we just spoke about different ideas to overcome some of the main barriers that people face when trying to participate in the life of their community. These ideas are about asking for and getting enough help services and equipment, thinking of how to include everyone when planning an event, activity or program, getting more comfortable with interacting with people who have different challenges and getting to know them as a person and finally making the entire community accessible to everyone no matter what they need to get around.

Sophie-Anne Scherrer

Now, those ideas help all of us because everyone needs support sometimes and everyone needs to connect with others. Making the life of a community more inclusive and accessible will help everyone have an easier time. Here are a few examples. Someone can be going through a rough time in their life and can be dealing with a lot of anxiety. And that can happen to a lot of us that person may also benefit from any adaptation that helps reduce their stress. Just like some of the adaptations you mentioned earlier, Bethany, if there is a quiet space or the schedule of an event is given in advance, they are more likely to feel good about going to that event. Another example is about accessible housing, streets and buildings.

Sophie-Anne Scherrer

They help everyone from women who are pregnant and have more trouble getting around to parents carrying strollers and to people carrying heavy stuff or moving furniture, having wider door frames, not having stairs, having more space to turn is going to help everyone having a bit of support is also going to help a lot of people.

Bethany Hartropp

Sophie-Anne, it sounds like what you are saying is that the whole world should be accessible and inclusive.

Sophie-Anne Scherrer

Yes, that actually would be a dream scenario and it would be the ideal situation, as everyone benefits from it. This is why we decided to do this podcast on inclusion and accessibility in the first place and why we presented the most common barriers people can face and general suggestions on how to go about these barriers.

Bethany Hartropp

And we cannot cover all situations in one podcast, all the barriers and the solutions, but we are hoping that we have planted a seed about being curious about the needs of people in our community to include everyone as much as possible. So we would like to end with an exercise for everyone who is listening. So we would like everyone.

We would like you to close your eyes and think of a recent community gathering work situation or family event that you were at. Now imagine it in your head. The place, the people and the activities. Was it accessible? Was it inclusive to people with physical health conditions, people in wheelchairs, people using walkers? Was it inclusive and accessible to people with invisible health conditions? And what is one thing that you could do that you could do next time to make it more accessible and inclusive?

Thank you for listening to our podcast.

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