Accessibility/Disability At BMC

Accessibility/Disability At BMC

Kate Walsh, BA, MPH, President and CEO of Boston Medical Center (BMC). BMC is a private, not-for-profit, 626-bed, academic medical center with a community-based focus. Ensuring accessibility for all is central to BMC's commitment to Exceptional Care without Exception. Each of us at BMC has a role to play in making sure BMC meets its access goals, and this teaching tool is one of many we will use to give us the skills and knowledge we need to do our best.

Disability Course Contents WHAT DOES DISABILITY MEAN? Defining Disability American Disability Act (ADA) Some Types of Disabilities Resources at BMC Equipment

An Individual with a Disability is a Person Who: 1 Has a physical or mental impairment that substantially limits one or more major life activities (i.e., caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning or working) A physical or mental impairment means: (1) any physiological disorder, or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genito-urinary, hemic and lymphatic, skin, and endocrine; (2) any mental or psychological disorder, such as intellectual disability, organic brain syndrome, emotional or mental illness, and specific learning disabilities. There are many other disabilities not listed here but identified by the US Department of Health and Human Services 1. http://www.eeoc.gov/policy/docs/qanda_adaaa_nprm.html.

AMERICANS WITH DISABILITIES ACT (ADA) IN SUMMARY The Americans with Disabilities Act of 1990 (ADA) prohibits discrimination against individuals with disabilities in every day activities, including medical services. The ADA mandates equal access to medical care services and the facilities where the services are provided.

Disabilities affect Americans of all walks of life Quick Facts: There are 56.7 million people who have at least one disability in 2010, about 19 percent of the total U.S. population. This is nearly 1 in 5 people. Those with vision difficulties number 8.1 million, 7.6 million experienced hearing difficulty, while 30.6 million have problems walking or climbing stairs or used a wheelchair, cane, crutches or walker. Another 15.2 million have difficulty with some kind of cognitive, mental or emotional functioning. http://www.disabled-world.com/disability/statistics/american-disability.php http://www.census.gov/newsroom/releases/archives/miscellaneous/cb12-134.html

DO S & DON TS when you meet a person with a disability The terminology associated with disabilities often changes as words and phrases take on negative connotations. Here are some examples of old phrases that have become unacceptable and their newer, more positive as well as other commonly used phrases. TIP: Use people-first language Put the person first. A person with.. Some people prefer identify-first language ie: Deaf person Ask the person: It is important to respect the person s preferences Unacceptable Victim of Confined to person Normal Slow, simple Crippled Insane, crazy Dumb, mute Retarded Sightless Acceptable Person with Uses Person who has Able-bodied, Non-disabled Cognitively Disabled Mobility-Impaired Emotionally Disabled Speech Impaired Person with intellectual disabilities Blind

PEOPLE WHO USE WHEELCHAIRS When offering assistance to a person who uses a wheelchair, ask first if they would like assistance and then follow the person s instructions, when possible. A wheelchair is part of an individual's personal space. Respect that space. It is not polite to touch or lean on a wheelchair without the user's permission. People are not "wheelchair-bound" or "confined to a wheelchair." Wheelchairs are a source of freedom and mobility for people who can't walk or have difficulty with movement or endurance. Wheelchairs help people get where they need to go and do what they need to do. If a person transfers from a wheelchair to a car, barstool, bathtub, toilet, bed, mat, etc., be sure not to move the chair beyond easy reach. Always make sure that a chair is locked before helping a person transfer. When conversing at length with a person in a wheelchair, sit or place yourself at that person's eye level.

PEOPLE WITH VISUAL IMPAIRMENTS There are many degrees of visual impairment. In fact, few people are totally blind. White canes with red tips are used both by people who have low vision and those who are totally blind. If you think someone needs help, ask first by saying something such as, "Would you like assistance?" Follow the person s instructions. They usually know what works best for them. When meeting a person with a vision impairment, announce yourself and introduce anyone else who may be with you or who may later join your group If requested, offer your arm as a guide (don't take the person's arm) and inform the person of obstacles such as curbs, steps or low arches. When offering a seat, place the person's hand on the back or arm of the chair.

PEOPLE WHO HAVE SERVICE ANIMALS Patients and visitors have the right to bring a service animal onto the BMC campus and into BMC buildings People who have visual, hearing or mobility impairments, may use a service animal such as a dog, cat or monkey. Don't pet or speak to a person's service animal. They are at work, even when sleeping under chairs or awaiting commands. If they are distracted they cannot do their job. Never feed a service animal.

People who are Deaf or Hard of Hearing There are many types of hidden disabilities and having a hearing impairment is one of them. There are different types and degrees of hearing loss; many people with hearing impairments are not totally deaf. Respect individual preferences and ask the person what kind of hearing accommodations they need. Communicating with those who have been deaf or hearing impaired since birth may be difficult and may require sign language or other gestures. People can lose their hearing after they've learned to speak. Those who are late deafened (deafness occurring late in life) may speak but sign language may be needed for comprehension.

People who are Deaf or Hard of Hearing Hearing aids do not restore hearing. They are usually only partially effective with certain tones and decibel levels To get someone's attention, touch that person lightly, wave or use another physical sign. Don't be embarrassed to rely on written notes. They can promote effective communication. However, many older individuals who have been deaf since birth, may not be able to read written language. Lip reading is another form of communication that some people use. Patients have a right to an interpreter. Certified American Sign Language (ASL) interpreters can be scheduled through the Interpreter Services Department at BMC. These interpreters specialize in medical settings. Do not rely on family members for interpreting.

PEOPLE WITH SPEECH IMPAIRMENTS Speech disabilities run the gamut from slight lisps to total speech loss. Be patient when a person with a speech impairment is speaking. Don't finish a person's sentence - although it's okay to rephrase a person's words to be sure you understand. Most people with speech impairments can communicate but doing so usually requires mutual effort. Different types of communication devices can be used to facilitate comprehension. Communication devices include alphabet boards, phrase cards, electronic voice box (electrolarynx), computer speech devices and voice output devices.

PEOPLE WITH SPEECH IMPAIRMENTS While there is much research in the field, most alternative speech technology is not yet on the market or is not appropriate for certain users. If you have difficulty understanding someone's speech, don't be afraid to ask for multiple repeats. Never pretend to understand when you don't. Don't be embarrassed to rely on written notes. Most people with speech impairments can hear. Loud or simple words aren't easier to understand.

CALL SYSTEMS COMMUNICATION DEVICES Different types of call light systems are available for patients with functional limitations. The sip and puff call light looks like a straw and is used by patients with tetraplegia (also called quadriplegia). When the client blows through the straw it activates the call system. Sip and Puff Another call light available is a pad style device that is initiated by applying direct pressure onto the top portion of it. A third call system device is a small bulb style device (press call cord) that is also activated by applying direct pressure to the soft cushion bulb. There are many other devices that the patient may have used at home which they may bring into the hospital with them. Pad Call Cord Pad Call Cord

People with Intellectual Disabilities Intellectual disabilities are often confused with mental illness, which accounts for most of the misunderstanding that surrounds this disability. People with intellectual disabilities are able to read, write, drive, think and lead productive, independent lives. When communicating, be respectful with all persons at different levels of intellectual disability.

People with Mental Illness Mental disorders are among the most common causes of disability. Mental illnesses are medical conditions that disrupt a person s thinking, feeling, mood, ability to relate to others, and daily functioning. Mental illnesses often result in a diminished capacity for coping with the ordinary demands of life and a decreased ability to participate in healthpromoting behaviors. According to the National Institute of Mental Health (NIMH), in any given year, an estimated 13 million American adults (approximately 1 in 17) have a seriously debilitating mental illness. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms and manage symptoms by actively participating in an individual treatment plan.

Resources at BMC BMC has an Accessibility website located under the Departments tab ADA resources and links, disability awareness, parking access, and other information is located here

BMC Contact Staff Chris Andry, MPhil, PhD Executive Director for Cancer Care Service Vice Chair for Operations & Management Associate Professor Department of Pathology & Laboratory Medicine Associate Professor Department of Family Medicine 670 Albany Street, 4 th floor room 413 Boston MA 02118 617-414-5292 Pager 617-638-5795 code 1027 Sheryl Katzanek Director, Patient Advocate Program Yawkey Building, Mezzanine, room15 617-414-1778 Pager 617-638-5795 pager # 7178

ADA Access and Equipment at BMC

Some Examples of Handicap Access and Parking

Specialty Nurse Call Systems Specialty nurse call systems are distributed by Transport/Equipment. Three types are available: Breathe Call Cords (sip/puff), Pad Call Cords (pillow), Press Call Cord (bulb). Pad Call Cords Breathe Call Cords (sip/puff) Press Call Cords

Resources for Patients and Staff Deaf and Hard of Hearing Language Interpreter Phones at each bedside and specified locations throughout BMC. Individual volume controls for each handset (patients and providers) can be helpful for some hard of hearing patients. Telecommunications Devices TTY device, cell phones for texting/emailing, amplified telephones and volume amplifying head phone device (pocket talkers) are available upon request. American Sign Language (ASL) interpreters can be requested. Video interpreting devices (MARTTI - My Accessible Real-Time Trusted Interpreter ) for communicating in American Sign Language (ASL) are available in areas of the ED, pre-op, some inpatient and outpatient and are available upon request.

Resources for Patients and Staff Requesting Deaf and Hard of Hearing Resources Contact the Interpreter Services Department: Monday-Friday 8:30 A.M. 5 P.M. at X 4-5549. After hours, weekends and holidays: Contact the Operator Services Department at X 8-5788 who will page the supervisor on-call for assistance Visually Impaired Telephones with Braille Keys are available in all patient areas. Braille version of Patient Rights and Responsibilities is available through interpreter services

Phones with Wheelchair Access

Phones with TTY (TeleTypewriter) access TTY access

Standup handbar weigh scale Wheelchair Weigh Scale

Exam table adjusts high/low for wheelchair

Bariatric wheelchair Bariatric Chair

Transfers using Slide Board Slide Board for transfers

Ceiling Lift Therapeutic Bed Mobile Lift

Disability Awareness For more healthcare stories you can go to this link: http://www.dredf.org/healthcare-stories/

Bibliography AMERICANS WITH DISABILITIES ACT (ADA) IN SUMMARY United States Equal Employment Opportunity Commission (EEOC) and "The Positive Workplace," internet address: http://www.thebody.com/pos-work/ada.htn-d WORLD HEALTH ORGANIZATION International Classification of Functioning, Disability and Health (ICF) May, 2001 http://www.who.int/classifications/icf/en/ DISABILITY - MYTHS AND MISCONCEPTIONS The Commonwealth of Massachusetts, Massachusetts Rehabilitation Commission 10 DO'S AND DON'TS WHEN YOU MEET A DISABLED PERSON Provided by the Massachusetts Office on Disability TERMINOLOGY ASSOCIATED WITH DISABILITIES The Commonwealth of Massachusetts, Massachusetts Rehabilitation Commission and "Straight Talk About Disability: A Guide to Basic Understanding and Common Courtesy," Rehabilitation Institute of Chicago MENTAL HEALTH AND MENTAL DISORDERS US Department of Health and Human Services, Healthy People 2020 http://www.eeoc.gov/policy/docs/902cm.html#902.1 http://www.unitedspinal.org/disability-publications-resources/disability-publications/ http://www.123rf.com/search.php?start=0&word=disability&itemsperpage=100&searchopts= http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=28