Universal Design for a Lifetime: Interprofessional Collaboration and the Role of Occupational Therapy AOTA 95th Annual Conference & Expo April 18, 2015 Tracy Van Oss, DHSc, MPH, OTR/L, SCEM, CHES, CAPS [email protected] Amy Wagenfeld, PhD, OTR/L, SCEM, CAPS [email protected] Debra Young, M.Ed., OTR/L, SCEM, ATP, CAPS—EmpowerAbility® LLC [email protected] Network within your community to build partnerships by highlighting the benefits of having an occupational therapy practitioner on the team. A few resources include: • AARP: Give input on areas of home modification, Home Fit program, injury prevention, leisure exploration (e.g., parks), and social participation (e.g., malls). • Area agency on aging: Provide modification suggestions to the physical environment to optimize safety and livability in the home and community. • Centers for Disease Control and Prevention and National Institutes of Health initiatives: Give input on occupational therapy specialty areas, including environmental modification and fall prevention. • Disability agencies (e.g., Parkinson’s) local and state support groups: Suggest modifications to the physical environment to optimize safety and livability in the home. • State grant–funded community wellness programs: Provide input on walkways in the community and fall prevention. • Habitat for Humanity: Suggest modifications to the physical environment to optimize safety and livability in the home. • Healthy People 2020: Work toward meeting national goals in your community that are linked to livability. • Local health departments: Work on current grant-funded health promotion/fall prevention initiatives. • National Association of Home Builders: Suggest modifications, including assistive technology, to the physical environment to optimize safety and livability in the home. • Rebuilding Together: Suggest modifications to the physical environment to optimize safety and livability in the home; become a member of the safety committee or Board of Directors. • Safe Kids Worldwide and local coalitions: Help prevent unintentional injuries in children, including advocacy and environmental modification for safe play. • School-based health centers and community recreation centers: Promote developmental play activities for all ages and abilities, playground safety, and injury prevention. • State occupational therapy associations: Create a new program or link to an existing health promotion or wellness program • State agencies: Promote advocacy efforts; partner with grant initiatives. RESOURCES: Sanders, M. & Van Oss, T., Hussey, B., Eich, A., Kapilow, L., & Santoro, D. (2014) Community-Based, Interprofessional Experiences in Education: Real-Life Learning about Older Adults. Geriatric Special Interest Section Quarterly, 32(2), 1-4. Van Oss, T., St. Rose, C., Bivona, S., Johnson, K., & Najarian, T. (2013). Environmental Modifications to Enhance Pedestrian Children’s Safety at School. AOTA OT Practice, 18(16), 20-22. Van Oss, T., Quinn, D., Bretscher, K. & Viscosi, P. (2013). PHOTOVOICE: Reducing Pedestrian Injuries in Children, WORK, 44(1), 83-93. Van Oss, T., Rivers, M., Heigton, B., Macri, C., & Reid, B. (2012). Bathroom Safety: Environmental Modifications to Enhance Bathing and Aging in Place in the Elderly, AOTA OT Practice, 17(16), 14-16, 19. Wagenfeld, A. & Westley, M. & Young, D. (2014, July 14). Let's all play! Designing universal and inclusive playspaces. AOTA OT Practice, 19(12), 7-11. Waite, Andrew. (2011). Home teams: Practitioners partner with contractors for home modifications. AOTA OT Practice, September 26, 2011, 9-13. Young, D., Van Oss, T., & Wagenfeld, A. (2014, July 28). Universal design for a Lifetime: Interprofessional collaboration and the role of occupational therapy in environmental modifications. AOTA OT Practice, 19(13), CE1-CE8. Young, Debra. (2013, November). Collaboration for successful aging in place outcomes. NAHB CAPS Connection, retrieved from http://www.nahb.org/generic.aspx?genericContentID=219316 Young, D. (2013, March). Universal design and livable communities. Home & Community Health Special Interest Section Quarterly, 20(1), 1-4. Young, D. (2011). Assembling the team: Occupational therapy and the building profession. AOTA OT Practice, September 26, 2011, 11. 7 Principles of Universal Design 1. Equitable Use: the design is useful and marketable to people with diverse abilities. a. Provide the same means of use for all users: identical whenever possible; equivalent when not. b. Avoid segregating or stigmatizing any users. c. Make the design appealing to all users. 2. Flexibility in Use: the design accommodates a wide range of individual preferences and abilities. a. b. c. d. Provide choice in method of use. Accommodates right-or-left handed access and use. Facilitate the user’s accuracy and precision. Provide adaptability to the user’s pace. 3. Simple and Intuitive Use: use of the design is easy to understand regardless of the user’s experience, knowledge, language skills or current concentration level. a. b. c. d. e. Eliminate unnecessary complexity. Be consistent with user expectations and intuition. Accommodate a wide range of literacy and language skills. Arrange information consistent with its importance. Provide effective prompting and feedback during and after task completion. 4. Perceptible Information: the design communicates necessary information effectively to the user, regardless of ambient conditions or the user’s sensory abilities. a. Use different modes (pictorial, verbal, tactile) for redundant presentation of essential information. b. Maximize ‘legibility’ of essential information. c. Differentiate elements in ways that can be described (i.e. make it easy to give instructions or directions). d. Provide compatibility with a variety of techniques or devices used by people with sensory limitations. 5. Tolerance for Error: the design minimizes hazards and the adverse consequences of accidental and unintended actions. a. Arrange elements to minimize hazards and errors: most used elements, most accessible; hazardous elements eliminated, isolated and shielded. b. Provide warnings of hazards or errors. c. Provide fail safe features. d. Discourage unconscious action in tasks that require vigilance. 6. Low Physical Effort: the design can be used efficiently and comfortably and with a minimum of fatigue. a. b. c. d. Allow user to maintain a neutral body position. Use reasonable operating force. Minimize repetitive actions. Minimize sustained physical effort. 7. Size and Space for Approach and Use: Appropriate size and space is provided for approach, reach, manipulation, and use regardless of user’s body size, posture, or mobility. a. b. c. d. Provide a clear line of sight to important elements for any seated or standing user. Make reach to all components comfortable for any seated or standing user. Accommodate variations in hand and grip size. Provide adequate space for the use of assistive devices or personal assistance. (NCSU, Center for Universal Design http://www.ncsu.edu/ncsu/design/cud/pubs_p/docs/poster.pdf ) Table 1. Developments in Disability Rights Legislation and Accessibility Guidelines from 1961 to 1991 1961 ANSI publishes ANSI A117.1, Making Buildings Accessible and Usable by the Physically Handicapped 1968 Congress passes the Architectural Barriers Act (ABA) (P.L. 89-333) 1973 Congress passes the Rehabilitation Act (P.L. 93-112) 1982 U.S. Access Board publishes Minimum Guidelines and Requirements for Accessible Design 1984 Federal ABA rule-making agencies publish Uniform Federal Accessibility Standard 1988 Congress passes Fair Housing Amendment Act (P.L. 100-430) 1990 Congress passes the Americans with Disabilities Act (ADA) (P.L. 101-336) 1991 U.S. Access Board publishes Americans with Disabilities Act Accessibility Guidelines for Buildings and Facilities (U.S. Access Board, n.d.a; U.S. Department of Justice, 2009)