Ernesto Morales

Making rural and remote communities more age-friendly: experts' perspectives on issues, challenges, and priorities.

With the growing interest worldwide in making communities more age-friendly, it is becoming increasingly important to understand the factors that help or hinder communities in attaining this goal. In this article, we focus on rural and remote communities and present perspectives of 42 experts in the areas of aging, rural and remote issues, and policy who participated in a consensus conference on age-friendly rural and remote communities. Discussions highlighted that strengths in rural and remote communities, such as easy access to local leaders and existing partnerships, can help to further age-friendly goals; however, addressing major challenges, such as lack of infrastructure and limited availability of social and health services, requires regional or national government buy-in and funding opportunities. Age-friendly work in rural and remote communities is, therefore, ideally embedded in larger age-friendly initiatives and supported by regional or national policies, programs, and funding sources.

The experiences of participating in winter among youths with a physical disability compared with their typically developing peers

BACKGROUND Having a physical disability and using a wheelchair can create difficulties in navigating the physical and built environment, especially during winter when snow and ice become problematic. Little is known about the experiences of winter among youth who use an assistive mobility device. This study aimed to understand how youth with a physical disability experience winter, compared with typically developing peers. METHODS A purposive sample of 25 youths (13 with a physical disability; 12 typically developing) completed a 2-week weather journal and photographs in two Canadian cities during winter. These data were used to guide semi-structured interviews with participants. RESULTS Youths with disabilities experienced many similar challenges in winter, such as health and safety concerns and accessibility issues, compared with typically developing youth - but to a greater extent. Youths with disabilities reported more challenges going outdoors during winter and negative psychosocial impacts, including loneliness and increased dependence, compared with peers without a disability. They also, however, described developing several adaptive strategies to cope with these challenges. CONCLUSIONS There is a strong need to remove physical and environmental barriers to facilitate the participation and inclusion of youth with disabilities in winter.

Which Areas of the Home Pose Most Difficulties for Adults with Motor Disabilities

ABSTRACT The objective of this research was to determine the most difficult areas of the home for adults with motor disabilities. Descriptive analyses were developed using the database (n = 66) of the Home Assessment of Environment Interaction instrument in the cities of Quebec and Montreal and their suburbs. Despite the general belief that the bathroom is the most difficult space, the results showed the entrance to a home to be the most difficult area, followed by exterior components (mailbox, car, garbage cans). This paper highlights the significant problems that modern homes in this region of Canada present for adults with motor disabilities.

Using a Co-Design Methodology for Research on Environmental Gerontology

Environmental gerontology has addressed the description, explanation, and modification or optimization of the relationship between seniors and their environment [1-3]. In all likelihood it seems imperative to have a serious understanding of this relationship and yet, imagining other people’s experiences (seniors, children or adults) is one of the most difficult tasks one can undertake. This is probably why, in the past few decades, a few designers have moved closer to the needs and aspirations of future users [4]. In the 1970s in Norway, Sweden and Denmark, a “Collective Resources Approach” (CRA) was born as a result of trying to increase the value of industrial production. The CRA attempted to empower trade unions and workers at the local level by exploiting the needs of the highly integrated Scandinavian economies to constantly improve their technology using the workers experience to do so [5]. This “democratization of design,” as some authors call it [6], considered the workers (users) of the machinery as “experts,” who provided significant input into the design procedure. This idea of including users in the process of designing an object was soon adopted as a marketing strategy for product development and enjoyed significant success [7].

Disability, Rehabilitation Research and Post-Cartesian Embodied Ontologies – Has the Research Paradigm Changed?

Abstract Purpose Since the mid-1990s, the social model of disability has come under scrutiny. Several researchers have examined the role of ontology (philosophical ideas about the nature of what it means to be human) in relation to disability. In this paper, we situate this burgeoning understanding of disability within the set of post-cartesian ontologies, which disrupt the separation of the mind from the body and its attendant dichotomies. Furthermore, we seek to show how such a change can carry through to the research paradigm and therefore affect tangible outcomes of disability research. Design/methodology/approach A commitment to an embodied ontology requires first and foremost that researchers rethink what is being studied by focusing on the diverse characteristics of being and its actualization within the world. This will involve an emphasis on the lived experience of the body, including issues of affect, identity and movement, as well as broader issues of embodied being. Findings Using a research program currently underway at the Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) as a detailed example, we draw on the ontological framework to help articulate the way research can be re-organized. We show how projects at different scales can be brought to work together, and highlight how a focus on embodiment issues facilitates such multi-disciplinary, inter-project collaboration. We note that adopting such an ontology-based framework will accomplish three major outcomes: (1) increase the relevance and effectiveness of new projects with regard to the overall vision; (2) enhance cross-project synergies and ensure stronger ties between research and practice; and (3) contribute to shifting the underlying ontology from a more cartesian approach to a post-cartesian embodied perspective. Originality/value The new ontologies embrace, integrate and extend the earlier social and biomedical perspectives, and offer a critical perspective on technology. The embodied approach recognizes not only the embodiment of research subjects, but also the embodied experience of the researchers themselves. In addition, the approach leads to a more holistic organization of research within a global, interconnected structure of projects rather than simply a collection of separate projects organized into thematic areas, as was done in previous decades. This reorganization of research enhances the ability to engage academic researchers with practitioners not just in the hospital and clinical settings, but also within the wider community.

Mapping review of accessible pedestrian infrastructures for individuals with physical disabilities

Abstract Background: Due to the ageing population and higher prevalence of individuals living with physical disabilities, there is a critical need for inclusive practices when designing accessible pedestrian infrastructures for ensuring social participation and equal opportunities. Purpose: Summarize the physical characteristics of current pedestrian infrastructure design for individuals with physical disabilities (IPD – motor, visual and hearing) found in the scientific literature and assess its quality. Materials and methods: A mapping review of the existing literature on pedestrian infrastructures specifically built for individuals with physical disabilities identifying measurable physical characteristics for their design was done using online databases (Urban Studies Abstracts, Geobase, PubMed, and Cairn and secondary research). Information about accessibility (physical characteristics) of existing pedestrian infrastructures was extracted. The quality of the evidence was assessed using the Guidelines for critical review form – Quantitative studies and Qualitative studies version 2.0 (SAGE Publications, Inc., Thousand Oaks, CA). Results: Of the 1131 articles identified, forty-one articles examined access to bus stops, curb ramps, lighting, pedestrian crossings, ramps, shared spaces, sidewalks and steps. Six articles reported on more than one physical disability. Quality scores were generally low (quantitative: 2–11/15 and qualitative: 1–22/23). Recommended design features differed for the same infrastructure. Conclusions: While there were a fair number of articles (n = 41) documenting accessible design features of pedestrian infrastructures, the quality of the evidence was low. The review identified knowledge gaps. Although specific design solutions exist, they have not yet been tested among individuals with various or multiple types of physical disabilities to ensure access to pedestrian infrastructures by all. Implications for Rehabilitation Pedestrian infrastructures still pose problems to mobility, limiting social participation and quality of life outcomes for individuals with physical disabilities (motor, visual and hearing). The results of this mapping review show that few articles are concerned with the accessibility of pedestrian infrastructures for more than one type physical disability, which might lead to recommendations that are inadequate for individuals with differing disabilities, few recommendations have been compared, most studies have been performed in environments not representative of northern countries and their quality score was generally low. Health professionals and State Parties have a complementary expertise that should be put to use in the determination and implementation of best design solutions to ensure the respect of the needs of individuals with physical disabilities. This review can thus help them have an idea of what has already been done to identify what needs to be achieved to fill the gap of knowledge required to insure access for individuals with motor, visual as well as hearing disabilities. Rehabilitation profesionals should take part in the assessment of the proposed solutions as well as the development of new designs to fill knowledge gaps.

Which grab bar do you prefer in the bathroom

Purpose The purpose of this paper is to verify whether the horizontal grab bar for the toilet and the bathtub suggested by the Code du bâtiment du Quebec conform to users’ preferences. Perceived effort, comfort and safety were considered. Design/methodology/approach In total, 31 adults and seniors using manual and powered wheelchairs were asked to test different grab bar configurations for both the toilet and bathtub. A questionnaire was designed to evaluate participants’ perceptions and preferences after the trials with each grab bar. Effort was measured using the ten-level Borg scale, while participants’ comfort and safety were assessed with a five-point Likert scale. Participants were finally invited to express an overall personal preference between the two grab bar used in each setup. Findings Participants showed preference for an L-shaped grab bar for the toilet, and a horizontal grab bar for the bathtub. The authors’ results differ from the recommendations of the barrier-free design standards of the province of Quebec’s construction code, which states that horizontal grab bars should be used for the toilet and bathtub. Originality/value This study suggest that despite the limited sample, there is an undeniable need for testing norms for public spaces, whenever is possible and has a direct effect on end-users, before publishing them.

Bathrooms in Retirement Residences: Perceptions and Experiences of Seniors and Caregivers

ABSTRACT Seniors may have difficulties interacting with their environment due to emerging motor disabilities. The bathroom is probably the first space where this can be observed, yet retirement residences continue to build bathrooms designed for adults without disabilities. This qualitative study aimed to shed light on the relationship between users (seniors with motor disabilities and caregivers) and their bathrooms in retirement residences, and on how users imagine their ideal bathroom. Most interviewees claimed to have no problems using this space; however, a decrease in both the frequency of hygiene habits and the need for privacy was observed.

The meaning of physical environmental factors on patient, family, carers and staff outcomes

The architecture, engineering and construction (AEC) sector can make an essential contribution to needed breakthroughs and provide new solutions for the improvement of independent and active living in the built environment, including for older adults. This is related to (i) reducing impediments of immobility and maintaining autonomy at home, (ii) reducing the number of accidents and increasing health, (iii) developing integrated care and cure of disabled and aging people, (iv) providing a setting that enables physical, environmental, and social integration, and (v) meeting personal needs, e.g. by realizing new forms of living arrangements that reduce loneliness and improve communication and social expectations in the built environment.