Author: Jane Bringolf

Older people, mobility and cars

An older man in a blue and white t shirt sits at the wheel of a car and is driving down the road.The policy push to encourage people to walk and use public transport is one way to reduce emissions and improve health. However, whether to choose the car or public transport, or not to go out at all, depends on many factors. So, do people choose the car because they are constrained from using other forms of transport? Or do they use the car because it just suits them better? 

A review of the literature found that people with poor health, older age, low income and lack of access to a car are less likely to get out and about. Difficulties with public transport are linked with walking difficulties. So the design of the public transport system itself is not the total problem. 

Some retirees might engage in several activities in one day making public transport a time consuming business. On the other hand, some retirees may only leave the house for medical appointments and grocery shopping. The paper based on the literature review goes into these issues in depth. 

Some conclusions

Policies aimed at reducing car usage by older people with physical and mental impairments, must be approached with caution. Car mobility represents a crucial means of maintaining independence for older people. 

The advantages of allowing older people to drive, despite minor disabilities, often outweigh the risks they may pose to themselves and others. It is noteworthy that France, togethr with the Netherlands and the UK, are nations with the most lenient procedures and minimal medical examination requirements for driving license renewal. However, these countries also report the lowest fatality rates for car drivers within this age group.

The links between mobility, safety, and older people shows that people aged over 65 are considerably more vulnerable to fatal incidents as pedestrians than as drivers. So there is an intricate balance between considering the mobility needs and safety of the older drivers and pedestrians.

Universal design helps

Researchers found that physical difficulties are contextual, and decrease when universal design measures are taken. Universal design is not a luxury for a few individuals. Physical accessibility helps a lot a people to move around more smoothly and comfortably. 

The title of the article is, Older adults’ immobility: disentangling choice and constraint. It looks at people who are not in the workforce and spend most of their daily lives in their homes.

In a nutshell: the motor car becomes a mobility device as people age and walking becomes more difficult. 

From the abstract

Our research challenges the prevailing notion that immobility only occurs in exceptional circumstances. Our work shows instead a close link with individuals’ activity levels and constraints on their schedules.

Retirees and non-working population groups exhibit higher immobility levels than workers. This is influenced by factors such as poor health, old age, low income, lack of access to a car, or rural residency.

Driving and walking difficulties are significant contributors to immobility, with age being a primary explanatory factor. However, living in dense urban areas tends to reduce immobility levels across household categories. Difficulties with public transport, as such, do not trigger immobility, but they are entangled with walking difficulties.

Implications for public action include targeting age-specific interventions for reducing car dependency, and approaching policies aimed at curbing car use by older people cautiously.

Implementing universal design measures to enhance physical accessibility also helps to make mobility smoother and decrease perceived walking difficulties. Finally, this paper underlines the interconnectedness of mobility, social isolation, and sedentary lifestyles.

University for all toolkit

Front cover of Unlocking Inclusion: Toolkit for Universal Design in Higher Education. The concept of Universal Design for Learning (UDL) has been around for a long time. UDL is not a special type of teaching method for certain groups. The principles are applicable to teaching and learning across schools, universities and workplace training. A group in Ireland has devised a university-for-all toolkit to show how to do it. 

The Toolkit is designed for university leaders, faculty members, and professional and administrative staff. By moving the focus away from deficits, universal design shifts the focus to proactive inclusive design.

The aim of the guide is to show how Universal Design for Learning can transform institutions into inclusive learning places. Using examples of good practice from both national and international institutions, it brings together universal design expertise from around the world.

The Toolkit includes self assessment activities and case studies. It covers institutional foundations such as leadership, approaches to access and inclusion and strategic planning. The four pillars of universal design for learning in higher education are explained in detail. Briefly they are: 

Adults seated at tables in a classroom setting looking forward to the instructor at the front of the room. university for all.

  1. Learning, teaching and assessment, curriculum review.
  2. Student supports, services and social engagement, library services
  3. Physical campus and built environment, challenges and solutions
  4. Digital environment, websites, social media platforms

The title of the publication is, Unlocking Inclusion: Toolkit for Universal Design in Higher Education. 

Additional information about the online training program and how to make the training and the toolkit suited for other nations.

The 2 minute video below provides an overview of the purpose of the Toolkit. 

 

Go-along techniques inform design

There’s nothing like getting instant feedback as people negotiate the built environment. Go-along techniques inform design because they really get to the key points. Some of the exclusions are only obvious when pointed out and that’s valuable information.

The go-along technique is where researchers walk with the participant and observe the barriers they experience as they encounter them. The dialogue that ensues provides rich information about design – how to do it and how not to do it.  

Image taken from the research paper 

Researchers in Sweden used this method and found there is an ongoing multifaceted exclusion of citizens in the built environment. This is despite current building regulations. Also, it doesn’t meet the aim of inclusion and international conventions. 

However, there are opportunities to change this with knowledge about enablers in the built environment. The researchers point universal design as an important planning variable to bring about change.  

The research paper has a lot of excellent information, much of which planners and disability advocates hear anecdotally. This paper documents the issues well and in detail. 

The necessary enablers

Benches, or seating were the most mentioned during the go-along activities. These are a decisive factor for spending a day in the city centre. People would walk more if they could also sit. 

Access to public toilets was also critical. Finding them, having access, and in some cases, navigating payment systems all pose problems. Again, another factor in visiting the city. 

People who live outside the city centre need flexible mobility systems – public transport, plus being able to use a car and then parking the car. 

Lighting in public places, clear signage and orientation board were also important along with handrails in challenging environments. 

Planning process needs a re-think

The researchers argue that there is an urgent need to rethink the planning processes to account for human diversity. It’s essential to move away from notions of an ‘average’ person or the idea of normal.

There is a gap between what building regulations state as accessible and the the lived experience of accessibility (or inaccessibility).  As the researchers say,

 “The pointing out of the necessary enablers is important knowledge to achieve accessibility also in an overall, entire-city-perspective. The concept and practice of Universal Design is a key to pursuing such a development.”

The title of the research paper is, Is the City Planned and Built for me? Photos highlight some of the key issues experienced by participants. There is a lot of really good information in this paper. 

Design skills in healthcare

Does the design of medical products impact on the safety of patients and health practitioners? The answer in many cases will be, yes. For patients it affects everyday medical items like respiratory equipment. But the real issues are for health practitioners. That’s why we need design skills in healthcare. Authors of a recent paper discuss some of the issues. They note that when design unwittingly excludes whole groups of users it becomes bad design. Medical products and services designed to best fit a Caucasian male body type means a poor fit for others.  The authors provide an excellent example of where a design is potentially dangerous. “In one example, the only green button on a defibrillator switched the device off, whereas the only red button was for shocking. In simulated A wall mounted defibrillator in bright orange.emergency situations, it was no surprise that some participants pushed the green button and inadvertently switched the device off when intending to shock.”  Co-design is considered the appropriate approach in healthcare services, products and building design. It enables stakeholders in healthcare sciences and delivery to provide input at the early stages of design. Although co-design is accepted as a good idea, design skills are yet to be emphasised and captured in co-design processes.  The title of the paper is, Design as a quality improvement strategy: The case for design expertise

From the abstract

Bad design in safety-critical environments like healthcare can lead to users being frustrated, excluded or injured. In contrast, good design makes it easier to use a service correctly. Design impacts on both the safety and efficiency of healthcare delivery, as well as the experience of patients and staff. Co-design as an improvement strategy has gained traction in the healthcare quality improvement literature. However, the role of design expertise and professional design is much less explored. Good design does not happen by accident: it takes specific design expertise.  We define design, show why poor design can be disastrous and illustrate the benefits of good design. We argue for the recognition of distinctive design expertise and describe some of its characteristics. Finally, we discuss how design could be better promoted in healthcare improvement.

Residential spaces for healthcare

An Introduction to Inclusive Healthcare Design By Kiwana T. McClungAn Introduction to Inclusive Healthcare Design is a book with more articles on healthcare design. It includes the built environment, allied health, social care, and urban studies.  One chapter, The Design of Residential Spaces for Healthcare, looks at homes and residential spaces for delivering healthcare. 

Stroke Toolkit co-designed

The Canadian Stroke Toolkit for Aquatic Rehabilitation and Recreation Therapy (STARRT) was devised using a co-design method. The STARRT website has a section on the process as well as using the toolkit. Briefly, the method has four parts:

    1. Scoping review focused on the implementation of the therapy
    2. Qualitative interviews with participants post-stroke and professionals
    3. Participatory design with design team and consumers for the toolkit
    4. Prototyping and dissemination of the toolkit.

Playgrounds: universal design not enough

A girl sits on the ground in a playspace. She is smiling at the camera. Universal design is not enough for inclusion.
Image from “Everyone Can Play” guide.

Children with disability are often excluded from playing at playgrounds due to design limitations. Of course, one solution includes building playgrounds using a universal design approach. However, playgrounds with universal design features are not enough to make an inclusive space. 

Universally designed playspaces bring play into the lives of families with disabilities. They also provide opportunities to champion disability advocacy, and support disabled children in developing critical social skills. However, additional work and resources are needed to achieve full social inclusivity.

Distance shot of children on a carousel or spinner
Image: Livvi’s Place Carousel

Findings from a Canadian study can help guide designs of future playgrounds and other community spaces to improve inclusivity for everyone. 

This paper begins with the playground experience and universal design and then applies this to other public spaces. 

The title of the article is, Understanding the experiences of parents of disabled and non-disabled children at playgrounds designed for disability inclusion. There is no free access to this publication in Disability and Society. However, you can request full access from ResearchGate. 

From the abstract

Disabled children and their families are often excluded from community play opportunities, including playgrounds. One potential solution is, of course, to design inclusive playgrounds.

This study explores the experiences of parents of disabled and non-disabled children at playgrounds inspired by Principles of Universal Design. Participants were 29 parents (16 with disabled children). They were located across four Canadian cities with newly built inclusively designed playgrounds.

Three themes were identified which provide deeper understandings of ableism in community playspaces and the impact on children and their families. 1. Inclusive playgrounds also act as a platform for disability advocacy. 2. They provide opportunities for social and emotional development. 3. Inclusive play may influence family dynamics.

Findings highlight the value of universal design, but indicate that physical environments alone do not ensure social inclusion, as social barriers can continue to exist even in spaces purposefully designed for disability inclusion.

Ableism in planning

Attempts to avoid catching COVID caused people to change their behaviour in many ways. Working from home and not being able to travel meant more people walked in their local neighbourhood. Open space was at a premium. This led to pop up cafes and parklets and a few more planter boxes to make places more appealing. Planners said “we can’t go back to the way things were”. In that case says Lisa Stafford, we have to discuss ableism in planning.

“Pop-up cafes and parklets used tape barriers and step-up platforms, while planter boxes or pallet seating were positioned to create what seemed like another obstacle course in getting about.”

A group of people, some wearing face masks, are crossing the road. They are walking a safe distance apart.

Lisa Safford says that ableism is an insidious, unspoken prejudice that favours an idealistic view of an “able body”. It is not just having negative views of people with disability, it is a way of thinking about bodies that rejects difference. It’s thinking that “normal” is a real thing.

Ableism is entrenched in walkability metrics such as walking speed, our ideas of liveability, and approaches to older people. Stafford claims that ableism is rampant in planning and design decisions. The misinformed catch cry is that it’s only for a small portion of the population.

“Time and again I have heard universal design omitted in the provision of social infrastructure, due to budget shortfalls or inclusivity being too hard…”

A child wearing a pink jacket sits on a stone wall. A pair of crutches are propped up next to her. They have red and blue handles. Footpaths are key for children.

Let’s talk about ableism

First, we do not lack literature, guides and other tools on the topics of disability, diversity, equity and inclusion. Planners need to talk about the issues with each other, welcome disabled planners and connect with disability communities and their expertise. Do some real co-design processes.

Ableism is just one lens and individual experience ableism and discrimination in different ways. Embracing diversity is critical for people with disability who are Indigenous, female, low income and LGBTIQA+

Planning can make social change – in shapes lives and livelihoods. If we want real change we must confront ableism and the idea of “normal” or “average”. The Australian Bureau of Statistics counts people with disability (18%) separately from people with a long term health condition that limits their daily activities (22%). It’s not a small portion of the population.

The title of Stafford’s book chapter is, Planners, We Need to Talk about Ableism. The chapter is open access in Disability Justice and Urban Planning.

Is a smart home a real home?

The sense of home is very personal, and as we age it is likely to become more personal as we spend more time at home. Younger people who build brand new homes are increasingly embracing smart technology. For older people, smart technology, especially that which collects data, disrupts the sense of home. So, from the lived experience perspective of older people, is a smart home a real home?

Older people want to stay in their own home. It is also the best place for people to manage the consequences of ageing such as dementia and physical conditions.

A living room with two couches and bookcase overlaid with a graphic of a smartphone with radiating lines indicating ambient monitoring of a smart home,

To age successfully and safely at home often means embracing a range of assistive technologies. They can be as simple as a raised toilet seat and using colour contrasts for interior design. But accepting these technologies is another thing. Grab bars are shunned because of the link with being disabled.

Assistive technologies impact on one’s sense of self – one’s identity. Assistive devices used outside the home feel particularly stigmatising and in too many cases these devices are abandoned. So can the same be said of digital assistive technology especially if it is monitoring your every move?

Tech and older people

Smart home technology in the age-related literature is more than a remote control for the window blinds. It is technology that collects monitoring data through sensors and wearables. The aim is to keep the person safe and improve their wellbeing. But who wants to have their life documented in a database?

A review of older people and the use of smart home technology looked at the issue of acceptance and use. The researchers wanted to find a way to make these technologies more acceptable to older people. They found that issues are not related to accessibility or usefulness but to an invasion of privacy and lack of human interaction.

Human-centred design solutions that take account of a person’s sense of familiarity and privacy at home could help overcome resistance. The researchers provide more detail about their research and the ethics of home monitoring devices.

A diagram of a two storey house with indications of the different types of smart technology that can be used and operated with a mobile phone.

The title of the article is, The smart home, a true home? How new technologies disrupt the experience of home for older persons.

From the abstract

Smart home technologies can support older persons to age in place, but adoption remains low in this age group. One reason is that they are not accustomed to having a home that is technologically enhanced. In this article, we focus on the older persons’ lived experience of “home” and show how this technology potentially disrupts it.

Humans rely on their physical body and they make decisions based on their perceptions of their physical body without the intervention of technologies. Smart home technologies potentially make the home seem unfamiliar and exposed.

By paying attention to the way smart home technology can disrupt the experience of home, the question of ethical use is brought into the frame. The design of these technologies has an important role to play in acceptance by older people.

Disability messaging guide

The Commons Social Change Library has a new guide for disability messaging. The guide has tips based on research which shows effective ways of building public support. The document was led by a steering committee of people with disability and messaging experts.

The guide is supported by Disability Action Network Australia (DANA), Centre for Australian Progress and Common Cause Australia. Access via The Commons Social Change Library or download in PDF.

Website banner for the disability messaging guide. Dark blue background with white text surrounded by a narrow yellow border.

Key content

The guide begins with a note about language and why they prefer the term “disabled people”. The introduction covers the messaging principles such as the audience and speaking from the frame of experience. The overarching themes for talking about disability are self-determination and diversity. This is followed by the 7 top tips.

  1. Story structure
  2. Design Frame
  3. Strengths language
  4. Our story, not theirs
  5. Bring NDIS back to values and benefits
  6. Build empathy with human stories
  7. Show change is possible
People on a fun run with two older adults being pushed in wheelchairs.

The guide has good examples to explain concepts and how to change old messages into ones that are more attuned to self determination. One example is to talk about being “led by disabled people” rather than “a seat at the table”. The reasoning is to replace inclusion and tokenism with self determination.

Another example is making passive sentences active. Rather than talk about how disabled people experience discrimination, say who is discriminating. And people like to be presented with solutions rather than problems so focus on these. 

The title is By Us, For Us: Disability Messaging Guide.

Disability organisations as social participation

Clubs and societies bring together members with a shared interest which also provides a platform for social participation. The same can be said for disability organisations – with some differences. Disability organisations are a hub of social activity, political activism, and a resource of lived experience for planners. A paper from Sweden looks at this concept focusing on rural communities.

Researchers found that interviewees have extensive social lives and that disability organizations act as a platform for many social interactions.

Two women sit under trees in an outdoor cafe. One sitting on a bench seat at a table and the other is using her rollator or wheelie walker as a seat.

Sometimes acquiring a disability such as rheumatism, prompts people to join groups such as the rheumatism association. Some disabilities cause people to leave paid work so this gives them time to channel their energies into these civic organisations. But it doesn’t end there. Members of these organisations also provide valuable lived experience for local authorities in planning.

There are three dimensions to disability organisations: social participation, political action, and a resource of lived experience. Just on the basis of participation, disability organisations provide good value for their government funding.

Protesters at a disability access rally. A woman is sitting in a wheelchair holding a sign saying access for all. She is wearing a blue jacket and wearing sunglasses.

Disability organisations, and the disability sector as a whole, provide inclusive spaces in which to socialise. The strength of inclusive spaces is they facilitate participation on equal terms. On the other hand, disability-specific places are potentially more flexible and adapted to individual needs. Disability organisations are a form of a disability-specific space which form a base for recognition and a political voice.

Living rural with disability

Living with disability in rural areas is viewed as more of a problem than in urban areas. According to the researchers this is a simplification of how people relate to their environment. Rurality and disability are two different concepts which are not complicated when put together.

The article is titled, “I am a very active person”: Disability organizations as platforms for participation in rural Sweden. The link provides an extended abstract and the full paper is available via institutional access.

A rural road with homes on each side. The homes are painted dark red with white windows.

From the abstract

Disability organizations are places for social interactions and for the accumulation of knowledge about disabilities as lived experiences. They also form a platform for dialogues and political influence work in the local community.

Participation means being included in societal activities in a way that suits the individual’s capacities and ambitions. The role of the public sector also enables participation. That’s because, in Sweden, it supports disability organizations and opens up opportunities to influence local planning.

If more support is given and more disability-specific arenas are created, there will be more open arenas for possible participation. What counts as participation must begin with individuals’ own experiences and values of what they appreciate and need in their daily lives.

Mandatory vs non-mandatory

Is there such a thing as non-mandatory when it comes to the Disability Discrimination Act? Access consultant Bryce Tolliday writes a thoughtful piece in Access Insight on this topic. He bemoans the way building certifiers, designers and others who request design changes. This is because, they believe the consultant’s design advice is non-mandatory. They just think it is “nice to have”. However, in the mandatory vs non-mandatory debate, it’s the Disability Discrimination Act (DDA) they should be thinking about.

There is a misunderstanding of the laws affecting new building work as well as the value a good access consultant can bring to the project.

Front page of the Access to Premises Standard.

A mandatory requirement is something you must to do and is non-negotiable. Tolliday argues that it’s not possible to have a non-mandatory outcome under the DDA. That’s because the objects of the law are to eliminate, as far as possible, discrimination on the grounds of disability.

Which law comes first?

It’s the mix of different laws, standards and regulations that confuse people. Some are enacted at a federal level and some are enacted by states and territories. Federal laws always trump state and territory laws.

People who want to press the non-mandatory argument rely on the NCC being the primary building regulation in Australia. But this is not the case. Each state and territory has to adopt the NCC elements into their respective building codes. Consequently, the Commonwealth law, the DDA together withe Disability Standards, becomes the law to follow.

The problem for designers and certifiers is that the DDA does not specify design standards or outcomes in the same way as the NCC. How can one know whether a design feature will discriminate or disadvantage a person with disability? Tolliday’s response is:

If they cannot provide an evidence-based reason demonstrating that disadvantage will not occur then what the access consultant is proposing is a mandatory requirement under the DDA.

A screenshot of part of the Australian Human Rights Commission's overview of disability discrimination.

The outcomes expected by the DDA are not covered by Australian Standards related to disability access. This is due to the minimal requirements of the Standards that do not cover the full diversity of disability.

Case study confirms what’s mandatory

In the case of Ryan v the Sunshine Coast Hospital and Health Service the mandatory requirements went beyond the NCC, the Premises Standards and AS1428. The late Peter Ryan who was blind brought the action. He argued he was disadvantaged by the design of the Hospital. Shorelines, glare, and luminance contrast were not covered by the NCC but covered by other design guidelines and international standards. Tactile and braille signage for the entire hospital was not covered by the NCC or AS1428 either.

Ryan frequently got lost when he visited as an outpatient. He posthumously won the case and it will cost the Hospital millions to address the 17 breaches of the design.

External view of Sunshine Coast University Hospital.

The Judge found Peter Ryan and been indirectly discriminated against. The Hospital had not considered key features that could impact patients who were blind or had low vision.

The key issue for Tolliday is that the Australian Building Codes Board, which looks after the NCC, has said it will not regulate internal fitouts. Office buildings, for example, are not fitted out at completion, so that is reasonable. However, schools, hotels and hospitals are fitted out at completion.

The title of Bryce Tolliday’s article is Mandatory vs Non-Mandatory published in Access Insight.