Module 1, Talk 1'2: Barriers for People with Disabilities

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Module 1, Talk 1.2Barriers for People with
Disabilities
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Access Barriers for People with Spinal Cord Injury

• National Rehabilitation Hospital
• Washington, DC

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The Consumer Professional Partnership Program

• Consumers co-present in education settings for
  health care professionals
• The SCI Life Educator Concept

• Training Manual
• Disability Awareness and Communication
• Prevention of Secondary Conditions
• Physical Activity and Exercise

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Goals

• To identify access barriers commonly encountered
  by people with SCI and other disabilities
• To present strategies for overcoming or removing
  these barriers
• To discuss how these barriers can cause negative
  health consequences for individuals with SCI

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Access Barriers

• Environmental
• Structural
• Attitudinal
• Combined or alone, these can cause
• negative health consequences for individuals
  with a SCI

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Environmental Barriers

• Physically inaccessible environments (e.g.,
  stairs, narrow doorways)
• Transportation
• Inaccessible equipment (e.g., high exam tables,
  mammogram equipment)

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Strategies to Address Environmental Barriers

• Make sure front office staff, including the
  appointment desk, makes patients with a SCI aware
  of the accessibility limitations of the
  office/building environment
• Clear hallways, waiting areas, and rooms of extra
  clutter and/or chairs to allow for sufficient
  maneuverability
• Reserve exam rooms with accessible tables for
  individuals with a SCI
• Be flexible if a patient is late for a scheduled
  appointment

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Structural Barriers

• Health plan limitations and restrictions
• Office/health plan procedures (e.g., referrals,
  short appointment times)
• Health care costs

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Strategies for Addressing Structural Barriers

• Allow patients with a SCI extra time during their
  office visit (for un/dressing, using the
  restroom, discussing health care issues)
• Be cognizant of the logistics and costs of
  requiring multiple visits in order to address all
  of their health care issues

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Attitudinal Barriers

• Lack of knowledge about SCI on the part of health
  care providers
• Always treating the patients disability as the
  primary health care issue
• Communication issues

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Strategies for Addressing Attitudinal Barriers

• Be willing to learn about SCI from your patient
  he or she may know more about it than you do
• A person with a SCI has at least the same
  preventive health care needs (and often more) as
  someone without a SCI (e.g., cholesterol and
  blood pressure checks, weight, flu shots) and are
  often physically and sexually active as well

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Consequences of Access Barriers

• Delayed or no receipt of health care services
• Diminished health and function
• Increased secondary conditions, illness,
  hospitalizations, and healthcare costs
• Loss of faith and trust in the health care system
• Decreased independence and self-direction for
  individuals with SCI

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Optional Teaching Exercise

• Youve just had an accident on the slopes and
  broken your leg. Youre in a leg cast and on
  crutches. Think about how your daily life would
  change.