Accessibility and Introduction to W/C

1973 Rehabilitation Act Section 504

Banned discrimination based on diability

Protection for "qualified individuals with disability"

- other than this disability, they could do what is needed of them

Recognized them as a minority group

Set state for ADA

What is a disability

impairment that limits someone's major life activities

- thinking, eating, breathing, seeing, etc

The Americans with Disabilities Act

Passed on July 16, 1990

5 titles

1. Employment

2. Public Service & Transportation

3. Public Accommodations

4. Telecommunications

5. Miscellaneous Provisions

Title I: Employment

No employer (over 15 or more employees) shall discriminate against a qualified individual on basis of disability

- they have to satisfy all other requirements of job

Employers must make reasonable accommodations (unless undue hardship/burden) to avoid discrimination

- aka. service animals (dogs only listed in II and III)

Title II: Public Service and Transportation

Cannot be excluded from participation in the benefits of a public entity

- II(a) = voting systems, all services owned by state governments

- 11(b) = public transportation

- Access to web content (2018)

Title III: Public Accommodations

Any public business cannot discriminate on basis of disability

- motels, theaters, restaurants, public transportation BUILDINGS

Title IV: Telecommunications

Ensure interstate and intrastate telecommunications are available to the hearing and speech impaired

Title V: Miscellaneous Provisions

States and private entities are responsible

It is illegal to retaliate against or intimidate someone with a disability who is seeking equity and enjoyment of activities covered

Equality

Treating everyone the same

Equity

Have the same experience as everyone

Accessible Housing

Built with accessibility in mind

Adaptable housing

Modifications to existing home

Wheelchair Accessibility Specs

Side walk = > 3 ft long

Ramp = 1 in per 1 ft run

Door & Hall width = 32 in

Kitchen turning radius = 5x5ft

Toilet = < 16 ins for commode, 18 for sitting

Why is the ratio 1:12 for ramps

1:12 = manuel pushing w/c

2:12 = occupied but not pushing themselves

3:12 = unoccupied w/c

Durable Medical Equipment

Manuel & power w/c, appropriate for pts with VERY basic needs and little to no complex comorbitiies.

Complex Rehabilitation Technology

Deemed medically necessary and individually-configured to pt that meets specific medical and functional needs.

Questions for W/C Fit

Patient's physical condition (growing, reducing capacity, sensory impairments)

Anticipated use (full-time vs part-time, travel, sports)

Additional environment considerations (person's living situation, occupation)

Financial implications

Resources (family, community, accommodations in vehicles)

W/C Components

Arm Rests: fixed or removable, adjustable

Caster Wheels: Small front sheels

Wheel locks

Lower leg supports

- removeable

- elevating LE support

- Foot support/footplate

Why is the axel important

More forward = less stable, more mobile

More backword = more stable, less mobile

Customizable parts of a W/C

Frame (fixed or collapsible)

Seat & Cushoid

Axel

Drive wheels (perpendicular or sports (camber))

Pushrims

Casters

Tires

How to measure for W/C Fitting

Know pt ht. & wt. diagnosis and participation levels, expected use, any special features

Pt should be upright with good posture on firm mat or table

- or 90, 90, 90 position

15 total measurements, Eight must haves

8 Must haves for w/c measurements

Shoulder Width

Chest Width

Hip Width (length + 1 or 2 in / side)

Seat to top of shoulder

Seat to Inferior Scapula

Seat to Elbow

Upper leg Length (length - 2 in)

Lower leg Length (length - 2 in)

How to go up and down stairs with W/C?

Use of multiple people (2-3)

Up = Backward

Down = Forward