What is Community Access?
Community access is the physical access to environments external to the home. It encompasses the travel to and from as well as the tasks performed in the community. This would include travel to and from clinics, to and from the doctor surgeries, and to and from the shops. Leisure and recreation encompass the activities that we engage in for enjoyment, relaxation or personal growth. The recreation and leisure activity usually holds personal value to that individual. Community Access recreation and leisure activities are a critical dimension in the quality of life for all people. However, many people are still limited to segregated recreation and leisure choices. It’s important to note that while not all people with disabilities or mobility restrictions need support to participate in recreation and leisure activities, some people with mobility limitations, disability, or those which require the use of equipment when out and about may occasionally require supports to access and participate in valued leisure and recreation activities.
First tip involves the planning and preparation of your community access trip. It’s important to note that the community activity selected is appropriate for the individual to engage in. Some of the questions you might like to review include has the activity being selected by the individual? Is that activity appropriate for the client to participate in? And do they have staffing, equipment and or the transportation needed to engage in that activity safely? It is important that the individual remains engaged in the activity and that it is within their personal interests. When you are considering if the activity is appropriate, think about elements such as functional capacity. So, when we refer to functional capacity, we are speaking about their ability to complete activities such as transfers, that is, sitting in a wheelchair and then standing up, completing a transfer in and out of a car, their capacity to walk and the duration in which they’re able to walk, or if they’re able to self-propel in a wheelchair. We also look at skills so their ability to handle goods and items if they go to the shops, their ability to manage money, the use of escalators and elevators, and also the level of experience. So, have they participated in activities similar to that before, such as, have they been to crowded places such as shopping centres? Would they be aware of how to find their seat in a dark and movie theatre, or are they able to use public bathrooms which may be different from their own home setup? This can include things like rails located in different places. In the bathroom, there may be a swing door rather than a sliding door to access or a button push to get in and out. If you are unsure about any new areas which the individual may be exposed to during community access and leisure tasks, it’s recommended that the area is explored by the carer prior to that activity being done. So, some of the things to have a look out for if you’re a carer is when you go to the shop, have a look around. Where would be the places for that person to sit? Where are the escalators located or where are the elevators located if you’re looking to take that person to a garden, where are the pars and the shady areas? Same with parks. Are there uneven areas? Are the birds nesting in cafes? Have a look at the circulation space available around the tables and the height of the bench for the service area.
Tip Two in figuring out how to best assist a person to be involved in recreation and leisure activities, it’s important to begin by getting to know the person. This involves spending time with the person and with others who know him or her well. The individualisation of community access and leisure activities means that the person is engaged in those activities as they find them meaningful and worthwhile. This enhances quality of life and promotes engagement in community access and social activities. It’s also important to note that increasing community access and leisure can have many benefits for the individual, such as increased cardiovascular endurance. Often, community access trips require longer physical engagement than homebased activities. This can be from the activity required when on community access, such as walking, pushing a wheelchair, using a trolley, or engaging in a physical leisure activity such as woodwork or hydrotherapy. Increased community access has also been linked to greater self-confidence and decreased feelings of social isolation, which is very prevalent in some of the communities. Some of the ways that we can identify leisure activities is through the use of a leisure checklist. It can be a great way to help identify a range of interests and to promote engagement in a varied range of activities which are tailored to the individual’s personal preference. There are a number of examples of leisure checklist and I don’t have a particular preference. I’ve listed an example below which you can have a look at. That’s the website name and if you can follow that link or you can type that into your web bar and it’ll pop up with a leisure checklist. So, a leisure checklist or something similar can be a fantastic prompt to exploring the range of leisure activities which an individual may be interested in. Often, it’s observed that leisure and recreation activities become the same each week, such as an individual going to the shops to have a coffee and watch a movie with their carer or family member. Also, we note that group trips are often planned to larger locations such as a shop or a local community facility, as they are often able to accommodate the size of the party. Usually, the members of the group each engage in the same activity such as watching a movie or going to the cafe.
While this may be a meaningful activity for some of those individuals, there could be other interests which they might like to explore. In the particular leisure checklist which I’ve listed, you can find activities in different categories such as health and fitness, looking at complementary therapies and swimming and yoga as well as sports creative pursuits such as singing, making music, writing, photography and woodwork. Also, there is productivity at home such as cooking or baking, and leisure such as playing cards, television and radio. Some of the social activities noted would be eating out or visiting friends and families, engaging in volunteering work or church activities. There’s also a section for outdoor pursuits that can include gardening, bird watching and horse riding. Some of the other sections include out and about or entertainment, so day trips to car boot sales and jumble fairs traveling and dancing going to the concerts or doing bingo, as well as an educational section such as attending lectures or adult education courses. Engaging in science or foreign languages. Individualized trips often planned in conjunction with the person themselves, post identification of a need or desire of that individual. They can therefore be much more tailored in their outcome. The use of a leisure checklist is just a prompt to explore these interests in the past. Some of the community activities and leisure tasks which I focused on include exploring interests such as a client wanting to be independent in going to the shops to buy a newspaper in their own language, or another who was keen to access a weekly bridge group for cards and socialization. Additionally, I had someone that was interested in going to and from the shops independently because they needed to pick up objects such as butter for baking tasks, or another lady who wanted to join the community garden club in their local area so they could tend to the vegetable garden, control the native plants and weeds in their local area.
Tip Three Equipment Use so what we like to do is ensure there is a match between the equipment used and the individual themselves. It’s key in ensuring success for community access trip. It’s important to note that whilst an individual around the home may only use some equipment, or perhaps none at all, this can often vary from what is required during community access trips. As noted, before, this can be due to the increased physical and cognitive demands when in the community, such as going for longer durations, traversing over rocky ground in a park, or getting on and off a bus. Wheelchairs. So, what you can see here is some picture demonstrations. You can’t see my cursor, but in the top left-hand corner I just put that picture in as an example. I’ve never scripted a wheelchair such as that, but it looks like it would definitely navigate over some rocky terrain. So, in the top right, you’ll also see what’s called a power wheelchair or an electric wheelchair. Now that electric wheelchair is fitted with a headrest, which you can see at the top. And also, electric wheelchairs are perfect to be fitted with transport tiedown points to allow them to access wheelchair accessible vehicles. In the bottom left-hand corner with the white background, is a simple self-propelled manual wheelchair. You can tell the difference between a self-propelled manual wheelchair and an attendant propelled manual wheelchair by the rear wheels. As you will notice in the bottom picture on the left-hand side, the wheels at the back are quite large and they encompass a silver rim which the person can use to push themselves along, thus acquiring the name self-propelled wheelchair. In the bottom right-hand side, the picture of the man in the park with the gentleman in the wheelchair, you’ll notice that the rear wheels on the back of that wheelchair are a lot smaller, thus being called an attendant propelled wheelchair. An attendant propelled wheelchair has no capacity for the individual in the wheelchair to propel themselves. They simply rely on a caregiver to move them from place to place. Some of the other things to think about with wheelchairs are fixed versus folding frame. So, with a fixed frame wheelchair, there’s no capacity to fold the seat up and collapse the wheelchair. Some of the advantages of this obviously means that there are fewer breakable points in the wheelchair. So, if you’ve noticed that you’ve frequently broken some of the elements on your wheelchair, it may be worthwhile looking into a fixed frame wheelchair.
Additionally, a fixed frame wheelchair can quite often be much, much lighter, as it means there are not so many moveable components. However, one of the other elements are a folding frame wheelchair. So, with the one on the bottom left-hand side, that would be a folding frame wheelchair. You lift from the base of the seat upwards towards the armrest and the wheelchair will collapse in on itself, which is referred to as a folding frame wheelchair. One of the advantages of a folding frame wheelchair is that it can be utilized by carers to load in and out of the boot of the car. Some of the other wheelchairs are the electric wheelchairs which are up in the top right-hand side. That’s the blue wheelchair with the joystick. You can get different types of joysticks for the person to propel themselves and you can get different types of seating systems. An electric wheelchair is a great script for someone that doesn’t have the capacity to push themselves along but has the cognitive capacity to get themselves from A to B if provided with the opportunity. There are also tilt in space wheelchairs which have the capacity for the seat to be tilted back into a reclined position. This can be particularly handy when going up and down curbs if the person has a tendency to shift forward in the wheelchair. Other accessories include handle brakes versus manual braking or caster brakes. So, they would be a gas assisted brake, similar to maybe what you would find on a push bike, and you squeeze the brakes at the back where the handles are. That would be a handle brake with the carer who is controlling the speed of the wheelchair. There are also caster brakes which the client can put on themselves. They would be wheel locks just down the bottom near those larger wheels. Some of the other accessories which are important to note for a wheelchair is the use of a headrest. A headrest is legally required by law if the person is traveling in their wheelchair in a vehicle. So that would be if the person went out in their wheelchair, in a wheelchair accessible taxi or a wheelchair accessible van. So for example, the wheelchairs, both of them on the bottom, would not be appropriate to use in a wheelchair taxi as they are not fitted with headrest and do not comply with law.
TO BE CONTINUED
In the Spirit of Reconciliation Q1 Care acknowledges, the traditional custodians of the lands on which we operate and respect elders, past, present, and emerging as we work towards reconciliation.
