Video Transcript: Mobility Differences and Medical Conditions

Again, if we go back to this great chart, are you getting this now?  So we talked about having attention controls where that was a bit pink, we talked about persons with intellectual disabilities, and perhaps having an impact on higher order thinking and those kinds of things?  We've talked about some individuals with social cognition, right?  If you think about persons with autism spectrum disorder, and right now we want to focus on, okay, what if that area that's pink involves either fine motor, gross motor, graph motor, which is the ability to write, or if we're talking about a person who may have a medical condition.  So we're putting some things together, but we think that this works well, in terms of understanding some strategies that you can use within a congregational setting.  

Again, mobility differences depend greatly on where you're located.  You know, mobility differences aren't as much of an issue if you're a wheelchair user and the building has a ramp and an elevator.  Mobility issues might be significant if there is no ramp, no elevator, and a significant number of steps to get up, or a muddy path that you are traveling on.  So again, there can be different obstacles.  And sometimes it's less about the device and the difference and more about the interaction with the environment when you're talking about mobility differences.

Mobility differences can happen for children who are born into some kind of a situation where they may have Spina Bifida or cerebral palsy, they may have a shorter arm.  I mean, there are so many different possibilities with children.  But mobility differences also happen as people age: arthritis, hips that have needed surgery, things that just happened to the body over time that cause less than pleasant opportunities to sort of navigate in environments.  So a person who never needed that cane, or walker, or wheelchair, all of a sudden find themselves with a mobility difference.  So those can happen right away at birth, they can develop over time, and certainly I always say, if we live long enough, that will be me.  And that can be a mobility difference that’s part of many of our lives.  

So how can we, you know, just think about that, add to that, I think, medical conditions.  So many times in that physical realm, we have some individuals who may have a certain set of braces that they wear.  We have some individuals who may have seizures.  We have some individuals who may have a procedure that needs to be done; a certain way to eat; but there's a medical condition that impacts that person's life.  Well, what does that mean to a congregation?  And again, I would say, we need to be ready.  We need to be ready with whatever that might take.  

So let's back up and think for a little bit just about mobility differences.  Because this is so individualized, I will say that that talk that we gave about universal design and making sure that you did some sort of an accessibility audit in your sanctuary is really, really helpful in terms of this mobility piece.  It will point out, are your toilets at the right place?  Do you have enough ways for people to reach a drinking fountain?  And let's face it, if you can't use the bathroom or get a drink somewhere, would you go?  So I mean, there are certain parameters we need to have for everybody to be able to at least access, access a bathroom and be able to get a drink.  So you know, there are some non-negotiables.

Mobility differences are as you go through that accessibility audit, it will point out all kinds of things.  If you're a church with a parking lot, that's one thing.  If you're a church that wants to set up opportunities within the sanctuary, they're called pew cutouts so that persons who are wheelchair users can have a vantage point there instead of an add on on the end of a row or whatever that might be.  That's a really important thing to think about. 

I was visiting a church the other day and again, they had all of their places for people to sit who are wheelchair users in the back row of the church, and they used PowerPoint a lot.  And so I looked at them and I said, you know, do most of the people stand up to sing?  Yeah.  Do you think that the people in the wheelchairs in the back will be able to see the words to the song?  Oh, I didn't actually think about that.  

So again, sometimes, we assume that people who are wheelchair users all want to sit in the back.  What if we had pew cutouts in different places or spots where we move chairs available to people who are wheelchair users, so they could sort of pick a spot, same as all of us do.  So someone may want to sit in, you know, the middle… in the middle and who knows, but we're finding places where people can hunker down and be part of that worship service, but also have access to the building.  So the accessibility audit will be so helpful, and will really help in terms of mobility.  

But I guess one of the tools that I often suggest to churches is, if you already know that you have a member, for example, who's using a walker, start in the parking lot or where people enter and have a similar piece of equipment and see what it's like for you?  What's hard?  Can you access all the places you need to access?  If you're in a room where this person will spend time, does this walker get in between the tables and chairs?  Are you able to move effectively around the environment?  So again, if you and this individual, sort of a fun group activity, can sort of meander through the building, it will highlight very quickly what might need to be changed.  And this is a person who has been showing up every Sunday or Wednesday or whenever the meeting time is.  So again, mobility differences, if you can just sort of figure that out based on moving through your building on an individual basis but then also that accessibility audit that we recommended under Universal Design is hugely helpful.  

Now let's spend a little more time thinking about medical conditions.  Many times, this is a very important reason to have a personalized plan.  So let's imagine that you're running a Sunday morning service.  This person will be attending, and Wednesday evening Bible study, but this person might happen to have a seizure disorder.  Well, you're going to need to know what to do.  If that happens, you're going to need to know what you're looking for.  You might even need to have some emergency supplies in place.  So instead of saying no don't come, I think even better response is to say, let's figure out what we need to know.  

So many times people with an emergency protocol or situation, it's got to be a written plan.  And there have to be some trained people there to know what to do should this occur.  And there might need to be some medication that stored in a backpack that travels with this person; whatever that may be.  But that emergency plan needs to be written out.  If the seizure lasts longer than X number of minutes, then this is what needs to happen.  But I think we need to really be prepared when it's a medical condition.  

The other thing that we do a lot at church and not just safety issues, but a safety issue that can happen around food.  So if there's a person who has some specific swallowing issues, or difficulty with getting food in, what's going to be okay?  And what snacks can we serve?  Is this person going to know whether they can eat that or not that?  So anytime there's a medical condition or something that might involve safety, I really think it's wise to have a personalized plan written out, authorized by that individual or by the parent or guardian so that people know how to interact should that situation occur. 

Now, we can't always plan for each person with an emergency.  An emergency could happen any Sunday when somebody might fall or whatever.  But most of us would know then that there's a 911 call or how to get emergency help there.  But for people who have an ongoing issue, I think it's just really wise for us to be prepared, and know, have a protocol, train some people around what that might look like, and have some written information and the supplies needed.  

So also some things to think about.  There might be some equipment that people have as part of physical or medical situations.  They might have some different braces that they wear or might have a particular stander or something like that.  Again, I think we're wise to know what it is and how to use it.  So if we have a youth group member that's going to be putting braces on and off their feet and we're going cross country skiing somewhere, we need to factor in how are we going to deal with those braces and how are we going to make room for that person on the cross country ski trip?  

So once again, it comes down to getting to know individuals, what things are going to work well, what things are not, or is there an emergency plan?  So many persons with physical differences are great at handling their own pieces of equipment but sometimes there needs to be some support, especially if that person has a child, youth group member, or need some help with medical situation.  So be ready to learn what those are.  

Also, it might be really helpful, especially for people with some mobility differences, to have a variety of fine motor tools available.  I went through some of those the other day as we were talking about different possibilities, but to have those pencils that have the grips on them… and actually, this is sort of fun… we just wrapped some wicki sticks, if you're familiar with those, around a pencil, creating this great grip on here.  This is actually just a piece of wax that is called a wiki stick.  Also great in a fidget bag, by the way.  But again, sometimes you can use these things to just create multiple options.  So to have those kinds of things available, those pencil grips.  To have pencils that might have weights on them or that are shaped like a triangle.  Again, these kinds of items you might have stocked or something like this, you probably just don't have setting around; you would need to choose to stock that item.  

One of the things I'll often say to churches, if you know that you're going to be using something like this often, please don't make that individual haul it back and forth all the time.  If there's a certain kind of scissors or pencil, and you can just stock that stuff at church, please do that so that, again, that individual doesn't have to be lugging along things all the time.  But those are sorts of equipment that sometimes come along with persons who may have a fine motor differences and differences with using eating utensils.  

So again, we covered a lot of those things in universal just design; just stock it.  And in some cases, you'll want to find out what might be helpful for an individual and then if possible, choose to keep that right there in the congregation.  

So one other note that falls under this category, we think, is just hearing from people about serving the Lord's Supper.  Again, sometimes we pass or use very small pieces of bread and expect people to grab them.  And we expect them to take this small cup out of this ring of other cups while they're balancing.  And if you have somebody who may have arthritis in their hands, or who find that difficult, this is a great time to plant in an option, right?  You could stock some larger pieces of bread.  You could have some choices of either having people take it themselves or asking the person next to them, or the person passing the plate to serve them that cup.  There are many options.  But once again, the Lord's Supper.  Watch people as they're interacting with those elements.  

For some it is almost like Oh no, not the Lord's Supper, because I'm going to spell this tray, I've got this tremor, or the arthritis is so bad.  If I pass it on today and don't partake, what are people going to think of me?  There's a whole host of things that can happen around the Lord's Supper.  So be sensitive.  

We often, I've seen some congregations, where they've simply said, we have some choices.  We welcome people to the front, to take the Lord's Supper by Intention, or we will come and serve you at your seat, whatever you prefer.  So again, building in those choices, and of course, that gluten free option, right?  Either just it's all gluten free, or we have a gluten free station in a certain area.  

So I guess just to review, there's no way, no way possible, that we could give you the whole list of things that you would need to know about medical conditions and mobility differences.  But what we can encourage you to do is stock what you can, make universal design choices about things like the Lord's Supper so this is not an issue.  Just create a couple of options.  But there will there will be individuals that you will really need to take some time and get to know their medical condition, the equipment that they have, those kinds of things so that people can participate.  

I go back to my friend Marie, again.  For her safety, we have to know how she communicates.  We have to understand how to operate and reposition her in that wheelchair for her comfort.  So some of it is just training and training a key set of people who can step in and who want to be there, partnered with Marie so that we can understand what she may need in the context of that service. 

I will give one other caution.  Be careful about helping someone before they actually indicate that they would like some help.  I know I was talking to a friend the other day and her husband is a wheelchair user.  He's very athletic.  He does a lot of climbing or whatever.  And so they do a lot of those marathon races in the wheelchairs.  They do a lot of hiking and climbing and things like that together.  

They were hiking in a national park here in the United States and he was lagging behind and she was starting up the hill as she was walking and he was coming in his wheelchair.  And these people were just really getting irritated that his wife was not helping him get up this hill.  And so they were coming alongside and trying to push him up there and his wife turned to the people who were there and said, you know, you can help him at your own risk.  I'll just say that to you.  He usually likes to do it on his own.  Now, he could have indicated that as well.  He was just being amused by the situation, because they were thinking that she was being this terrible wife.  But again, he's very athletic, it was just taking him some extra time.  At that point, he didn't need help with that wheelchair.  

So again, sometimes we over-help and make assumptions.  I know the other thing, he was in front of an art museum.  He didn't really care to go in.  His wife had gone in, and he was sitting there.  And there were people that were putting money in his lap, thinking that he was there asking others for money.  So we make all these assumptions and, maybe out of a good heart, let's help this man in this wheelchair up this hill.  And he's going, really? Because I'm here to get some exercise, and this is how I'm doing it.  

So clearly, we need to respect that with individuals and find out the plan.  What does that person need to do on their own?  What do they want to do on their own?  When is the point when help might be necessary?  Sometimes I've just bridged that by simply saying, Hey, let me know if I can give you a hand in any way.  Being a part of a setting and there's a buffet line, and this person who's a wheelchair user, or using a walker, but that, again, I'm volunteering, they can hit me up, I'm willing, but I'm not going to just take over and say here, I'll take your tray.  So again, asking questions, listening, I think is really important.  

So I hope this has alerted to at least to some key issues with medical and mobility differences, and giving you a somewhat of a roadmap to think about as you find those places where you can do worship and do education, do service, do fellowship together with people of all abilities.