A Day in the Life...A Mile in Their Chair

There are many worthy challenges going around social media these days.  Come to think about it, a lot of unworthy ones too.  But let’s stick to the positive – The Ice Bucket Challenge for ALS, the Push-up Challenge to honor those who served and No Shave November for prostate cancer – these challenges, however brief, can effectively spotlight a problem.  One that caught my attention was A Wheelchair for a Day.  When I came across it, my first thought was, “How did I not think of that?!”

Testing out the wheelchair - Day One.

Any architect who works in public spaces must know about accessibility issues, as they have been addressed by various laws and codes for the last several decades, including the Americans with Disabilities Act of 1990 (ADA).  It didn’t actually begin there, but the ADA is perhaps the best known law (The Architectural Barriers Act of 1968 preceded it as denoted in its name).  However, in our practice’s emphasis on Senior Living design, there is a much higher concentration of end users who require some form of mobility aid in a lot of our work.  This could be a wheelchair, a scooter, a cane or a walker.  In areas of nursing care, close to 100% of the residents will be confined to a wheelchair.  In these cases, the traditional large rear-wheeled chair will not be of any use because these folks lack the upper body strength to move under their own power.

Screen shot from the ADAAG website.  Every architect should bookmark this.

With twenty years of experience and in my capacity for being the office “Code Guy”, I feel confident can readily see accessibility clearances in architectural plans or the built environment, especially when those clearances are infringed upon.  I don’t really have to think about it too much; I liken it to being about to “see the Matrix” if you get my movie reference.  So I know the requirements we need to impart on the built environment, but how about the “Why”?  In theory, I thought I had a pretty good handle, but I wanted to test myself.

Our firm’s partnership was behind my desire to spend a typical day in the office in a wheelchair and it was suggested that I consider a motorized scooter as well.  Our current office is only a few years old, and as such has been designed to comply with all current accessibility standards.  Additionally, as our client base includes many senior living communities, we certainly want to be as inclusive as we can be.  Our old office was on three levels with no elevator.  The current office is all on one level.  My initial thought was that this should be relatively easy.

Day 1 – The Transport Wheelchair

I was able to borrow a wheelchair without any problem due to our firm’s close relationship with a nearby senior living community.  My ride of choice was what is called a transport wheelchair.  It is lightweight and folds easily.   It does not have the big rear wheel and it is what most residents in a skilled care or nursing home environment will spend most of their time in when they are not in a more comfortable stationary chair.  This meant that to move around, I would use my feet not unlike Fred Flintstone powered his car.  You may think this is a cheat, but it isn’t really.  My grandmother spent a lot of time in a chair just like this as her health declined due to Alzheimer’s Disease and was able to shuffle just as I described.  Additionally, my mother-in-law also has utilized the same kind of mobility device since a stroke left her uneasy on her feet and without the full use of her left hand.  And after spending 20 years designing skilled nursing facilities, I know that this chair is far more common in these kinds of environments than the more independent version.  So while this chair has foot rests, they were to remain folded up for the better part of the day.

My lunch was a bit of a reach.

I had not spent any time in the chair before I arrived at the office.  The chair was folded neatly in my trunk, so I felt that once I opened the chair and sat down in the parking lot, that would be the official start to my day in a wheelchair.  The first challenge was the hatch to my Subaru Outback – its height over my head was a stretch.  Being otherwise able bodied I was able to shift my body to get one hand high enough to clutch the hatch to close it, but a much shorter person may not have had the reach.  So immediately after sitting down, I had a different perspective.  Even though I was taking this challenge, I did not park in one of the close, handicap spaces, so I had fifty yards of ground to make up with all of my stuff in my lap – I had my lunch, my computer bag and my coffee (non-spill thankfully) – my normal array.  As I shuffled towards the back door, other employees thoughtfully asked if I needed some help at the door, but I was determined to do every task myself.  I asked that they go ahead and just let the door close behind them.

It was a reach to get a mug!

I knew that all the doors in our office would be of an approved size and have the proper clearances (for instance, 18 inches clear on the pull side of the door).  However, when pulling a door towards you, even with more than 18 inches in play, one’s feet (and footrests) will invariably still knock into the bottom rail of the door.  A lightbulb moment:  there is a code requirement that all doors be smooth for the bottom 10 inches – you can’t place trim or molding below this measurement, and you can't transition to a glass panel in that area either.  This is important so that your feet tangle as little as possible with the bottom rail of the door.  But aside from the foot banging, I did not have much issues with getting into the building.

There is a good reason that the door is solid at the bottom and the sidelights are not.

A typical day includes me dropping my bag lunch off in the refrigerator near the lunchroom.  We have a French door refrigerator with the freezer on the bottom.  That means while the doors into the fridge can be swung out of the way easily, very few of the shelves are at a comfortable height for someone in a wheelchair.  We have about 70 people in the office and one fridge for lunches – it’s always full.  I had to shift some of the 10 mustard bottles around to make a space out on the door shelf – luckily my packed lunch is normally fairly compact. 

That is a full refrigerator!  And boy, did I feel small.

My desk is literally the furthest point in the office from the back door – 294 feet in fact.  I had not considered this before I sat down in my chair.  We also have some pretty sweet reclaimed wood floors which are nice and smooth.  The problem is in the throw rugs.  Anyone who has run a vacuum cleaner into a throw rug knows the issue.  The rug itself is a bit of a jolt and it can tend to buckle on itself when the wheels hit it creating an even larger bump.  The rugs are only in the more central areas of the office and I was able to make the transition as I shuffled myself forward towards my desk.  I never knew 300 feet could be that far.  By the time I got to my desk my hamstrings burned at bit.  It wasn’t even 8 AM.

 

It may not look like much, but this is a significant speed bump in the chair.

Getting to my desk, there were fewer obstacles.  Our aisles are wide enough, although I forgot to move my office chair out of the way of my desk.  This was a bit of a challenge; positioning myself in the wheelchair in such a way that I could move the big bulky chair out of my workspace without slamming it into myself.  But it had to be done, I was not transferring to the other chair to work at my desk.  But once that was removed, I found my desk space to be big enough for me to get around.  My desk is U-shaped with an open area of 42” x 66”.  We normally provide a turning space a minimum of 5 feet in diameter, but the open space under my desk provided adequate knee space to make a full 360 degree turn.  As I was more or less able-bodied above the waist on this day, I found gripping the countertop useful in to swivel myself around without needing to use my feet so much.

Turning my computer on was no problem.  However, at over 30 inches deep our workstations are a bit deeper than the typical 24 inches.  This is due to the drawings we produce which are 30 by 42 inches.  Makes sense right?  But as architects we talk about side approach reach for people in a wheelchair, meaning if the chair is parallel to the counter, how far is one able to reach?  At about 24 inches away, one can reach about 8 inches above the countertop maximum.  My book shelf is further away than 24 inches, and the shelf is more than a foot above the counter.  It was a stretch for me, but again, for someone smaller with shorter arms, not possible.  I also tend to leave some books on top of the divider which is 27 inches above the countertop.  So when I needed my ANSI Standard for Accessible and Usable Buildings and Facilities, that book was inaccessible to me.  The irony was not lost on me and, fittingly, my first question of the day related to accessible storage.  I needed that book!

 

Our desk surfaces are very deep, which means the bookshelves above are hard to reach.

Early in the day I started to carry a notepad around to jot down my challenges (one of them being nowhere to put anything - including a notepad).  So I had a number of things I was trying to keep with me as I moved around the office, including said notepad and pen, tape measure, my phone and my coffee.  It was a lot of stuff to have in my lap while still doing my normal gig.  I went over to the copy machine which I found to be an acceptable height.  It even had a touch screen that could tilt to a proper angle for someone in a seated position.  However, I noticed the extra paper would have to be loaded by someone else; it is far too high in wall cabinets behind the copier itself – no access.

Even though the idea of our one story office was to facilitate face to face interaction of the staff all day long, I found myself utilizing email and phone calls to those in the office far more frequently on this day.  I normally walk over to talk to someone – I prefer that.  But it just seemed so far away today…and crap!  I left my coffee at the stupid copier.  Arrgh!  Pretty soon, I found that shuffling backwards to get from point A to point B was far more natural and less taxing on the legs.  I immediately recalled seeing this action by residents in the skilled care facilities I have worked in.  Duh, why didn’t I remember that?

After an hour or two at my desk, I noticed that I kept trying to pull myself closer to the countertop than I actually could achieve. I kept knocking into the edge of the counter: not with my knees, but with the bar that forms the armrest structure.  I noticed on my ‘other’ office chair, I have the armrests positioned pretty low so they run underneath the counter.  My wheelchair, like most, did not have adjustable armrests, and the aluminum tube forming the structure for the armrest started out several inches in front of the actual armrest pad, so it impeded my ability to get any closer.  My countertop height and clearance below it met all accessibility requirements:  it provides 27.5 inches clearance where the minimum for knee space is 27.  In order to get closer, I would have needed 29 inches to allow the armrest to pass under the counter.  I mentioned that to the individual who loaned me the wheelchair and she said it’s a very common frustration in their health center at dinner.  Residents can't get quite near enough to their dinner plate at a standard sized table.  I totally got it.  Adjustable height tables are available, but they are expensive and less easy for staff to use and move around.  They typically don’t get adjusted much after they are set in place.  And the standard height of a table is 30 inches which means it would be tough to get 29 inches clear beneath it.

 

The counter is accessible in height, but the armrests don't fit under it.

I did my best to move around as little as possible, but by this time it was almost noon and I had yet to use the facilities.  I am not going to get graphic here so don’t worry.  But I will say this:  I had no issue getting into the bathroom nor did I have any trouble turning around and getting the wheelchair alongside the plumbing fixture.  Once in position, however, I had absolutely no idea what to do next.  I sat there thinking about how I was supposed to transfer my body, using the regulation grab bars on the wall, from the wheelchair to the toilet seat, all without any use of my legs.  My ANSI Commentary book even has diagrams in plan view as to how this supposedly happens, but I still couldn’t quite figure it out.  Let’s just say I am sure I cheated a little bit in this one task.

Perfect access, except for the trashcan...

So with that behind me, it was time for lunch.  I normally retrieve my bag lunch and a water, take it back to my desk and read the news on my computer.  Having placed my lunch successfully earlier that morning I was fairly certain I could retrieve it, as long as no one moved it, which does happen, but fortunately had not occurred this time.  We have a second refrigerator that is only for drinks, which I opened.  I immediately felt much smaller than normal.  I was able to reach my seltzer of choice in the middle shelf with a bit of stretching, but as one of my coworkers so kindly put it, “no Diet Coke for you!” as it was on the top shelf.  On my way back to my desk I went by the mailboxes.  My box is luckily in a middle area, but it was still impossible to tell if anything was in it without reaching my hand into it due to my vantage point.  Our boxes are in alphabetical order; thank heaven my last name does not start with A or B!  Oh, when I finally got back to my desk, I had forgotten my fork.  I had to go all the way back to the lunchroom and didn’t bother coming back to my desk to eat.

My perspective this day was definitely adjusted.  Diet Coke is WAY up there.

I am one of those people who brushes his teeth at the office after lunch.  So I went back to the bathroom.  Our sink is open underneath, as it should be in a public bathroom.  But we often provide side approach clearance to a sink in an apartment residence so I decided to test this out (there was a trash can in the clear space but I could have moved that).  It was harder than I thought.  Washing your hands sideways is way different than trying to spit sideways.  I felt like I was at the dentist office and trying to hit that little bowl off to the side.  I always leave the dentist office with a wet shoulder.  Even when I switched to a front approach, I found it difficult to capture water in my cupped hand and get it to my mouth in order to rinse.  Again, the chair’s armrest did not let me get as close to the sink as I would have liked.  It was like that relay race you did as a kid, trying to fill a spoon with water and run across a field to fill up a cup.  There’s always spillage.

The second half of my day was much like the first half.  Needless to say I was anxious for the end of the day so I could stand up.  I will often work at a stand up counter in a normal day, and I couldn’t believe how much I just wanted to stand and stretch out on this day.  I know that one day is not enough to thoroughly experience what it is like to be in a wheelchair day in and out.  Some of the tasks I performed were very awkward for me doing them for the first time; I am sure that over time they become easier, but I am sure they are still a challenge.  And please know that any of the humorous comments made during my reflections on this day are 100% targeted at me and only me.  I am one of those people who, if I can't laugh at my own hardships, I might cry.  So the jokes or comparisons I related in this story are my built in defense mechanism, just trying to diffuse the tension. 

As it happened, my in-laws were visiting us for the week at the same time I had set up this trial.  I can truly say I felt thankful when I went home and saw the ramps my son and I had built set up at our doors that allow my mother-in-law to more easily make it into our house.  Our house was built in the early 1950’s and like many others of that era are not accessibility friendly.  So even though I ended my own trial before I went home, I really didn’t.  I know how hard it is to negotiate the steps into our house.  The doors are all too small in width.  There is a small powder room on the first floor, but no bathing fixture.  As an architect I had already seen all these shortcomings, but after my trial I saw them even more clearly.  My wife and I have some ideas on how to make one story living a possibility in our house, but it won’t be cheap.  It is much, much easier to make that possible if you consider all of the needs in design.

Day 2 – The Motorized Scooter

I had scheduled to have a day in a motorized scooter the very next day.  I can’t tell you how happy I was that I did not do it the other way around.  A local dealer allowed me to borrow a pretty nice unit that is not unlike many we see in retirement living environments.  Even relatively healthy independent living residents may need mobility devices to travel long distances on their own.  Retirement living campuses can get rather spread out.  As I found out the day before, even 300 feet (just the length of a football field) can seem much longer from certain perspectives.

My ride for the day.

The unit itself breaks down into five very manageable pieces such that most people could stow it in their car and then assemble it at the point of use in about 2 minutes.  The heaviest piece is the battery at just under 30 pounds.  From the moment I got on the scooter in the parking lot, I felt a huge sense of freedom compared to the day before.  This thing was pretty zippy.  It was entirely more maneuverable than I thought possible on three wheels.  I got a lot of amused looks from my coworkers on this day.  I didn’t get all the offers for assistance, and it was obvious that I was more willing to move about the the office than the prior day.

I found getting to my desk a breeze.  I had intended to transfer to my regular desk chair throughout the day today.  I assumed for my trial purpose that most people using a scooter are capable of walking short distances, and I would too.  I steered into my workspace and found that I had no problem getting the device to the spot I wanted.  The seat also swivels to 90 degrees which allowed me to face my computer with no problem.  The chair height of this model was not adjustable so I felt a bit too high at my desk, but throughout the day, psychologically I felt like I was closer to my coworker’s level.

I even made it through this cluttered corner (not mine) on the scooter, no problem.

After a bit of experience driving, I found there were really no barriers I needed to worry about.  The throw rugs were minor speedbumps today.  I soon found that I could go forward and backwards using the same thumb position making operating doors much easier as the day went on.  I didn’t bump into the doors much at all after a while.  Using the same bathroom as the day before, I found there was no issue turning it around the same as the wheelchair.  And I could drive up to the side of the sink and turn the seat in order to face the sink straight on with my knees below the counter.  Being a little higher up made brushing my teeth easier as well.  All of the kitchen appliances in our lunchroom were easily accessible from the scooter as well.

Generally, no issues with the kitchen on the scooter.

Very quickly I realized why we see so many of these devices in our work.  We may grumble a bit trying to fit ‘scooter parking lots’ in our projects near dining venues or assembly areas.  But I get it.  The freedom I felt that day must not compare at all with someone who can use those machines to get from their apartment to a destination a quarter mile away in just a few minutes.  Anyone with any kind of joint pain, respiratory issues or any other medical problems must LOVE the independence they gain when they straddle one of these bad boys.  Mine even came with a basket for storage!

Swivel action on the scooter made for an easy desk maneuverability.

At the end of the second day I left the wheelchair and the scooter out by our lunchroom for our staff of architects and interior designers to try out.  My hope was that the staff would get an understanding as to the ‘why’ when I mark up their drawings if a clearance space is missing or something is mounted too high in reach range.  Because even though I could see most of the infractions before my trials, I have a much better understanding now as to how it affects someone in the position I was in for just one day.  While it is easy for many of us to fixate on the mobility kinds of issues when thinking about accessibility requirements, let us not forget the many other accessibility issues dealt for those with vision, hearing, hand dexterity and height limitations.  While it is utterly impossible to address the challenges of all, merely walking a mile in another’s shoes can open your eyes to the challenges that others experience daily, and there are some relatively small design features we can provide to help without adversely affecting anyone.

Going...

...going...

Gone.  My car fit the folded wheelchair as well as the broken down scooter without any problem.