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Annex VII

Disability Simulation Exercise (*4)


1. What Is It?

This is an exercise that can be used to give participants an understanding of what it is like to be elderly and disabled. It is most effective if the exercise can span an overnight period, as many normal acts of daily living, such as going to the toilet, walking, eating and dressing, can be experienced.

2. When to use the simulation exercise

It is best used in a workshop situation. It can be used for small groups of five or six people or a large group of up to 30 which is divided into smaller subgroups.

3. Disabilities that can be simulated

Paraplegia, stroke, arthritis, being an amputee, having a broken leg, cataract, tunnel vision, blindness, hearing loss, heart/chest conditions can all be simulated.

4. Equipment and materials required for simulation exercise per group of ten participants

One self-propelled wheelchair, two pairs of adjustable crutches, one adjustable walking frame, one adjustable tripod walker, one camera jacket (with several pockets), sunglasses (lenses smeared thickly with soap), sunglasses (adapted for tunnel vision), one set of industrial protective earmuffs, two sets of shin protective guards, one set of elbow proective guards, one set of wrist weights (1 kg), one set of wrist weights (2 kg), one set of ankle weights (1.5 kg), one set of ankle weights (2.5 kg), two crepe bandages, cotton wool, one set of thin surgical gloves, safety pins, and talcum powder.

5. Briefing on disability

It is important that a short briefing is given on each disability, its causes, effects and limitations. This will help to improve understanding and involvement in the role play situation. If blindness is being simulated, then a demonstration of how to lead a blind person must be given by someone who is familiar with the correct way of doing this.

6. Demonstration on use of devices

A demonstration is given of how to measure the correct height of the walking devices, to adjust them and to ensure their safe use on steps/stairs and outside in negotiating kerbs. It may be useful to have a physiotherapist take part in this exercise.

7. Medical conditions

There are various medical conditions that could be aggravated by simulating some of the disabilities. Advise the whole group about this. Check with the group if anyone has a heart condition, chest condition or arthritis and avoid allocating them a "disability" that may be detrimental to their health.

8. How to simulate different disabilities

There are a number of different physical and sensory impairments that can be simulated in this exercise by using the equipment listed above.

(a) Paraplegia

Use the wheelchair. Check that the person can use the wheelchair correctly, knows the procedure for both kerbs and steps and is comfortable. Check that the person can use the walking device correctly, knows the procedure for steps/stairs and is comfortable.

Someone with a heart or chest condition or arthritis should not try simulation of paraplegia.

(b) Heart condition/chest condition

Use the camera jacket. Put weights into the various pockets around the jacket. Judge the total weight according to the size of the person. Small woman: 5 kg; large man: 8 kg.

Someone with a heart condition, chest condition or arthritis of the spine should not participate in this simulation exercise.

(c) Cataract

Use sunglasses, the lenses of which have been thickly smeared with soap. As an alternative, the lenses may be covered by semi-opaque plastic. Check that the glasses are comfortable.

(d) Tunnel Vision

Use sunglasses that have had cone-shaped tubes of cardboard attached to the lenses and the sides screened off. Two sections of an egg box could also be used. Ensure that the centres of the cones are aligned. Alternatively, blacked-out spectacles with pin holes to simulate tunnel vision may be used. Check that the glasses are comfortable and that the person is aware of the necessity of turning her/his head from side to side to compensate for the narrow field of vision.

(e) Blindness

Use a crepe bandage tied around the head to cut out all vision. A sleeping mask or sunglasses that have had the side screened off and the lenses blacked out may be used. Check that the blindfold is comfortable.

(f) Deafness

Use a set of industrial ear protectors with cotton wool tightly packed inside them. Have enough cotton wool to replace it for each participant; if someone has an ear or skin infection this will avoid it being passed on. An alternative to the ear protectors is to use wads of cotton wool over the ears, held securely in place by a crepe bandage, but this does not cut out sound as effectively as the ear protectors.

9. How to conduct the simulation exercise

(a) Pre-preparation

Asseble the various "devices" that will be required in the exercise. Be sure to have enough for the whole group. Work out an itinerary of places and activities for each group, i.e., four or five places could be visited in sequence. Examples could be: a public toilet; a bedroom with attached bathroom; a bus stop; a post office (to buy and post stamps); a lift to go from one floor to another in a building; a shop to price some items on sale; a kitchen to make afternoon tea for the group, and so on.

Each group will encounter various barriers in everyday life. If the workshop is residential then having a meal together can be a good idea. The sequence should be different for each group so they do not all try and visit the same place at the same time.

Decide beforehand the duration of the exercise, e.g., half a day or 24-hour period.

A separate itinerary should be prepared for each group, with a list of the activities that they should undertake in each location.

(b) The Simulation Exercise

Briefly explain what is to happen during the exercise and its duration.

Give a short briefing on each disability.

Check with the participants for any contraindicated medical conditions.

Demonstrate how to measure and adjust the walking devices for correct height and confirm that this is understood.

Demonstrate the correct use of the various devices and ask for a return demonstration.

Demonstrate the correct method of guiding a blind person.

Outline the itinerary and what is to be done at each location.

Divide the large group into smaller groups and allocate "disabilities", ensuring that no participant in that group already has a medical condition that could be aggravated by the assigned simulated disability. If so, reallocate a "disability" that is safe for the individual. Each group member should have a different "disability".

Advise the group members to change "disabilities" after a specified time depending on the duration of the simulation exercise.

Go over that groups itinerary and check that it is understood. Dress group members up in the simulation devices, adjusting walking devices for each individual. Check that each person is comfortable and knows how to use the devices correctly. Inform the group at what time it is to meet together again.

If the exercise is to span overnight, allow each participant to select a different "disability" when the group meets again.

(c) At The End of the Exercise

It is important that the whole group comes together at the end of the exercise and discards its disabilities. Time must be given for participants to express their feelings and to discuss the barriers and difficulties encountered during this exercise.

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*4 Contributed by Ursula Craig, Regional Training Adviser, Asia Training Centre on Ageing, Chiang Mai, Thailand.


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ECONOMIC AND SOCIAL COMMISSION FOR ASIA AND THE PACIFIC
Promotion of Non-Handicapping Physical Environments for Disabled Persons: Guidelines
- ANNEX 7 -

UNITED NATIONS
New York, 1995