Show Notes:
National List of Centers for Independent Living
Transcript:
Sarah: [00:00:00] You’re listening to Good Fit Poor Fit. Our podcast is part of The UD Project, a small business rooted in occupational therapy that looks at how the design of a home environment impacts how well people of different ages and abilities perform everyday activities. We chat about this unique perspective to boost your knowledge and help you consider what can be changed in communities like yours.
Learn more about our work at universaldesign.org.
Hi listeners. Welcome back for yet another special episode in our series, UD and Me. Today Rebecca and I will be introducing you to Ashley Roberts Dulany. She has her Master’s in OT and has gone back to school to get her Doctorate in OT at the University of Missouri. She asked us to mentor her in her capstone project in the completion of that project [00:01:00] in which she has developed a guide for an architect who has a specific interest in accessibility as a lot of her work centers around accessory dwelling units or ADUs. We thought a UD and Me episode would be a great opportunity to have her share more about the guide and discuss a bit more about herself and her favorite accessible things.
Rebecca: Yes. I’m so excited to hear more about you and your universal design journey, Ashley. So before we jump into your project, can you share more about yourself and your background, maybe why you’re interested in home accessibility and universal design?
Ashley Roberts Dulany: Yes. Thank you for the introduction. I’m happy to be here. My interest in accessibility started with an internship I did in OT school in 2018 and 19. The internship was at our local Center for Independent Living, working in the access services department. In case you’re not familiar with Centers for Independent Living, they’re nonprofit resource centers that help [00:02:00] people with disabilities advocate for their rights and access the tools and services they need to live independently. At least 51% of their employees identify as people with disabilities, so they’re run by the very population they serve. In my internship, I helped recycle used durable medical equipment such as walkers, commodes, and hospital beds that were donated by community members to other local consumers who needed them. I also train consumers on how to use assistive technology like computer screen magnification programs, and captioned telephones. That internship first sparked my interest in this population of people with disabilities living in the community. Once I graduated OT school in 2020, my first OT job was in a continuing care retirement community. This community had independent homes and apartments, assisted living, memory care, long-term care, and a short stay rehab unit. That job gave me great experience with multiple levels of [00:03:00] care, and help me see firsthand how important it is to a lot of people to maintain their own independence and have their own space as long as possible. That brought me to my current job on a grant funded aging In place program. We use in-home sensors and smartwatches to monitor older adults and people with disabilities in their homes and provide health coaching services. Part of my role as the OT in this program is completing a home safety assessment for each client and providing education on home safety. Seeing a variety of homes through this work has helped me appreciate how important an accessible environment is for supporting optimal functioning. Last year I also worked as the OT for a grant funded program called the Older Adult Home Modification Program through HUD, The Department of Housing and Urban Development. In this program, I worked with a Certified Aging in Place Specialist and contractors recommending home modifications for older adults. That work [00:04:00] gave me more exposure to the world of home accessibility and deepened my appreciation for homes designed with accessibility in mind from the start.
Sarah: Ashley, you have had some amazing experiences and have actually gotten to get into some of those non-traditional OT roles that many OTs are trying to find in their journey of working outside the typical clinical role. I don’t think a lot of people know about The Centers for Independent Living, and my husband, Scott, has actually been on a board for that.
And so listeners, if you don’t know, they’re around the country and they’re wonderful resources. So look to see if there’s one close to you. But the HUD funding has certainly opened up a lot of opportunities for OTs to serve their communities, such as assisting with needed home modifications, and providing consumer education on ways to make their homes safer and functional. Ashley already having your Master’s and going back for your Doctorate has given you some really great real world experience plus flexibility [00:05:00] to refine this project you’ve been working on, focused on design. Can you share with our listeners what you’ve learned and what you’ve produced in collaboration with an architect?
Ashley Roberts Dulany: Yes. I’ve always enjoyed discussions on emerging practice areas for OTs because I think our skill sets are well suited for a lot of areas that are not yet mainstream in OT practice. I’ve been really fortunate to find positions in some non-traditional roles. As you mentioned, the post-professional doctorate program allows for a lot of flexibility to choose a capstone project that aligns with each student’s professional interests and goals. Being that my career has centered around aging in place, I decided to focus on accessibility. A major component of my capstone work was collaborating with an architecture firm to develop a resource document for use with architecture clients interested in home accessibility. This document included information on accessible kitchen features, bathroom recommendations, general design [00:06:00] principles, as well as some local resources and vendors of accessible appliances. The architecture firm, Monarch Architecture specializes in ADUs or accessory dwelling units, which are often used as living spaces for aging relatives to live in. In talking with the architect, it became clear that many of her clients would like to know about options to incorporate accessibility without following full on ADA standards. Many don’t have current mobility limitations, but would like to plan for future aging in place. We wanted to focus the resource document on providing information and options so the clients can choose what’s most important to them. Sarah and Scott were a huge help in creating the resource document and shout out to Monarch Architecture for collaborating. Prior to reaching out to the architecture firm, I reviewed the research literature on OTs role in accessible design and also dove into other media on the topic, including podcasts and blogs by people with disabilities sharing their experiences [00:07:00] and struggles finding accessible housing. One point that stuck out to me in the literature was that sustainability and eco-friendly design are big trends in architecture and education programs, but accessible design is not yet a major focus in most programs. This highlights a major gap that OTs can fill by collaborating on design projects. There’s also some evidence about interprofessional education between OT education programs and architecture education programs. And I’d love to see that become more common. The literature also suggested that OTs wanting to work in the design space should seek continuing education on topics like basic building codes and design principles to gain respect from design professionals and to speak the same language, so to speak. So I also completed a couple of certification programs to deepen my knowledge, namely a Certified ADA Coordinator Training and a Certified Aging in Place Specialist training. [00:08:00] ADA training taught me about a variety of disability rights topics, including the specific ADA building standards and the legal requirements for accessibility in buildings and communications. The Certified Aging in Place Specialist training was focused on home modifications and design principles to support aging in place.
Rebecca: It sounds like we went through rather similar exploratory journeys with these topics. The literature, the comparison with the eco-friendly design world. Learning to talk the talk when you’re thinking about working with people in the building industry, and I just wanna spend another quick second on a few bits of this, if that’s okay.
In terms of the eco-friendly design comparison, I’ve had conversations with architects and other people in that industry who’ve talked to me about the LEED certification, which is a globally recognized certification system for public buildings that meet certain sustainability requirements. And I just wonder like.
Why don’t we have something like this for universal design [00:09:00] or for accessible design? It could be an interesting incentivization, I think, for, different companies or, you know, different, public buildings to actually consider accessibility. I don’t necessarily think that the ADA is working as incentivization in that space right now.
Also in terms of talking the talk and learning more about the nitty gritty of the ADA, I personally think that more time should be spent in OT school, definitely at the doctorate level, on content around this. I think it’s so critical for OTs to think about the context in which they’ll be sending patients out into the world when they’re working with them.
And just understanding what codified supports exists and what communities and employers and, business owners are legally required to provide. And I feel like that’s a really important part of patient advocacy that isn’t really covered too much in a lot of OT curricula. Do you guys have any thoughts about this?
Ashley Roberts Dulany: I just absolutely [00:10:00] agree with that and I think that would be a great step for getting more accessible homes out there is having some sort of incentive for people to design that way rather than the bare minimum of the ADA standards.
Sarah: Sure.
Yeah. Scott and I have actually talked a lot about the incentivization and the LEED and things like that, and I think one thing that he brought up is he was just worried that it would turn into the ADA, like a checklist and then if you have like the gold, bronze, and silver, how do you decide which accessibility features are the most accessible or that we should use because something is going to be omitted, which might still create accessibility problems for someone. So it is a hard nut to crack, but I feel like there needs to be something out there that provides more guidelines and provides more, opportunity for tax breaks, yeah, I, I don’t know if felt like a, a stamp or a certification would do it, um, but I think if there’s more incentive financially for people to [00:11:00] add more things in, that might be something that they would do.
I also agree with you, Rebecca, about more information in, schooling. We actually recently talked to, an architecture class at Virginia Tech, and we got the opportunity to talk about the medical side to design, or about the importance of considering people with disabilities.
And so I think it goes both ways, if we need to learn more about how to talk the talk to architects, I think it would be helpful for them to understand some things too, knowing we don’t need to know it all, but we can collaborate together to make something great for the end user. So anyway, those are my 2 cents.
Rebecca: No, I agree with everything that both of you said. I appreciate you, uh, ad-libbing a little bit with me. So, Ashley, usually on our UD and Me episodes, we have our guest talk about their favorite universal design things. So could you share your favorite universal design features outside of the home or around in the community?[00:12:00]
Ashley Roberts Dulany: Outside the home. I love to see aesthetic ramp options built into the landscaping. I often have to walk across campus with a rolling briefcase to transport home safety items for my job, and it’s so nice to have an option to take a ramp instead of stairs. I love to see ramps that look like they’re just part of the landscape, not an industrial looking add-on. Ramps, of course, are great for anyone using a wheelchair, pushing a stroller, or transporting items. In a rolling briefcase or cart like me. It’s still nice to have stairs as an option though for anyone who finds them easier. For example, ramps need to meet certain slope requirements to keep from being too steep to navigate. That means sometimes the ramp route has to be a longer distance than the stairs route to keep it from being too steep. Some people have lower endurance and would find a few stairs easier to complete than taking a longer route for a ramp.
Sarah: That’s a really great example because a lot of times we think, oh, the more ramps the better. [00:13:00] But there is that endurance piece and I think having both options is helpful. And I do love to see a good ramp integrated into the landscape. My example again goes to my recent conversation at that architecture program at Virginia Tech. They had the opportunity, to get in some wheelchairs and wheel around campus and try out some newly constructed ramps on their campus, and it was very eye-opening. It was a great opportunity for them to see the benefits of a gently sloping ramp for going down, compared to this neighboring hill that we made them push up the slope.
They were like even showing me the blisters on their hands after the day was over. It was great to see them have that experience. One student even shared with me while she was sitting in the wheelchair for her class that when she normally walks to places on campus, she avoids certain routes of travel with lots of steps and hills ’cause it’s easier to find a flatter route.
So this concept can easily be something for people walking or rolling, that a lot of people [00:14:00] can benefit from. What a good example, Ashley. Now let’s shift into the home. What is your favorite UD concept or product for a home setting?
Ashley Roberts Dulany: One of my favorite UD concepts is dimmer switches for lighting. Lighting is not always the first thing that comes to mind when thinking about accessible design, but lots of conditions can make a person sensitive to light. Having the ability to adjust the intensity of lighting can be so helpful in so many scenarios. You may want lower lighting options if you have a headache, if you’re winding down before bed or if you get up in the middle of the night to name just a few examples. When the only available lighting option is too intense, people are more likely to forego turning on a light at all, which can lead to a fall.
Rebecca: This is a great example, Ashley. In our home, we have different stages, as we call them, of lighting for different parts of our day, and different activities. For example, we’ll dim the lights after dinner in the evening when we’re ready to start to wind down. So having that ability to dim the [00:15:00] lights is a great piece of that.
Just letting the lighting compliment what we want our bodies and minds to be doing. And also on the side of safety, like you said, lighting is so critical. I hadn’t really thought of the fact that non dimmable lighting may make people more likely to not even turn their lights on at all, which could potentially be a safety risk.
So I think that’s a really smart point, and I’m glad that you brought that up.
Sarah: Yeah, definitely. I actually think lighting is often underestimated in accessibility conversations, even those that are motion censored in the middle of the night. When you put your feet on the floor, the lights can turn on. It not only, helps with ambiance and making the space feel cozy, but it has so many functions for working on tasks in the kitchen and the bathroom if you like to do crafty things. Plus showing us potential safety issues and outside pathways at night. Simple changes in our light bulbs are even considering smart bulbs to help activate our lights with our voice or our phone provides us [00:16:00] with much flexibility. I can’t tell you how many times I’ve appreciated the voice activated lights after I’ve already gotten into bed for the evening.
So before we finish up here, I do want to give a shout out to Ashley’s next podcast episode. We were talking about her experience working with individuals in their homes, and I thought it would be super interesting to our listeners to provide an entire episode of simple and fairly inexpensive modifications for homes that many people would find beneficial. It’s easy to think bigger scale and consider all the major renovations that can make a home easier to use, but sometimes it’s the little things that make a big difference for people’s daily lives, and I thought it would be fun for Ashley to highlight that.
Ashley Roberts Dulany: Thank you for having me. I’m looking forward to coming back.
Rebecca: Awesome. We can’t wait. Thanks for your time, Ashley and listeners. We’ll be back real soon.
Sarah: Thanks for listening to Good Fit Poor Fit. If you want to learn more… first, find more episodes with transcripts and show [00:17:00] notes at goodfitpoorfit.com. Don’t forget to subscribe! Second, check out our courses at universaldesign.org.
We cover housing topics like advocacy, collaboration, home modification, universal design and task adaptations. Lastly, if you have questions or topics you’d like us to discuss, email us at [email protected]. Thanks for fitting us into your day.
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