Healthcare Workers with Motor Impairments – Part 2

Posted by Kim Cordingly on August 18, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

In this final segment of the 2-part Blog on accommodations for healthcare workers with motor impairments, JAN Lead Consultant Elisabeth Simpson, MS., CRC, in collaboration with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, continues the discussion on some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the remaining four questions and offering resources and information on the topic.

Questions:

1) When a limited schedule is needed (e.g., 10 hour shift in place of a 12 hour shift), would allowing this for one nurse on a unit really be a hardship for the other nurses working?

The accommodation of a schedule modification, as well as modifications of a workplace policy regarding scheduling, are a couple of types of accommodations an employer would need to consider providing, absent undue hardship. The EEOC’s Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act (ADA) offers guidance on this area of accommodation that might be useful for an employer or individual to review.

According to Dr. Maheady, in some cases an employer may be able to limit an individual’s schedule without it posing a hardship. However, in most situations, nurses are working with limited staff and adding additional work can be problematic for various reasons. Safe staffing ratios are critical to patient care outcomes and allowing a nurse to leave early or come in late could impact safe staffing ratios.

Alternative options could be to consider accommodations that would enable an individual to work the hours required. This could include periodic breaks, modifying policies around eating and drinking, providing equipment, or restructuring a job to reallocate marginal functions. Reassignment may be necessary if accommodations would not be effective or would pose a hardship. This type of accommodation may also be necessary if an individual needs to limit hours to the extent at which they would be working part time rather than full time.

2) For medical professionals with upper extremity limitations, what are some alternative ways to place a catheter (male or female)? Is maintaining a sterile field ever a concern?

It depends on many factors (age of patient, patient’s condition, etc.). For males, in some instances, it is appropriate to have the patient assist while placing the catheter. Also, if teaching the patient to self-catheterize (or a family member), this is part of the teaching/learning process.

What would work best is to have a second person, possibly a nurses’ aid or family member, don gloves and assist. Then the individual can don gloves, clean the meatus, and insert the catheter. Dr. Maheady notes that, in her experience, many nurses ask for assistance, disabled or not.

3) How can a medical professional who uses a cane or mobility device address concerns around sterilizing the device?

In these situations, Dr. Maheady recommends that the Infection Control Department or designee should always be consulted. There may be specific infection control issues related to a facility or unit. Collaboration with all parties in determining effective solutions can help to speed up the process and ensure that policies and procedures around sterilization are kept in mind.

Concerns around cane or wheelchair use in sterile medical environments can be addressed by:

  • Having two wheelchairs available and keeping one chair in a sterile area. The individual could switch chairs in a dedicated area.
  • Using wheelchair tire covers.
  • Wheeling into the room with one pair of gloves and changing to a new pair of gloves before touching the patient.
  • Surgical gowns could also be used to cover exposed areas of the chair.
  • A long narrow plastic bag (like ones for wet umbrellas) could be used with a cane and taped around the cane to secure. Bags could be changed as needed.

It is important to note that in general patient care areas, nurses do not sterilize their shoes, sneakers or clogs. An employer would not want to unnecessarily impose more stringent rules or requirements for employees with disabilities as this could be a violation of the ADA.

4) When a patient lifting device is not available, what are some alternative options that a medical professional with a lifting restriction could consider?

This is another situation where job restructuring may be the most effective form of accommodation for individuals who have lifting restrictions and are working in healthcare positions that require them to lift. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as patient lifting techniques, individuals with a disabilities should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. For example, an individual could be permitted to ask for assistance when lifting a patient. Team lifting, or lift buddies, can also be a solution. However, there will still be risks associated with lifting patients and injuries can occur with any employee, not just those with restrictions. It is important to remember that team members have different strengths and body sizes and may contribute differently when lifting a patient.

Ultimately, if an individual is not able to lift patients even with accommodations, reassignment would need to be considered. Reassigning the individual to another unit (e.g., pediatrics, newborn nursery) where there is a vacant position could be explored.

JAN and Elisabeth would like to extend our appreciation to Dr. Maheady for her assistance in answering these common, but difficult questions related to healthcare workers with motor impairments. For assistance in determining accommodation options for individuals with motor impairments, JAN consultants are ready to assist!

Healthcare Workers with Motor Impairments

Posted by Kim Cordingly on July 1, 2015 under Accommodations, Employers, Organizations, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

According to the Bureau of Labor Statistics (2013), the health care and social assistance sector will account for almost a third of the projected job growth between 2012 and 2022. With 16,971,800 healthcare workers employed in the United States in 2012 (Bureau of Labor Statistics, 2013), accommodations for those with disabilities working, or planning to work in, the healthcare field is a timely topic to be discussing.

With the over ten thousand calls JAN has received related to accommodations in healthcare settings, JAN consultants can offer a wealth of experience with accommodation situations. For healthcare workers with motor impairments such as carpal tunnel, back conditions, leg impairments, or arthritis, certain job duties – tasks such as lifting, carrying, moving, transferring, standing, walking, manipulating extremities, and positioning individuals for activities of daily living or physical therapy – may be difficult to perform without accommodations.

There are a variety of accommodation options that can be implemented in order for an employee to perform the essential functions of the job. Proper lifting techniques, lowering adjustable exam tables and equipment (low-lipped showers), ergonomic layouts for equipment (cranks and handles on beds and carts) and supplies (storing items at waist height, lowering bed rails when attending to patient needs, etc.), and team lifting are beneficial work site and procedural changes.

Still, accommodation situations in healthcare settings can be tricky or complicated. When this is the case, JAN consultants might turn to other experts in the field for assistance so that those contacting us for guidance are provided with the most beneficial and accurate information. For this two part blog, I collaborated with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, to discuss some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the first three questions and offering resources and information on the topic.

Questions:

1) For medical professionals with either a hand or arm amputation OR restrictions that limit the use of one hand, what are some alternative methods for giving injections? What about placing IV’s?

According to the Equal Employment Opportunity Commission (EEOC), a reasonable accommodation must be provided to enable a qualified employee with a disability to perform the essential functions of a job currently held. In general, an accommodation is any change in the work environment or in the way things are customarily done that enables an individual with a disability to enjoy equal employment opportunities.

Job restructuring may be the most effective form of accommodation for individuals who have limited or no use of one hand and are working in healthcare positions that require them to perform injections, place IV’s, etc. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as placing an IV, an individual with a disability should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. Time to practice clinical skills or tasks may be needed as part of the accommodation.

A number of videos and articles are offered as an additional resource to support the work of those with motor impairments in healthcare settings:

Videos

Foreign object removal with prosthesis

Adult CPR with prosthesis

Nursing with the hand you are given

Disabled Nurse: Focus on abilities

Danielle’s story (nurse missing her lower arm)

A sequence of photos demonstrating the donning of sterile gloves with one hand can be found within the article: “Nursing with the Hand You Are Given

Articles and Book Chapters

In the book Leave No Nurse Behind: Nurses Working with Disabilities by Donna Maheady, Susan Fleming (nurse born missing her left hand) wrote a chapter about her journey.

In the book The Exceptional Nurse: Tales from the Trenches of Truly Resilient Nurses Working with Disabilities, edited by Donna Maheady, Connie Stallone Adleman wrote a chapter called “Loving Ourselves Exactly as We Are: Nursing after a Stroke.”

In the article “Missing a Limb but Not a Heart,” Carey Amsden, RN, discussed how she practiced performing certain job tasks with the use of one arm, such as starting an IV, and donning a sterile glove in nursing school and has been able to successfully work in the field of nursing.

2) For medical professionals who need to wear a brace or post-burn glove, how can concerns around sterility be addressed?

An employer may require as a qualification standard that an individual not pose a “direct threat” to the health or safety of the individual or others, if this standard is applied to all applicants for a particular job. Additionally, employers may comply with medical and safety requirements established under other Federal laws without violating the ADA.

However, an employer still has an obligation to consider whether there is a reasonable accommodation, consistent with the requirements of other Federal laws, which would not exclude individuals who can perform jobs safely. In situations where sterility is a concern, alternatives to standard practices should be explored with the individual.

One option could be for the employee to wear a sterile glove (perhaps a larger size), gown or drape over the brace or glove. In doing this, sterility would be addressed to the same standard that others would be held to.

It is also recommended that the Infection Control Department or designee be consulted. There may be specific infection control issues related to a particular facility or unit to consider.

3) Are there alternatives to taking a leave of absence during flu season for medical professionals who are not able to receive the flu vaccine?

Flu season, in some areas, can last a while and a leave of absence may not be feasible or could pose an undue hardship to the employer. Alternative options for accommodating those who are not able to receive the flu vaccine can include: allowing the employee to wearing a mask or protective gear, reassigning the employee to a position that does not require direct-patient contact, considering flu shot alternatives, modifying a policy if applicable and depending on state law, or allowing an extended leave and offering reassignment to a vacant position upon return. For more information, see the following article: “Vaccinating the Health-Care Workforce: State Law vs Institutional Requirements.”

Next month we will be exploring schedule modifications and specific work tasks, so stay tuned!

Resources:

Monthly Labor Review (2013). Bureau of Labor Statistics. Retrieved from http://www.bls.gov/opub/mlr/2013/article/industry-employment-and-output-projections-to-2022-1.htm

February Heart Health — Accommodating Employees with Pacemakers in the Workplace

Posted by Kim Cordingly on February 26, 2015 under Accommodations, Employers, Organizations, Products / Technology | Comments are off for this article

By: Sheryl Grossman, Consultant – Motor Team

For some, the month of February is about expressing love for family, friends, and even co-workers. For others, February is about thawing out from the cold and dark of winter and beginning to realize results from health commitments made in the New Year — to eating a healthier diet, exercising more regularly, and improving overall heart health.

However, for those who have experienced a heart attack, atrial fibrillation, or other heart conditions requiring a pacemaker to assist in maintaining a normal rhythm, February like any other month is a time to focus on the love of one’s work and new heart related concerns. This may seem particularly daunting to those who work around utility lines, strong electrical/medical equipment, or near the potential for a spark, like when welding. Electro-magnetic radiation emanating from these devices may cause electro-magnetic interference (EMI) that can interrupt the pacemaker’s functioning.

Fortunately, advances in occupational safety allow for job accommodations that may not have been possible years ago. The American Radio Relay League (ARRL) provides many suggestions for working around electrical appliances, cellular telephones, medical devices, and when working as arc welders if an individual has a pacemaker.

Due to increased exposure of those with pacemakers to EMI-producing elements in their day to day lives, pacemaker manufacturers have responded with more and better implant protection; however, this cannot protect against all incidents of exposure. For this reason many people using pacemakers also use an EMI detector to warn them of an EMI source above the threshold for their implanted device in the near vicinity. Most individuals will experience only minor and temporary interference with their implants when exposed and this will most often disappear as they move away from the source of the interference.

Employers can assist these individuals who are returning to work by:

  1. Ensuring electrical appliances and equipment are well-maintained to prevent leakage and sparking;
  2. Shielding gas-powered generators and gas-powered saws;
  3. Providing EMI protective gear for these workers;
  4. Providing electro-magnetic frequency (EMF) blocking/shielding devices and appropriate long-corded, headsets for cellular telephones;
  5. Allowing the use of an EMI detector and the ability for one to move away from an area if the alarm goes off.

On the JAN Website, you can find additional tips for accommodating people using pacemakers in the workplace.

Take a Deep Breath

Posted by JAN Tech on January 28, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Beth Loy, Ph.D. – Principal Consultant

For individuals with chronic obstructive pulmonary disease (COPD), it can be difficult to take a deep breath at times. This difficulty may be triggered by temperature changes, humidity levels, contaminants, pollution, chemical fumes, and the performance of a strenuous task. COPD is a progressive disease that gets worse over time, making it hard to breathe (National Heart, Lung, and Blood Institute, 2013). Millions of people have been diagnosed with varying levels of COPD. However, with advancement in oxygen portability, medications, and therapies, many individuals are continuing to work after a diagnosis.

High air quality is very important for those working with COPD. To improve air quality, workplace accommodations can include: air purifiers, fragrance-free common areas, and fresh air breaks. Fans can also help circulate air in confined areas. Telework and a modification of work schedule can also be helpful during times of inclement weather, such as excessively hot or cold temperatures.

Location of workstation can also be important to someone with COPD. Being close to food areas, restrooms, cleaning materials, and maintenance areas can cause odors that are hazardous to someone with COPD. Keeping a work area free of pollutants such as cleaning agents, pesticides, exhaust fumes, and tobacco smoke will improve air quality.

Use of oxygen at work is often a consideration when accommodating an employee with COPD. Besides compressed oxygen gas in a tank or cylinder, many portable and stationary concentrators are now available for use, making it easier for someone with COPD to use supplemental oxygen outside of the house. This could include work-related travel. Accommodations may need to be made to arrange for the transport of an employee’s oxygen when the employee is required to travel for work. This may include talking with hotels, airlines, and other facilities regarding what is needed for the employee to carry oxygen. Safety is always an important consideration with oxygen use, including accessing a safe electrical connection and keeping oxygen canisters and other devices away from an open flame. Often, an oxygen supply company will do an on-site visit regarding safe usage upon request.

For more information on how to have supplemental oxygen in the workplace, see: Oxygen Therapy Safety Tips: Preventing Fires and Other Accidents.

Other resources that might be helpful:

Because COPD can have such serious effects on an individual, it may also be linked to anxiety and depression. The lifestyle changes that accompany the disease cause physical as well as mental challenges. For more information on accommodations for individuals with anxiety and depression, see JAN’s Accommodation Information by Disability: A to Z. For additional information on accommodation ideas, contact JAN directly.

 

Elevating Lift Office Chairs

Posted by Kim Cordingly on January 8, 2015 under Accommodations, Products / Technology, Vendors | Comments are off for this article

By: Linda Batiste, Principal Consultant

For years, JAN consultants searched for an office chair that can elevate while a person is seated in the chair and that also has a braking system to prevent the chair from moving when a person is getting into or out of the chair. A chair with such features could be useful for employees with various motor impairments working in all sorts of jobs. For example:

A bank teller with multiple sclerosis uses a motorized scooter, but must work at a standing height. She needs to transfer into a chair and then raise up to the height of the teller workstation. The chair needs to stay in place while she is transferring, but then allow movement once she is seated.

A cashier with cerebral palsy and lower extremity limitations cannot stand for long periods, but has to work at a standing height. He cannot get up on a standing-height stool, plus he needs more support than offered by a stool; he needs an ergonomic chair that can raise him up to the proper height.

A little person works in an office setting with shared workspace. She needs a chair that will raise and lower her to average desk height while she is seated in the chair.

Happily, JAN consultants recently found a couple options for these types of accommodation situations:

The first is called the VELA Tango, which is a chair that has a both a locking mechanism to stabilize it as needed and a motorized lifting mechanism that operates with a person seated in the chair.  If you want to see the chair in action, visit https://www.youtube.com/watch?v=cSQsBflJIU4.

The other option is an elevating office chair from Clark Medical. This one is basically a lift with an ergonomic chair attached. The company will also custom mount other chairs to the lift if preferred.

And if you know of any other office chairs that can be raised and lowered with a person seated in them, please let us know!

Allergy Reminder for End of Year

Posted by Kim Cordingly on December 18, 2014 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Sheryl Grossman, Consultant, Sensory Team

It’s that time again! With all the festivities at the end of the year, we may be tempted to bring in those leftovers or wear that new perfume, but what may seem like a nice gesture or harmless fun can turn deadly if someone in the workplace is allergic.

If your business has a fragrance-free policy in place, this is a good time to remind folks about it.
If your business does not currently have a policy, this may be a good time to institute one.

Sample policy language can be found at: Accommodation and Compliance Series: Employees with Fragrance Sensitivity.

The additional following general policies may be good starting places:

1. Ensure that all employer controlled spaces are fragrance-free:

  • Remove air fresheners from bathrooms
  • Use only fragrance-free soaps in bathrooms and kitchens
  • Provide hand lotion and hand sanitizer for employee use, ensuring only fragrance-free types are used
  • Ensure frequent and appropriate cleaning of workspaces with fragrance-free/chemical-free cleaners

2. Ensure that all employer controlled maintenance, repair, and remodeling are fragrance/chemical-free:

  • Use fragrance/chemical-free insecticide/pesticides
  • Use fragrance/chemical-free industrial cleaning agents
  • Use fragrance/chemical-free glues, sealants, waxes, and paints/stains

3. Ensure that all employer controlled spaces are free of known food allergens:

  • Do not permit foods with known allergens onsite
  • Provide all food on premises
  • Provide ample off-time for lunches to be done offsite
  • Provide designated, well-ventilated area for all food to be stored, prepared, and eaten

Additional information regarding accommodating people with fragrance/chemical sensitivities can be found on the JAN Website.
Additional information regarding accommodating people with food allergies can be found there as well.

Here’s wishing everyone a safe and happy rest of 2014 from the JAN family!

Focus on Effective Workplace Accommodations for Employees with Hearing Impairments

Posted by Kim Cordingly on October 7, 2014 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Teresa Goddard, Senior Consultant, Sensory Team

Recently, JAN’s Sensory Team has received a number of calls involving employees who are having difficulty purchasing or repairing hearing aids. Some employers choose to purchase hearing aids, but it is rare for them to have an obligation to do so as part of a workplace accommodation. Hearing aids are typically considered to be personal use items, meaning they are devices or equipment that are primarily for personal use and needed both on and off the job.  Other examples of personal use items include wheelchairs and prosthetic limbs.

In the context of the Americans with Disabilities Act (ADA), the guidance on providing personal use items is not as clear-cut as it may seem at first. There are some rare situations in which an employer may need to consider providing something that would otherwise be considered a personal use item. According to the Equal Employment Opportunity Commission (EEOC), equipment that is specifically designed or required to meet job-related rather than personal needs may be something that employers need to consider and provide, absent undue hardship, even if the item is something that would typically be seen as a personal use item. Likewise, employers may need to provide other reasonable accommodations to employees who are experiencing job-related limitations due to hearing loss, regardless of whether or not they obtain hearing aids on their own.

For more information about personal use items and the ADA, see the excerpt below:

From the ADA Technical Assistance Manual, Title I, Equal Employment Opportunity Commission (EEOC), III. THE REASONABLE ACCOMMODATION OBLIGATION, 3.4 Some Basic Principles of Reasonable Accommodation:

 “An employer is not required to provide an accommodation that is primarily for personal use. Reasonable accommodation applies to modifications that specifically assist an individual in performing the duties of a particular job. Equipment or devices that assist a person in daily activities on and off the job are considered personal items that an employer is not required to provide. However, in some cases, equipment that otherwise would be considered “personal” may be required as an accommodation if it is specifically designed or required to meet job-related rather than personal needs.”

“For example: An employer generally would not be required to provide personal items such as eyeglasses, a wheelchair, or an artificial limb. However, the employer might be required to provide a person who has a visual impairment with glasses that are specifically needed to use a computer monitor. Or, if deep pile carpeting in a work area makes it impossible for an individual to use a manual wheelchair, the employer may need to replace the carpet, place a usable surface over the carpet in areas used by the employee, or provide a motorized wheelchair.”

Whether or not an employee acquires hearing aids, accommodations may be needed to ensure effective communication in the workplace. One type of equipment that may be useful as part of an accommodation for an employee with a hearing impairment is an assistive listening device such as an FM system, induction loop system, or an infrared system. These types of devices assist with listening by enabling the user to hear the voice of a speaker who is wearing a microphone by making their voice louder than the background noise in a room. The speaker talks into a microphone or transmitter and the listener either uses the T-switch on their hearing aid or wears a receiver designed to work with the specific assistive listening device. These devices can usually be used with other sound sources as well, such as radios and training videos.

Some assistive listening devices are very simple, and basically consist of a microphone, an amplifier, and an earpiece or headphone jack. Others are more complex. When selecting an assistive listening device, it is helpful to know whether or not the individual uses hearing aids or cochlear implants and if the aids or implants have any special features such as telecoils or Bluetooth connectivity. This will make a difference in the type of listening device that might work best for the employee. Often the employee’s audiologist will be able to provide information about the type of hearing aid as well as individualized equipment recommendations.

More information regarding assistive listening devices is available in JAN’s Searchable On-line Accommodation Resource (SOAR) section of the Website.
For a person with a hearing impairment, one typical workplace task that may require an accommodation is telephone use. Telephone amplification is one type of accommodation that JAN consultants often discuss with employers who are seeking to accommodate employees with hearing loss. This is particularly the case if the employees do not currently use hearing aids or prefer to remove their hearing aids when using the phone. There are many types of telephone amplification devices and choosing the right one for a particular employment setting can be a challenge. A qualified audiologist may be able to provide valuable individualized advice. I often suggest working with the individual and their treating medical providers when appropriate to find a customized solution.

One option I often suggest exploring is whether an amplifier that the employee can adjust on their own would meet their needs. Most people with hearing impairments can hear some types of sounds or frequencies better than others. No telephone amplifier is as customizable or adjustable as a hearing aid, fitted by a qualified audiologist. However, one example of a telephone amplifier with easily adjustable volume across multiple frequencies is the Speech  Adjust-a-Tone from Hearsay. This device has six sliders which can be used to adjust the volume of sounds ranging from bass, mid, to treble. Some individuals with hearing aids can also benefit from this product since it can be used with a neck loop. It can also be used with certain types of headsets as well as with a bone-conducting transducer. Since there are multiple models of this product, it may be helpful to consult the manufacturer or a vendor to see which might work best in your setting. You can find more information on telephone amplification on the JAN Website.

If an employee needs assistance purchasing hearing aids, he/she may wish to apply for services through their state Office of Vocational Rehabilitation Services.

There are also organizations that provide hearing aid funding assistance, or refurbished hearing aids, based upon financial need. You can find information about hearing aid funding sources for individuals on the JAN Website.

It is also important to remember that even if an employee obtains hearing aids, the employer may need to consider equipment-related accommodations in order for the employee to use their hearing aids effectively at work. Additional information on accommodation ideas for employees who are deaf or hard of hearing is also available on the JAN Website.

JAN Blog – Focus on Technology

Posted by Kim Cordingly on July 23, 2014 under Accommodations, Entrepreneurship / Self Employment, Products / Technology | Comments are off for this article

The JAN Team focuses on technology – new and old – and its possible applications in accommodating people with disabilities in the workplace.

Lyssa Rowan, New Media Assistant

One of the most talked-about trends with today’s technology is wearables – technological devices that you wear as part of your clothing or accessories. One example of these is Google Glass. JAN has had a chance to take a look at Glass to see how it could be used as a type of assistive technology (AT). While it’s a newer product and is in active development, we’ve seen apps that include voice recognition for real-time captioning of conversations, heads-up GPS navigation, timers, presentation assistance, and many more – there’s a lot of potential here. Look for more tidbits coming soon!

Melanie Whetzel, Senior Consultant, Cognitive/Neurological Team

Trying to keep up with all of the new apps is virtually impossible.  There are apps for just about anything these days, and knowing which ones are worthwhile can be quite difficult. Listed below are a few apps that individuals with mental health impairments may find beneficial:

Bipolar Disorder Connect helps individuals with bipolar disorder to stay connected with a large growing community of people living with the same diagnosis. It’s the place to discuss treatments, start conversations, and learn from others.

CBT Calm helps assess stress levels, provides relaxation skills, and contains links to online resources for stress and anxiety.

DBT Diary Card and Skills Coach is a resource of self-help skills, reminders of therapy principles, and coaching tools for coping.

Operation Reach Out is a free intervention tool that helps people who are having suicidal thoughts to reassess their thinking and get help. Also helps those who are concerned about the safety of others.

WhatsMyM3 provides a reliable gauge to determine if users exhibit symptoms of various mental health impairments, then monitors moods and tracks mental health over time.

Linda Batiste, Principal Consultant

I recently read about a new technology for runners that also can help people with vision impairments navigate their environment. The product is from a company called Lechal and is basically a Bluetooth-enabled shoe or insole with haptic feedback vibrations that tell you which direction to go. For those of you who aren’t tech-savvy, haptic feedback just means that the device provides some kind of physical sensation to tell you something, like vibrating a certain way to tell you to turn right. According to an article in Boston Magazine, “the shoes and insoles—customers can choose between the two—rely on Bluetooth technology to connect to a person’s smartphone, and can map out the route to their destination, guiding them with the buzzing feelings on their feet along the way.”

The best thing about this product and the people who designed it is that they plan to help people with vision impairments get the shoes. One of the inventors told Boston Magazine that “for every pair of shoes that someone that isn’t visually impaired buys, another pair would be subsidized for a person that’s blind. Because that is the people who we started this for.”

This product might also help people with cognitive impairments who have difficulty getting around independently. Pretty cool!

Beth Loy, Principal Consultant

Lily Born, an 11-year old granddaughter, designed something called the Kangaroo Cup for her grandfather who has Parkinson’s Disease. Lily wanted to help her grandfather, who had trouble drinking from other cups, keep from spilling his drinks. The three-legs of the cup help stabilize it to make it harder to knock over. Individuals with Parkinson’s disease can have fine motor limitations such as tremors and a loss of strength in their hands. Check out the JAN Website for more accommodation ideas for individuals with Parkinson’s disease.

Lisa Dorinzi, Consultant, Motor/Mobility Team

I learned about Telorion Vox at the 2014 Annual International Technology and Persons with Disabilities Conference (CSUN). Telorion Vox makes select smart phones accessible to low vision and blind users. The device comes with software that features voice recognition, screen reading and optical character recognition (OCR) capabilities, and talking GPS. There are built- in features such as a color detector and light sensors as well.

The software is integrated with the phone’s platform, but it also comes with accessible applications such as alarms, an agenda, weather information, and voice memos.

Along with the software, it comes with a removable keypad overlay that gives the user points of reference on the screen. The overlay also serves as a key guard, which could be beneficial for users with tremors.

Elisabeth Simpson, Senior Consultant, Sensory Team

AT in higher education is often a vital part of a student with a disability’s success in the classroom. Technology advancements have brought about AT equipment that is portable, user-friendly, and multifunctional. For students with a vision impairment, deciphering text on handouts or other print material distributed during class can be difficult. Professors and instructors may modify lecture slides as the class progresses, write notes on a whiteboard or Smart board, or reference a video as part of the instruction. Without AT, students with a vision impairment could be missing information necessary for class participation activities and exams.

Optical Character Recognition (OCR) technology and video magnification are two types of AT that a student with a vision impairment may benefit from using in the classroom. OCR allows people with a vision impairment to scan printed text and receive a synthetic speech output or save it to a computer.

Optical Character Recognition (OCR) has three factors: scanning, recognition, and reading text. First a camera scans the printed document. Next, OCR software converts the image into recognizable characters/words. Then the user can store the information in electronic form to a computer or the OCR system itself. Video magnifiers vary in size, as well as magnification level, and use a camera to project a magnified image onto a computer monitor, television monitor, or other type of video monitor.

Some AT devices, such as the MagniLink S and the SmartView Graduate combine OCR and video magnification. With this, one AT can be used in a class for both reading printed material and for distance viewing. In addition to the camera scanning printed text, the student can tilt the camera head to the appropriate position for viewing a whiteboard or smart board. The images on the board are then displayed on the student’s laptop where color, contrast, and magnification settings can be adjusted.

It is important to note that each individual’s needs are different and what works for one student with a vision impairment may not work for another. Accommodations should be determined on a case-by-case basis. For more information about accommodations related to a vision impairment, check out JAN’s Website.

Sheryl Grossman, Consultant, Motor/Mobility Team

I have two technologies I’d like to highlight for Blog readers.

The first is an oldy but goody — the Logitech T-CD2-6F TrackMan Stationary Mouse. For those with very little arm/hand movement, this stationary trackball can be fixed to a specific location and allow for angled use of the selection part without changing the hand/finger position again.

A technology less often discussed — for those who have a private office and need a quick getaway to a private restroom, having a built-in, concealable commode that fits in with the office décor can make a huge difference for some individuals with disabilities.  Check out the following Websites for more information:  http://www.whitehallmfg.com/patient-care-units and http://www.metcraftindustries.com/Catalog/Hospitals/Swing-a-Way.pdf.

Kim Cordingly, Lead Consultant, Self-Employment Team

In working with individuals with disabilities interested in self-employment and small business development, where and how to market a new product frequently comes up in our conversations. This led me to locating a product Website called The Grommet. The site helps launch new and innovative products – some with very practical applications and others just for fun.

Recently, one product in particular caught my eye – the AirPhysics Hands-Free Hair Dryer. This hair dryer is not shaped in the traditional “gun” design, but has a more “ergo friendly” shape — sits straight up and down and can rest on a counter.

Jeffrey the inventor who is a hairstylist himself writes, “This hands-free hair dryer was created in order to prevent the painful wrist, shoulder, and neck injuries that have been attributed to traditional gun-type hair dryers. We originally created this hands-free method of drying for use in our own salon, and we’re thrilled to be able to offer it to all of you for use in your own home.”

I was talking to the hairstylist I use about fatigue and repetitive strain issues, and he said most professional stylists reach a point in their career when they’ll no longer be able to do their jobs due to the repeated motions of cutting, pulling, styling, grasping, and so on. He said for those stylists who are self-employed, your income is based on how many clients you are able to serve each day, so the impetus is to see as many clients as possible – hence, more repetition and risk of injury.

The potential applications for this dryer are numerous not only for those contemplating a career as a hair stylist who may need this type of accommodation, but also for those veterans in the field who may be able to extend their careers by reducing strain. This dryer can also serve as an accommodation for home use.

You can read more about The Grommet and view their interesting product selection on their Website.

Don’t Break the Bank in 2014 — Low Cost Accommodations Do Exist!

Posted by Kim Cordingly on January 24, 2014 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Senior Consultant – Motor Team

What do tennis balls, a headlamp, and curtains all have in common? They can all be used as a reasonable accommodation in the workplace. But wait — how can that be? Aren’t all accommodations expensive and high tech? In actuality, many accommodation solutions can be considered “low tech,” and according to an ongoing study conducted by JAN since 2004, employers report that a 58 percent of accommodations cost absolutely nothing to make, while the rest typically cost only $500.

A common misconception about accommodations is that products and equipment that have been developed to assist individuals with disabilities with various activities, including those that are work related, are expensive, high-end electronics and technology. It is not uncommon for employers to ask about a high cost device before considering low cost/low tech options or simple modifications that work just as well.

It is important to note that some types of assistive technology (AT) that are more expensive may be necessary. The type of equipment, product, or AT that an employee with a disability needs (or has requested) will always be a case-by-case determination. But one thing for employers to consider is that, in some cases, something as simple as putting curtains up to reduce glare on a computer monitor for an employee with migraine headaches is much less complicated than searching for the best anti-glare computer monitor on the market.

Here are a few real-life JAN examples of low cost accommodation solutions:

A clerical worker who stamped paperwork for several hours a day was limited in pinching and gripping due to carpal tunnel syndrome. The individual was accommodated with adapted stamp handles. Anti-vibration wrap was placed around the stamp handles. In addition, tennis balls were cut and placed over the wrapped handles to eliminate fine motor pinching and gripping.

A production worker with intellectual or cognitive impairment and cerebral palsy had difficulty grasping a plastic bottle to accurately apply an adhesive label. JAN suggested making a wooden jig to hold the bottle while the employee applies the label. Approximate accommodation cost was under $50.

A grocery stock person with autism could not remember to wear all parts of his uniform. JAN suggested taking a picture of the employee in full uniform, giving him the picture, and allowing him to use the picture as reference when preparing for work. Approximate accommodation cost is $5.

A custodian with low vision in a public school setting was having difficulty viewing the carpeted area he was vacuuming. A lighting system was mounted on the custodian’s industrial vacuum cleaner, and the custodian was provided a headlamp.

As these examples show, often accommodations are low cost, low tech, and can be implemented fairly easily. Workspace modifications can be made at little to no cost and there are all kinds of inexpensive devices on the market. Accommodations might also include a specially designed or modified product, but customization doesn’t always translate into high cost. Removing the legs of a computer desk can be a very low cost custom modification for an individual of short stature.

JAN consultants can provide individualized case-by-case assistance regarding various accommodation options; information on products; organizational referrals; and locating specific vendors of a wide variety of low cost and low tech accommodations.

For onsite assistance, rehabilitation professionals and assistive technology specialists can be great resources for employers. These individuals have been specifically trained to perform assessments that identify the individual’s needs; strengths and abilities; environmental consideration; tasks that are problematic; and the tools necessary for success.

So remember, before jumping to the conclusion that an accommodation will break the bank, low cost accommodations do exist! If you are wanting to learn more about the JAN study and the various findings related to the costs and benefits of providing accommodations in the workplace, you can review the JAN Accommodation and Compliance Series Workplace Accommodations: Low Cost, High Impact.

Scents and Sensitivity in the Workplace

Posted by Kim Cordingly on November 26, 2013 under Accommodations, Employers, Products / Technology, Uncategorized | Comments are off for this article

By: Tracie DeFreitas, Lead Consultant

When we talk about making facilities accessible and useable as a type of accommodation under the Americans with Disabilities Act (ADA), most people don’t necessarily think about invisible barriers that may be in the air. They may think about more obvious physical barriers like stairs leading to an entrance, narrow doorways, or inaccessible restrooms. However, for some people, irritants like fragrances, deodorizers, scented candles, and other chemicals in the air can be as much an access barrier as a missing ramp or inoperative elevator. People with asthma, allergies, or other respiratory disorders may be more susceptible to the effects of these irritants at levels that are much lower than what might cause problems for those in the general population.

In particular, exposure to fragranced products can make it difficult for some employees to function effectively at work. JAN Consultants talk to employers who are trying to accommodate employees who report fragrance sensitivity. Fragrance sensitivity is either an irritation or an allergic reaction to some chemical or combination of chemicals in a product. Although perfumes and colognes are generally what come to mind, fragrance is commonly added to a variety of daily use items like toiletries, cosmetics, air fresheners, laundry soaps and softeners, and cleaning products. People with fragrance sensitivity often experience symptoms such as breathing difficulties: wheezing, a tight feeling in the chest, or worsening of asthma symptoms; headaches; nausea; hives and other skin irritations; and limitations in memory and concentration.

Situations involving fragrance or scent sensitivity can be a little complicated because accommodations sometimes impact others in the work environment. For example, some employers have implemented workplace policies or made requests that all employees refrain from wearing and using scented products in the workplace. While a 100% fragrance-free environment may not be reasonable, an employer may still take measures to reduce exposure to such irritants. It becomes an issue of fragrance-use awareness. As with any accommodation situation, it is up to the employer to determine what is reasonable with regard to the type of accommodation(s) that can be implemented. JAN offers a number of accommodation solutions that may help:

  • Reduce exposure to scented products by asking employees to be conscious of their choice of products (opt for non-scented) and to refrain from wearing fragrances and colognes to the workplace
  • Move the employee’s workstation away from co-workers who use heavily scented products, fragrances, etc.
  • Do not situate the employee’s workstation near areas of heavy foot traffic or congregation (i.e., break room, restroom, elevator area)
  • Provide an enclosed workspace
  • Provide an air cleaner of the right size to effectively clean the space (i.e., select a model sufficient for gaseous filtration) and make sure the HVAC system is working properly
  • Provide a desk fan
  • Allow a flexible work schedule so the employee who is sensitive can work when fewer people are in the building
  • Allow the employee to wear a mask (e.g., http://www.icanbreathe.com/favorite.htm)
  • Allow breaks to take medication or get fresh air
  • Allow telework
  • Implement and enforce a fragrance-free policy

For additional information regarding accommodation ideas for people who are sensitive to fragrances, see JAN’s publication Employees with Fragrance Sensitivity or contact JAN to speak with a consultant.