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Canada's Social Policy - Positive Changes and Persistent Challenges

Editor's Note: Michael Prince is the Lansdowne Professor of Social Policy at the University of Victoria in British Columbia, and is a board member with the BC Association of Community Living.

For persons who are blind, deaf-blind and partially sighted, what in Canadian social programs has changed over the past 20 years that positively affects their quality of life and status of citizenship? And, just as importantly, what has not changed?

The specifics of reform no doubt vary by provincial and federal jurisdiction. In a political system of federalism, it is more useful to think of a multiplicity of policy records. Ideally, then, to answer the question of the Canadian record of progress, we would need a series of case studies that cast light on results spanning an array of government jurisdictions, communities, services and instruments of public policy. Moreover, the timeframe to assess changes in approaching disability issues, and the expectations for major changes, likely vary among interests within the Canadian disability community. Here, I can offer only a selective overview assessment.

Positive developments over the last few decades in advancing access and inclusion for Canadians with disabilities include:

  • New tax benefits recognizing additional needs and costs of persons living with prolonged or severe disabilities, and their families. Examples include the Child Disability Benefit, Disability Supports Deduction, and the Registered Disability Savings Plan.

  • Public education and social awareness campaigns by governments, employers and broadcasters that contributed, along with other factors, to a shift in discourse from a personal tragedy to a public participation viewpoint.

  • Changes to federal, provincial, and some municipal election laws and procedures, including outreach measures to improve the accessibility of voting for citizens with disabilities. From a survey of almost 200 associations representing people with disabilities about the 2000 federal election, 89 percent reported a positive impression of Election Canada's role, 75 percent were satisfied with services to Canadians with disabilities, and 72 percent were aware of these access services.

  • Technological advances in communication that include captioning of all national programming by Canadian television stations and some local programming, TTY (teletypewriter) access through telephones, video relay services and, most recently, wireless pagers and messaging services.

  • Legal developments regarding disability and political victories, such as the right to sign-language interpreters in health-care services; Québec legislation in 2004 to further secure handicapped persons their rights to achieving social, school and workplace integration; and passage in 2005 of the Accessibility for Ontarians with Disabilities Act.

  • A concerted effort by Statistics Canada since the 1980s to conduct surveys on Canadians with disabilities in order to identify their lived experiences, the barriers they face, and trends over time. Other federal departments and think tanks also have greatly assisted in the development, interpretation and dissemination of much disability information.

  • Adoption by the United Nations General Assembly, in 2006, of the UN Convention on the Rights of Persons with Disabilities. The Canadian government in 2007 signed the Convention and fully ratified on March 11, 2010. The Convention covers civil, political, cultural, economic and social rights--a multidimensional conception of citizenship--supported by a monitoring body to encourage the compliance of states to their obligations.

Hence, there have been many achievements in Canadian disability policy and practice in recent decades, but they have been uneven and incomplete.

There have also been setbacks. For example, in the mid 1990s, the federal government withdrew from cost sharing with the provinces the provision of core social services and social assistance across the country. In the late 1990s, the federal and most provincial governments approved reductions to CPP (Canada Pension Plan) Disability benefits. Federal expenditures on employment services for persons with disabilities remain modest and, more significantly, stagnant in real terms over the last decade. As grounds of discrimination, disability is by far the most common type of complaint brought to the Canadian Human Rights Commission.

Serious gaps persist in access to affordable, quality disability-related supports for a considerable number of Canadians with disabilities. The default is informal family care and charitable services where possible, and where not, social isolation and unmet basic needs with everyday activities.

The general picture in Canada on employment for persons who are blind, deaf-blind and partially sighted continues to be one of relatively high rates of unemployment and underemployment, with barriers to training and placement services, along with inadequate supports for employment preparation and accommodations in workplaces.

Large numbers of people with disabilities are not receiving the essential services they require because of cost, lack of availability and inaccessible environments. Entry to some supports are still tied to receipt of income benefits, most notably social assistance, which adds a barrier to gaining access to needed services.

As I point out in my recent book Absent Citizens: Disability Politics and Policy in Canada (University of Toronto Press, 2009), individuals and their families bear a disproportionate share of the costs, work and responsibilities associated with addressing the everyday needs of living with disabilities. As a consequence, they experience undue hardship and are restricted from full and active participation in economic, educational and social life.

Due to inadequate supports, attitudinal barriers, and insufficient employment opportunities, plus provincial government efforts at moving "able bodied" people off welfare, people with disabilities now represent between 40 to 70 percent of those on income assistance, the so-called "social safety net." This program of last resort has become the program of first resort for thousands of people with disabilities across the country--a program distinguished for minimal rights, complex rules, and the sting of stigma.

Most social policies in Canada still regard disability as specific impairments, diseases and disorders; programs are categorical rather than a continuum of services, with sharp distinctions and abrupt changes when a person experiences a life transition. Living with a disability in Canada remains a strong predictor of welfare dependence and poverty for individuals, families, and many of the agencies struggling to assist them. A critical need therefore exists for enhanced income security, personal supports and public services.

For younger Canadians who are blind, deaf-blind and partially sighted, a key social policy goal must be accessible school-based supports, and school-to-work transitions to employment preparation and placements.

For the current generation of older Canadians who are blind, deaf-blind and partially sighted, important social policy issues concern ensuring more adequate and dignified provision of financial support at the federal and provincial levels of government as well as encouraging social participation and inclusion through such local and municipal activities as adult education, community services, recreation and peer support.

For all Canadians, the necessity exists to raise awareness on an ongoing basis about the fact that people who are blind, deaf-blind and partially sighted are still among the most vulnerable citizens in our society.

Photo: Michael J. Prince

Boomers Are Renovating With "golden Years" in Mind

Editor's Note: The following article is reprinted from the Toronto Star, May 29, 2003.

It can happen like this: Looking in a store window, you find yourself staring at a middle-aged woman who reminds you of one of your parents. But it's March, and your parents are in Florida. The realization dawns: That parental look-alike is you. Aging is inevitable, and DNA will do its work.

At least you're not alone. Canadians as a whole are getting older. In less than two decades, half of all Canadian households will be headed by people over 55. Like generations of oldsters, this bulging demographic group will want to grow old in their own homes. With a little foresight, that's a reasonable option, especially for the large number of homeowners who plan to renovate over the next few years.

Victor Helfand is the owner of Barrier-Free Architecturals, a Toronto company that sells senior-friendly home-improvement products, such as raised toilets, grab bars and shower seats. He's been in business for three and a half years, and he says that his clients increasingly include middle-aged people renovating with an eye to the future.

Jim Wolff, owner of Wolff Construction in Thornhill, is now installing grab bars in about half the bathroom renos he does now for boomer clients. That's a huge jump over the last five years.

Helfand says that more and more people are opting for shower stalls without lips because, in 15 years, the room may have to accommodate a wheelchair. Shower seats are also becoming more common. (Admit, even pre-old age, wouldn't it be nice to sit down in the shower to shave your legs or attend to foot care?) Other senior-friendly options include tilted mirrors (better for those in wheelchairs), or a "soft" bathtub made of acrylic and foam, so that a fall in the tub won't be deadly.

Cathy Solman is only 50, but when she decided to renovate the main bathroom of the Pickering home she's had for almost 20 years, she chose to add a grab bar, raised toilet and whirlpool. "The whirlpool isn't really that senior-friendly, although it's awfully good for relaxing tired bones at the end of the day. But the raised toilet and the grab bar are for safety and comfort--things you need to be aware of past a certain age," she says.

In the kitchen, Helfand suggests adding extra lighting in work areas for weakened eyes, and installing lower light switches and non-slip flooring. If money is no object, about $2,000 will buy you a mechanism that will raise and lower five feet of cupboards at the touch of a switch. "It's a great idea for seniors," says Helfand. "I certainly thought about installing one for my mother when I found out that she was climbing on top of the kitchen counter to reach her Passover dishes!"

Other tips include making doorways wider, eliminating thresholds, and ensuring that entry to the house is level. Faucets should have central controls; they're easier for arthritic hands to move up and down. Knobs that glow in the dark can be added later.

While adding the basics needn't add inordinate costs to a reno, Jim Wolff says not everyone is ready to renovate for their golden years. "I try to convince people that it's a good idea to install a grab bar, or at least lay down a piece of plywood under the drywall and tile," he says. "Some aren't sure. But it makes sense. A kitchen or a bathroom renovation can cost a lot of money. Middle-age people who have paid off their mortgage can spend money like crazy on extensions or refinishings. Why not make it work for you for a long time?"

Barrier-Free Architecturals is at 2700 Dufferin St. (at Castlefield), 416-783-5331.

Wolff Construction in Thornhill can be reached at 905-509-5048.

Moving Experience

Editor's Note: The following article is reprinted from the Victoria Times-Colonist, June 7, 2006.

How do you know when it is time to pack up a lifetime of memories, sell the family home and move to a seniors' residence? As life expectancy approaches 79.9 years for men and 82.4 for women in Canada, according to Statistics Canada, the question gets asked more often.

A large number of seniors start to consider a life change when they lose their spouse. According to retired palliative-care physician, Dr. Mary-Wynne Ashford, sickness or death of a spouse can have a profound effect on seniors. "Not only are they losing their present--they are losing their past."

Jane Dewing is a moving consultant with 25 years in the housing industry and owner of Changing Places, a one-person business that helps clients, mainly seniors, make housing choices and changes. "There is no 'Ah-hah' moment that tells an individual that it is time," says Dewing. "You can use any checklist you want, but in the end every person is different."

Some essential points to consider are:

What type of care you need now--and in the future?

Do you want a private or community setting?

Do you want to stay in the same neighbourhood?

Compare services offered as part of the rent.

Do you qualify for subsidized housing?

What are the extras and how much should you expect to pay for each?

How many meals are offered? Is there any accommodation for special meal requirements?

Are there any restrictions on pets? Smoking?

Ask if there is a security deposit charge.

Check to see if the activities offered are what interest you.

Check with friends or other referrals.

Take a free tour of residence.

Ask about trial stays at residences that you are considering.

But even if the time is right, the decision is never easy. Most people try to stay in their homes as long as they can, relying initially on family and then non-profit and private care providers to take over personal care and homemaking.

Charlotte St. Clair, 81, and her husband, Vic, who is 89, considered a retirement residence but settled on renting in an adult-oriented apartment building. "I talked it over with my husband and family and I felt I can still live in an apartment with just a little help with cleaning and personal care," said St. Clair. "I don't need somebody cooking for me all the time." She downsized into a two-bedroom in a quieter building in a different part of town from a three-bedroom they were in. They say they're settling in nicely.

The final decision may be based on simple economics, a desire to be closer to family, or health issues that require some type of medical supervision or monitoring. Adult children of seniors can also be an important influence as they see subtle changes in their parents. It can be a difficult and trying time as a senior wrestles with a fear of losing independence.

Seniors' housing choices range from independence to intermediate care to full care. The trigger for residential care is when the facilities stop referring to their offerings as apartments and start calling them beds. Care options are:

-Abbeyfield houses--An inexpensive option for the social senior, run by a non-profit organization. Residents have their own rooms but share washrooms, kitchens and living areas. Meals are prepared by a house manager.

-Independent Living apartments with a combination of housing and hospitality services. Residents generally have the option of housekeeping, laundry services and the number of meals they require. Independent Living can include rented, owned and life-lease options.

-Assisted Living--Residences offering a wider range of personal support services such as grooming, bathing or taking medication. Residents can still direct their care but need some assistance. Some facilities have nurses and 24-hour emergency response to medical emergencies.

-Residential Care--Adults living in this setting require assistance with activities of daily living. This type of accommodation includes intermediate care, extended care and private hospitals. A senior's financial situation has a bearing on the choices available. Those who have owned real estate are often more fortunate because they can use the funds from the sale of their house to pay the rent. Low-income adults--defined as any individual or couple with income under $25,000 a year--can apply for assistance with rent.

Victoria Senior Citizens Housing Society executive director, Kaye Melliship, says that some of her income-assisted suites can rent for as low as $235. Her clients usually pay up to 30 percent of their income for rent. At the other end of the range, more well-heeled seniors can expect to spend up to $3,940 for rent and one meal at Somerset House on Dallas Road.

Independent Living is about independence. It can also just be about one less chore to do. Asked why he is in the Alexander Mackie Lodge in Langford, Sy Blair had a simple answer, "I got tired of cooking."

Owned by the Royal Canadian Legion's Prince Edward branch No. 91, the newly built Lodge is a four-storey building with 75 subsidized suites. The facility is staffed 24 hours a day, and provides weekly housekeeping, in-house social activities and two meals a day.

The 90-year-old Blair has been a widower since 1982. Although he gives high praise to the staff at the lodge, he reiterates, "I just got tired of cooking and washing up the dishes."

Housing Resources:

-Senior Living Magazine publishes an annual housing guide, Right, for seniors that covers what's available on Vancouver Island.

-The Senior Services Directory, published by Seniors Serving Seniors, lists services available to seniors from activity centres to veterans' services, and includes a section on housing options.

Technology, Aging and Disability

Editor's Note: Kaye Leslie works at Scotiabank in Toronto as a Manager of Workforce Diversity. She has written and published a chapter on disability and seniors that has been incorporated into a textbook, which is being used by faculties of Social Work in universities across North America.

As a baby-boomer with a disability, I have a particular interest in the way in which technology is going to affect the quality of our lives over the next few decades. And, having recently taught a course at Ryerson University on Aging and Disability, I maintain a professional interest in examining projected technological trends that will affect seniors with disabilities.

My interests in the field of aging and disability have led me to accept the position of co-chair of the "Growing Older with a Disability" conference to be held in Toronto on June 16--19, 2007. This conference is part of a Festival of International Conferences on Disability, Aging and Technology that will include the following four concurrent conferences: Growing Older with a Disability, International Conference on Technology and Aging, Advances in Neuro-rehabilitation, and Caring for the Caregiver.

The second on the list, The International Conference on Technology and Aging, will explore how the technological revolution can contribute to a positive quality of life as we age. This conference will provide researchers, designers, policy makers and consumers the opportunity to present and learn about new and innovative technologies being developed to help older adults participate fully in their daily lives.

Some topics of interest will include the design and use of assistive technology, smart homes and intelligent systems, technology for caregiving, impact and outcomes of technology on quality of life, policy and legislative issues.

For further information: http://www.ficdat.ca/en/conference2.php

Through the use of assistive technology I am able, without vision, to access text on my computer using screen reading software, read the latest novels on CDs in digital format, communicate with friends and family using email and accessible cell phones, watch movies with descriptive video captioning and enjoy many other activities that the previous generation would not have imagined possible.

During the past 40 years I have seen many changes in technology for the vision-impaired. I recall, for instance, my first talking books arriving in a large container filled with vinyl records. And while I am astonished at the changes that have occurred in technology in just the past 20 years, I know that these changes are just the tip of the iceberg.

Ray Kurzweil is as knowledgeable as anyone as far as the future of technological change is concerned. Ray Kurzweil is the inventor of the Kurzweil Reading Machine, the first device to transform print into computer-spoken words, enabling blind and vision-impaired people to read printed materials. When this print-to-speech reading machine was invented in 1976, the technology was regarded as the most significant advancement for the blind since braille's introduction in 1829.

For further information: http://www.invent.org/hall_of_fame/180.html

Kurzweil explains his concept of the rate of technological change in exponential terms: "[I]t is not the case that we will experience a hundred years of progress in the twenty-first century; rather we will witness on the order of twenty thousand years of progress (at today's rate of progress, that is).

Recently, a Nobel Prize winning panelist announced, "we're not going to see self-replicating nano-engineered entities for a hundred years." I pointed out that 100 years was indeed a reasonable estimate of the amount of technical progress required to achieve this particular milestone at today's rate of progress. But because we're doubling the rate of progress every decade, we'll see a century of progress--at today's rate--in only 25 calendar years.

When people think of a future period, they intuitively assume that the current rate of progress will continue for future periods. However, careful consideration of the pace of technology shows that the rate of progress is not constant, but it is human nature to adapt to the changing pace, so the intuitive view is that the pace will continue at the current rate. Even for those of us who have been around long enough to experience how the pace increases over time, our unexamined intuition nonetheless provides the impression that progress changes at the rate that we have experienced recently.

From the mathematician's perspective, a primary reason for this is that an exponential curve approximates a straight line when viewed for a brief duration. So even though the rate of progress in the very recent past (e.g., this past year) is far greater than it was ten years ago (let alone a hundred or a thousand years ago), our memories are nonetheless dominated by our very recent experience. It is typical, therefore, that even sophisticated commentators, when considering the future, extrapolate the current pace of change over the next 10 years or 100 years to determine their expectations. This is why I call this way of looking at the future the "intuitive linear" view.

To appreciate the nature and significance of the coming "singularity", it is important to ponder the nature of exponential growth. Toward this end, I am fond of telling the tale of the inventor of chess and his patron, the emperor of China.

In response to the emperor's offer of a reward for his new beloved game, the inventor asked for a single grain of rice on the first square, two on the second square, four on the third, and so on. The Emperor quickly granted this seemingly benign and humble request. One version of the story has the emperor going bankrupt as the 63 doublings ultimately totaled 18 million trillion grains of rice. At ten grains of rice per square inch, this requires rice fields covering twice the surface area of the Earth, oceans included. Another version of the story has the inventor losing his head.

Visit: http://www.kurzweilai.net/meme/frame.html?main=/articles/art0134.html?

It is no secret that the population is aging, and with advanced age comes a variety of sensory losses, mobility restrictions, cognitive challenges and ultimately the inability to drive a car or perhaps function with stairs and other issues in the home environment. Our workplace may also need to be altered in order to accommodate employees who are working longer and whose needs are changing.

Now consider this interesting development, as reported by Karen Solomon in Robotics Trends ( http://www.roboticstrends.com/displayarticle35.html?POSTNUKESID=7221431a0861f91d9f1b8003893ac4cc):

Dean Kaman is the developer of the Segway Human Transporter, the gravity defying, upright scooter with oversized wheels that was shrouded in secrecy while under development. But the same technology that propels the Segway - the microprocessor assisted gyroscopic wheels that allow the Segway to balance the same way the human body does--was incorporated into one of Kaman's earlier, and possibly more high-impact, inventions.

Kaman's company has also developed the Independence iBot Mobility System. The iBot, a type of wheelchair on steroids, is a revolution in transportation for those that use wheelchairs. It offers unprecedented independence and mobility. Not only does the iBot operate as a slimmed-down standard wheelchair, but it also has 4-wheel drive mechanism, designed for rough terrain like sand and gravel, uneven surfaces, as well as slopes and hills. But most incredibly, the iBot has two gyroscopic wheels that balance the chair with the stability and reliability of a standing person. When working together, these wheels can scale staircases of any length, either with the use of a handrail or with an assistant. (A small amount of physical strength in the upper body is required.)

When not using both wheels to scale stairs, the two wheels stack one on top of the other and allow the iBot to elevate the user to a normal standing height, enabling the user to see in a crowd and reach items from a top shelf. To see this is incredible - it's as if two small unicycle wheels were stacked vertically to balance a 200-pound wheelchair with a 200-pound person.

For further information: http://www.independencenow.com/ibot/

As reported by the Canadian Medical Association, in 1900 life expectancy at birth in developed countries was about 40 years. By 2000, life expectancy in Canada had nearly doubled.

For further information: http://www.cmaj.ca/cgi/content/full/171/10/1203

In order for people to live long, happy and productive lives, it is necessary to plan for the future needs of aging individuals and create an infrastructure that is integrated and does not lead to social isolation and limited communication.

People with disabilities have been advocates of the concept of "universal design" for many years. If adopted by developers of appliances, homes, cars, communication devices, and transportation and recreational facilities, universal design will enable all citizens to have equitable access to products, services and information. It will undoubtedly result in a healthier and a more independent quality of life for all.

As it stands, people with disabilities are constantly faced with barriers when accessing everyday tools such as bank machines, telephones and VCRs. Many stoves and ovens are designed with flat screen panels, preventing blind or vision-impaired individuals from being able to access the unit without sighted assistance or some form of marking system. Rather than having to retrofit, it would be much more economical if these products were designed with universal access in mind in the first place.

The economic basis for addressing these changes is sound now that we have come to realize that there is a sound business case for making our workplaces accessible to all. Accessibility results in employers being able to access a highly skilled segment of a previously untapped labour pool--people with disabilities.

I have worked in Human Resources for the past 25 years. As a "Manager of Workforce Diversity", one of my roles involves recruiting employees with disabilities, both hidden and visible in nature. I am frequently astonished at the calibre of candidates applying for positions who are prepared to accept contract or part-time opportunities in spite of their experience and credentials. With technological advancements in conjunction with the trend toward universal design in both technical and non-technical areas, it is my hope that existing barriers to employment will be eliminated and that hiring managers will then be able to focus solely on the skills, abilities and motivation of all potential employees.

Enabling Seniors to Live Independently

Editor's Note: The following article is reprinted from the National Organization on Disability's website http://www.nod.org and is dated July 1, 2005.

As we age, assistive technology will play more of a role in our lives than in the lives of our parents. Living safely, independently and comfortably are important to us and technology can assist us in these areas.

To provide a safe home environment for a person with low vision, poor manual dexterity or difficulty remembering, there are monitoring products that can turn off devices that have been on too long, can emit warning alerts, measure temperatures, watch for movements in a room and activate switches. Privacy is important, but where alerts are triggered, cameras can help relatives or care professionals to communicate and respond.

Help systems can activate reminders, control heating and entertainment systems and many other devices that will enable people needing care to live independently and yet feel safe and in touch.

Sixty-nine-year-old, visually impaired widower Jonathan Boyd has programmed his kitchen to help him maintain a "desirable quality of life." "The screen on my help system reads my messages for the day. And when need be, I can contact my friends and relatives for assistance."

Boyd invested several thousand dollars to program his house. Boyd has a telephone that responds to voice commands and so when he says, "Peggy," the telephone automatically dials his daughter's office.

Boyd lives in a rural area and is investigating the smart house and telecare and telemedicine in rural areas. He wants to be sure that living in a rural area does not prevent him from having immediate access to health care. For example, Boyd has high blood pressure, and he needs to check it daily.

"I am investigating how monitoring devices can transmit information to my doctor's office if my blood pressure level is rising. If a problem occurs, my doctor can respond quickly. A quick response could save my life," says Boyd.

The concept of monitoring raises a number of ethical and legal issues. Any monitoring system should only be implemented with the full agreement of all parties involved, including relatives.

Boyd is not alone in using technology to give him a peace of mind. Seventy-four-year-old Marilyn Horne, a former medical technician, says, "I am worried about being alone and losing control of my life and so I have become an investigative sleuth in the technology area."

A diabetic, she has a talking glucose monitor, a talking computer to help her read, and a voice activated program that will turn appliances on and off on command. Pressure sensitive switches turn the lights on and off in her kitchen, bedroom, bathroom and living room.

Was she afraid of using computers at her age? "No," she says with a laugh. She's used computers for 24 years. She uses her laptop to watch movies and to listen to songs.

Mobility is important to her. She does not drive anymore. Instead, she takes public transportation, taxis or her children pick her up for shopping and pleasure events. When she goes to movies or plays, like Boyd, Horne asks for Assistive Listening Devices.

How does her family view her use of technology? Horne's daughter Emily Cressey says, "Mom has become a rabid fan of technology to maintain her quality of life. We are proud of her. She is trend setting for my brother and me when we are her age."

When doing business with the bank, Horne uses a Talking ATM and receives her bank statements in large print.

Horne estimates she has spent close to $2,500 from her savings for her technology. She firmly believes the investment is worth it. "I still control my life. As long as I can, I want to live," she says.

Useful Assistive Technology Resources for seniors

SeniorNet

SeniorNet is a non-profit organization of computer-using adults, age 50 and older, whose mission is to provide these older adults education for and access to computer technologies to enhance their lives and enable them to share their knowledge and wisdom. SeniorNet supports over 204 Learning Centers throughout the country, and provides online opportunities for learning and discussion amongst older adults.

American Foundation for the Blind

The American Foundation for the Blind (AFB) is a non-profit organization whose mission is to ensure that the ten million Americans who are blind or visually impaired enjoy the same rights and opportunities as other citizens. AFB promotes wide-ranging, systemic change by addressing the most critical issues facing the growing blind and visually impaired population--employment, independent living, literacy and technology.

Their technology web page has information on assistive technology, web accessibility, electronic books, how to get an accessible telephone, buying a computer. It also has screen reader tips, and tips for computer users with low vision.

Telecommunications for the Deaf, Inc.

TDI (also known as Telecommunications for the Deaf, Inc.) was established in 1968 originally to promote further distribution of TTYs in the deaf community and to publish an annual national directory of TTY numbers. Today, it is an active national advocacy organization focusing its energies and resources to address equal access issues in telecommunications and media for four constituencies in deafness and hearing loss, specifically people who are deaf, hard-of-hearing, late-deafened or deaf-blind.

Their Telecommunications Access web page provides information on wireless telecommunication devices, internet relay services options, TDD & TTY modem and software manufacturers, and video relay services options.

CTC Foundation

At this website, one can order the directory Assistive Technologies: Creating a Universe of Opportunities for People with Disabilities. This directory lists hundreds of assistive technology manufacturers in the United States, Canada, Europe and Asia. Employers, educators and rehabilitation workers looking for information on products benefiting speech impaired, blind, visually impaired, deaf, hearing impaired, physically challenged and mobility challenged individuals will discover it in the book.

Additional contents include: summaries of federal legislation passed on disability issues; an overview on the status of assistive technology today; key Supreme Court decisions on the Americans with Disabilities Act; 12 columns by author John M. Williams; articles by IBM, Microsoft, Oracle, Deque, Kurzweil and their philosophies behind accessibility policies; and definitions of assistive technology terms.

Creating a Comfortable Environment For Older Individuals Who Are Visually Impaired

Editor's Note: This item is excerpted from the website of the American Foundation for the Blind: http://www.afb.org/section.asp?Documentid=1417

Making a private or public environment comfortable and functional for individuals who are blind or visually impaired should be part of universal design for older people, benefiting all older individuals.

Making facilities and programs and activities safe and accessible for older participants who are blind or visually impaired does not necessarily require a great deal of time, energy or money. It is a matter of knowing the basics and planning for easy access during the initial design of the facility and its programs.

The use of lighting, colour contrast and the reduction of glare are important factors architects and interior designers must be aware of for effective environmental design.

Individuals working in the field of aging should take these vision factors into consideration when designing environments for older persons, particularly senior centres, retirement communities, assistive living environments and nursing homes.

The suggestions below can be used to conduct an initial assessment of the environment. A vision rehabilitation professional can provide further assistance in assessing the environment and making recommendations for changes to enhance safe and independent functioning, and active participation. Here are the primary environmental elements needed for older persons who are blind or visually impaired to be able to function independently in any environment.

Environmental Adaptations or Modifications that Enhance Functioning

Lighting

-In recreation and reading areas, provide plenty of floor lamps and table lamps.

-Advise people who are visually impaired that light should always be aimed at the work they are doing, not at the eyes.

-Replace burned out light bulbs regularly.

-Place mirrors so that lighting doesn't reflect off them and create glare.

-For window coverings, use adjustable blinds, sheer curtains or draperies, because they allow for the adjustment of natural light.

-Keep a few chairs near windows for reading or doing hand crafts in natural light.

Furniture

  • Arrange furniture in small groupings so that people can converse easily.

  • Make sure there is adequate lighting near furniture.

  • When purchasing new furniture, select upholstery with texture when possible. ---Texture provides tactile clues for identification.

  • Use brightly coloured accessories, such as vases and lamps, to make furniture easier to locate.

  • Avoid upholstery and floor covering with patterns. Stripes and checks can create confusion for people who are visually impaired.

Elimination of Hazards

  • Replace worn carpeting and floor covering.

  • Tape down or remove area rug.

  • Remove electrical cords from pathways, or tape down for safety.

  • Do not wax floors; use non-skid, non-glare products to clean and polish floors.

  • Keep desk chairs and table chairs pushed in.

  • Move large pieces of furniture out of the main traffic areas.

  • If telephone booths protrude into main traffic areas, have them moved.

Use of Colour Contrast

  • Place light objects against a dark background, a dark table near a white wall, for example, or a black switch plate on a white wall.

  • Install doorknobs that contrast in colour with doors for easy location.

  • Paint the woodwork of the doorframe a contrasting colour to make it easier to locate.

  • Mark the edges of all steps and ramps with paint or tape of a highly contrasting colour.

  • Hallways and Stairways

  • In hallways, make sure that lighting is uniform throughout.

  • Place drinking fountains and fire extinguishers along one wall only throughout hallways to allow individuals who are visually impaired to trail the other wall without encountering obstacles.

  • Install grabs bars where they may be needed.

  • Light stairwells clearly.

  • Make certain that stairway railings extend beyond the top and bottom steps.

  • Mark landings in a highly contrasting colour.

Signs

  • Place all signs at eye level, with large lettering according to specifications outlined in the Americans with Disabilities Act.

  • Provide braille signage according to ADA specifications.

  • Mark emergency exits clearly.

  • When making signs by hand, use a heavy black felt-tip pen on a white, off-white or light yellow, non-glossy background.

Telephones

  • Provide some telephones with large-print keypads or dials.

  • Provide telephone amplifiers, which increase the level of sound.

  • These basic environmental design and safety tips can go a long way toward making a facility a comfortable and accessible environment for older persons who are visually impaired, and for everyone else who uses the facility and services. Increasingly, these elements must be incorporated into universal design.

Copyright 2004. Reprinted with permission of American Foundation for the Blind. All rights reserved.

Nana Cannot See Very Well

Editor's Note: Beryl Williams is the NFB:AE\'s former 1st Vice President. She lives in Saskatoon, Saskatchewan.

Becoming grandparents is something all parents contemplate periodically, and then it becomes reality!

The long awaited arrival brings a variety of emotions including relief, pride, joy and wonder; for me, there was also apprehension. I wanted to have an active role despite the limitations that blindness might present, but how would I gain the necessary self-trust and confidence to have meaningful and fulfilling involvement with my granddaughter, along with any other little ones to come in the future?

After the initial stages of adjustment by all, especially the new parents, I was entrusted with short periods of babysitting, which presented no immediate problems or anxieties. The time between feedings was usually taken up with the baby sleeping, interrupted only by occasional fussing and diaper changing. As baby Alice developed, however, her natural curiosity soon began to expand the boundaries of her environment, and my role became more challenging.

As anyone with personal experience caring for infants knows only too well, it is necessary to be constantly alert and aware of their every movement. This presents a definite challenge to someone unable to keep a sharp eye on their charge. Monitoring requires 100% awareness, and lack of sight demands being at hand's reach at all times.

Children's instinctive curiosity motivates mobility sooner than is good for their safety, and it is imperative to create a hazard-free environment. While it is virtually impossible to avoid all the potential disasters quietly lurking around every corner or behind every door, using common sense, child-proof safety techniques can guard against obvious dangers, making child care a more relaxed occupation for all concerned. This is true for anyone but particularly so if one is not able to keep a visual check.

I have not taken on the responsibility of outdoor activities beyond our fenced garden or neighbourhood sidewalk yet; I am more at ease in a familiar setting, where the comfort level is almost up to par with that of sighted family members. There will be lots of opportunity for venturing further afield once a strong mutual understanding and respect of limitations and boundaries has developed. I am proving to myself and family members that, despite my limited visual acuity, I am more than capable and responsible to be in sole charge of my grandchildren.

I do miss participating in visual activities like drawing, painting, crafts, looking at and reading picture books; nevertheless, there are many ways I can compensate. Traditional and improvisational storytelling, nursery rhymes and games, along with a wealth of songs, all provide wonderful quality time together and opportunities for sharing.

Baking and cooking are other popular activities although things can get a little hectic now that there are two little assistants dragging over stools as soon as they notice I am about to start something. The children are also learning that certain things are out of bounds, particularly around the stovetop burners.

I believe my greatest contribution is the quality time we share talking and listening together, which certainly can never be diminished or compromised by my lack of sight. I trust there are some very positive images and attitudes being absorbed by these children, which will remain with them forever. Their understanding is already beyond their years. They see nothing unusual about Nana seeing and doing things in a different way. As Alice often remarks, "That is because you cannot see very well, isn't it Nana?"

Naturally, there are times when I wish I could see. Sight would allow me greater freedom to do many more activities, but there is far too much joy and happiness at hand to cherish and little gained by dwelling on the negative. I am reassured by the confidence and trust that are enabling me to be the Nana I always hoped I'd be.

I now have four grandchildren, on whom I can lavish all my affections and indulgences while developing and building a strong and lifelong relationship with the next generation. I believe I can enrich the lives of all my grandchildren. As time passes, all too quickly, their memories of times spent together with Nana will be happy ones.

Seniority: The Growing Market For Bigger Buttons

Editor's Note: The following article is reprinted from the New York Times, December 14, 2003.

I THOUGHT about Richard Nixon the other day as I was struggling to twist the "easy open" lid off a jar of olives. I remembered reading in a book that his prescription containers had tooth marks on the childproof caps because, in frustration, he had tried to gnaw them off.

I know how he must have felt. I finally used a screwdriver to pry the vacuum-sealed lid off the olive jar. For a fleeting moment I had considered breaking the jar in the sink and salvaging what olives I could (or resorting to a lemon peel for my martini).

The higher point here is that many products, and how they are packaged, ignore the physical limitations of an aging population. I\'m a fairly healthy specimen; however, I often find myself struggling not only with lids but a lot of other things, like the thick plastic armour that encases most small electronic products. It has also taken several months for my wife and I to master just the basics of the tiny, unclearly labelled buttons on the remote control for a combination TV-DVD-VCR. I\'m still not sure what "zero return" and "repeat A-B" mean.

Sella Palsson of Salt Lake City was so frustrated looking for products to help her mother see better that in 1999 she started a business called SeniorShops to sell products to aid older people in coping with everyday problems. She has a retail store in Salt Lake City, but 95 percent of her business comes through the internet (www.seniorshops.com) or the telephone (800-894-9549). In the last three years sales have more than tripled.

Ms. Palsson is among a growing number of entrepreneurs taking advantage of the apparent unwillingness of many big manufacturers to tailor their products to accommodate the graying of America.

"Manufacturers that make packaging that is hard to get into are just not thinking," she said. "The baby boomers are the largest part of the population and they\'re getting older and have money to spend."

One of SeniorShops\' most popular products is a cordless phone for people with hearing and vision difficulties. It amplifies a caller\'s voice and has large lighted numbers for dialling. It costs $109.95, plus shipping. Another is a device called a Videolupe for people with macular degeneration. It can be hooked up to a television so that magnified images of photographs or printed material can be displayed on the screen. It\'s $499.95, plus shipping.

Other popular products include low-cost gadgets for kitchen chores like opening jars. There are also talking clocks and watches, and even a talking caller ID device ($36.95) that announces who\'s calling.

Of course, some of these products are available at big retail stores. But they are usually not displayed in one place, and finding them can be a haphazard process.

"What makes companies like us unique is that these products are our sole focus," said Andrea Tannenbaum, who started Dynamic Living (www.dynamic-living.com; 888-940-0605) as an internet-only retailer in Windsor, Conn., in 1997. Since then it has had yearly sales growth of 30 to 40 percent and has expanded to include catalogue sales, which now account for 30 percent of business.

"We\'ve been increasingly moving to catalogue sales because many of our customers don\'t have access to the internet," she said.

One of Dynamic Living\'s most popular offerings is offset hinges that allow a door to be opened a couple of inches wider for wheelchairs and walkers. They cost $24.99 a pair, plus shipping.

Lids Off is another big seller. It\'s an electric jar opener made by Black & Decker and priced at $39.99. Demand is so strong that the product is back-ordered. "I don\'t think Black & Decker anticipated how popular Lids Off was going to be," Ms. Tannenbaum said.

She noted that many of these products were not made exclusively for older people. They could also help those with disabilities or temporary limitations resulting from an accident or surgery.

She is keenly aware that the baby boomers are a prime target for businesses like hers. "Older people will often just get by if products like this aren\'t put in front of them," she said. "The baby boomers, on the other hand, will seek out products to help them because they won\'t accept limitations as readily as the older generation. But boomers don\'t like to think of themselves as old. So we don\'t use the words \'disability\' or \'senior\' on our website. We just say, here\'s a functional problem and here\'s a solution to that problem."

Connie Hallquist, the owner of an online and catalogue store called Gold Violin (www.goldviolin.com; 877-648-8400) in Charlottesville, Va., says her internet sales have increased about 25 percent a year since she started in 1999. But overall business this year has grown threefold because of a marketing arrangement with QVC, the television shopping channel.

ONE of her big sellers is the Secret Agent Walking Stick ($69, plus shipping), which has a built-in flashlight and pill compartment. Big-button remote-control devices for televisions are also popular, along with the Jar Pop, a device for opening jars; it looks like a cross between a shoehorn and a bottle opener and costs $5.95. There\'s also a jumbo caller ID display ($89.95) that shows a caller\'s name and phone number in large type.

"We try to stress products that are stylish, well designed and fun; nobody wants to face shopping in a medical supply store," Ms. Hallquist said. "I aspire to be the Williams-Sonoma of products that will help people stay independent and active."

Fred Brock is an editor at The Times. His column on the approach and arrival of retirement appears the second Sunday of each month. Email: fbrock@nytimes.com

Copyright 2003 by the New York Times Co. Reprinted with permission.

Aging and Vision Loss in Canada

Editor's Note: Sean McNeely is a writer/editor with the national communications department of the Canadian National Institute for the Blind. This article discusses some of the material presented at the 2004 Cost of Blindness: What it means to Canadians Symposium, which was organized by health care professionals, researchers and service providers, at which no presenters representing consumer organizations were included. The new study released at the symposium by the Environics Research Group also shows how far we still must go and how important public education work remains.

Imagine, for a moment, attending a Toronto Maple Leafs hockey game at the Air Canada Centre.

It?s sold out, with all 19,500 seats filled. As you look across the rows of seats and scan the crowd, imagine that every fourth person will experience vision loss by age 75.

Every fourth person will no longer be able to drive, to read, or to see the faces of loved ones. Within this group, many will experience depression, requiring counselling or medication. And each will have to adjust to vision loss and overcome emotional and physical challenges in order to maintain an independent lifestyle.

While the hockey game is fiction, the numbers of those that will lose their vision and the consequent effects are very much fact.

Canada is experiencing a crisis in age-related vision loss, stressed speakers at The Cost of Blindness: What it means to Canadians symposium, held in Toronto on January 31 and February 1, 2004.

Hosted by The Canadian National Institute for the Blind (CNIB) in partnership with Canada?s leading vision health organizations, the event featured national and international experts in the fields of blindness, low vision and epidemiology.

The event was organized in part because of the need for blindness research in Canada, which is sorely lacking when compared to the U.S., U.K. and Australia. For example, compare the amount of money spent on blindness research north and south of the border.

In 2003, Canada spent about C$28 million on blindness research. The National Eye Institute of America, along with two major private research agencies spent U.S.$660 million (C$839 million).

And yet a new study released at the symposium by the Environics Research Group shows Canadians cherish their vision and would go to great lengths to preserve their sight.

Seven out of ten Canadians say they fear losing their vision more than losing the use of their legs or their hearing. One third would sell everything they owned to save their eyesight.

For hundreds of thousands of Canadians, this fear has become a reality.

Dr. Ralf Buhrmann, of the Ottawa Eye Institute, told the symposium audience that there are approximately 387,000 blind and vision-impaired Canadians over 40.

However, what is alarming is how this figure is expected to skyrocket over the next 25 years, as more and more Canadians reach their senior years.

Incidence of age-related macular degeneration (AMD) is soaring as baby boomers reach 50 and 60. In 2003, just under 80,000 new cases were diagnosed across Canada. Glaucoma and diabetic retinopathy are also on the rise with thousands of Canadians totally unaware they have glaucoma or diabetes.

While there has been much concern about the rising incidence of age-related vision loss, there has been little research on the impact of this vision loss,? said Dr. Hugh Taylor, head of the Centre for Eye Research Australia.

Recent research in Australia shows that elderly people with vision loss are admitted to nursing homes on average three years earlier than those without vision loss. Their risk of falls is twice as high, their risk of depression three times as high, and their risk of hip fracture--a leading cause of death in the elderly--is four times as high. Worst of all, their risk of death is twice as high.?

While no similar research has been done in Canada, the medical costs related to treating these types of injuries and conditions are also substantial.

Professor David Foot, author of the best-seller Boom, Bust and Echo, told the symposium audience that falls are the fastest growing cause of death for people in their 70s and 80s. Also alarming, motor vehicle accidents are almost as high for people in their 80s as for those in their 20s--the decade of highest incidence for such accidents.

Given that these are the years when vision loss is greatest, could these falls and accidents be happening because people can?t see properly?? asked Foot.

For thousands of Canadians, losing their vision may also mean losing their jobs. Recent studies state that in Canada and the United States about 70 percent of working-age adults who are blind are unemployed.

Four out of five working-age blind Canadians do not have an opportunity to work and contribute to this country?s economic growth,? said Chris Stark in a magazine article published last summer by the National Federation of the Blind: Advocates for Equality.

Most blind persons have an inadequate income during working age and after retirement, well below the level of other Canadians. Blind persons have a standard of living inferior to all other Canadians,? he added.

To bring about change, a shift in attitude towards investing in blindness programs is needed, urged Corinne Kirchner, director of the Department of Policy Research and Program Evaluation at the American Foundation for the Blind.

Instead of asking, ?What are the costs to society of having X number of blind and visually impaired people?? one should ask, ?What are the costs to society of preventing or limiting the economic productivity of people who are blind or visually impaired??

For information on the symposium, including video and audio presentations of each speaker, visit: www.costofblindness.org

Seniors Stuck After Giving Up Driving, Study Finds

Editor's Note: Editor's Note: The following article is reprinted from the Toronto Star, September 21, 2002.

Seniors are outliving their ability to drive, according to a new study.

"Hundreds of thousands of older people quit driving each year and must turn to alternative transportation",says Dan Foley, a biostatistician at the National Institute on Aging in Bethesda, Md., and lead author of the study.

"I don't think sufficient attention has been paid to the transition from driver to non-driver in the aging population."

The aging of the boomers and an increase in the number of female drivers is expected to yield a growing population of seniors living longer than they hold a driver's licence.

Foley and his colleagues found that the largest number of older drivers giving up the privilege did so around age 85, which suggests that the "oldest old" may be most in need of transportation help.

Dr. Arun Karlamangla, a geriatrician at the University of California, Los Angeles, says it's often difficult for non-driving seniors to arrange transportation to appointments. Many of his patients arrange rides through a local organization, but often wait a couple of hours for the ride back home. Others rely on relatives or pay for assistance.

"This is going to become an issue, more among the people who are less well off," he says.

In the study, the researchers analyzed data gathered in 1993 and 1995 about a sample of Americans age 70 and older, along with follow-up data on 4,996 male and female drivers with access to a car. Some 88 percent of men and 70 percent of women were driving in their early 70s. For those 85 an older, the driving rate fell to 55 percent for men and 22 percent for women.

Seniors may stop driving because of poor vision, memory impairment or mobility problems. The so-called driving expectancy for an older adult fell short of overall life expectancy. Men and women able to drive at ages 70 to 74 were expected to keep on driving 11 more years. But the men statistically were expected to live an additional 17 years, and the women 21 years.

Copyright 2002, the Los Angeles Times. Reprinted with permission.

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