Barriers to healthcare.
What is a barrier to healthcare? Well, a barrier is an obstacle. And barriers to healthcare can mean poor health and well-being for people of all ages.
Healthcare is delivered by many different health professionals or healthcare providers which may include:
- hospitals and hospital staff,
- medicine or medical services delivered by physicians or medical doctors,
- nurse practitioners, and nurses,
- occupational therapy,
- physiotherapy/physical therapy,
- speech-language pathologists,
- social workers,
- and so on.
Healthcare also treats both physical health and mental health.
For people with sensory sensitivity, they might feel senses more or less than other people. Some people might be highly sensitive or hypersensitive. They feel from their senses more intensely. Some people have less sensitivity or be hyposensitive. They feel from their senses less intensely. Further, sensory sensitivity is a problem for many people. It is a problem for veterans with PTSD, people of any age with anxiety, autism, concussion, hearing loss, and many other challenges or underlying disabilities.
Sensory sensitivity is a documented barrier to healthcare.
Sensory sensitivity is a common problem for people with autism. A recent study shows that adults with autism identify sensory issues as a barrier to receiving healthcare services. In an article published in 2017, the authors of the study reported that autistic participants identified barriers to healthcare, particularly in areas related to emotional regulation, patient-provider communication, sensory sensitivity, and healthcare navigation. This was in comparison to people with other disabilities or people without autism. Moreover, 30% of the adults with autism who responded, said specifically that the facilities themselves contributed to their sensory issues and were a barrier to their access to healthcare.
Sensory sensitivity is not just a problem for adults with autism. There are many people with sensory sensitivity that contributes to sensory issues and in particular, sensory overload. Furthermore, this includes people with a number of other underlying conditions that are increasingly prevalent, such as anxiety, autism, concussion, dementia, hearing loss, and post-traumatic stress disorder. As well, these conditions and their associated sensory sensitivities impede people’s ability to engage in daily life.
What helps people with sensory sensitivity overcome barriers to healthcare?
Did you know that there are very practical things to do to help people with sensory sensitivity overcome barriers to healthcare? One of the biggest changes is to make healthcare facilities and environments sensory-friendly. Sensory-friendly means creating a space that is friendly to the senses. In addition, the sensory experience will be less intense, especially for people who have sensory sensitivity or experience sensory overload.
Sometimes environments are sensory-rich, meaning they are by nature busy, noisy, and bright and it can be difficult to change all the features and characteristics that make it so. Where possible, reducing background noise in general, is critical. For example, many places have background music playing at all times. Eliminating that background music or limiting it is very helpful.
Another important part of being sensory-friendly is letting people know what to expect and when to expect it. So for a large healthcare facility, having a sensory-friendly map that lets people know where the noisy spots are and where the quiet spots are, both on a map and on local signage, is helpful.
A sensory-friendly example for veterans that removed barriers to healthcare.
A wonderful example of a sensory-friendly transformation project is removing barriers to healthcare for veterans by creating a sensory-friendly space. That sensory-friendly transformation encompassed designing a room where veterans would come in for interviews and meetings about their healthcare services and benefits.
In the transformation of this small meeting room, a key consideration was that veterans of all ages and all abilities would come in to meet with staff at the office that served veterans.
- Younger veterans with PTSD might use the room.
- Also, veterans who were in their 80s or older with mobility difficulties might also use the room.
- In addition, veterans with hearing loss might use the room.
- Finally, family or caregivers might also accompany veterans.
First of all, in this setting example, there were many sensory sensitives to account for, in addition to accessibility and the comfort of both the staff and the veteran. Second, there were guidelines from the veteran’s facility itself to follow and a local interior designer helped throughout the process. Third, the facility had a specific budget to order new furniture for the room.
Both a love seat and individual upholstered chairs were included. For example, sometimes veterans might like to sit in their own chair, but other veterans might want to sit on the love seat next to their spouse, partner or caregiver. Likewise, seating is important for the senses of balance, movement, and touch. The spacing of the seating is important for hearing. For some veterans, the staff would need to sit directly in front of the veteran, so they could see each other’s faces easily. It was important to set up the chairs and loveseat so they could face each other, but also allow for a different choice, sitting side by side. Someone could sit facing the window or with their back to the window. Sitting facing or away from the window was important for the sense of sight.
A great deal of thought went into the simple décor. Cool tones were used for the room, a bright, slightly aqua blue (so it would not feel too military) and greys for the most part. The color palette was simple. Likewise, simple décor was added, but there was plain space on the walls too, so it was not too visually overwhelming. What is more, the room needed to feel comfortable and not institutional. The room had the advantage of great natural light. Finally, it was important to ensure that the light could be blocked off easily with blinds to avoid glare from the sun and light coming through the windows.
A small table that could be easily moved around from in front of the seats to beside the seats was added. In addition, furniture risers were put under the the love seat and couch so that it was easy to sit down on and get up, at a slightly higher seat height. This was important to many veterans with knee and back problems that affected their movement. Furthermore, chairs and a love seat were added with arms and they had firm seats and backs. A few pillows softened things up and provided extra back support if needed.
Care was taken to what was on the walls. Photography and prints of nature are nice, but caution was taken to not evoke memories of the theatre of war. As well, a clock, garbage can and a table with a box of tissues, were added, just to be practical. To manage smells, the garbage can was on the cleaner’s list to empty daily. Small things, but nevertheless important to include. There is also a public bathroom and public water fountain about 50 feet away from the room.
Let us go through each of the eight senses with examples of how to make a space sensory-friendly and helped remove barriers to healthcare.
“Cool” room colors
Few room colors
Photography prints from nature
Uncluttered wall space
|Hearing||Spacing of seating so people can see each other|
|Smell||Garbage can with lid|
|Touch||Spacing of furniture
|Taste||Water fountain nearby|
|Balance||Spacing of furniture
Room to move
|Movement||Spacing of furniture
Small moveable table
Chairs with arms for support
Upholstered furniture with medium firm density
Pillows for back support
|Interoception||Spacing of furniture
Public bathroom and water fountain nearby
Table 1 sensory-friendly examples for a veterans interview room in a healthcare services facility