It’s been just over two years since I first wrote about Emergency Preparedness , a topic prompted by my unexpected role as healthcare proxy for a dear friend who was seriously injured in an accident. With four surgeries behind her, my friend continues her long road to recovery and a new normalcy. During this time, we’ve both learned a great deal about struggling to navigate through pathways we once took for granted. This first-hand experience has deepened my commitment to advocating for physical and digital accessibility – that is, advocating for equal access to the tangible and the virtual places we all need to be.
Understanding accessibility
First, what is accessibility? Simply put, it’s the design and implementation of environments, products, and services so that they are easily usable by all, regardless of their physical abilities, age, or proficiency with technology. Accessibility covers both physical spaces and digital platforms ensuring both are navigable by everyone.
Currently, there isn’t a global standard for ensuring accessibility though laws and guidelines continue to emerge and evolve worldwide.
In the US,
Guidelines:
- The Americans with Disabilities Act (ADA) was enacted in the 1990s and originally focused on prohibiting discrimination against individuals with disabilities in areas such as employment, public services, and accommodations.
- Later, in 1999, the World Wide Web Consortium (W3C) developed an initial Web Content Accessibility Guidelines (WCAG 1.0*). The standard includes online spaces and digital accessibility.
Enforcement
- ADA compliance is enforced by the Department of Justice and several related agencies. Complaints can be filed with the DOJ and legal actions may result in fines and directives for remediation.
- WCAG is not a comprehensive law… yet. However, it is often referenced in legal settlements and agreements related to digital accessibility. Similar to complaints of ADA non-compliance, complaints may be filed with the DOJ and legal actions may result in fines and directives for remediation.
Real life scenarios and accessibility considerations
Consider my friend’s situation: having a mobility impairment while navigating historic Boston neighborhoods and her second-floor, walk-up home. What was once seen as Boston’s charming and historic South End neighborhood has become a series of obstacles, with cobblestone after uneven cobblestone sidewalk, steep and narrow stairs, high ceilings with floor to ceiling cabinets. Further complicating matters, now home bound, digital platforms for health, commerce, and entertainment become essential services. Tasks that we all take for granted become significant hurdles, making simple activities nearly impossible without accommodations and help.
While my friend was (literally) working to get back on her feet, we asked: how might she safely get around? What online services and resources might ensure she has what she needs? How might she find and use information online? Here are a few considerations we focused on:
1. Physical Accessibility at Home
- Home Modifications: For getting around within her home, certain modifications such as ramps, handrails, and stair lifts made her 2-story walk up home more navigable. Programs like the Department of Housing and Urban Development (HUD) or Rebuilding Together offered resources and funding for these adjustments.
- Accessible Communication Devices: Devices like smart speakers, which enable hands-free control over lights, security, and household appliances, greatly enabled her independence. Options like Amazon’s Alexa or Apple’s Siri gave her easy access to communication, reminders, and even ordering groceries.
- Medical Equipment and Emergency Alerts: Medical alert systems with features like fall detection or emergency calling can be essential for safety. Companies such as Life Alert offer wearable or wall-mounted options that ensure she has help at hand in case of an emergency. (A current iPhone/Watch also provides this detection and notification option.)
2. Services and Resources
- In-Home Assistance Services: Accessing in-home assistance—like personal care aides, meal preparation, or laundry services—is critical for a homebound individual. Platforms such as Care.com or the local government Council on Aging often provide lists of licensed home care professionals who can be scheduled online or by phone.
- Library Resources: Accessing reading material can be facilitated by local libraries offering e-books, audiobooks, and large-print digital content. Many libraries also provide delivery services for physical materials, as well as phone assistance with setting up digital access.
- Social Services Check-ins: Maintaining social connections and mental health support is essential. Many social services and nonprofits offer remote support groups, virtual counseling, and peer support check-ins designed for older adults, such as through AARP or Meals on Wheels programs.
3. Digital Accessibility
- Online Shopping and Grocery Delivery: For essential items, accessible web sites or apps for online shopping, including grocery delivery, can be a lifeline. Easy navigation, large font sizes, and voice search options make it easier to browse and order from home. Accessing platforms like Instacart, Amazon Fresh, or local grocery sites that offer senior support could help streamline this.
- Telehealth Services: Virtual medical appointments are increasingly available, allowing her to connect with healthcare providers without leaving home. Platforms like Patient Gateway provide an aggregation of her medical information including records, test results, access to educational information to help her manage her health with her care team.
- Online Banking and Investing: Managing finances online can be challenging without accessibility features. Many banks offer mobile apps and online portals with screen reader compatibility, large icons, and clear labeling, making it easier to handle routine banking from home.
These tools and resources help her connect to the world from home, supporting her daily needs, safety, and independence.
Learn more and get involved
If you are still reading, thank you. And if you’ve come this far, I urge you to reflect on the environments you inhabit and the digital spaces you navigate. Are they accessible to all? As we’ve seen through my friend’s journey, accessibility is not just a consideration for those already facing challenges—it’s a proactive step we can all take to ensure inclusivity and safety for everyone.
Consider incorporating accessibility accommodations now, before an emergency situation makes them a necessity. Whether it’s installing ramps and handrails in your home, ensuring your website meets accessibility standards, or advocating for inclusive practices in your workplace, every action counts. Some of us aren’t getting any younger <wink wink>.
By taking these steps proactively, we not only prepare ourselves and our communities for unforeseen circumstances but also contribute to a more equitable and compassionate world. Accessibility should be a required standard, not an afterthought. Everyone’s proactive efforts today can make a significant difference tomorrow.
To get started, these resources will help you gain a better understanding of accessibility principles and legal frameworks.
- What is Accessibility? | IxDF (interaction-design.org)
- Introduction to the Americans with Disabilities Act | ADA.gov
- Introduction to Web Accessibility | Web Accessibility Initiative (WAI) | W3C
Post script: What we do at Dana-Farber
Here at Dana-Farber, we are committed to ensuring accessibility for all. For the folks we serve, our practice focused on accessibility is designed to create an inclusive environment, both physical and digitally. We continually strive to meet and exceed both ADA and WCAG guidelines. For employees, our KGA Employee Assistance and Work-Life Programs are available for reference, consultations and referrals. By embracing accessibility, we not only fulfill legal requirements but also contribute to a more equitable and compassionate society.
*WCAG Version 2.0 guidelines are continually updated with incremental updates published in 2018 and 2023. Version 3.0 is currently in draft form and projected to be published by 2028.