Thursday, November 11, 2010

Flying With a Disability

In 2008, my wife and I decided to take a vacation to Florida to visit my parents.  We established that even though being confined to a wheelchair, and not knowing what to expect, that we would fly.  I was almost dropped, the staff was not educated about wheelchairs, and we had to wait at least 30 minutes after each flight before anyone came to help.  Needless to say, it was a horrible experience, and I haven’t wanted to fly since.  This sparked me to research possible similar reactions to flying with disabilities. 
Ellen Brehm, a retired nurse who walks with cane, was stranded last September after flying home from California following the annual trip she's been taking with college friends since 1947.
Her flight, which departed six hours late, landed at Newark at about 1:20 a.m. The wheelchair service she'd requested was nowhere in sight. Brehm returned to the plane to sit and wait, but a flight attendant told her she must get off so the crew could leave.
She then stood on the jet bridge, balancing on her cane, to wait. About 30 minutes later, another flight attendant exited the plane and asked if she needed help. The woman eventually returned with a wheelchair attendant.
"Here I am, at 2 a.m., 83 years old, all by myself," Brehm says. "There wasn't one person in this whole huge airport. I don't know what I would have done if she hadn't come out."
Airlines are obligated to provide free, prompt wheelchair assistance between curbside and cabin seat to comply with the 21-year-old Air Carrier Access Act, an anti-discrimination law.
But, as more disabled and elderly people take flight in today's congested air system, many are finding that the assistance is difficult to get. In the three years that the government has issued statistics, more than 34,000 disabled fliers have complained about their treatment, and 54% of the incidents have involved wheelchair assistance.
In 2006, the most recent year available, the USA's six large network airlines received 1.07 complaints per 100,000 passengers about inadequate wheelchair assistance. Network airlines — American, United and the like — connect more passengers, and often have a higher complaint rate than low-cost airlines.
Airlines accurately note that the vast number of wheelchair orders from customers come off without a problem. But many disabled fliers and their advocates say the airlines could do a better job.
With pressure on their profits — collectively, they lost $35 billion in the five years ended in 2006 — U.S. airlines typically contract with outside companies for wheelchair service at airports. Critics such as Fernando Torres-Gil, a Los Angeles airports commissioner and polio survivor who uses a wheelchair himself at airports, say the contractors often give substandard service. Torres-Gil cites low wages, high turnover and a lack of training.
"The individuals hired to help people in wheelchairs are some of the most valuable employees," says Torres-Gil. "Yet, (they) are usually the least compensated and most exploited."
According to a survey last year by a workers' advocacy group of 275 Los Angeles International passenger-service workers, the average pay is less than $19,000 a year. Some 60% said they had not been formally trained in how to lift an immobile passenger.
"Service workers are vital to the health and safety of the traveling public, (but) these workers are poorly compensated, receive little training and have few incentives to stay in their jobs," concluded the survey report by Los Angeles Alliance for a New Economy.  Los Angeles World Airports, the body that runs four airports, including LAX, is trying to raise standards for wheelchair attendant training, service quality and pay and benefits. The Service Employees International Union sees opportunity in low wages. It's organizing workers at six California airports and may expand the campaign nationally, says Mike Garcia, president of the union's California chapter.
The main obstacle to better service is money, says Eric Lipp of Open Doors Organization, a Chicago-based non-profit that tracks the disability consumer market for the travel industry. Open Doors three years ago started organizing conferences for contractors and airlines to improve communication and service. He says that airlines pressure contractors to deliver the work cheaply.
"Ninety percent of the wheelchair problems exist because there's no money in it," Lipp says. "I'm not 100% convinced that airline executives are really willing to pay for this service."
The USA's largest airlines, including No. 1 American and No. 2 United, declined requests for interviews about their wheelchair-assistance programs.
Stranded for 24 hours
During the last Christmas holiday rush, Sile Jaboni, a 70-year-old Albanian woman who spoke no English, was left stranded by her wheelchair attendants for 24 hours at Chicago O'Hare. On Dec. 18, Jaboni flew United from Orlando to O'Hare, where she was scheduled to catch a flight back to Europe, says Steve Crandall, the Jacksonville travel agent who booked her travel.
Her first wheelchair attendant left her at the wrong gate. Later, another attendant pushed her to the correct gate, but after her flight had already departed.
Eventually, an Air Jamaica employee stopped to see if Jaboni needed help. She handed him a piece of paper with her nephew's phone number. The nephew paid for his aunt to return to Orlando, Crandall says. United eventually agreed to pay Jaboni's fare back to Albania, but only after Crandall contacted local media, he says.
Robin Urbanski, a United spokeswoman, called the incident "an unfortunate oversight." She and Adam Taylor, a vice president of Air Serv, the service provider, each said improvements are in the works.
On several Delta flights, wheelchair user Mary Verdi-Fletcher, founder of the Cleveland-based Dancing Wheels dance troupe, says people who help transfer her from wheelchair to cabin seat usually don't know how to do it properly. She's grown accustomed to talking them through the process.
"Most of the time they cannot figure out the seat belts or the braking system on the (wheelchair), so we are tossed and jarred about and cannot really catch ourselves if they stumble," Fletcher says. Delta declined comment.  Roger Lotz, a Travelers Aid volunteer at Reagan Washington National, says he has seen the wheelchair-request system fail at times, especially during peak holiday periods. Airline gate agents are overloaded, and, as a result, the airlines and contractors don't coordinate wheelchair usage, he says.
Lotz, a former flight attendant, says on Dec. 23 he borrowed a wheelchair from a passenger to help an American Eagle passenger off her plane when the assistant didn't arrive after 40 minutes.
Lotz wheeled the woman off the plane, but her exit wasn't entirely smooth. "She was hissed at and even booed" by the passengers waiting to board the flight as she was wheeled off the plane, he says.
American Eagle spokeswoman Andrea Huguely said the failure of the wheelchair assistant to show up was unfortunate, and said airline employees, not volunteer Lotz, should have assisted the passenger.
She says the airline received over 2 million requests for help last year and that most went well.
Concerns about adequate wheelchair assistance are expanding beyond disability-rights groups. AARP, for instance, is now monitoring how airlines treat people with limited mobility. Brewster Thackeray, an AARP manager, says AARP views wheelchair service as an important quality-of-life issue for baby boomers and their parents.
According to the complaints and interviews with disability-rights advocates, factors other than the service providers combine to cause the system to sometimes come up short:
•Higher demand. Americans on average are growing older, leading to an increase in fliers with disabilities.
By 2030, Open Doors estimates that nearly 24% of the U.S. population will be disabled, and 15% severely disabled, resulting in about 53 million more disabled people than in 1997. The group estimates that around a third of adults with disabilities fly at least once every two years.
It's not just aging that contributes to the increase in travelers with disabilities. Medical technology allows people who have endured severe trauma from war, vehicle crashes and the like to travel with relative ease, says Kate Hunter-Zaworski, director of the National Center for Accessible Transportation at Oregon State University.
"We are facilitating living a fuller life, and air travel is essential to a full life," she says.
At JetBlue, the growth in passengers who request wheelchair assistance has outpaced overall passenger growth consistently since 2004. Last year, about 262,000 JetBlue passengers, or 1.2%, requested such assistance when making their reservations.
•Late-arriving flights. Flight delays make it harder to coordinate wheelchair assistants, reduce the amount of time disabled people have to board and exit flights, and reduce connection times. Last year, just 73.4% of flights arrived on time, the second-worst annual rate since the government began tracking.
•Passenger behavior. Travelers who request wheelchair service in advance don't always receive it immediately when getting off a plane because another passenger who didn't request help in advance may have reached the wheelchair first. Attendants are typically told to help anyone who sits in their chair. Some travelers also cheat, particularly at large international airports, where able-bodied people sometimes get wheelchairs to cut into long lines at Customs, say airport and airline officials.
Airlines have an incentive to improve wheelchair assistance, says Lipp, of Open Doors, the Chicago non-profit. Passengers with disabilities generate nearly $3 billion a year for airlines, and the market's potential grows each day, he says.
Making some improvements
Some in the travel industry are responding to the need for better wheelchair service. Seeing a rise in elderly travelers and a reduction in airline staffing, the Fort Lauderdale airport now deploys its own staff to pitch in at times when the airlines' staff or contractors can't keep up, says Greg Meyer, the airport's spokesman.
The Minneapolis-St. Paul airport plans to test premium wheelchair service. For a fee, passengers will be able to hire an attendant who will meet them at their gate with a sign bearing their name and a reserved wheelchair, says airport director Steve Wareham. In 2003, Alaska Airlines created a training program at its Seattle hub to improve the way its staff members lift immobile passengers from wheelchairs to aircraft seats — a task that had been a source of injury to some passengers and employees. Today, Alaska transfers an average of 22 passengers a day between wheelchair and cabin seat and has had no recent injuries, says Ray Prentice, Alaska's head of customer care.
And some contractors are introducing better technology to improve tracking of requests, the dispatching of attendants and accountability. At US Airways' Las Vegas hub, the global-positioning technology that contractor Prospect uses allows better staffing for peaks and valleys in demand for service, says John Romantic of US Airways. The system also enables wheelchair attendants to know the name of the passenger they're waiting for so that they don't push the wrong passenger, he says.
Brehm, the retired nurse stranded at Newark, complained to Continental. The airline apologized and gave her a $100 voucher good toward a future flight, she says. The airline's wheelchair assists usually go smoothly, says David Messing, Continental's spokesman. Brehm says she plans to fly the airline again.

"Don't allow your disABILITY to shut you out of life; your request for Access has been Granted"

Wednesday, November 3, 2010

Epilepsy

I was 10 years old when I met a pretty young girl named Jenny.  She was as normal looking as anyone I had ever met.  One day, while sitting at lunch, it happened.  Jenny blanked out, fell to the floor, and began to violently shake.  I was completely overwhelmed by what I was witnessing.  I thought she was dying, but in fact, a teacher informed us that Jenny was having a seizure caused by epilepsy.  I decided to educate myself.

Billions of tiny cells make up our brains. These cells transfer information from our brain to our thoughts, emotions, actions, and feelings. If someone has a short disruption to the brain it is called a seizure. These disruptions to the brain can be caused for different reasons. Some of the reasons are not even known! Some of the reasons include:
  • Brain damage
  • Brain scarring
  • Chemical imbalance
  • Hormonal imbalance
  • Having a sensitive, vulnerable brain

How can epilepsy be treated?

Everyone that has epilepsy is different and will have different experiences. Most people will take anti-epileptic drugs (AED's) to stop or reduce the amount of seizures. AED's are not used to treat someone who is having a seizure.  Even though there are lots of types of treatments for different types of epilepsy, some people might not get in control of their epilepsy.

Facts about epilepsy

  • About 1 in 200 people will have epilepsy
  • 30% of learning disabled people will also have epilepsy of some kind
  • In people with severe learning disabilities about 50% will have epilepsy
  • Having epilepsy is not caused by having a learning disability
  • Epilepsy and learning disabilities are separate causes of brain dysfunction or damage. For example damage at birth, tumours and accidents

Types of epilepsy

There are lots of types of epileptic seizure.

Generalized seizures

Generalized epileptic seizures affect the whole of the brain. There are different types of generalized seizures:
Tonic clonic epileptic seizure (this used to be called the Grand Mal seizure)
  • The person will become stiff and jerk about
  • The seizure may begin with a loud cry
  • The person will look and sound like they are in pain but they are not
  • They are unconscious and are unaware they are having a seizure
  • Their breathing will become shallow and slow they will have lots of saliva coming from their mouth
  • When a person comes out of a seizure they may be confused and will not remember what has happened. They might have a headache and be tired
Tonic epileptic seizure
  • The person will lose consciousness and become stiff
  • If standing the person will fall over
  • The person will lose consciousness
  • The person will recover quickly
Atonic epileptic seizure
  • Sometimes known as the drop attack
  • This is the opposite of the tonic seizure
  • The person loses all muscles tone and goes floppy
  • The person is unconscious throughout
  • The person recovers quickly
How can I help someone have a generalized epileptic seizure?
Things to do

  • Remain calm
  • Remember the person is unconscious and feels no pain
  • Put a cushion, coat or something soft under the persons head to prevent further injury
  • Cup your hands under the person's head if there is nothing around to put under the head
  • Remove objects from the area
  • Only move the person if they are in danger. For example at the top of the stairs
What to do after the seizure has finished
  • Do put the person in the recovery position as soon as possible
  • Do First Aid on any injuries if you are trained in First Aid. If you are not trained in First Aid call for someone who is
  • Do wipe away any saliva and if the person is not breathing follow the First Aid (ABC) procedure. Check that there is nothing blocking their mouth
  • Do phone an ambulance if the person is not breathing
  • Do all you can to avoid the person being embarrassed and keep reassuring them
  • Inform a relative or friend
Things not to do

  • Do not move the person unless they are in danger
  • Do not put anything in the person's mouth
  • Do not give the person anything to eat unless they have regained consciousness
  • Never try to restrain the person

Absence seizure (this used to be called the Peti Mal seizure)

This type of epileptic seizure:
  • Mostly happens in younger people
  • Can be mistaken for day dreaming
  • The person will look blank and stare into space for a few seconds
  • They will not respond to anything going on around them
  • The person will become unconscious and will stop what they are doing for a few seconds
  • They will not necessarily fall over
Myoclonic seizure
  • The arms, head and sometimes the whole body will jerk and the person will lose consciousness but only for a few seconds
  • They may be thrown off balance
  • They often happen in the morning

Partial/focal seizure

These seizures affect one small part of the brain
Simple partial seizure
  • When someone has one of these seizures they will be aware of what is going on
  • They might have a strange taste in their mouth and smell strange smells. These signs might be warnings before a seizure
  • These seizures sometimes develop into other seizures
Complex partial seizure
  • The person will not be totally aware of what they are doing. They might fiddle with their clothes or even undress
  • They may get very confused and act in a strange way
  • They make speak but not make sense

Status epilepticus

  • Most seizures end on their own but some seizures will not stop or another one will happen straight after
  • If this type of seizure happens you must phone an ambulance straight away

When do I call emergency medical help?

  • If someone has injured themselves badly in a seizure
  • If they are having trouble breathing after the seizure
  • If the seizure does not stop and the person has another one immediately afterwards
  • Either call an ambulance, or if there is someone who is trained to give emergency treatment to the person concerned, alert them of the situation
"Don't allow your disABILITY to shut you out of life; your request for Access has been Granted"