mental/cognitive impairment

People with Activity Limitations (2001 WHO ICF) ?

2009-05-12:  Or … in French: Personnes à Performances Réduites … a term which should be used much more often !

 

For many decades, the language of ‘disability’ has been all over the place, to put it mildly … others might suggest, however, that it lacks coherence, and is fragmented and chaotic !   As a result, it has been difficult to make any sort of solid progress on harmonization … at a technical level … in Europe.

 

Adopted on the 22nd May 2001, the World Health Organization’s International Classification of Functioning, Disability & Health (ICF), changed that situation for the better.  It is important to emphasise that the ICF is a classification of ‘Health’ … not of ‘Disability’.

 

 

People with Activity Limitations (English) /

Personnes à Performances Réduites (French):

Those people, of all ages, who are unable to perform, independently and without aid, basic human activities or tasks – because of a health condition or physical/mental/cognitive/psychological impairment of a permanent or temporary nature.

 

This term includes …

 

         wheelchair users ;

         people who experience difficulty in walking, with or without aid, e.g. stick, crutch, calliper or walking frame ;

         frail, older people ;

         the very young (people under the age of 5 years) ;

         people who suffer from arthritis, asthma, or a heart condition ;

         the visually and/or hearing impaired ;

         people who have a cognitive impairment disorder, including dementia, amnesia, brain injury, or delirium ;

         women in the later stages of pregnancy ;

         people impaired following the use of alcohol, other ‘social’ drugs, e.g. cocaine and heroin, and some medicines, e.g. psychotropic drugs ;

         people who suffer any partial or complete loss of language related abilities, i.e. aphasia ;

         people impaired following exposure to environmental pollution and/or irresponsible human activity ;

 

and

 

         people who experience a panic attack in a fire situation or other emergency ;

         people, including firefighters, who suffer incapacitation as a result of exposure, during a fire, to poisonous or toxic substances, and/or elevated temperatures.

 

 

Anosognosia:

A neurological disorder marked by the inability of a person to recognize that he/she has an activity limitation or a health condition.

 

 

 

What is the big deal here ?

 

Because of the stigma which still attaches to ‘disability’ … and because some people are unable to recognise that they have an activity limitation or a health condition … depending on self-declaration, alone, for the purposes of developing suitable Fire Safety Management Procedures in a building (of any type) is a recipe for certain failure of those procedures.

 

And … of very direct relevance to design practice generally … compare the weak and inadequate definition of people with disabilities in Part M4 of the Irish Building Regulations (there is no reason to suspect that there will be an earth shattering improvement to this definition in the Revised Technical Guidance Document M … whenever it eventually sees the light of day !) … with the definition of disability in Irish Equality Legislation.

 

Chalk and Cheese !   Or … from the ridiculous to the sublime !   Check it out for yourself.

 

The consequence of this remarkable difference in definitions for anyone involved in the design and/or construction of a building is that … while they might very well be satisfying the Functional Requirements of Parts M and B in the Building Regulations … they will, more than likely, be still leaving the owner and the person who controls or manages the new building open to a complaint under our Equality Legislation.

 

In the case of Workplaces … truly brave is the person who will design a ‘place of work’ just to meet the minimal performance requirements of Building Regulations !

 

 

As a Rule of Thumb, therefore … architects, engineers, facility managers, construction organizations, etc, etc … should become more comfortable working with the concept of People with Activity Limitations.

 

 

This practical Rule of Thumb is also what lies behind the concept of Maximum Credible User Scenario, i.e. building user conditions which are severe, but reasonable to anticipate …

 

         the number of people using a building may increase, on occasions which cannot be specified, to 120% of calculated maximum building capacity ;   and

         10% of people using the building (occupants, visitors and other users) may have an impairment (visual or hearing, physical function, mental, cognitive or psychological, with some impairments not being identifiable, e.g. in the case of anosognosia).

 

 

 

[ Please note well … that miserable piece of legislation … or, bureaucrats’ charter .. the 2005 Disability Act (Number 14 of 2005) … is irrelevant to the above discussion.  But … when Irish Politicians, Senior Civil Servants and the National Disability Authority begin to take seriously the 2006 United Nations Charter on the Rights of Persons with Disabilities … the 2005 Act will have to be scrapped altogether and/or dramatically re-drafted ! ]

 

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