Ask Elklit
Ask Elklit presented the National Centre for Psychotraumatology, the EUNAD project and the goal of the day, which was to exchange knowledge about physically disabled people in a crisis situation and to create guidelines for helping these individuals. He then gave a presentation on the psychological mechanisms of trauma reactions.
The presentation covered criteria for ASD, PTSD and complex PTSD, types of trauma, consolidation of traumatic events, immediate trauma reactions, and late effects and comorbidity. In addition, he touched on the prevalence of PTSD and exposure to trauma in general, vulnerabilities and coping mechanisms, as well as gender and age differences. Throughout the presentation, the importance of the individual's perception of the traumatic situation was emphasised.
Susanne Olsen
Susanne Olsen, National President of the Danish Disability Federation, presented the specific challenges physically disabled people face in a crisis situation. She explained that although it is not something she, as a disabled person, thinks about in everyday life, there are several dangers associated with being physically disabled. Most people try to accept it as a fact of life rather than letting fear limit them.
She talked about the responsibility she feels having carers who could potentially be in danger and shared her experience of planning for a crisis or evacuation situation with family and friends. She shared her personal experience of telling carers and relatives that in such a situation, they should save themselves rather than her. In addition to these psychological aspects, she talked about building design with an eye for evacuation of the physically disabled.
The Danish Disability Federation has built their office building with this in mind by making lifts usable even in the event of a fire and by fireproofing the lift shafts. Since these options exist, she hopes that more will build similar buildings in the future.
Adnan Todorovac & Louise Simonsen
Adnan Todorovac and Louise Simonsen, volunteers at the National Centre for Psychotraumatology, presented the Convention on the Rights of Persons with Disabilities, the EUNAD project and results from the study they conducted in collaboration with Ask Elklit on physically disabled people in crisis situations. The results included the problems physically disabled people face in crisis situations, reactions in the situation, and problems with rescuers and healthcare professionals lacking knowledge or training in working with disabled individuals.
Problems in a crisis situation consisted of a lack of guidelines, avoidance of thinking about or preparing for a crisis situation, and the diversity of needs among disabled individuals. In addition, many felt that test evacuations did not take physically disabled people into account. Reactions ranged from freezing to actively participating in problem solving, and the subsequent reactions varied between individuals. In addition, it was emphasised that communication with and information to the physically disabled is an important aspect that is not always adhered to. In general, individuals with physical disabilities did not seek psychological counselling, but instead sought out conversations with other physically disabled people instead.
Carsten Fladmose Madsen
Carsten Fladmose Madsen, Consultant at the Department of Orthopaedic Surgery at Odense University Hospital, gave a presentation on the acute treatment of physically disabled people in accidents with few or many victims. The presentation included the treatment of physically disabled patients compared to non-disabled patients, what special needs to take into account and how to create understanding and awareness of these needs among healthcare professionals. The specific vulnerabilities of the physically disabled, as well as important tools for medical and supportive care were described.
He emphasised the importance of listening to the physically disabled person and creating a treatment plan together, as well as the importance of involving and informing relatives. In mass casualty incidents, the injured are triaged based on who needs help the most, leaving other patients at risk of being left behind. Patients are prioritised to help as many as possible with the least amount of resources, which can have an impact on the physically disabled. However, prioritisation is not based on physical ability, but on the immediate state of injury.
Ellen Madsen
Ellen Madsen, physiotherapist at the Special Hospital for Polio and Accident Patients gave a presentation on the specialised rehabilitation of patients with physical disabilities after an accident. The presentation included a description of the hospital, the patients and the treatments offered.
The staff consists of several professional groups, including psychologists, doctors, physiotherapists, occupational therapists and social workers. Treatment does not take place immediately after the accident, but in the transition from hospitalisation to rehabilitation or living at home. In addition to rehabilitation, staff offer help with compensation, adaptation and acceptance of the new living conditions after the accident. The collaboration with patients was also emphasised in this presentation. Ultimately, the goal is to achieve a meaningful life with the highest possible quality of life.
Mariann Krogh
Mariann Krogh, psychologist and mother of a physically disabled daughter, gave a presentation on the psychological aspects of accidents involving disabled people and the involvement of relatives. The presentation was based on personal experiences and dealt with the many losses, both of function and social life, that a physical disability brings.
She shared her experience of having a home that is also a workplace for carers and the feeling of knowing that her child would likely be left behind in a crisis situation. She described the perpetual conflicts about accessibility and integration with schools and institutions, and she shared her experiences of others perceiving her daughter as less worthy. In a crisis situation, she perceives both her daughter and herself as helpless, describing that she would probably not be able to leave her daughter behind to save her own life.
Recommendations
Participants discussed for half an hour which guidelines could be recommended and were asked to present 3 guidelines per discussion group.
These recommendations were:
- Legal requirements for new construction projects for disability-friendly evacuation options, including follow-up on compliance.
- All public sector workplaces have a responsibility to their employees and should, as far as possible, make individual considerations for disabled employees in evacuation plans.
- The medication card, which is available to all patients regardless of hospital, should include a description of disability.
- Implementing first aid and rescue drills in primary schools that include rescue of the most common disabilities.
- Events to make disabilities visible and recognised.
- Easy access to psychological counselling for people with disabilities and their families.
- Involvement of the disabled person themselves in treatment, rights and plans.
- Evacuation plans with a focus on disability-friendly facilities.
- Education in primary schools about disabilities.
- QR codes for mailboxes, lifts and ID cards that paramedics and emergency services can scan to ensure appropriate treatment.
- Specific contact persons who can communicate with patients and be aware of special needs.
- Disabled people themselves and society in general need to be more aware of issues and informed of rights, perhaps through the media.