Active Community Living

One year post injury, Mr. LM’s mother is diagnosed with cancer, and Mr. LM’s parents are no longer able to care for him. The resources provided by government administered care programs are insufficient, and Mr. LM has not received any funds from the tort court case.

Mr. LM wants to continue living in the community, and has arranged for subsidized living accommodations, in addition to private caregiver services to supplement the personal care services available through provincial government home care services. He has just received approval for additional provincial funding for patients with disabilities. Mr. LM recognizes that the financial constraints imposed by this living arrangement will result in decreased opportunities for things like vacations, and other social events like trips to the movies or restaurants with friends. He is afraid this will result in some isolation. Mr. LM is dismayed to find out that subsidized public transportation for people with disabilities is not readily available. He will be physically challenged by taking the bus, or financially challenged by taking taxis to meet with friends and travel to work. He knows he does not have the funding to hire a permanent van and driver.

Mr. LM’s parents are concerned that this arrangement is unsafe, and request that you speak with their son, encouraging him to consider a group home for people with spinal cord injuries. Alternatively, they believe he will be best cared for in a long term residential setting nursing home, even though Mr. LM is opposed to this. Mr. LM states to you that he feels the two available nursing home options in his community are designed for patients far older than he is. He is afraid that friends and family will not make the long drive to see him, since the nursing home is an hour away from his current residence. Mr. LM is also afraid of living in a nursing home because of the limited opportunities for social events with age and interest matched peers. Feeling trapped in his own body and dependent on others since his injury, like many other patients with spinal cord injury, Mr. LM is reluctant to introduce new caregivers into his life. He is afraid he will not have access to caregivers of his choice at the nursing home, and instead will constantly have new ones. Active living in the community is important to Mr. LM. You have a conversation with Mr. LM about active living and whether this will be possible in a group home.

What does active living refer to and what are the benefits of active living?
1. Active livingis a broad term that encompasses virtually all types of physical activity (e.g., exercise, activities of daily living, occupational activity; Figure 6).
2. Benefits of active living for persons with SCI and their communities include enhanced function, physical health, mental health, and social wellbeing.

For more information please see: Effects of Physical Activity

Figure 6. Active living post SCI

What is the evidence for low rates of community active living?
1. Physical activity participation rates are substantially lower than in the general population and it has been estimated that 50% of people with SCI participate in no physical activity whatsoever compared with about 35% of Canadians without a disability (see Figure 7).

Figure 7. A comparison of the percentage of individuals with and without SCI who participate in no physical activity

What evidence is there for active living as an intervention to promote community reintegration post SCI?
1.  Locomotor training may enhance community-based active living.
2. Participation in a community-based exercise program can improve various dimensions of quality of life.      

For more information please see:Active Living