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Social & Policy Environment and Balance

For background information on the characteristics of balance disorders, a description of who is affected and the types of issues functional limitations in balance create, please refer to Understanding Disability: Balance Disorders.

Issues Related to the Social and Policy Environment

With normal balance, one can walk without staggering, get up from a chair without falling, climb stairs without tripping, bend and clean without effort. When balance is impaired, an individual has difficulty maintaining orientation and stability. For example, an individual may experience the "room spinning" and may not be able to walk without staggering, or may not even be able to arise. It is common for people with balance disorders to describe the problem as "dizziness." In an attempt to avoid the "dizziness," a survivor may avoid common tasks like showering, coming downstairs to dinner, or helping to clear the table after dinner.

Examples of Problems

  • After several days in a domestic violence shelter, a woman has obviously not showered and makes everyone uncomfortable.
  • A survivor with a balance problem seems to avoid meals. Someone has to go to her room to get her.

Suggested Solutions

  • It may be necessary to establish some simple procedures for staff or others to assist a survivor with a balance disorder in ordinary tasks like showering or climbing stairs. Policies for emergency situations should include attention to buddy systems for survivors who may have conditions like balance disorders that make independent action difficult and unreliable. Modification of a policy may be necessary relative to responsibilities for maintenance of the residence. Simple chores like setting and clearing a table, making a bed, doing the wash or sweeping the floor may not be realistic for a survivor with a balance disorder and alternatives that can be done while seated may be a practical substitute.

  • A staff person can ask if there are ways that they can make the bathroom safer for her to use. It might mean offering to get her a shower chair, an additional supporting grab bar or it might mean that someone would be on hand when when she showers to ease her anxieties about falling alone.

  • Everyone needs to help with the ordinary chores of the daily routine with a variety of tasks associated with meals. Preparing food, setting the table, clearing the table and washing the dishes may be very difficult for a survivor with a balance problem. Rather than ask for an exception to policy, she avoids participating. Anticipate that some survivors may have conditions that make some chores impossible and identify a set of chores that could be done by someone with unsteady movements or dizziness. It might be cleaning out a drawer or doing computer work.  

  • Stress and anxiety can precipitate an episode of dizziness. The disorientation and confusion accompanying dizziness put the person at risk of falling and being able to concentrate during conversation. Jane Doe, Inc. recommends each person who uses your services should be asked for any known behavioral or emotional tendencies when in crisis. Ask for the person’s own advice about what works to alleviate her response to crisis. Create an accommodation plan for the onset of symptoms and also take any preventative measures that are learned. Allow flexibility in any activities, like support groups, in which the person may want a particular chair and location. Chores are another example, in which it may take longer to complete when symptoms are escalated. 

  • People who have balance disorders may take much longer to get places. When they get there they may arrive exhausted or in pain. Even facilities that provide ramps as an alternative to stairs, while overcoming the limitation posed for some women of climbing stairs, the distance of ramps adds the burden of traveling much longer. In this case providing occasional chairs and places to sit can help tremendously.