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Issues Related to the Physical Environment

A person with limited stamina and fatigue looks for every opportunity to extend the length of time she can sustain her stamina by reducing unnecessary expenditure of energy.

Due to the episodic nature of stamina and fatigue, a person may make different decisions in the same situation on different days depending on their level of fatigue.

Providers underestimate the power of design as one of the elements survivors manage. Design can either contribute to or relieve stress. For the person with limited reserves of energy – any amount of stress can erode their energy.  Important design details include lighting quality & control, acoustical conditions, temperature control, proximity between locations of activities, not having to use stairs, and not having to carry anything.

Examples of Problems

  • A provider leads the survivor down a long narrow hallway. The provider is in front her and talks to her during the length of the walk. The survivor has limited stamina and cannot walk quickly. There is no handrail to assist her along the length of the walkway.
  • A survivor in a shelter takes a long time to cook a meal. Everything is spaced far apart in the kitchen. She also needs to sit while she works, and she moves slowly with a chair from place to place in order to extend the amount of time she has before her stamina gives out.

Suggested Solutions

Space Considerations

The goal is to offer avenues for reducing unnecessary expenditure of energy.
  • Long hallways are easier to navigate and less tiring if there is a place to sit mid-way. A rail along the wall can also be helpful to many people.
  • It is important to understand the power of napping to refresh those with fatigue conditions. Having a flexible policy of allowing someone to take a short rest of 10-20 minutes on a quiet couch may be enough to keep someone fully participating in the program. A couch or a floor mat with a pillow should be considered for support groups as well.
  • In a shelter, a shower seat and grab bars should be available for stabilizing while bathing and toileting.
  • An adjustable-height rolling stool can be useful for large kitchens. All survivors should be given the option of sitting while working in the kitchen.
  • Cleaning equipment should have full-extension capacity so that a person does not have to bend over or stretch upward to clean.

Lighting

Attention to lighting for survivors with limited stamina or fatigue helps to reduce potential sources of stress and enhance a sense of comfort and control. Maximizing access to daylight, offering flexible lighting that permits the individual to make choices about what works best for them and using lighting to create a safe but serene environment are important for a woman with limited stamina or fatigue.

Temperature and Air Quality


  • Ideally, each room in a building has individual temperature control that a survivor or employee can use. If an independent room control thermostat is available, give the survivor the opportunity to adjust it to help give her a sense of control over the environment.
  • Have fans and lightweight, safe portable heaters in parts of the building that have variable conditions or poor temperature control.
  • Air quality affects everyone, particularly people with limited reserves of energy. Maximize fresh air transfer, minimize toxins from cleaning products, eliminate scented products and fragrances, monitor for environmental molds and address problems quickly. See the Addressing Individual Needs section on Respiratory Limitations for detailed recommendations.

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