Inclusive Designers Podcast

By: Janet Roche & Carolyn Robbins

Design + Menopause

Menopause is no longer a taboo topic! Join ‘Inclusive Designers Podcast’ in a special episode on ‘Design + Menopause’ that breaks the silence on what menopause is, how it impacts women in the workplace, and what designers can do to create supportive environments!

Our expert panel includes: Menopause Educator Lisa Scully, Women’s Health Advocate Dr. Nathalie Bonafe, and Dr. Erika Eitland from Perkins&Will. Together, we discuss the stages of menopause and offer actionable design solutions.

Through personal stories and professional insights, our guests provide valuable perspectives on fostering a workplace that supports women through every stage of menopause. Tune in for a conversation that’s both informative and empowering.

Panel:

Lisa Scully– is an official Brand Licensed partner with the award-winning ‘Menopause Experts Group’ (MEG). She provides organizations and individuals with up-to-date scientifically based and medically backed information. She is also the Civic Mission Project Manager at Wrexham University,

Quote: “My mission is to demystify menopause, providing support, guidance, and evidence-based information to individuals experiencing this phase of life.”

Nathalie Bonefe, PhD –  is a molecular biologist with 25 years of biomedical research experience, who now advocates for women’s health from midlife on. In her private practice, she educates and coaches women through peri-menopause, menopause, and beyond.

Quote: “Menopause is a transition, not a disease, and post-menopause lasts for the rest of a woman’s life!”

Erika Eitland, ScD, MPH – is a Public Health Scientist and the Co-Director of the Human Experience Lab at Perkins&Will. She received a doctorate in Environmental Healthfrom the Harvard Chan School of Public Health and a Master of Public Health in Climate and Health from Columbia University.

Note:

Menopause Cafes– can be a great resource for those suffering with symptoms! We briefly touched upon their existence in this discussion and felt it was important enough to create a separate episode where we share more on what they can do, and how to find one if you or someone you know needs help or support going through these life stages.

– Definitions: 

– Menopause Stages: Perimenopause; Menopause; Postmenopause

– Symptoms of Menopause may include: Depression; Anxiety; Panic Attacks; Brain fog; Hot Flashes; Night Sweats; Anger/Mood Swings

– References: 

Book: What to Expect When You’re Expecting

Other IDP Episodes:

Menopause Cafes (Season 5, Episode 5b)

(Music / Open)

Janet: In this series we will be discussing specific examples of design techniques that make a positive difference for people living with certain human conditions.

Carolyn: The more a designer understands the client and or the community the more effective and respectful the design will be.

(Music / Intro)

Janet: Welcome to Inclusive Designers Podcast, I am your host, Janet Roche…

Carolyn: and I am your moderator, Carolyn Robbins…

Janet: We have a very special episode for our listeners today. We are talking about Menopause and Design… what it is, how it affects women in the workplace, and what we as designers can do about it when creating these environments.

Carolyn: It’s an important topic that we feel needs more attention and is finally starting to be addressed. We’ve assembled a panel of experts in this field: Menopause Educator Lisa Scully; Women’s Health Advocate Doctor Nathalie Bonafe; and Doctor Erika Eitland from Perkins & Will.…

Janet:  We’ll discuss the different stages of menopause, and of course, design solutions. They also share their own personal stories in an honest and open discussion. I love that we have women from different generations, including myself. I usually do the interviewing but this time I am a part of this round table discussion…

Carolyn: it’s an incredible group of women… period.

Janet: (laughs) Hey, did you mean that as a pun?

Carolyn: oh yeah…

Janet: Oh my goodness. Well, you usually throw in a couple of puns, and just because this is a serious subject doesn’t mean there can’t be a few laughs.

Carolyn: So true. As long as it’s a part of the natural flow of the conversation?

Janet: Oh no…

Carolyn: too much?

Janet: maybe…

Carolyn: Okay, so before I add to the cycle (J: oh no), and get myself into more trouble, here is our panel discussion on ‘Menopause and Design’…

(Music 2 – Interview)

Janet: Hello and welcome to Inclusive Designers Podcast. I am your host, Janet Roche. Today we’re going to be talking a little bit about menopause and design. And we’ve got a couple of experts on here who will be talking to us about the stages of menopause and how that works, and the trials and tribulations that women go through with menopause and also within the workplace. So I’m going to dive right on in. I’m going to ask them to go around the room and introduce themselves briefly. So, Dr. Eitland, could you go first, please.

Erika: Hi, everybody, I’m Dr. Erika Eitland, and I lead the human experience research at Perkins and Will, an architectural and urban design firm. I am a public health scientist proudly, and I am the first public health scientist to be in a leadership role at a major architecture firm in the industry. So I take that with a lot of humility, and I feel so honored to be joined by all these incredible guests today.

Janet: And we’re thrilled to have you too. So then we’re going to go to Lisa Scully.

Lisa: Thanks, Janet. I’m Lisa Scully. I am a licensed menopause expert champion with Menopause Experts Group, based in the UK, but they’re part of an international company. I’m an organizational development professional as well. So I work with different organizations with regards to taking the organizations through change, processes, but particularly specializing in menopause in the workplace.

I also have another hat, that’s where I met Janet. I am a trauma-informed project manager for Wrexham University in North Wales. And we have been on a journey for the past three years and continue to be on a journey to become a trauma-informed organization.

So, changing mindsets, behaviors, processes, and driving a culture of compassion and kindness. And I am amazingly working with Janet on an amazing physical design project about the physical environment and trauma informed approach.

Janet: Great. Thank you, Lisa.

Lisa: Thanks for having me.

Janet: And next up we have Dr. Bonafe.

Nathalie: Hello Janet, thank you for having me here. Hello everyone, Erika, and Lisa. I’m Nathalie Bonafe. Generally, only my mother calls me doctor.

Janet: (laughs). Well, that’s actually a very nice thing, she’s not seeing you as six. Right. So, yeah. (laughs).

Nathalie: Yes, yes, that’s the joke. But thank you. So, yes, I actually have a PhD in biomedical science. And because I do not work for any university or any big corporations anymore, I actually go by Nathalie Bonafé. And, but that background is extremely useful in being, like Lisa, a menopause expert champion, representing here in the USA as part of this wonderful group, you know. Originally based in the UK, but it’s not now really global. (Erika: yeah). (Janet: yeah). And I love being part of that group because we grow together the awareness.

So I am a woman’s health advocate, specialized in transitions. So you can call me a coach or a doula. A woman who serves at two transitions at menopause and at end of life. That’s me.

Janet: Right, which is interesting. Until I met you, I didn’t realize there was end of life doulas, which I think are quite important. And, so, thank you for everybody for being here. It’s such an important topic.

I am a woman who is now approaching 58 and I had a surgical hysterectomy in November of 2020. To be honest with you, when I got out of surgery, I was about as happy as one could be. Well it was over, right?

And I was healthy and okay, and I was really quite ecstatic. I never had kids. I didn’t want kids. And my journey going through menopause was quite extreme. I had a lot of cervical cysts. I had heavy bleeding. I mean, it was, it was bad.

And so once that, what I figured was the journey was over, I thought ‘hot diggity’, right? Like, I could not have been more thrilled. And I know I had a lot of friends that said, “this is like going to be the worst thing you’re ever going to go through” and having the uterus taken out, like that was the defining moment. And that was it, like, your skin is never going to be the same. Your hair is never going to be the same. And all this other stuff.

They’re not wrong. However though, the thing that I really found to be true, and what started kicking off this session, was my real moments of dealing now with bits of depression that hadn’t really happened since I was a teenager and an early adult age. I’ve been a pretty happy person.

I’ve also have been dealing with a lot of anxiety, which I’ve never had in my life. And to the point where I think sometimes, I have panic attacks. And then, also there’s a lot of anger and rage. Forgot to mention that part earlier. It’s coming through. I might have always been a little quick to fire off, but like I feel like this is a little bit something else.

I was asked by a doctor recently, “did I have any thoughts about hurting myself or others?” And I thought about it for half a second and I thought, I couldn’t figure out if I wanted to cry or ask her, “describe exactly how I was supposed to hurt people.” Like, I had somewhere between this wanting to cry because I was depressed, but also this complete rage where I thought to myself, “Yeah, I might want to hurt somebody. How can I go about that?” (Lisa: chuckles).

And I wanted some sort of answers, And I just shut down, and I just said nothing. And, because I knew it was just a f fleeting moment. And so I said, “no, I’m good, you know” but it really wasn’t true. And so then I got a chance to meet Lisa on this Wrexham University project. And when she told me that she was a menopause expert and I said, “Oh, we have to talk, we have to get you on Inclusive Designers Podcast. It’s so important. We need to talk about this.”

And then I started doing a deep dive and I started to realize that, even when I asked my doctors, and I was going through perimenopause, and they told me I was just too young to be going through perimenopause. I said to myself, ‘but I’m having all these problems, like, you know, the cysts and the mood swings and all this other stuff’. “You’re too young. Don’t worry about it.”

And then from there, once I did go into menopause, and I have a great OBGYN, I really like him an awful lot. And so I said to him, “you know, now I’m in menopause, you’ve taken the uterus out, like, this is a real defining moment. I said, what can I expect?” And he goes, “well, what do you want to know?” And I thought to myself, “oh, I don’t know what I want to know. What do I, how… what?”

And so then I kind of shut down from that because then I didn’t know what to ask. And then it wasn’t until I went back and started doing more research, I realized doctors aren’t taught, at least in America, what menopause is, because we don’t know.

So his answer was technically kind of correct. So he could probably help with certain questions that I might have, but I didn’t know what questions I was supposed to ask. I didn’t know what this next step meant. I didn’t know I was going to have depression. I didn’t know I was going to have anxiety. I didn’t know I was going to have the complete fits of rage. I nearly took out the refrigerator the other day because I spilt water. I did it. I spilt water and I just started pounding on that thing. And I mean, it’s not good. so, (Lisa: chuckles), yeah.

So again, I was already going through this anyways, and then when Lisa and I had that initial conversation and I found out that there was actually like, like menopause experts out there. I was like, wait, what? And so immediately afterwards, I called up Carolyn and I said, ‘ahh, I have our next show.’ And even though we weren’t planning in doing it for this season, I said, ‘we have to do it for this season, and we have to do it now.’ Yeah.

So I’m going to let you guys jump in. I don’t know who wants to go first. Maybe we could talk about what is menopause and let’s start with that basic conversation.

Lisa: Shall I? (Janet: Yeah, go ahead, Lisa). Do you want me to start the ball rolling? (Janet: Yes). Okay, yeah. So a lot of what you said there Janet, you know, those who are listening that have experienced any of those feelings or any of those symptoms as they’re called, will completely empathize with you. Because it is true… (Janet: Nathalie is raising her hand), (Lisa: laughs). And I recognize the rage and I do recognize the anxiety because that was me, 3-years ago. I mean, I’ve always been quite a nervous energy type of person. And when I was young, I would worry about little things and mum would call me ‘Nervous Nelly.’ That was my nickname, you know, but in a very loving way, but that was fine.

And I’ve been through life events like we all have where, you know, I’ve had resilience, but I’ve always had hope, faith, and trust in myself that, you know, I’ll push through. But for me, the anxiety and the depression, now when I reflect back, and I didn’t know what on earth was happening to me.

It was during lockdown, so 2020, that lovely year, you know, in lockdown, not being able to access the normal medical services or speak to somebody. And also it being a subject that actually, although it was being started to talk about in the UK, and Mariella Fostrops’ program had been on, it wasn’t actually in full swing, the conversation. And also, I think there was a bit of denial, I mean, I was 47 at the time, or 48 nearly, uh, I don’t know why I was in denial, but nobody had ever told me.

So the anxiety part, and that’s where we’re at, I mean, I am still perimenopausal as it calls it, and that’s the first stage. So anybody who goes through a natural transition in terms of no medical or surgical intervention, it is a staged approach in menopause. And we talk about the average age being 51 in the UK and the US where actually that’s when your period stop.

And it’s only one day menopause, (Janet chuckles). Mark it in your diary, the day your period stop, because it’s done retrospectively and that’s your menopause day. But the lead up to that is known as perimenopause and that for some people can be between 10-to-15 years of changes in our transition from reproductive years to our non-reproductive years. Yeah. (Janet: yeah).

Erika: Lisa, this is the part that’s just like, this is the crazy part, right? Like when we say like, “oh, menopause, this is one day, it’s when our period stops.” But the fact that like menopause and this perimenopause part is a sixth of a woman’s life. And like, “oh, by the way, here you go, and nobody talks about that.” (Janet: no). I just have to say, that was also the wild thing. It’s like, a huge portion of every woman’s life is going to experience this. And we don’t even have basic leave. (Janet: right).

We don’t have menstruation leave. And I know, UK, you rejected a proposal for menstruation leave there. But it’s like, that got, it’s just, it’s wild. (Janet: yeah). So, not to cut you off, but as someone who’s 33 and trying to navigate this space and be like, “what is this whole thing?” The numbers are like, so stressful as someone at my stage. So, hopefully, we deal with this anxiety together in this next, you know, hour.

Nathalie: Erika, we also want to prepare you. I think we wish our mothers had told us. (Janet: yeah). But I think there’s been a lot of things in the past 20, 30-years that have kind of prevented, you know, this transmission of information. (Erika: yeah).

First, you know, some research that has contributed to a lot of confusion on whether it’s a good thing to replace some hormones for women, but that’s another conversation. (Janet: chuckle). But my point also is that, actually, menopause is a lot more than that, in my opinion.

But if you ask a doctor today, as we were discussing Janet, you know, what did you want to know from your doctor? He should have told you that actually menopause now is considered to be the day after you haven’t had your periods for one year. So you see the confusion? It’s not just because you don’t know when your last period is. Really, you know, you think you might have one in 6-months because natural menopause, it kind of slows down.

You have less eggs in the basket, so you don’t necessarily have periods every month. So it could be, you know, every month for 6-months and then you skip 1 month and then you skip 6-months and then you skipped 11-months. And then you skipped and then it comes back. (Janet: yeah). And then it skips another 12-months and that’s after 12-months that you’re pretty sure that there are no eggs in the basket. (Janet: yeah). And that they call menopause.

Janet: Mine was actually 1-year, 11-months to the day. And I was like, I’m over it. Didn’t have to have a hysterectomy. They told me I needed to. I was, again, I was a happy camper. And then ‘boof’ (Nathalie: it came back). it just came back like that. (Erika: ooh). And then they were like, you know, basically coming to get you so you can have a hysterectomy, but it was during the pandemic.

I was so floored by that. I was like, (Nathalie: you were not prepared), I wasn’t even prepared for almost 2-years. 2-years! (Lisa: um-hmm). And it seemed a little cruel. It was like 1-year and 11-months to the day.

Erika: I feel like Dr. Bonafe, you know, we have this book of like what to expect when you’re expecting. Like really, they should just rewrite it for about menopause. It’s like, what do, what do we expect? You know, when we’re waiting to find out.

Nathalie: I think they, uh, please don’t call me doctor. (laughs).

Erika: The reason I call you doctor, because I think it brings up actually another important point that I was going to bring up earlier is women don’t refer to ourselves as doctors. We diminish the knowledge and information that you have acquired (Janet: yeah). And so when we’re talking about menopause, you being doctor and having this accumulation of knowledge gives it some validity. (Janet: yeah).

That to me, I think is something that we need to own. And so often as women in this space, talking about something men simply cannot understand, the power of having doctor in front of our names I think sometimes gives us at least a little bit more of a place at a table.

We might not have the full seat, but at least we’ve, you know, been invited to be in the room and I just, it is out of like respect for the amount of work that you’ve done to get to this point. So I will call you Nathalie from the rest of this conversation. But I do think it is important to where we are in this conversation that there is this need for true research and science and care on this topic. And so, you know, I really am grateful for sort of your effort in this. And so it’s more out of respect than anything else.

Nathalie: Thank you.

Janet: That’s amazing. Thank you, Dr. Eitland for reminding us of that important fact. Let’s kind of, I also want to talk about women in the workplace with menopause. Like, this was part of the catalyst that started this all, but I also want to, let’s talk a little bit more briefly about what menopause is. Anybody have any thoughts on that?

Nathalie: Well, I thought about that, Janet. And if I may, just respond to Erika about that before I go into the medical definition. (Janet: sure, absolutely). This is for you that we’re doing that. (Erika: yeah). This is for your generation, and this is thanks to you for pushing us to do that, and there is a lot of that that we could share at another time.

Janet: It’s another show, right? (laughs).

Nathalie: It’s like, it’s because of your generation that we are speaking up.

Erika: No, and we need that support. (Janet: claps).

Nathalie: We are speaking up. You are helping us, and so we help you. (Erika: thank you.) And so it’s, it’s really a beautiful thing. So thank you. (Erika: hmm). (Janet: yeah).

For me, the way I see menopause is, yes, menopause is this point in time where a person has gone an entire year without menstruation. You know, that’s really what it is. But menopause is a midlife event for most women. And it is really gradual, and it happens in several stages. So we don’t know we are in menopause, really, until we’ve gone through the years that have led to menopause, that one day. And until we also start understanding what comes after. So there are the years that lead to menopause that are perimenopause.

And that is for some women, they’re going to navigate it and it’s not going to be a problem at all. They may have been a little bit moody. They may divorce, (Janet: chuckles). You know, they may just, you know, all these things.

But for most women, they’re going to experience at least some of the symptoms, whether they’re going to start peeing in their pants when they laugh, (Janet: chuckles), whether it’s going to be feeling bloated, not being able to regulate their body weight anymore, or their appetite, whether it’s going to be an anxiety, whether it’s going to be brain fog.

And I believe that menopause really starts in the brain. So I say in the head, but as a joke. (Lisa: laughs). And all our body has estrogen and progesterone receptors, and we are all dependent on that estrogen. It’s not just for us to make babies that we have sex hormones. (Janet: yeah). Then there is a day of menopause in that period of, you know, 1-year, 2-years, where we kind of really in that flux.

And then there is the post menopause, that lasts until we die. And that is something that, because I also do end of life, I care a lot about that other part. Because when I hear women say, ‘Oh, I’m past menopause.’ And I think, ‘Okay, have you looked at your bones? Have you looked at your blood vessels? How are you mentally? Is your weight regulated? Are you at risk of a stroke; at risk of not being strong enough to carry your activities of daily living; how is your thyroid? et cetera, et cetera.’ (Janet: …well that’s just it).

And that is why I think that, yes, we’re talking a lot more now about menopause and social media about perimenopause, but let’s also not forget the post-menopause. And it’s in that sense why I think it’s even more than 10-years in my opinion. It lasts, it could last 50 years (Lisa: chuckles), if we live until 100, okay?

Janet: Yeah. I forgot about the brain fog. That drives me nuts. Because I’m pretty organized and it’s definitely, I’d say, going into one room only to realize I’m picking up something else that I didn’t want, and then I’m carrying that around, and I’m like, wait, what happened to the other thing? And it’s this whole like kind of spider web of, just kind of confusion. Don’t get me wrong. I can still put on my pants. So I’m a happy girl, but it’s still, it can be frustrating for sure. Lisa, do you want to jump in?

Lisa: Yeah. Exactly what Nathalie just said. It is that we talk about these stages, and it might be, as of then, we’re actually ignoring the whole. The menopause, its word is, technically it’s that one day, after 12 months and one day, without a period, but that’s when you’re looking at it from a medical perspective.

But actually, menopause is a whole life transition, and that it lasts up to the day you die, as Nathalie said. So, you know, if, for example, I know for myself, I look back now and, you know, hindsight’s great, isn’t it? You know, when my perimenopause symptoms started kick in at the age of 40. And if I actually end up living until the ripe age of 80, if I’m lucky enough, then it’s 40 years, half of my life has been in this life transition. (Janet: yeah).

And I’ve gone on a journey of understanding. And I know that Dr. Erika earlier, we talked about, you know, reproduction and, you know, we start at maybe an average age for our menstruation at 11, for example. I mean, I’ve got a niece, sadly, who started hers at the age of 8. I mean, God love her. (Janet: yeah). But we get to 11, and then, you know, get to 40, and then we think it’s all, we’re getting there. No one told us, which is the problem around the history of it, and us not knowing,

And maybe previous generations not feeling comfortable in sharing and talking about it. Because, you know, we get on with things, you know, we’re stoic. We can solve the world, we’re superheroes. But we can’t really talk about things that are happening, particularly in the body and how it might be affecting our mind, or how it might be affecting us wanting to go to the toilet every two minutes, and all, you know, how it’s affecting our periods every month if we’re lucky to have them on a 28-day cycle.

So yes, it is a big chunk of our life. And most importantly, as Nathalie said, is it is with regards to the long-term health. So we’re very immediate in our looking at finding the instant answer.

So perimenopause is about maybe managing the symptoms, which because of our ovaries going into retirement. They’re not going into retirement quietly. (Janet: chuckles). They’re turning up one day and they’re boosting us with 2 ton of estrogen and we’re feeling on top of the world. (Janet: laughs). The next day or the next few weeks, they won’t turn up hardly.

And therefore, if you looked at it as an ECG, for example, you go from menstruation, which is an up and down cycle, and it looks like a perfect ECG, if you look at the hormones that are produced on a cycle. You go into perimenopause, and you’d be very worried if that was an ECG, (laughs), because you’d be thinking what on earth is happening.

And, and that’s, it’s good that people are talking about it, but trying to get beyond the symptom management is a challenge, but it is important. It’s not just for now, it’s for future protection of our health. And cardiovascular disease. As we talked about on strokes, talked about osteoporosis. There’s over 3 million people in the UK with osteoporosis diagnosed. A majority of them are women because of bone density and estrogen has disappeared. So we’re not actually, our body’s not protecting itself as it used to do.

And the mental health, the anxiety and depression we’ve already talked about as well, along with a whole host of other symptoms. It doesn’t just stop when your periods stop. Because your body still has to readjust and it’s also to do with what can we do for ourselves as well. So there’s a whole load of education, you know, before, during, and it continues. (Janet: yeah). (Erika: yup).

Janet: So, we’ve done a bit of a piece on menopause. Should we go talk about Perimenopause, or…

Erika: I kind of want to jump to the implications. I really appreciate everyone’s definition and experience, but I think, you know, what’s important to me as we talk about these life changes that women uniquely experience, it’s also, what does that mean for us? And I think when I hear ages 40, 50, I mean, that’s when you start to like also in your career, start making magic happen.

And yet when I see sort of, there was a big survey done in 2021 by Newson, you know, where they are saying 1-in-10 people are resigning because of their menopause symptoms, 18-percent taking more than two months off due to these symptoms. So this is like a considerable amount of time that is adversely affecting women.

And as we have more women in the workforce, to me, it’s something where you’ve made it over all of these hurdles only to get to this point then whereby these symptoms are severe enough that people are willing to leave the workplace. (Janet: right). And so, when we think about say the inclusive    design part of this and we think about, there’s definitely gender differences in some of these key building types that we use.

If we think about just even a K-12 school, we know 77-percent of those teachers are women. And, you know, in those younger grades, it’s even more. And so, as we think about our teacher shortage and retention, and we’re losing our female teachers and our older teachers. Well, is this a part of it?

And so how are we responding with a certain level of dignity and honesty about this? And so, going to Nathalie’s point of like, I’m going to call you Doctor, is because we need to be able to boost up these women who are in these professions that sometimes are lower paying, and aren’t able to have the efficacy and comfortability to speak open about what they’re experiencing. So we can have honest dialogue about symptoms and what does it feel like for us, but how often do we hear that on a day-to-day basis? (Janet: Right), It’s very few.

Janet: Yeah, well and Dr. Eitland, you have a really good point and I do want to get into the implications and that is the catalyst for how this whole conversation started. I just want to remind listeners that you can find all the information we’ve already put out there so far on inclusivedesigners.com, and so there’ll be a whole bunch of resources as well as everybody’s contact information.

So to Dr. Eitland’s’ point, Lisa, maybe you could talk to us a little bit about what you know to be true, and the financial implications for women that end up having to leave because the workplace is non-forgiving, non-understanding. And I mean that from the built environment all the way up to policy and management. So let it rip, that’s all I have to say. Go ahead. (laughs).

Lisa: Yeah, so I think Janet, when we were talking and I think I got on my soapbox, didn’t I, that day?

Janet: And I loved it. I loved it. (laughs).

Lisa: The ‘mini meno-rant’ as I call them, (Janet: right exactly, laughs), with regards, probably frustration, but we have got to turn that frustration to passion, haven’t we, to make that difference. And yeah, I mean, me personally, I’ve now, I was full time temporarily last year, but I’ve gone back to part time.

And I, you know, do a mixture of things to allow the flexibility. And that’s not because of my employer, who I’m employed part time with, because they’re a very good and supportive employer, but it’s because it’s a way of me being able to cope.

But that does impact us, and it does impact those women because I mean in the UK, say for example, the figures are 900-thousand women have left their jobs due to menopause symptoms, (Janet: that’s crazy), and not being able to cope with the symptoms and in the workplace. (Janet: right).

Now obviously there’d be a story and a narrative behind each one of those, but the implications when we look at it practically because it’s not just a medical situation or a well-being when it comes to our social or our psychological well-being or our physical well-being, it’s about our financial well-being as well. (Erika: wow).

So if the average age is 51 and people are struggling through this transition in life, where they find themselves having to go part time for example, or the worst-case scenario, 1-in-10 women leaving the workplace. Then you think about the loss of income in the short term or even the long term because they may never return to other work or increase their hours or go back to part time, full time. So loss of income in the first instance, on the backdrop of a cost-of-living crisis, on the backdrop of what are your responsibilities if you’re trying to bring up a family, (Janet: right), you’re trying to be their…

Janet: Sandwich, right? You’re also that sandwich position. (Nathalie: caregiver). Your parents are getting old, and your kids are still maybe not out of the house, (Lisa: yeah), or the word failure to launch, right? (Lisa: laughs, yeah). Economically it’s for the younger generation. Your children at this particular age, then, you know, you’re still taking care of them because it’s harder for them, the cost-of-living wage has gone up exponentially, whereas wages have not. So that’s a problem as well. (Lisa: most definitely). I’m sorry, I didn’t mean to interrupt you, so….

Lisa: No, no, no, definitely. You’re quite right. And I love the failure to launch thing, yeah, most definitely. (Janet: chuckles). I think as well, it’s a long term, isn’t it? Because then you get to retirement and the years where you should actually be putting more and more into your savings and more and more into your pensions, so that you can enjoy retirement are suddenly impacted (Janet: right), because you’re on a less income. So actually for the rest of your life financially you can be at a bit of a loss in compared to, to others.

Now, I know for example in the UK, actually, if somebody leaves work or is struggling, the average figure is that they’re going to be 126-thousand pounds, which I think is about 160-thousand dollars, lacking in their pension pot, in their savings pot, in comparison to those who work right through. So, there’s those. And there’s also then, there’s the mental health impact of, you know, feeling like you might have failed. You know, I’ve had to give up work (Janet: right), or the psychological, so all maybe the things that the symptoms are brought on anxiety is then exacerbated and compounded by this sense of (Janet: wow), why, (Janet: failure, why me, right), yeah.

So, but the financial impact’s a real one. And there are only estimated figures that have been done, study by Royal London Insurance here over in the UK, has shown that it’s a real thing. So nearly a million women in the UK. How will that reflect in the US if they did the same study? I’m sure it’d be significant.

And then that’s our standard of living for the rest of our lives. If we don’t have partners or others to support us, or another income coming into the household, then we’ve got to be thinking about that as well. But it’s the last thing you think about. (Janet: right). If you want to go part time and you want to get out and you can’t cope, and even if you’re in a good organization, you know, it’s real.

Nathalie: May I add a little bit more to what you’re saying Lisa, from another perspective. I totally agree with everything you’ve just said, and it is just so devastating, for menopausal women are the fastest growing demographic in the workplace. (Janet: right). And that’s from that aspect.

So about 8-years ago, I reached the glass ceiling at my company. It was a good biotech company, small biotech company, was fairly supportive for what I needed, until then, 47. And then I started to demand for more. Demand more opportunities. I really wanted to help my small team, you know, work better together. I didn’t necessarily need to be at the bench and write grants. I really wanted to be in that manager team, and which didn’t really exist in the company I was in.

And I was gently said, well, Nathalie, this is all good, but I cannot provide this for you. I mean, basically, no. (Janet: chuckles). And so that’s when I said, okay, so let’s negotiate, and I negotiated my exit. And I found strengths to develop what I really wanted to do on my own, but it took me time because it was on my own. So can you imagine if I had had a manager who said, ‘Hey, Nathalie’… so 47, retrospectively, I was at the beginning of perimenopause. (Janet: right). So basically, I was already fed up with a lot of things. (Janet: chuckles).

And what it would have taken, you know, to just been able to say, okay, get a mentor. There was no mentor. I’ve never had a mentor. (Janet: no). In the 25 years from my PhD through my work experience in science, whether it was at Yale University or in the biotech world, I have never had a mentor. I’ve had one time a senior woman tell me, ‘Nathalie, what is it that you want?’ And I was about 35. What did I know about what I wanted? I had no idea, as you were saying, Erika. I have no idea of what’s coming up. I have no idea of the possibilities.

So not only did I not have that offered, but no sponsorship either. So what I see from younger women, and that’s why they are pushing us, you know, to speak louder. (Erika: yeah). I don’t speak very loud generally, just my personality, but I just want to scream now, (Janet: laughs), and I want to share everything. It’s like, get a mentor. Talk to your boss. Talk to your HR, if you have an HR.

And if what we can offer the companies now is actually to get this education, as Lisa, you know, through us or through other people, get some education in the companies about what they would lose if they lost all the women already on their way up. Or even in medium level, they would lose these women who have worked very hard at developing their skills, at making those companies very successful. (Janet: yeah).  If every company lost their women in their 40s, we’re really losing great potential here. And of course, I lost my income 6-months later. Right? So I had to find other ways to do that. So does it make sense?

Erika: Yeah, no, it makes tons of sense, and yet I think the thing that we also need to sort of pause on is just the idea that when we talk about, say, diversity and equity and inclusion, and we want to diversify our workforce. And yet when we see studies, you know, where they’re following 3-thousand women in perimenopause and menopause for decades, and they’re finding that Black and Hispanic women are going through menopause earlier than their white counterparts. They’re going to be in it for twice as long and they’re experiencing more intense, more frequent hot flashes and enduring those for more years than any other race.

So when we talk about this work, if a company is dedicated to, you know, this equity, diversity, inclusion work, then, if you have women of color in these places, you need to do more for them because these are impacting them even greater, even earlier. (Janet: right). And so therefore as we talk about these ages, again, it’s always a range, right? And I think for us if we’re going to be talking about equity, it’s important to remember that those stats are there.

And to me it’s a very humbling thing because it means that all of those other burdens that we place on women of color in the workforce then gets exacerbated. Even now when we go through, say, menopause and even recognizing that they’re not receiving certain treatments at the same rate as their white counterparts. So this is something that we really need to be mindful of that, you know, how are we supporting women across their life course just generally. (Janet: right). So I wanted to bring up that point,

Janet: It’s an excellent point.

Nathalie: This is so true. (Janet: yeah). This is so true. May I add one thing? (Janet: go ahead). Just in that regard, I am a white woman and I started talking from the very beginning about how Hispanic women— because we have a lot of Hispanic and Black women in America— are absolutely just affected even greater than most white women. (Erika: um-hmm).

So you were talking about teachers who were greatly affected because, what, 70-, 77-, 80-percent of the teachers are female?  (Erika: hmm). (Janet: Yeah). Well, look at nurses. (Janet: another group, yeah). I once, I was visiting an assisted living, and I was talking to this gentleman — older, white gentleman— leading the company. And I would say, ‘so how are your nurses and CNAs doing? They’re mostly women, yes? So have you noticed anything, you know, said, how are they doing?’ He said, ‘Oh, I did notice that at lunch break, they were all in that one room and they cranked up the AC.’

Janet: (laughs) I don’t mean to laugh, but that is just, I mean, it’s very indicative, right?

Nathalie: This was awful. (Janet: yeah!).  Yeah. How can you just ignore the fact that these ladies…

Janet: And it’s somehow, it’s a mystery, right? Like, this cannot be a mystery at that point, right?

Nathalie: I was never re-invited in.

Janet: No, but you bring up a good point. It’s a good transition because I’m keeping an eye on the time. You know, I’m very mindful of our guest’s time. We get on these great subjects, and I get it, but it is also about inclusive design. So, we’re going to start to mold it into that area.

And it brings up a great point, right? I would say that’s probably on the high part of design. I mean, because I remember, I’ve always had hot flashes, I feel like it was since I was a little girl. But when things were going really sideways, I’m up here in Vermont and I ski, and you’ll be up on the top of the mountain, like, unzipping your parka and pulling off your helmet because you’re having a hot flash. And it’s like 17-below and you don’t care. It is so incredible.

But this is also about design for women who are having their periods. I used to have bad periods. There was one company I used to work for had a couch in this storage-slash-handicapped bathroom. And it was air conditioned, like to the T, because there was nothing there but air conditioning vents. And I remember going in there and finding that respite that I desperately needed that I wasn’t finding at my desk. (Nathalie: when your clients are warm? laughs). Yeah, right. (Erika: yeah).

So can we talk a little bit about what might make the workplace a little bit better? I know that there’s some pillars that we can maybe discuss, but let’s throw out some ideas for designers to think about in order to mitigate some of these stressors for women. And again, it also goes through women who are having their periods, women who are pregnant, and perimenopause, post-menopause. So, I started with the air conditioner, so I got that one. (Erika: yeah, I mean…), go ahead, Dr. Eitland.

Erika: I kind of want to pause on this for a second before we get, like, into it, which is, as a researcher— and joined by all of you who are also researchers— I think there’s a shocking (pounds desk) lack of evidence. (Janet: yeah). Peer reviewed literature about the physical environment and the association with outcomes for women going through perimenopause, menopause. (Lisa: hmm).

And so anything that we are about to share, I think is very much like what we think makes good sense based on what we know symptoms are. And I have my list and kind of rooting around. But I, you know, as someone who’s a part of a large, major, international design firm, I went to a couple of my female mentors and asked, ‘Hey, what’s the research on this?’ And they go, ‘I really wish I know’. It would have helped me so much if I had had this information. (Janet: absolutely). So that evidence is lacking. (Lisa: hmm).

Janet: You’re absolutely right. It goes back to even that conversation I had with my doctor about him saying to me, well, what do you want to know? (Erika: mm-hmm). And you know, volleying that ball back into my court.

Because I didn’t know what I was going to try to ask. (Erika: sure). And then it wasn’t until I left and then I was like, wait a minute, they’re not being taught. (Lisa: hmm).

Erika: But I would say that this goes beyond medicine. I think this is, when we talk about inclusive design, to me, I think there’s a really important point where this is an issue of legacy, in my opinion, (Janet: right on), which is we know that architecture has been dominated by older white males.

And still 65-percent of architects are… (Janet: white men, chuckles). We know that we’re at an inflection point that gives me a lot of hope. (Janet: yes). But I would say that to me, you know, if only a quarter of licensed architects are women, and only less than 1-percent of them are Black women, then how are we actually going to meaningfully embed research and this discussion in design? (Janet: right).

And so that’s something where I really want us to, we have to acknowledge the importance of research in design. We have to acknowledge that we have impacts and implications on women going through a sixth of their life, we know it impacts workplace. (Janet: yes). These are topics that are not something that we can shy away from and yet, because of who has had the power of design, we need to remember that we need to be centering people. We need to be centering the non-male experience. And so therefore, you know, it is excellent to be talking about energy efficiency in the future of this planet, but at the same time what is that resilience? Because women offer something in those workplaces to make us more resilient and be able to adapt.

And if we are systematically creating hostile environments where they do not want to participate and would rather quit their job and their life’s work, then that’s really saying something. (Janet: yeah). So I would say from a designer’s perspective, we need to invest in research. (Janet: yup). We need to be really prioritizing what are those metrics, who are the people we are designing for? Like that is something we need to really be investing in, because otherwise, you’re just making energy efficient sculptures. (Janet: right).

I also feel, I’m an environmental exposure assessment scientist, so I bias towards things that I think are universal aspects of our built environment. And so you’re right, Janet. It’s like air conditioning, number one. But what’s interesting about this to me is, what is the controllability? I do not want us to create places that are stigmatized. I do not want us to be like, ‘oh, just use a little fan’. Because why do we need to put that on display?

If our car seats can hot and cool our butt, (chuckles), but we can’t do that in a workplace. I mean, this is like an industry wide problem where y’all making bougie chairs for people to sit on, you know, ergonomic this, but where do we actually invest in those types of things that are responding to women in this place?

And I would say this also goes back to even just the very building standards that our buildings are designed for. (Janet: yeah). So if we go to ASHRAE 55 which is a big thermal comfort standard, it’s been designed for men in 3-piece suits. (Janet: right). And so when I think about women going through menopause, here’s this thing where we haven’t thought about the temporality, the variability, the controllability. That’s not okay.

And so, as I was thinking about this question and kind of getting ready, this is the least sexy thing that I could probably share, (Janet: laughs), but I also would say, maintenance matters. (Janet: yeah). If I think about it, our facility managers in our buildings do more for our health on a given day than our primary care providers. Because if they’re making sure that our ventilation is, you know, properly maintained, we’ve changed filters, we know things around ventilation and air quality have impacts on improving our cognitive function, reducing headaches. (Janet: yeah). You know, sick building syndrome symptoms. And so when I think about all of this, it’s that why would we add additional burden to our occupants’ bodies?

And so by simply improving ventilation, we improve it for everybody, especially for our women going through menopause, because this is not a ‘like to have’ — it’s a ‘must have’. And when we’re talking about things like lighting and we know flicker glare, repetitive patterns trigger migraines, how are we ensuring that we’re actually not leading and creating environments that are exacerbating some of these conditions around headaches? So I think that’s like one aspect of it. I think you got me on a rant because now I’m all warmed up because of Lisa and Nathalie. So sorry y’all. (Janet: laughs).

Janet: it’s all good.

Nathalie: I think it’s great. I see one problem though (Erika: hmm), is that not everyone works under the same conditions. I mean look at the teachers, (Erika: right), look at the nurses, right? They don’t necessarily have the option to control the temperature because they’re not alone in those rooms.

Erika: They’re not alone in those rooms, but there is this opportunity for designers to be really thoughtful in creating spaces for it. (Nathalie: yes). When they’re with a patient, that might not be possible, but I think it really is about how do we stitch space. And what are those guiding principles?

And so to me, you know, is there a space for rest? (Janet: rest, yeah). I have heard from too many people that I care about, ‘Oh, well I would drive down the road, and go park in the Wendy’s parking lot and take a nap for a half an hour and then drive back to the office for my lunch break’. (Nathalie: I know). Where is the dignity in that? (Nathalie: yeah).

So to me, I think there’s a want in designers to really say that this is a part of our due diligence, our code of ethics, is making sure that we have at least thought about it. And is there private space to rest, sleep, be cooler if you need to. If you’re in a more of an office setting and you can be at your seat and that’s where you are, which is already a sedentary environment where you’re not moving and generating heat, how do we just make that a bit of a private moment where you get that control that you desperately need? (Nathalie: yeah).

Is it something where you can control the light levels so that it isn’t so bright, and maybe there’s glare? So I think there’s that part of it, but there’s moments, even within an environment that might be more chaotic, of, you know, where is the wayfinding? How do I have redundancy where it’s not just a single sign, but if you’re having brain fog and you’re just like, I need to space out, but like, here, it’s going to branch and this hallway is going to be confusing and unclear, (Janet: right). Especially in hospital settings. (Janet: absolutely). We can do better, you know? (Nathalie: yes).

And it’s like, where are we putting windows? Are our nurses working in spaces that have no windows, but the hallway’s got a whole bunch of windows that people pass in for maybe 5-minutes? (Janet: maybe, chuckles). So is that the most, like, beneficial way for us to serve that population? And so I think it’s just this re-centering of that experience. Because I think, they don’t have to be expensive changes in this situation, just we have to be more thoughtful. (Janet: yeah).

And I think there’s, again, where do you spend your time and invest that? We don’t have the research to say what the priority list is here, and that is also problematic. And I would say is, still we have a young population of women coming up through design, and we have a mostly male leadership within design. We have to be pushing though for these conversations. (Janet: right).

And I think it becomes everyone’s responsibility to look at the people who caretake us, whose womb we were in, that’s why we exist in the first place. And so to me, I think it’s, you know, I have hope, especially having opportunities like this, that in the next 5, 10 years, there is a true guideline (Janet: right), that is being enacted in all these different building types you’re bringing up, Nathalie. Right? Like it’s not just about workplace. (Janet: right).

Nathalie: Oh yeah, and so many more. (Erika: hmm). So 20 years ago, 30 years ago when I was younger, there was no special room for breastfeeding. (Janet: no). Okay. There was nothing. I did not have children of my own, but my girlfriends were breastfeeding in the bathroom, okay. At least pumping, not breastfeeding, but pumping. (Janet: pumping, yeah). But now, now you have those rooms that are available in a lot more facilities. (Janet: yeah). So how did this happen, and can we learn from that and just go through the process faster? (Janet: yeah).

Erika: And I think so. I think that maybe it’s like an interesting moment where we’re, at least in the US, I know we have a lot of federal dollars we’re investing in our buildings. Right now we’re working on a firehouse and most of these firehouses are 50-years old. So in this environment, female firefighters, which are few and far between, are still pumping in the bathroom stall. And then where do they dry their equipment and all of that.

So I think it’s the speeding this up, it has to be in any new building. We are doing these things. And those principals have to be there early because then the next 50-years is what we’re going to be dealing with. (Janet: right). And so I would say that even when we talk about public transit, it’s like those are things that, to me, as somebody who was pregnant and has miscarried since then, that was one of the most exhausting environments to be in. (Janet: right).

And so how do we actually start doing those things that the entire journey between our home and the places we occupy is actually as seamless and as inviting and calming as it can be. So that we are not physically exhausted, even by the moment we walk into those places. (Janet: right).

So, I want it to be faster. I don’t think it’ll be as fast as we would all hope. We needed it like 50-years ago. Since the beginning of time. (Janet: chuckles). But I do think that as we have more public health folks, as we have people like you, and as we’re vocal about it, it at least brings the attention. And the more we talk about it, we de-stigmatize it. The more we talk about it, we acknowledge that this is a lived experience that every single woman goes through for a huge part of their life.

Janet: Right. It’s such an important part and a lot of this stuff that you are bringing up, we do a lot of that with trauma informed design. That is such an important piece of all this. (Lisa: hmm), because it’s, you know, ultimately about bringing down that stress level, right? So it would try to help to mitigate headaches and you know, just maybe the overall stress.

So, but anyways. Lisa, I saw you nodding over there. (Lisa: yeah). Do you want to like jump right on in, because I, again, I’m getting a little worried about time. I want to make sure that everybody has a little bit of a moment. Maybe we’ll actually just start with you. (Lisa: chuckles). Tell us what you think and then any kind of last words you might want to pop in.

Lisa: Yeah, no, I think that that was amazing then. Sort of me reflecting back on listening to Doctor Erika and Doctor Nathalie then. You know, it’s so, so true. And it is a time thing, isn’t it? It is about us speaking up as we are now. It is about us empowering others to speak up because the voices get louder, don’t they? And that comes through education and empowerment. (Janet: right).

And very much so in terms of some of the basics that a lot of businesses and organizations and workplaces don’t have. You know, you could have your sort of bronze standard, your silver standard, your gold standard, couldn’t you? That becomes affordable, so for like the charity sector, for organizations that would do all of this if they had the money, but they don’t have the means.

And but the trauma informed was exactly what was coming to my mind and the work that we’re doing with you, Janet, on the trauma informed design piece, and the analysis that we’re doing at Wrexham University, and the tool that you develop for schools and, you know, that we’re now going to be developing this one for higher education which is both staff and students that, you know, occupy that space as is our visitors. All of those things will be about creating, but we have to put multiple lenses on, don’t we?

From menstruation to menopause, basically. (Janet: right). You know, that whole reproductive cycle, we have to bear that in mind, and it wouldn’t come under necessarily one of your standard protected characteristics, for example, in the Equalities Act, but it’s about that inclusive design.

Then we look at it through multiple lenses, menopause, and women of color, that various things, you know, we’ve got, everything we look at has got to be through these multiple lenses, but from a design perspective. There’s probably a lot more influence that can be done because it is a physically built environment, isn’t it?

We’re not talking in nuances here. We’re talking that something when it’s built or changed, whether it’s through retrofit refurbishment or new build, (Janet: right). It’s something that can, you know, be achieved and can be there right in front of you where the other work that we’re doing might feel a bit like sort of hit and miss sometimes writing a policy and then getting people to implement that policy.

So, I’m really encouraged though by that whole sort of explanation there and thoughts with regards to what we talked about then because I think all of that, the small little things we can do quite quickly at low cost. There are bigger things. It is a time thing, but let’s focus on that sort of what can we do now? What’s for the medium term? What’s for the long term?

Get more women into architecture, more women into the design. (Janet: right). And also women of, you know, various backgrounds, women of color, all of those so that everything can be represented alongside what we already do. (Janet: yeah).

Nathalie: We want women to talk to one another and to exchange regardless of their situation, their education, their skin color, etcetera. (Janet: right). And that’s what we do in some cafes, or here. Here we do this. You know, we would not have met otherwise. It’s wonderful.

Janet: Right. You know, I think it should probably be a two-part series for this particular program because there’s so much more to go into, and I think you’re right, we have a lot more to discuss. I also want to say, though, to Dr. Eitland, yes, there’s so much that needs to be explored. We all need to start talking about this. We can’t be sweeping it underneath the rug anymore. Like, enough is enough.

That also includes understanding what happens to us when we get our periods. I mean, there’s information, but I think it’s also about mothers to daughters, sharing that experience and not being ashamed of it. But we’ve got some work out there, I know, I’m going to put it on our page, so the resources that we have, we’ll put everybody’s information on: inclusivedesigners.com.

And I’ve pulled some papers and stuff like that, but to Doctor Eitland’s point, there are few and far in between. Our friends at MotionSpot had done some work around menopause. They’re about beauty and function meeting together for types of inclusive design, and so they decided to take a deep dive into this area, which I thought was pretty amazing. And so we’ll have all that information on the website. Again, just keeping mindful of the time…

Erika: I still get a last word I thought…

Janet: Yes. You both… I already had Lisa, I thought I would jump in. And so, Dr. Bonafe and Dr. Eitland, if you would please do us the favor in closing out the show.

Erika: Dr. Bonafe, hop in there.

Nathalie: Well, you know, coming to this podcast, I was not really sure how I could contribute, (Janet: clearly you have, laughs)), but at the same time what I’m seeing is— and what Dr. Eitland is also encouraging me to do— is we need to continue to speak up. (Janet: yeah). Wherever we can, based on our own personalities, based on the opportunities, wherever, we need to have more of those conversations where we can work together. Only through synergetic work that we’re going to really go a lot faster. (Erika: yeah).

And, I’m just delighted to have been invited to be there with you. I’m blown away by the energy that Dr. Eitland is bringing, and Lisa is. You know, we’re talking from the other side of the pond and I’m just very grateful that you had me come and collaborate with you. Together we are so much stronger.

Janet: Right on. Doctor Eitland….

Erika: I completely agree, and I think that’s giving me a lot of strength and energy, just like, ‘Alright, we got to keep going. What are we going to get after? Who we got to yell at?’

Janet: (laughs). You’ve got a whole bunch of post-menopausal women out here willing to yell at people. Don’t you worry about it.

Erika: Perfect! I mean, I think the last thing I want to say— and I feel a little bit embarrassed that it’s a last word and wasn’t one of the first— is I think it’s really important that we talk about this also through the language of disability inclusion. (Janet: right on). I think it’s one of these things where we know women with disabilities experience menopause at earlier ages, and yet some of these studies are from the early 2000s.

And I really, even though obviously menopause isn’t, you know, described as a disability, to me, it’s also this moment for, you know, and a good friend reminded me, this is not a dichotomy. you know, you’re not able bodied or you’re disabled, it’s a spectrum and a state that we pass into at any phase of our life.

And so to me, when I’m thinking about a topic like this, it is a very humbling experience to say, ‘what does that mean?’ you know, and how are we going to support people? And this is, especially with people who are experiencing these unique and sort of intersectional identities and we really show up for them.

You know, I, as an able-bodied person myself, and there are moments where I know I have sort of ableist tendencies, and I don’t even realize it. (Janet: you don’t even know, yeah). And so for us, when we’re having these conversations, let us kind of correct the wrongs and do things differently in the sense that who needs to be at the table, who hasn’t been at the table. (Janet: right).

And so that as we move forward, we’re not leaving anybody behind. And so I just really wanted to kind of make sure that that’s shared because I even think, you know, when we’re talking about our transgender friends, colleagues, you know, family members, to me this is something that, how are they experiencing this, even if they’re presenting differently. (Janet: right on).

And so, these are topics that really, we have an opportunity to make it a different way of having these conversations. So I really am so grateful to be with all of you today. And even though I’m kind of the young punk in the group, (Janet: laughs). I really have appreciated all of this time. So thanks so much, Janet.

Janet: Oh, you’re welcome. You brought so much to the conversation. All of you guys did. Again, I feel like this could be a 2, 3, 4-parter. We could even just work on the disability and work on all the LGBTQIA plus community. And again, I think ultimately, it’s about having— they’re not tough conversations, right? This isn’t some sort of, like, we’re trying to explain how sex works, right? Like, sex works I can see being a little, you know, it shouldn’t be, natural. However, I can see where that gets a little kind of pointed, but this is not. This is human health. This is women’s health. This is people of all different ages and races.

So, maybe we can continue to have this conversation. And I can’t thank you guys enough. I was so excited to do this today. I can’t even begin to tell you. We’ve been doing this for 5-years now and I think that this is probably one of the better episodes we’ve done. And I couldn’t have done it without you guys. So thank you. Thank you. Thank you very much.

Erika: Thanks for having us.

Nathalie: Thank you and be well.

Lisa: Thank you Janet, thank you.

Nathalie: And reach out to one another.

Erika: Definitely.

Lisa: mm-hmm

Janet: Thank you.

Erika: Thank you everybody.

(Music / Outro)

Janet:  What an important discussion! We covered everything from menstruation to all the phases of menopause, and what that means for women in the community and the workplace.

Carolyn: Yes, and the economic impact for women who struggle and decide they can’t cope with an unsupportive work environment— it’s just staggering.

Janet:  I never knew and was just so floored— according to the study Lisa quoted, they reported that 900-thousand women in the UK left their jobs. That’s 1-in-10 women just leave! 1-in-10!!! And there are some adjustments we as designers can make in the built environment if we take women’s well-being into consideration during planning.

Carolyn: Along with that, we heard how important it is to diminish the stigma associated with menopause which can be done through education and empowerment. And also to create and implement menopause workplace policies aimed at supporting women during these life stages.

Janet: I do like the idea of a menopause mentor! That would have been so helpful to me.

Carolyn: Hopefully this episode will be helpful for everyone listening.

Janet: You are so right Carolyn.

Carolyn: We briefly touched upon the existence of Menopause Cafes in this discussion. We decided to focus on them in a short chat that’s posted as a separate episode.

Janet: It’s truly worth a listen. These Menopause Cafes can be a great resource. We wanted to share just what they can do, and how to find one if you or someone you know needs help or support going through these life stages.

Carolyn: Should we call these our period pieces?

Janet: Let’s not.

Carolyn:  More seriously, if you need more information on either of these episodes, you can find it on our website.

Janet: Absolutely! You’ll also find how to contact Lisa Scully, Doctor Nathalie Bonafe, and Doctor Erika Eitland, as well as links to the other things touched on during this discussion… all on our website at: Inclusive-Designers-dot-com.

Carolyn: That’s: Inclusive-Designers-dot-com…

Janet: And a big thank you to Lisa, Nathalie, and Erika! And, again, to all of you for listening.

Carolyn: Along with all the regular places you get your podcasts— such as Apple, Spotify, and Pandora— we are now on YouTube Music which replaced Google Podcasts.

You can also find us on our regular YouTube Channel. What hasn’t changed is our name – Inclusive Designers Podcast. And of course, if you like what you hear, feel free to go to our website and hit that Patreon Button, or the link to our GoFundMe Page.

Janet: Yes, please do. And let us know if you have any questions or suggestions for topics we should be covering in upcoming shows!

And as our motto says: ’Stay Well…and Stay Well Informed!’

As always, thank you for stopping by.

We’ll see you next time.

Carolyn: Yes, thanks again.

(Music up and fade out)

By: Janet Roche & Carolyn Robbins

Menopause Cafes

Do you think it’s taboo to talk about Menopause? Guess again!

In our Inclusive Designers Podcast “Design + Menopause” episode, our experts introduced us to a unique and vital concept: Menopause Cafes. These gatherings provide safe, brave spaces for individuals to share their experiences with menopause, free from judgment and stigma.

Menopause Educator Lisa Scully and Women’s Health Advocate Dr. Nathalie Bonafe know first-hand the global reach and impact of these cafes since they facilitate them both in person and online. They share their insight of how these can empower women to connect, learn, and find community during these significant life stages.

IDP is excited to share that there are now spaces like Menopause Cafes that focus on breaking the silence and taboos around menopause, and provide a way to foster open dialogue for women in need of support.

Interested in learning more about how design can influence and support the menopause journey? Check out our other episode on Design + Menopause.

Panel:

Lisa Scully– is an official Brand Licensed partner with the award-winning ‘Menopause Experts Group’ (MEG). She provides organizations and individuals with up-to-date scientifically based and medically backed information. She is also the Civic Mission Project Manager at Wrexham University,

Quote: “My mission is to demystify menopause, providing support, guidance, and evidence-based information to individuals experiencing this phase of life.”

Nathalie Bonefe, PhD –  is a molecular biologist with 25 years of biomedical research experience, who now advocates for women’s health from midlife on. In her private practice, she educates and coaches women through peri-menopause, menopause, and beyond.

Quote: “Menopause is a transition, not a disease, and post-menopause lasts for the rest of a woman’s life!”

– Definitions: 

– Menopause stages: Perimenopause; Menopause; Postmenopause

– Symptoms of Menopause may include: Depression; Anxiety; Panic Attacks; Brain fog; Hot Flashes; Night Sweats; Anger/Mood Swings

– References: 

Book: What to Expect When You’re Expecting

Other IDP Episodes:

Menopause Cafes (Season 5, Episode 5b)

(Music / Open)

Janet: In this series we will be discussing specific examples of design techniques that make a positive difference for people living with certain human conditions.

Carolyn: The more a designer understands the client and or the community the more effective and respectful the design will be.

(Music / Intro)

Janet: Welcome to Inclusive Designers Podcast, I am your host, Janet Roche…

Carolyn: and I am your moderator, Carolyn Robbins…

Janet: This episode is a little different than our other ones, but so interesting… and not just because it’s short!

Carolyn: That’s so true!

Janet: In our most recent episode, we had a wonderful multi-generational discussion on Menopause and Design. Joining me on this panel… Doctor Nathalie Bonafe, Doctor Erika Eitland, and Lisa Scully… experts in the world of design and menopause.

We explored the different stages of menopause, how it affects women in the workplace, and of course, design solutions…

Carolyn: We think it is a very timely topic, and hope you’ll take a listen to that episode, or maybe you have already. You’ll find it on our website, as well as all the other places you get your podcasts.

Janet: Yes, please do.

Carolyn:  During that episode, the topic of Menopause Cafes was brought up. And we decided we needed to continue this discussion and give it its own spotlight. I’m calling it our “…but wait, there’s more to the story” episode.

Janet: I love that! Two of our experts—Dr. Nathalie Bonafe and Lisa Scully— have great knowledge of Menopause Cafes. They have facilitated them both online and in person. We felt it was important to share just what these cafes can do, and how to find one if you or someone you know needs help or support going through these life stages.

Carolyn: And with that, here is our intriguing and informative look at Menopause cafes…

(Music 2 – Interview)

Janet: Hello and welcome to Inclusive Designers Podcast. I am your host, Janet Roche. Today we are going to be talking a little bit about menopause, and we’ve got a couple of experts on here who will be talking to us about the trials and tribulations that women go through with menopause. So, I’m going to dive right on in, and I’m going to ask them to go around the room and introduce themselves briefly. So, we are going to go to Lisa Scully…

Lisa: Thanks, Janet. I’m Lisa Scully. I am a licensed menopause expert champion with Menopause Experts Group, based in the UK, but they’re part of an international company. I’m an organizational development professional as well. So I work with different organizations with regards to taking the organizations through change, processes, but particularly specializing in menopause in the workplace.

Janet: Thank you, Lisa.

Lisa: Thanks for having me.

Janet: And next up we have Dr. Bonafe…

Nathalie: Hello Janet, thank you for having me here. Hello everyone, I’m Nathalie Bonafe. So I am a woman’s health advocate, specialized in transitions. So you can call me a coach or a doula. A woman who serves at two transitions at menopause and at end of life. That’s me.

Janet: Great. So thank you to everybody for being here. It’s such an important topic. You know, these Menopause Cafes can be a great resource. That would have been so helpful to me.

Nathalie: So yes, the menopause cafe concept is also coming to us from the UK. So, it started in 2017, and it started to be hosted in Scotland by Rachel Weiss. And basically when I had the idea of, you know, having conversations about menopause about 4-years ago. I googled it and I found that it already existed so I connected with Rachel, and I was able to bring it here.

So the cafes are actually a concept of no agenda. Safe-slash-brave spaces for anyone who want to talk about those topics. (Janet: hmm). It’s recognized as educational, supportive, but menopause cafes are not medical per se. I often have a co-host or a guest who is a retired physician who comes. So we sometimes can discuss some of the medical options, but this is not a place where you find solutions.

This is a space for community and sharing experiences confidentially. There’s no recording. I don’t sell anything that I do. We share experiences. We share resources as well, articles, et cetera. (Janet: right). And this is really, um, just really beautiful space. (Janet: right). and we laugh…

Janet: Okay, you got to laugh about some of the menopause, right?

Nathalie: We laugh, we joke, we cry together, we hear, we listen to one another.

Janet: Well, that’s just it, that you know that you’re not alone, right? It’s such an important and strong message, right?

Nathalie: Yeah, and people come from all over the world because I do them online. It started during COVID. It really allows people to come from all over. South America, Europe, China. (Janet: That’s terrific). But some people do them, uh, especially in the UK, they do them in person.

Janet: Right. That’s great.

Nathalie: You know, people like Lisa or me— and there are more and more people throughout the world now— could be invited to some of the rooms, (Janet: yeah). You know, so Boston is not that far away or anywhere, you know, we could be part of the conversation and give some feedback. (Lisa: hmm).

So that I think, we talk to so many women, (Lisa: yeah), I cannot write all the stories. (Janet: chuckle). I’ve been hosting menopause cafes just virtually for 4-years now. I have like 400-women have come in. I don’t record them because this is a, I would say as safe as it is possible for everybody to come in. But really, you know, brave space and people share a lot. (Lisa: yeah). They share a lot. (Janet: right). And just, uh, we may not be able to put it on paper because it’s confidential, but if you had a meeting, you wanted to say, ‘Hey, can you run it by us?’

Lisa: Yeah, that’s it. We’re all about creating space, aren’t we? Because that’s what it is. It’s creating space for conversation in a safe and friendly environment. So, actually, even if there was a question you wanted to ask or, you know, just feedback generally, or, you know, just to, we could facilitate that conversation for you, you know, or connect you into those conversations or connect you into people, because a lot of these people come back over and over again, don’t they? They grow in confidence, but they’ve had a lot of life experience, a lot of stories to tell. (Janet: oh, yeah). Yeah.

Nathalie: I get to work with a lot of women and a lot of women with invisible diseases. (Lisa: yeah). So these invisible disabilities that they’ve never named, but that prevent them from being active, so I help them, you know, just find meaning or purpose.

So these stories of any color, I mean, people who were mistreated, you know, by the medical system, (Janet: right), treated for depression while they were menopausal, you know. (Janet: right). So whatever you, you’ve all brought up, we could have constructive stories, or we could connect you with people who can help you more specifically. Because that’s what we do. We’re facilitators, Lisa, right? (Lisa: yeah).  This is how we see ourselves. We fill the gaps.

Lisa: It is about us speaking up as we are now. It is about us empowering others to speak up because the voices get louder, don’t they? (Janet: right).

Nathalie: We want women to talk to one another and to exchange regardless of their situation, their education, their skin color, etcetera. (Janet: right). Originally based in the UK, but it’s now really global. (Janet: yeah). And I love being part of that group because we grow together the awareness. So you can Google it and find it. And mine is, uh, the one here is called Menopause Cafe Connecticut.

Janet: That’s great, thank you.

Nathalie: Thank you and be well.

Lisa: Thank you Janet, thank you.

Janet: Thank you very much.

(Music / Outro)

Janet: I wish I knew about these menopause cafes sooner myself. It’s wonderful to know that there is a place to get information on what’s going on, share experiences, and get some much-needed support.

Carolyn: For so long, women have been raised not to talk about menstruation at any age. Rachel Weiss started the café concept in Scotland to get conversations going and break the stigma. And she is still leading the way. I understand they even have annual ‘Menopause Festivals’!

Janet: I believe it’s now celebrating its fifth year! If you want to learn more about the festival, or information on finding a virtual or physical café near you, check out the ‘resources’ listings on our website for these episodes.

Carolyn: Absolutely! And speaking of which, if you want to learn more about ‘Menopause and Design’ in the workplace, take a listen to our other episode.

Janet: For information on contacting Dr. Nathalie Bonafe, Lisa Scully, or Erika Eitland…  as well as links to what was talked about during both discussions… you’ll find all that and more on our website at: Inclusive-Designers-dot-com.

Carolyn: That’s: Inclusive-Designers-dot-com…

Janet: A big thank you to Lisa, Nathalie and Erika! And, again, to all of you for listening.

Carolyn: Along with all the regular places you get your podcasts— such as Apple, Spotify, and Pandora— we are now on YouTube Music which replaced Google Podcasts.

You can also find us on our regular YouTube Channel. What hasn’t changed is our name – Inclusive Designers Podcast. And of course, if you like what you hear, feel free to go to our website and hit that Patreon Button, or the link to our GoFundMe Page.

Janet: Yes, please do. And let us know if you have any questions or suggestions for topics we should be covering in upcoming shows!

And as our motto says: ’Stay Well…and Stay Well Informed!’

As always, thank you for stopping by.

We’ll see you next time.

Carolyn: Yes, thanks again.

(Music up and fade out)

By: Janet Roche & Carolyn Robbins

Designing for: Crisis Centers   (Season 5, Episode 4)

Inclusive Designers Podcast: Currently, there’s a significant rise in people with mental health issues. But the current system often sends a person in crisis to an already overloaded emergency department. Creating separate Crisis Stabilization Centers can play a key role in addressing the need for better mental health care treatment.

But just what do you need to know to design an effective facility that both reduces the stigma, and takes evidence-based research into consideration?

Guests Stephen Parker & Robyn Linstrom share their very knowledgeable views on the specific challenges designers may face. Spoiler alert, the best solutions use Trauma-informed Design principles!

Guests:

Stephen Parker (AIA NOMA NCARB LEED AP) – is a dedicated Behavioral and Mental Health Planner. Stephen is a proponent of “architect as advocate” for colleague, client, and community alike. Advocating by design for humanity at its most vulnerable, elevating communities in crisis, and serving those that suffer in silence.

His projects range from community-scale recovery centers to expansive mental health campuses— using dignity-driven design research for communities in crisis— with work ranging from China, India, Kenya and across the US & Canada.

Quotes: “Trauma-informed Design principles really are a key factor in informing those very community specific needs to avoid coercion and help individuals in crisis in a humane and safe way”

“We strive really hard to design for dignity. We balance and harmonize the evidentiary with the empathetic, and really championing that lived experience, talking to those individuals in crisis, the family members that have endured it with them, and not make assumptions”

“Every design decision will help or hinder an individual in crisis. And we have a responsibility as designers to do better”

– Contact: Stephen Parker, Stantec

Robyn Linstrom (AIA, EDAC, LEED AP) – is a healthcare architect and senior associate at Stantec, with a passion for behavioral health and designing for healing environments. She believes that the built environment can be a partner in supporting healing.

According to her bio, Robyn is focused on changing design from the institutional to a more therapeutic environment. This challenge drives the work she does. Her goal as a behavioral health specialist is to de-stigmatize psychiatric facilities— with design that provides an environment of hope, dignity, and support.

Quotes: “It’s about creating this environment that allows people in crisis to come in and accept treatment to get out of that crisis that they’re in.

“I want to help reduce stigma. I want to be part of that solution that we could all find ourselves in a situation of needing help at any time”

“It’s really nice to see the gaps being bridged in peer support and all of the different things that we’ve been working on as advocacy is making it into the design world”

“My biggest hope working on these types of facilities is to make this a conversation. Let’s design places that are healing and support people”

– Contact: Robyn Linstrom, Stantec

– References: 

– IDP Episodes: 

– Articles: 

Designing for: Crisis Centers   (Season 5, Episode 4)

(Music / Open)

Janet: In this series we will be discussing specific examples of design techniques that make a positive difference for people living with certain human conditions.

Carolyn: The more a designer understands the client and or the community the more effective and respectful the design will be.

(Music / Intro)

Janet: Welcome to Inclusive Designers Podcast, I am your host, Janet Roche…

Carolyn: and I am your moderator, Carolyn Robbins…

Janet: We have another amazing episode for our listeners today.

Carolyn: And a very timely hot topic which may present challenges for designers.

Janet: Right? There is an enormous increase in the amount of people seeking help for mental healthcare today, and with it, a rise in the need for Crisis Center facilities to take the overwhelming burden off of local Emergency Rooms.

Carolyn: We realized how important this issue really is, and that we had to do an episode on it.

Janet: These centers need to reduce the stigma, and taking evidence-based research into consideration can do just that. It’s those things we tend not to think of when people are in crisis that can make a huge difference.

Carolyn: Luckily, we found two very knowledgeable experts in this field, Stephen Parker & Robyn Linstrom from Stantec. Let me tell you a little more about them…

Stephen Parker- is a Behavioral and Mental Health Planner. His projects range from community-scale recovery centers to expansive mental health campuses— using dignity-driven design research for communities in crisis— with work ranging from China, India, Kenya and across the US & Canada.

Janet: As a mental health design subject matter expert, Stephen believes strongly in advocating by design for humanity at its most vulnerable, elevating communities in crisis and serving those that suffer in silence.

Carolyn: And we are also delighted that Robyn Linstrom is joining us. She is a healthcare architect and senior associate at Stantec, with a passion for behavioral health and designing for healing environments. She believes that the built environment can be a partner in supporting healing. According to her bio, Robyn is focused on changing design from the institutional to a more therapeutic environment. This challenge drives the work she does.

Janet: I love that her goal as a behavioral health specialist is to de-stigmatize facilities— with design that provides an environment of hope, dignity, and support.

Carolyn: And speaking of support, if you or someone you know is having mental health issues and needs help, know that it is available – you can call 1-800-273-8255 or simply dial 988.

Janet: And here’s a little pro tip for you—to help with any anxiety try sitting with your feet on the floor and focus on your breathing. That can help calm you. Or- take a drink of water and just focus on how your body feels. These are grounding techniques that can be used anytime, anywhere.

Carolyn: Sometimes, that may be all that is needed, but if not, it’s so vital for someone in crisis to get more help.

Janet: And ideally, they will be able to get it in a facility that has taken all the right steps in the design phase.

Carolyn: Sounds like it’s time to hear from our guests…

Janet: Yes, and these two truly know what it takes to design a good mental health crisis center.

Carolyn: and with that, here is our interview with Stephen Parker & Robyn Linstrom…

(Music / Interview)

Janet: Welcome to Inclusive Designers. I am your host Janet Roche and today I have Steven Parker, as one of our guests. Hi Steven.

Stephen: Hello Janet. Great to be here.

Janet: Thank you. And we also have Robyn Linstrom. Hi Robyn.

Robyn: Hi Janet. Nice to see you.

Janet: Thank you. Well, listen, I’m quite excited about this episode because it’s such an intricate balance of design and human behavior when we’re talking about crisis centers. Is there a starting point for you guys? Like is there something that right off the bat, you have to know to do designing for some sort of crisis center.

Stephen:  Yeah, I’ll, I’ll start off here. I’m sure Robyn can, uh, embellish…

Robyn: Yeah.

Janet: Everybody just jump right on in. It’s all good.

Stephen: So, uh, crisis centers is an interesting subspecialty in mental behavioral health design. It’s not kind of your run of the mill inpatient psychiatric facilities. It is not outpatient. And it’s intended in terms of helping the continuum of care, as the name suggests, in crisis, individuals that are emerging in crisis.

And so to divert individuals from overburdened emergency departments or worse, law enforcement settings, and diverting them to this kind of third place, is actually the third leg in the stool of the 988 system, if you will. So part of that, just to give you the context of it, is that 988, which was a, kind of like the crisis hotline that subsumed all of the suicide prevention hotlines across the country. Some place to call, someone to come get you, and some place to go. (Janet: right).

So they’re less than a day of stay, so less than 24 hours, much like emergency departments. (Janet: huh). and every community is different. So you’re, when you ask, you know, what makes them different than anything else, is that there’s typically a ‘no wrong door’ policy.

You don’t know who’s going to walk through the door and in what crisis they’re in. (Janet: right). Is it addiction? Is it withdrawal? Is it acute psychosis? Is it a child or adult on the spectrum who is escalating? You really don’t know. (Janet: right). An individual who was formerly unhoused for a long period of time. So I think that’s what kind of makes it fairly different than what you might see in other mental behavioral health settings.

And every community is dealing with that a little bit differently. And I think that’s one thing that trauma informed design principles really has a key factor in informing those very community specific needs to avoid coercion and help individuals in crisis in a humane and safe way.

Janet: Yeah, the community specific is such a big part of all of this, isn’t it. Robyn, I see you, you’re nodding your head. So…

Robyn: Yeah, absolutely. You know, I guess what I’d add to that as well, and Stephen sort of touched on it a little bit was just that, having these crisis centers now is a location and a place for first responders to take people, right? So when you start to see people on the street that are clearly in behavioral health or mental crisis, normally would go to either the E.D. or jail, right? (Janet: right). Which neither of which are appropriate place for them to be.

So the emergence of these crisis centers is really a wonderful place to get the help that they need in that immediate crisis that’s happening. So, you know, when you start to say, ‘what do we look at as designers when we’re looking at these facilities,’ that access is a huge piece of it, right? (Janet: right).

And that understanding of who’s coming to it and how they can get there. Because it can be a first responder. It could be an ambulance. It could be a walk in. And really distinguishing those different pieces and how somebody is going to enter the facility, in terms of their treatment and how they’re going to receive that treatment is key and important to understand as we start to look at these facilities and how we lay them out and design them.

Janet: Okay. So now my head is spinning. (Robyn: chuckle). All right. So I wasn’t expecting those kinds of answers, but they’re great. (Stephen: uh-huh). You know it’s also that attitude of looking at how are they coming to this facility, right? My assumption is that most places have like the walk-in ambulance, police, type of vehicles or ways to get to the facility. Am I understanding that correctly? I would assume most of them, correct?

Stephen: So, um, that’s the interesting thing about it. Different communities have slightly different needs. A standalone crisis center, and they go by crisis receiving center, crisis response center, crisis intervention center. (Robyn: stabilization unit, yup). Find the derivation of the name and acronym that comes with it, because we have a wonderful patchwork of a healthcare system.

And so what’s interesting there is that they can be independently standalone which is really helpful for rural and suburban settings where you don’t have a major medical center with which to attach this facility to or otherwise triage from emergency department from. (Janet: right).

So if it’s, let’s say, again, I’m part of the continuum of care; that law enforcement is aware; that there are crisis mobilization teams; that there are crisis centers that are getting calls and routing those calls for individuals in crisis to these centers; and that, you know, they take walk-ins and referrals. So there’s a multitude of paths. So it’s about that accessibility that Robyn mentioned. And the fact that these are triaged to be medically stable.

So if an EMT or an ambulance picks them up and they’re clear, medically stable; if they find themselves emerging in an emergency department and they’re clear, medically stable, but have this emerging crisis diagnosis or psychiatric need, and they’re diverted from that overburdened E.D. which is, you know, think about last time you went into an E.D. The national average is, what, 8-to-10 hours of wait time? (Janet: yeah). And for psychiatric needs and consults, it’s 3-times that. (Janet: wow).

So, imagine spending a day or longer, or in some cases for pediatric, youth, or ‘Geropsych’ needs, so specific patient populations where you need a consult beyond, like, kind of general adult, you could be there days. Or weeks. Because you’re not just waiting for the consult itself, but the bed to open up. And so a crisis stabilization is kind of very interesting is that you find the opportunity to put these facilities in a much more accessible location in a broad number of community settings outside of those major medical centers, if needed.

You can also attach them to those facilities. um, you see them in psychiatric EVs, there are empath units associated with major medical centers. (Janet: right). But also the fact that since they have a ‘no wrong door’ policy most of the time, that intake, that kind of first handoff between— and a warm handoff, as we like to call it— what is the experience of someone in psychosis being dropped off of this facility?

Is it because the EMT and the law enforcement officer have been trained and kind of integrate well with the facility staff to have that warm handoff? And that the first sign is not law enforcement entrance, but first responder entrance. (Janet: right, right). Because you can imagine the community connotation of an individual taken to a facility that has that sign on it, and what they’re expecting next. And I think that’s a trauma-informed principle is ‘nothing about me without me’. And so letting them know what’s happening to them next is very, very important. (Janet: agreed). (Robyn: yup).

Janet: You know, it’s also the Trauma-informed Design lens involved. I mean, and it’s also goes into everything from dignity to self-empowerment. It gets rid of the stigma, you know, to a large degree. (Stephen: uh-huh). So Robyn, did you want to join in? It looks like you were getting ready to say something and then I popped in. (Stephen: chuckles).

Robyn: No, absolutely. I, you know, I get excited about these conversations for sure. And I mean…

Janet: … who doesn’t Robyn, who does not get excited about these conversations (both laugh).

Robyn: …but you know what Steven is saying too, it’s also about acceptance of the individual coming in, right? It’s about creating this environment that allows them to come in and accept that treatment to get out of that crisis that they’re in.

You know, I have done a crisis facility and we went back and did kind of a one year, you know, retrospective, if you will, of how is the building working and how is it functioning? And one of the key takeaways I took from it was, in this kind of crisis piece, this particular facility served a lot of those experiencing homelessness, right? And that trust is not there. And that feeling of coercion of having to do things is huge, right?

And so they talked about how there are people that come and maybe they’re there for an hour. And they don’t know, they don’t trust you. They don’t know, you know what I mean? And they leave.  (Janet: hmm). But then come back and next time they’re there for maybe 2- or 3-hours, right? And so it’s really about creating these environments that allow people to build up that trust in order to receive the treatment that they need.

Janet: Right. So what would you do for something like that? How do you create that through design? I mean, I think it’s also seeing the same people and knowing that ‘we’re here for you, come back when you’re ready’ type of deal. (Robyn: um-hmm). But also how do you as designers design for that type of, you’re trying to gain their trust, right? (Robyn: right). Because that’s another Trauma-informed Design principle, trustworthiness. (Robyn: yup, and transparency, right). and transparency. (Stephen: uh-huh).

Robyn: I think that’s a lot of it in the built environment, right, as being able to see where are you going? What’s happening to me next?  Just having that environment that really meets people wherever they are, right? So somebody might feel the need for feeling safer in a smaller space. Someone else might want to see it kind of more transparent and open and be able to see everything that’s happening around them.

So it’s understanding the clients that might be using this facility and trying to kind of react to those environments, and providing those different types of spaces so that each individual can find what is comfortable for them.  (Janet: right), (Stephen: yeah).

Janet: Go ahead. Go ahead, Steven.

Stephen: Yeah, I mean, so we’re always trying to harmonize risk and recovery, or safety and serenity, if you will, in those spaces. (Janet: right). So they give the individual choice in the organization trust. Because, you know, you need good lines of sight for staff, but that’s good lines of sight also for those individuals in crisis so they understand where they are and kind of fit in the context. And they don’t, you know, have a feeling of entrapment and coercion and confinement. And avoid re-traumatization through the spaces that you may be forcing them to choose from if they’re given a choice.

And so I think voice and choice is really important to Robyn’s point is that the seating arrangement, so they can self-reflect safely, that they can choose to engage one-on-one, or they can socialize in larger gatherings, and every variety and spectrum in between, right?

So I think that’s a key part of it in terms of laying out the space. Because it’s, it’s a lot of nuances that are also very culturally specific. As Murat mentioned, an unhoused community, or those experiencing specific addiction types, whether it be an opioid, specifically fentanyl, alcoholism, so forth and so on. And so there’s, you know, different acuities and different needs that you really need to listen to the community and kind of hone in on.

Janet: Right. You know, it was interesting. I’ve been very excited to interview the two of you. And I think that designing for crisis centers and mental health and all of that through design, like it’s such an important part. And I was doing a lot of thinking about how I usually just do kind of riff, but I really want it to make sure I hit all the notes.

So I was thinking that we kind of walk through the, the front door, so to speak, (Stephen: sure). We go and we think about what that space might look like, you know. and I know we’re looking at it in terms of depends, right? It depends on the community, depends on what kind of crisis center it is, that type of deal. But maybe we can blend all those. I wonder if walking through the front door isn’t a bad place to start.

Stephen: I’ll let Robyn, unless she wants me to do it. I’m happy to walk, do a day in the life of and kind of walk through the flow.

Robyn: Yeah, we can, and we could even tag team Steven if you want, (Steven: sure, yeah). You know, I mean, I think it’s kind of coming into that space that maybe not the first thing you hit is a security or safety, or you know, it’s coming into much more of a welcoming space. (Janet: yeah). I think it’s about creating different types of environments, right? Maybe there’s an area that’s kind of a seating waiting area that’s more open.

You’re going to have smaller rooms, consult type of rooms (Janet: right), where you can have those kinds of one-on-one conversations, and where a clinician can really start to understand ‘what is this individual dealing with?’ and, kind of, ‘where are the traumas and the crisis coming from?’ to have that space. We often have spaces where we can bring in family members (Janet: yeah), (Stephen: uh-huh), because sometimes the family is part of that trauma or trying to kind of understand how that all plays into it. (Janet: right).

So it’s really to me about designing these different types of spaces. We often have what we call quiet rooms or calming rooms. (Janet: right). Sometimes they’re sensory type of rooms, right? So we can start to look at different, depending on, again, what the clients that are being served there.

You know, I had a facility where it was children, and they had these calming rooms that had different themes, right? (Stephen: uh-huh). One was just a room of ‘stuffies’ (Janet: chuckles). And that’s helped comfort children. That they could just go into this room. They could self-regulate. (Janet: right). A space that they can feel comfortable in, right?

I’ve done in adult facilities, color light therapy is a huge piece of it. Being able to go into a space and change that color of the room to what feels right for you at that moment. (Janet: right). Again, to kind of help self-regulate.

So it’s about creating all of these kinds of spaces that people are allowed to choose. And I think when you first walk in the door, there’s going to be sort of that assessment piece, right. That’s going to have to happen. (Stephen: uh-huh). But once you get through that piece, it’s really about creating this environment that allows people to find where they feel the best and able to have the conversations to kind of get themselves through that crisis with the, you know, trained folks that can help them. (Janet: right).

Stephen: And I think that gets to Robyn’s point of, if that is the initial intake assessment and evaluation that’s a key part of the crisis care model is that you’re not waiting for that immediate assessment to understand what is the best path for you moving forward. (Janet: yup).

So whether it’s that first responder entrance where they kind of take you through that intake and assessment space, they’ve kind of figured out, you know, ‘Hey, do you have anything on you that can hurt yourself or others?’ You know, ‘What was the circumstances of which you were found?’ and ‘Who brought you in?’ ‘Who called?’ ‘Did you call yourself?’ (Janet: right).

And getting all of that kind of download between staff. Oftentimes, you know, if it’s an individual that’s unhoused, ‘Where did all their personal belongings go?’ right? (Janet: yeah). And so there’s some kinds of security around literally all of their earthly possessions. (Robyn: um-hmm). You know, ‘Who’s taking care of that?’ ‘Where’s it going?’ (Janet: yeah). Not just chain of custody, but just the sense of security around my sense of belonging and the belongings I have, right?

Robyn: Do I have access to it, right? (Stephen: yup).

Janet: Well, that’s huge, right? (Robyn: uh-huh). (Stephen: um-hmm). To your point, it could just like be the clothes on their back and whatever they have in their bag, right? (Robyn: yup). They want to be able to keep their eyeballs on it all the time, right? (Robyn: yup).

Stephen: If they have a service animal, ‘Where is that pet going to be taken?’ You know, so accommodating even kennels in some cases. Or if they’re on the other end of the spectrum, oftentimes we kind of see facilities set up with four department types.

So you might see mental health urgent care, where you can do walk ins and referrals, where you have that kind of counseling and consult either individual or family. The crisis stabilization unit itself. So typically it’s a big living room style with a staff station and a variety of those other spaces Robyn mentioned that allow people to do one on one consult group therapy. (Janet: right).

Family counseling, sensory spaces, nourishment, as well as like hygiene and other things, but a variety of spaces within the living room environment. So that way when it’s typically recliners, so that boy, if they’re there for 23-and-a-half hours or so, you know, they can fully recline, get some rest. They may come in in the middle of the night.

But they also might have a more social space where, you know, we’re doing a youth crisis unit where, hey, the big topic is the video games, you know, (Janet: yeah). ‘Who’s playing what and where?’ because that’s how they relax for example. (Janet: right).

And then other components of the program could be a transitional outpatient program. So they’ve gone on their observation for that amount of time, and it’s realized that their medication is stabilized or otherwise their treatment plan, which, they’ve engaged with, and with providers, have established some sort of therapeutic alliance about what their next steps are happening to them.

Okay, we can discharge them into an outpatient or transitional program. (Janet: yeah). And that can be a day hospital, you know, sort of like a very half to full day group therapy sessions and other therapy modalities that can be accommodated in the facility. And then if it’s deemed during that observation period in the crisis unit, they need to be admitted to a longer length of stay, 3-to-5 days, 7 days longer, depending on what the facility needs.

So sub-acute units, so inpatient beds, being accommodated and therefore having kind of an inpatient setting. But you can see there that you have something of the spectrum of continuum of care within one facility, possibly, urgent care walk in; the crisis stabilization unit that has its own intake for those folks that come in hot in crisis; the transitions program for outpatient care; and then if they need to be elevated to a higher level of care, sub-acute, inpatient. That’s a lot.

Janet: Yeah, there’s a lot to digest there, but I’m wondering though, in your opinion, and maybe this is stuff that you’ve also done in post occupancy reviews or what have you, you know, is there like a sweet spot for the amount of beds? And for different types of timing that, you know, a couple of days versus like a week or so? Should designers be looking to try to fit in, say like 6 beds or say 12 beds, if it’s 7, you know what I mean, is there something along those lines?

Stephen: You want to talk about a sweet spot, Robyn? (all laugh).

Janet: Yeah, sweet spot. Is it true? I, I got to think it might be, right?

Robyn: Yeah, I think there is. I think some of that sweet spot really relies to on the staffing (Stephen: uh-huh), and sort of that staffing model. (Janet: right). Some of it is tied to licensure components, right? (Janet: sure). I often see— and Steven, you can see if you agree— but you know, that 12-to-16 beds is usually kind of that sweet spot. (Stephen: yeah). In terms of the staffing, it’s usually 8-to-1. So kind of that 16 gives you kind of 2 within there. But that seems to be manageable from the clients as well as, as the staff and the people coming in.

I think you see the kind of crisis assessment piece. As Stephen said, there’s different ways you kind of come into that initial intake assessment area, right? (Janet: correct). And then oftentimes you might have an observation area that’s sort of that less than 24-hour kind of piece. And then sometimes you move into a longer-term crisis, right? Sort of that 2-to-5 day stay until you can really understand where someone might need to be, whether it’s an outpatient, whether it’s inpatient, whether it’s additional kind of services. (Janet: hmm).

Stephen: And I think, even with 16 beds for just kind of making staffing work is that you try to lower the social density in those settings as much as possible, right? So the variety of spaces in the therapy and kind of programming and functionality you can imbue into it. So that way you’re not sort of confining a mass of people, if you will. Yeah. If you’re in a living room style crisis unit or in the subacute unit with 16 beds.

If you’ve ever had a roommate, or a sibling in my case, (Janet: chuckles), you kind of know that usually your pain points around bathrooms (Janet: yes!), and personal belongings and food. (Janet: preach). (Robyn: chuckles). So, what is your sense of personal space and belonging? Like how do you feel like you own a sense of space and some personalization if that’s the case in the subacute unit?

So how do we break that up so you’re not dealing with 16 personalities, but you’re dealing with 3, or 4, or 5, so that we can kind of lower that social density. You know, from evidence-based design research that you lower the number of incidents that lower that social density is less friction with individuals that gets back to widening corridors and creating more buffer space. Because also a lot of these spacers intended to lower the barriers between patient and provider as well. (Janet: yeah).

So the idea that you’re not creating authority dynamics of ‘us versus them’ as much. (Janet: yeah). So a ‘being out in the milieu’ as we call it. So I think particularly for crisis, a lot of providers push a peer model. So peer specialists are individuals that have gone through crisis, gone through recovery, and then have clinical training to help other individuals in crisis.

So you have someone or multiple someone’s on staff (Janet: right), that have gone through what you’ve gone through, similar age and so forth and so on. So that you can start building that trust, which is a two-way street between the organization and the individual. And it really comes down to a staff member having positive engagement and rapport.

Is that coming down to, they have a nutrition station outside in the milieu area, and they have access to it, and they don’t have to tap on the glass every time they want a drink of water, right? (Janet: right). So what are the things that help the providers not create friction points with patients because they can see a patient as a human being. And provider can be seen as a human being in the same way.

Janet: As opposed to like, maybe behind the glass, you know, the pulling back of the glass, ‘what do you want?’ You know, like, ‘I just want some more water, please.’ Right? (Robyn: uh-huh). Something along those lines. Well, you gave me a lot to unpack there as well.

You guys keep throwing out all these nuggets, which is just fantastic for designers, like, things to think about when designing crisis centers. And it’s interesting to me, the first grant we got in Trauma-informed Design was to do it for schools and we found that kids were most dysregulated in the hallways.

I mean, we knew like gyms, cafeterias, right, but it’s really the hallways, and then you only have to do is think about your own experience in school and be like, ‘Oh, right. They were.’ you know what I mean, they terribly were. (Stephen:  um-hmm). So it’s giving people their space in the hallway. So I appreciate both of those nuggets of information there.

Were there any kind of like big takeaways when you first started to do all these behavioral health centers? You know, I know that this is your job, you came into it, but was there any time that you thought to yourself, like, ‘Holy moly, why didn’t I know that, why didn’t I think of that, like, why haven’t we been doing this all along’ or along those lines?

Stephen: Yeah, I’ll let Robyn take that first one away.

Robyn: Sure. It sounds odd, but my biggest nugget when I first started doing these types of facilities was really how simple, (chuckles), the solutions can be. I think as designers, we want to be innovative. So I guess I would say, you know, I’ve started my career, I’ve always focused it in healthcare design but started kind of more in the physical health world.

And one of the things that we do is we always meet with the users of the space, right? Which is typically our nurses, our doctors, the facilities people, to really understand how they’re using the space. And when I started doing behavioral and mental health facilities that peer support that Stephen talked about is such a key piece of it and that lived experience.

And so that voice started coming into those user group meetings, right? And as designers, we’re always trying to be innovative. We’re trying to really look at how can we do something different. And I learned in talking with the peer group, how simple the solution can really be. (Janet: right). And that it’s really just about exactly what Stephen said of, ‘How do we widen the corridors so that we’re not brushing against each other as kids and poking each other and causing those friction points’ right? (Janet: friction points, right).

I mean, we had a peer group that, you know, they come in with some lofty goals. ‘We want a swimming pool’ right? Some of the things that are probably not going to happen in the facility. (Stephen: chuckles). But the simple things like, ‘I just want to get a drink of water without having to ask somebody for it.’ And as designers, well, how can we do that?

You know, from a safety perspective, drinking fountains can cause safety issues, right? (Janet: sure). There’s ligature risks and concerns. (Janet: right). But as a team, we came together and said, ‘this is something so simple that we can do. How do we do it safely?’ Right? (Janet: right). And so you have those conversations.

So I guess for me, those kinds of little nuggets are those little, smaller things is what I’ve really learned as a designer, to hear the voices and what’s really important to them oftentimes is something very simple that we can do.

Janet: Isn’t that true though? I’m so happy you said that too, because sometimes it seems like a pretty simple solution right there in front of you.

Robyn: And sometimes we make it complicated, right? (laughs). (Steven: yeah). (Janet: exactly). Yeah.

Janet: Funny. Steven what, like what’s been some of your takeaways?

Stephen: (laughs). Yeah, I would echo Robyn’s points, that’s for sure. Lived experience, I think, is very important. I serve as a board member for the Design and Mental Health Network in the United Kingdom. And they’re expanding to North America, and a big proponent of their platform is this lived experience. But that’s not just stakeholder groups kind of in that design process, it’s more holistic.

And so we see this in other parts of the world where they inform the model of care, (Janet: right). Like before the building is ever programmed. They inform the design process for how the building takes form and kind of manifest organizational goals. (Janet: right). But also, in their operations.

And so I, that’s what I like about crisis centers in particular is that as a subspecialty within mental behavioral health, it’s kind of this unique manifestation of where lived experience is becoming much more manifest. I find that engaging and worthwhile. (Janet: yeah).

I will say having a parent who’s a psychiatric patient, the kind of role of family and visitation and maintaining or forging social connections is so critical for some people’s recovery (Janet: right). And the traumatization of the individual going through crisis just ripples through families and their support networks.

So you have secondhand trauma that really needs to also account for that visitor comfort and ability to see someone in crisis and make it through crisis. So you’re also not thinking about just the individual who may be exhibiting self-harm or addiction or harm to others, but you know, how are you healing this greater community and this greater family, this greater context, by treating the individual in a much more holistic and humane facility that we’re designing.

Janet: It’s such an important part, isn’t that? I mean, to piggyback on what you said, you know, I too have had a family member that ended up in some sort of psychiatric facility. It was older, so it was bad, like really bad.

You know, like the windows with like the wires in them and stuff like that, you know what I’m talking about, right? (Robyn: uh-huh). You know, it has like the chicken coop kind of wiring. (Robyn: yup, yup). (Stephen: absolutely). Yeah, it was, I think it was early ways so that it wasn’t able to like, be broken, and then, right? (Robyn: Yeah, yup. Fire ratings, and…), Right? (Robyn: yeah). Fire, all that other stuff.

Robyn: Newer technology has improved that for sure.

Janet:  … has improved that tremendously, thank God. (Stephen: yeah). you know, but as the family member coming through, that was, I mean, I’m not allowed to say exactly because we don’t swear on this show, but it was a holy ‘beep’ kind of moment for me. (Robyn: laughs). And I just remember feeling uncomfortable.

You know, at the end of the day, I mean, it was an addiction problem, not a psychiatric problem, but they needed to put him somewhere. So that was sort of what was going on. And I just remember, besides saying, ‘holy boop,’ that it was very, it was just, it was horrifying.

And, you know, and if you’re going through that type of crisis and to be in those types of spaces, again, I know we’ve changed quite a bit since these days, but there’s still a lot of them out there that seem to be a-okay with the built environment that is not conducive to healing whatsoever.

Robyn: The built environment should support that healing, right? And it traditionally has not. (Janet: That’s our plan, right?) Yeah, hopefully we’re changing that, right? (Janet: yeah). And it’s, you can see where it came from because there’s this level of safety that we’re trying to be conscious of, of people in this facility is that may want to self-harm or, you know, harm others. (Janet: right).

And so there’s that safety level that has to be there, but how do we do it better, right? (Janet: exactly). How do we infuse it with an environment that is supportive, that allows people to receive that healing and treatment that they need. (Janet: right). Because the environments we had previously just didn’t, unfortunately. (Janet: yeah).

Stephen: And they can help or hinder, right? (Robyn: absolutely). So, I mean, it’s not neutral. And I think that the growing societal awareness around mental health has really kind of catalyzed this conversation in the last few years. (Janet: yeah).

But there’s still a lot of stigma because of ignorance, even just people using the products and just as an applique, not really understanding they can really either enhance or hinder the care that’s there. (Janet: right), and the feeling of humanity and dignity and empowerment and agency. (Janet: yeah), for patients and the safety of staff.

I’ll give a shout out to the manufacturers for providing a lot better options in recent years, (Janet: yeah), but Robyn and I especially do a lot of risk assessments of existing facilities where it was just, ‘Oh, we knew it was tested and we just used it,’ but not how it was used or how it was supposed to be installed or, you know, the feeling when someone is locked in a room, and they count every bolt and nut and screw and fastener, (Janet: right).

Janet: Yeah, it reminds me of being in church, but that’s another story. I always try to count how many crosses, (Robyn: laughs, I do the same thing, count the ceiling tiles, yes). So I’m not equating the 2, I’m just saying like, that’s how I get through church. So… (Robyn: yeah), but yeah, I mean, it, it’s changed quite a bit, and I’m glad we’re looking at that. (Robyn: yeah).

I had so many questions and then I had to do the church joke. (Robyn: laughs). So my apologies. We talked about so much and this has been just terrific. So I want to know, when you’re designing, are there things that designers kind of need to think about?

Is there something that is a crossbreed between walk-in services and has like a bit of a residential program, right, it’s sort of a mixed program, I guess, some sort of hybrid? Is there a way that you look at that differently than maybe just like a walk-in?

Stephen: Every community is a little different, I will say. We’re seeing a lot more blending and fusing of programs. (Janet: yup). And, uh, I know Robyn’s worked on some projects out her way in the west that can speak to those.

One that comes to mind, up in the far north of Canada is a recovery center that’s for a very specific indigenous community. (Janet: yeah). And so their approach to care for flow acuity is to address generational trauma and fetal alcohol syndrome. So a very specific community needs, and they do that in an inpatient setting.

So they’ll take entire family units, and kinship cohorts in for inpatient care for generational trauma and treatment. (Janet: right). So that’s very unique. And, very specific to the cultural context (Janet: yeah), dealing with addiction for that specific cohort of mother, baby. Or in the case of mother dealing with addiction of alcoholism and a much older child dealing with the developmental disorders from having fetal alcohol syndrome is a very interesting family comorbidity in a way. (Janet: right). And how they deal with that within a very specific cultural context that has a spiritual lens to it.

A very unique rural and isolated part of the world, that, you know, is very humbling to us that get to work on those projects. But they blend housing; they blend childcare; they blend counseling, both for family and individuals; they blend ceremonial and spiritual spaces, and a variety of therapies that are very unique to that context that you don’t see anywhere else. (Janet: yeah).

And so that’s one community’s response of like blending these things together instead of having disparate programs and facilities that don’t really treat the individual, much less the family or the community holistically. So those are some things that we’ve come across. We’ve had the opportunity to work on across Stantec that we’ve really enjoyed. And then Robyn’s had some similar experiences out west.

Janet: Right. I just want to remind our listeners that you can go to InclusiveDesigners.com, because I want to promote that facility that you’re talking about in Alaska, because it’s so unique and I think the pictures are pretty wild. And we will have all of that, plus other references on our reference page.

But so I didn’t mean to interrupt you, Robyn. So I seem to be doing that a lot today. So my apologies.

Robyn: (laughs). No, all good, no. You know, I would say in terms of kind of the hybrid, I feel like these facilities in general are kind of all hybrids. And I think the biggest piece to me is about flexibility, right? (Janet: yeah). And how we design the spaces.

You know, when we’re talking, someone’s coming in in crisis, if it’s substance use, they say substance use is a disease of isolation, right? It’s people that have isolated themselves. And being in a facility with potentially a roommate may be what they need as part of their treatment and their healing process, right? (Janet: hmm) versus oftentimes we’ve heard that those experiencing homelessness will choose to be on the street, (Janet: yeah), because a shelter has been a traumatizing environment for them, right? (Stephen: hmm). (Janet: right, wow).

And so that more wanting the sense of isolation and that security and safety for themselves, they might want a room that’s just an individual room, right? So when we’re looking at these types of facilities, it’s really about how do we design in that flexibility (Janet: right), to really be able to meet whoever comes into the facility where they’re at, (Janet: right), if that makes sense.

Janet: Oh, I was just going to say so well said Robyn. So yeah, you’re, you’re, you hit it right on the head. And so thank you for answering that question. And I still can’t remember what the other question was before I did the church joke, (Robyn: chuckles), but so I can jump into my next question, which is about staffing. Like I know for myself as a designer, if you’re not paying attention to the staff, if you’re not taking care of the staff, I’m not taking the job.

Because our mentality is if the staff isn’t able to find a place to be regulated and be able to bring down their own stress levels, then you can put it in a beautiful place, and have all the bells and whistles and all the finest of the finest. But if that staff is just like going off the charts, it doesn’t matter, right?

Stephen: Oh, absolutely. It’s huge. (Janet: yeah). (Robyn: huge). We’ve had the opportunity to help master plan for entire health systems, provinces and states, their mental behavioral health facilities. And so what we have come across that almost every state is deficient in thousands of beds in some cases. But even the beds they have, they don’t have the staff to staff them. (Janet: yeah).

So thinking about recruitment, retention, how to mitigate burnout. (Janet: yes), And so a lot of, you know, thinking about the mental wellbeing as well as the mental health of staff and patients, how do you give them some level of parity of patient spaces to staff space. You know, is the break room embedded into the facility with no light, or have you given them some glazing in the perimeter? Have you given them an outdoor space to kind of decompress, (Janet: right),

Even just looking at wellness rooms with the same sort of sensory lens that we take for the calming areas or other neurodiverse considerations that we have for these unique patient populations are just as beneficial to individuals on 12-hour shifts in very emotionally charged behavioral health units, right? (Janet: yeah). That they need to decompress from.

So it’s when we do observation, it’s not just the step study of between the meds room and the care desk. It is, you know, how far off to the break room does it take to kind of feel like you’ve gone away from quote unquote, the space that is causing your stress and your spike in cortisol level, right? (Janet: yeah).

So, I think that’s a big part of why we are looking at, you know, how to use these facilities as not just to create great deference. I think that goes to pay for staff, the recruitment of staff.

Janet: You’re so right. I have another story for you. So, I went to boarding school and we had a dining hall, and the dining hall was just awful. You couldn’t get a good chef in there to go work the facility because they’re like, I can’t work with this. So they would get like these terrible chefs. So they had a terrible kitchen with a terrible chef. And then somebody gave some money and then all of a sudden, they had a brand-new building and then all the chefs came running. So it’s along those lines, right?

Stephen: Absolutely. Yeah. And I like to think that, you know, we can do a lot with very little. We find that the reimbursements for mental health facilities are typically less. So there is still a lack of parity in the health system and that mental health is health and they should treat it with the same deference. (Janet: right). I think that goes to pay for staff, the recruitment of staff, and the investment in these facilities. But if you look at the capital costs versus one year of operational costs, yeah, you’ve saved a little bit up front, by picking a little bit lower finish or fixture or things of that nature when long term you’re increasing your staff retention because you’ve invested in the spaces that reflect the value you have in your staff, right? (Janet: yeah, right).

Robyn: Yeah. I mean, I think that staff retention is so important and so key in these facilities that can be very, as Stephen said, emotionally charged. Right? And I think one of the key things that we need to focus on is making sure we have dedicated space for staff. (Janet: correct). We’re always pushed and crunched on square footages and costs.

And the first thing to go is always the staff support, right? And we have to really fight for that. (Janet: don’t worry about it, they’ll be fine, right?). Yup, yup. And it can be, again, it goes back to that simple solution thing, right? I mean, it doesn’t have to be the Taj Mahal of spaces, right? But it has to be spaces that are purposeful for staff, (Janet: right).

We had a facility that I worked on where we had these sort of ‘quiet rooms’ on each of the units for the patients that had this kind of color light therapy. And we ended up doing the same thing for the staff.

It was a small room with just a chair, but it had this color light therapy in it. And we did kind of post occupancy surveys with the staff, 100-percent of the staff said that it was incredibly helpful for them. Both from an emotional standpoint of having a place to go to just decompress, but also, you know, we have to remember that these staff often in these inpatient facilities are on 24-7 in these crisis facilities. They’re on 24-7. They’re overnight, right? (Janet: yeah).

And so having a space where there’s kind of that circadian lighting, the color therapy that, you know, say they’ve worked a night shift and they’ve got to go home and go to sleep. (Janet: yeah). Can they go into a space, turn on that amber light, start to bring their levels down and then get prepared to be able to go home and go to sleep, right?

And vice versa, (Janet: right). If they’re starting a night shift and they’re getting tired, can they go in there, you know, get that dose of the blue light (Janet: right), to kind of, you know, increase that cortisol. So it’s small spaces, but they’re so important and so key and something that we really need to be considering and part of the projects.

Janet: Yeah, absolutely. I’m such a believer of that. And we did an episode of Inclusive Designers with Alex Tan from Philips. And Philips had created these— I think it was for a pilot, but it was for adolescents in crisis. And what they had done was, is that they were really giving the autonomy back to the patient, resident, what have you.

And they were able to pick like the noise level, what their images were supposed to be. And all this, I mean, again, it goes back to the trauma-informed design principles where it was about choice and agency, you know, and giving them that option, but it really helped to bring down, I mean, sure there was loud music probably at points, but it helps to bring down your levels.

Stephen: Absolutely. We find that integrating these sensory enabled architectural elements, so they’re not just isolated to one sensory room. For some sensory enabled spaces we did for Cooper Health, is it in the pre-op area. Is it in the post-op areas, the subway. Is it where the siblings are waiting, who might be having anxiety of waiting for a loved one coming out of the crisis unit?

As well as the staff to Robin’s point of, it can be anything from, you know, in the mother room. (laughs), you have a bottle washing feature, because it’s not just simply the time it takes staff to do something if you’re a nursing mother, but also like, you can kind of give them a little bit extra functionality and flexibility in a space’ and then that pain point is kind of taken care of if you just think a little bit more thoughtfully, a little more deeply, and ask a few more questions.

So whether that’s a piece of functionality, if that’s kind of a sensory element, that’s great. It can be very, very, very simple tactile strips to, I can create a wind generator and a setting in the room to make it feel like an autumn breeze and everything in the room to transform through a haptic projector.

And it makes me feel as if you are in kind of New England right there in fall, or you’re on the spring and the coast. So you can really transport somebody and aid in their self-regulation through the built environment, which is one of those key coping skills they kind of teach you in these environments.

Janet: Yeah, I, you know, we could all use that in our homes. But I love the fact that, you know, things are changing so much and we’re also recognizing the built environment is such an important piece of this.

And I want to tell you another little story. So we just finished up our trauma-informed design class that was at the Boston Architectural College. And one of the students was redoing and rethinking ER and the ER process. And her first instinct is, as all of ours would be, was that, you know, you’re just trying to lower people’s stress level. So like yoga, Zen type of, it’s just everything that you would kind of think about. Like I see a lot of bamboo and I see a lot of waterfalls, that type of deal.

And she said, ‘you know, you’re in such a state of stress, it felt incongruent to have that type of like complete utter change, right? You’re coming from this heightened state and then you’ve got all the, like again, the bamboo and the wind chimes and all that stuff. And I would think to myself, if I’m in that heightened state, I might want to take the wind chimes and knock them off there, you know what I mean?

Is there like a reality to like trying to bring that stress level down within the built environment, but that it’s in stages. Because that question kind of came up and I thought it was interesting to have that gradient as opposed to going from 100 to down to 0 Zen and have a Kumbaya moment. I don’t think it’s really realistic, right? Am I missing something here?

Robyn: No, I 100-percent agree with you. And I’ll give you an example of this was actually in an inpatient facility, but you know, it’s about, again, I think it’s that flexibility, right? (Janet: right). So if you’ve got someone in an inpatient unit, they’ve got a room. They’re kind of isolated in that room. Often therapy wants to bring them out, wants to bring them into group settings. Well, somebody might not really be at that place in their journey to be able to be in a room with a whole bunch of people interacting, you know what I mean?

So it’s about creating spaces. It’s that sort of step down, as you said, right? (Janet: yeah). So we started to create little niches in the corridors that people could go and still be individual, but outside of their rooms. So starting to interact more with people, but not yet quite ready to be in that group setting. (Janet: yeah). So it’s about, it’s exactly what you said. How do we, as that built environment, support all those different levels to meet people where they’re at? (Janet: yeah).

Stephen: Yeah, absolutely. They talk about it fairly often with autism because the transition between spaces and activities, and a lot of, you know, if you look at evidence-based design studies, usually they go back to attention restoration theory. (Janet: um- hmm). And so how do you get that time to kind of refocus from one element, or focus, or space, or task, to the next? And how do you recharge from it?

So you obviously see that in autism where, ‘what is the transition from one activity or one space to the next?’ So that way you’re transiting an individual, they aren’t sort of drawing them through, but you’re decanting them and their stress levels to have them acclimate and give them a greater choice and empowerment as they choose to go through a space.

So a sense of procession, I think is really important. (Janet: yeah). I would orient your focus around a couple of interesting in developments. The state of South Carolina is currently funding a 3-year grant through Clemson University for pediatric behavioral health needs in the emergency department. (Janet: hmm).

And we’re, you know, supporting that research through our professional practice use of our case studies and things of that nature. They’re going to have some really interesting findings to address those specific needs that you just mentioned that your student was going through. (Janet: yeah).

We recently funded a small grant through the UNC Greensboro for a sensory room for college students. And so we’ll be publishing the findings from a sensory room or a built environment intervention for, you know, stressed out college students and sort of what they gravitated towards in the built environment to help them through those critical times which is really exciting to see the investment in practices like ours, but across the industry at states, you know, organizations that are coming together, like the intentional spaces summit that was hosted by John Hopkins this past year. (Janet: right).

They’re coming out with an intentional network, and great findings that are bridging, you know, neuro architecture for the greater understanding and knowledge of all practitioners to view in their projects.

Janet: That’s amazing. I appreciate all that. And again, for the listeners, we’ll have all of that on our website on InclusiveDesigners.com. I’m getting a little bit aware of the time, and so, this has just been fascinating to me. I feel like this was a master class, quite frankly, in this particular world of design for crisis. and I can’t thank the two of you enough for coming on this journey today.

Is there anything that I’m missing? Anything that designers want to know? Was there something when you walked into this conversation, you thought to yourself, I hope Janet really asked me this. I want to make sure that I’m hitting on the notes because you guys have so much knowledge in this area. I want to make sure that, you know, we help to send that out to other designers.

Robyn: Sure. You want me to go first, Steven? (chuckles)

Stephen: Yeah, yeah.

Robyn: Yeah, I mean, I think we’ve touched on a whole lot of stuff today. Kind of a lot of the key design pieces of these types of facilities. I mean, I think for me, the biggest thing is just, I want to help kind of reduce that stigma. (Janet: yeah). Right?  I want to be part of that solution that we could all find ourselves in a situation of needing help at any time, right? (Janet: right).

And my biggest hope working on these types of facilities is to make this a conversation, you know, that it’s not something to be scared of talking about. And that it’s okay. We could all need a place like this, and let’s design places and have places that are healing and kind of support people.

Janet: And support people. How great is that, right? And Stephen, what about you? (Stephen: hmmmm). You can totally say no. And I am A-okay with that. (laughs).

Stephen: No, no. I would say that we strive really hard to design for dignity. And, you know, we balance and harmonize the evidentiary with the empathetic. (Janet: yeah). Right? So, I think we often rely on as designers, this kind of experience we have in the past. But, you know, really championing that lived experience, talking to those individuals in crisis, the family members that have endured it with them, and not make assumptions. And not, to Robyn’s point, let stigma really drive your design decisions. Because every design decision will help or hinder an individual in crisis. And we have a responsibility as designers to do better.

Janet: Yeah. I completely agree with you.

Robyn: This was really nice to be able to hear all of the things that you’re doing that I don’t understand as a person who’s not a design person, and how you’re bridging those gaps in peer support and all of the different things that we’ve been working on as advocacy on this end is making it into the design world. And it has been, but we weren’t aware of it.

So it’s really cool to be able to hear it from the other side, and being able to sort of, see the gaps being bridged. Like that’s exactly what we’ve been trying to do for a long, long time. So it’s really cool to be able to hear it. And there’s a lot of stuff I have to learn yet as well. I was thinking about the blue light thing, because we have in our bedroom, we have lights. I try to make my house into like a sensory house, I don’t know what I’m doing. And then I was like, wait, blue light raises cortisol, and I’m looking at it before I go to sleep. Uh oh!

So like, I find blue light calming, so I thought it would be cool. So like, now I’m like, googling it while you guys are talking.  (Janet: laughs). Well, I’m in, I love learning. (Stephen: um-hmm). So, (Janet: yeah). Well, it’s, it’s fascinating to how something like that can have such a huge impact. You don’t even know it. Right. You know, cause it’s just part of our, it’s just sort of the cycle of life, right? You don’t even realize it, but once you start looking at the science of it, it’s pretty amazing.

Stephen: And that’s just one sense. I mean, we’ve had other like aromatherapy be considered and trying to like get people into a specific mind space, right? Or that trigger of a nostalgia to kind of help them with fixation. we’re doing a neurological institute for Cleveland Clinic and, you know, they’re exploring research around psychedelics. So there’s all kinds of, of, of fun, interesting things going on in the world. (Janet: yeah, wow).

Yeah, I mean, I think there’s, I was doing a behavioral health clinic in Lake Tahoe area. And so we have all these beautiful, like local photography that we commissioned. And so we’re doing renderings of it and it’s a group room and then some break rooms for staff and that kind of thing.

And it’s these majestic mountain ranges. It was snow caps. And they’re like, ‘It feels very cold, and it’s a cold part of the world. You made an assumption about kind of our landscape geography, but it doesn’t kind of fit our culture as a provider organization.’ But you know, that’s part of the conversation, not to make those presumptions and kind of listen.

Janet: Right. It’s funny you should say that. So we, the Trauma- informed Design class that we had, in the front we had all this stuff about you know, if this is too hard for you, please stop. Well, you can come back, you know, like it’s recorded. It’s not like a one-time thing, or, you know, if there’s real issues, contact us or the suicide hotline.

And then at the end we would have this, let’s bring down the stress levels, let’s do a little Zen kind of thinking. And we would have an image and it turns out like Christine and I both were like, well, we should get the one with the mountains with the snow on it. We’re both skiers. So for us, that was sort of in our mindset, right. And then I’m like, we probably should put a beach in there. I think some people might want the beach. They seem to like that. So it was a very humorous comment. (Robyn: laughs). (Stephen: um-hmm).

Robyn: Yeah. I, you know, I did a facility, it was children’s hospital. It was MRI. We use the ambient experience, right? And you know, research shows, you know, oftentimes children will need sedation in order to get into the, do the MRI (Janet: right). And that it actually reduces it.

And it’s like they have this selection of, they can create this whole world, right? You know, they can create a jungle or an underwater, whatever. I mean, it’s pretty amazing. (Janet: right).

Stephen: Oh yeah! There’s a new product that basically lets you preset so you can change the lighting, you can change the wind, the temperature system. (Robyn: yup). A couple other settings of like the features in the room so you can kind of make it… this is a rainbow; this is a spring day; this is a fall; this is, you know, pick something. And then I think that goes, you know, back to like, ‘Hey, we can dial this in a lot better nowadays, if the product is well supported and, and kind of thought through’ and presumably we’ve got, we’ve got the budget as always.

Robyn: Well, there’s that, that’s the key, yes. (laughs).

Janet: There’s that, (chuckles), I know. It’s nice, but you know, it’s a little expensive. but yeah. (Stephen: chuckles).

All right, so I do have one last question. But you know, I can’t go into my doctor’s offices, wherever it is, and I sit there, and I look around, and I’m like thinking to myself, ‘are you kidding me? Come on, like you can do a lot better.’

And it’s interesting to me that at the moment, it’s not all, I’m not talking about like the, the newer high-end hospitals, right? I’m talking about just going to like you know, the local dentist, the local eye doctor and stuff like that. And I just, I can’t understand it. Like the gynecologist. And I would, I’ll tell him things like, you know, listen, you can just put something up on the ceiling, you know what I mean? To distract what’s going on. (Robyn: yup), you know, some pictures of biophilia, something, anything.

And, actually with my gynecologist, there’s a, it’s a frosted window and it’s a frosted window and you can’t see in, but it’s a window to one of the exam rooms that’s behind the table. (Robyn: not what you want. laughs). They now don’t put me in there because I’m just, I am, I’m like triggered by the fact that they thought this was reasonable.

And I said to them, a couple of times now, I’m like, listen, I’m more than happy to like, I’ll go to Walmart. I’ll get our little spring rod, like put some curtains there. You know, it’s a simple solution to fix it. But I was just, I don’t understand, you know, like there should be more stuff like in medical journals. You know?

Stephen: As a member of the American Association for Emergency Psychiatry, I will say that there is very little thought given to the education of clinicians that I’ve seen, to like, these kind of spatial environmental factors. (Janet: yeah). They will definitely point it out if it’s like, yeah, it’s lead based poisoning; or it’s nutritional factor; ‘Oh, wait a minute, you have a vitamin D deficiency. You should probably get out and get some sun’.

And so it’s, it’s fascinating. I’m usually the only architect at these things. And they’re just like, why are you here? I’m like, well, I’m learning from you and hopefully you’ll learn from me, because I want to know how I can better design the spaces for your patients, and for your acute needs. And hopefully you’ll see an example of how for your next project to do something a little differently, a little better. You see in dentist’s office all the time is like the goldfish tank, right? People can just look at that thing all day.

Janet: Right, well, it’s true. I mean, yeah, and it, it always drives me nuts though, that, you know, I come back like the next year or dentist maybe every 6-months or so, they’re not sitting there and like, ‘Oh, we, we took you up on your offer. You know, I’m like more than happy to help let’s just go do this, you know.

Robyn: Yeah. I think it’s just a lack of understanding of how impactful that stuff really is, right? (Janet: bingo). You know, I mean, I think clinical doctors are so focused on their specialty and what they’re really good at, which we need them to be, right? (Janet: right).

But we also have to look at the holistic approach that I think just often gets missed, you know, like that, that emotional reaction to an environment is part of whatever’s happening to your health. You know, it’s so intertwined. And I think we just don’t give that enough credit, honestly. (Stephen: yeah). It’s like, I fixed your leg or I’ve whatever, (Stephen: um-hmm). So everything’s good. But that whole experience of getting my leg fixed is part of that journey for me, you know, and it just gets missed, unfortunately. (Janet: Yeah).

Stephen: You know, they say break a leg, so… (all laugh).

Janet: Oh my goodness. You guys, I have taken up way too much of your time. This has just been quite amazing. I just got chills. Like you guys have been just so wonderful and thank you for your time today. And we just could not be more thrilled that you came today and shared your knowledge and, you know, please come back. We’ll talk about this again, whatever you would like. (Stephen: laughs). I mean it was really, really, you guys know your stuff. Like, there is no ifs, ands, or buts. (Robyn: laughs). So, I really appreciate it. Thank you so much.

Robyn: Absolutely. It’s been a pleasure talking with you. Appreciate it as well. (Janet: great, thanks).

Stephen: Yeah. Thank you again for the opportunity to share.

Janet: Yeah. Thank you. Have a great day. Bye-bye.

(Music / Outro)

Janet:  As a designer, I find this information really exciting to talk about. Good design really can make a difference in mental health treatment centers.

Carolyn: As Robyn said, “the built environment needs to support healing, and typically, it has not.”

Janet: And it’s also about creating trust and showing that we are trying to treat them with dignity. And to be sure that nothing in the environment will re-traumatize them.

Carolyn: seems like that in itself can really make a difference.

Janet: Yes, you’re right. Creating a welcoming environment that gives clients or residents autonomy over their space, and surroundings, is key.

Carolyn: And as Stephen mentioned, it’s important to remember to keep the mental health of the staff in mind too, with spaces for them to decompress. Be sure to let the stakeholders know that this will help with staff recruitment, retention and to mitigate burn-out.

Janet: You are so right Carolyn. This is such an important piece of information for all you designers out there. If the stakeholders do not address the staff’s mental health within the built environment, you can have the most beautiful design in all the world, but it ultimately won’t be as effective to those in crisis.

And I was very happy to hear that a lot of what Stephen and Robyn are doing follows the Trauma-informed Design and SAMSHA principles.

Carolyn: And of course, if you need more information on these, you can find it on our website.

Janet: Absolutely! And we will also let you know how to contact Robyn and Stephen, and provide links to the projects they mentioned, as well as many of the other things touched on during this discussion… all on our website at: Inclusive-Designers-dot-com.

Carolyn: That’s: Inclusive-Designers-dot-com…

Janet: A big thank you to Robyn and Stephen! And, again, to all of you for listening.

Carolyn: Along with all the regular places you get your podcasts— such as Apple, Google, Spotify, and Pandora— you can also find us on YouTube as, you guessed it again, Inclusive Designers Podcast. And of course, if you like what you hear, feel free to go to our website and hit that Patreon button, or the link to our GoFundMe Page.

Janet: Yes, please do. And let us know if you have any questions or suggestions for topics we should be covering in upcoming shows!

And as our motto says: ’Stay Well…and Stay Well Informed’!

As always, thank you for stopping by. We’ll see you next time.

Carolyn: Yes, thanks again!

By: Janet Roche & Carolyn Robbins

The Ins and Outs of Urban Design   (Season 5, Episode 3)

Inclusive Designers Podcast: What are the best practices for Urban Design? Whether it’s getting around in our cities and streets, or within the buildings where we work, IDP explores the barriers that exist every day in terms of accessibility!

Guests Meg O’Connell and Steve Wright share their views on urban design for disabilities in the workplace and beyond. Plus how to create spaces that work for everybody- without special considerations or accommodations- because they’re already built into the environment. And pet peeves? Yes, they share them too!

Guests:

Meg O’Connell – is the founder and CEO of ‘Global Disability Inclusion’. She is an award-winning disability inclusion expert who provides strategic direction, design, and implementation of disability employment and inclusion programs. Her clients include Global 500 companies, plus foundations, universities, and nonprofits.

Meg is also involved in disability employee research.  She co-authored ‘The State of Disability Employee Engagement’ to help companies understand the workplace experiences of their employees with disabilities.

Meg on Accessibility- “It’s not a facilities issue. Not a building issue. Not an maintenance issue. Everyone has a responsibility to it”

– Contact (LinkedIn): Meg O’Connell

Steve Wright – is a educator, communicator, and award-winning journalist who is an advocate for positive change. He has presented on design issues and solutions at national conferences, and advises clients on diversity, equity, inclusion, and accessibility. As a storyteller, he creates content for major non-profits and corporations.

Steve believes in creating a better built environment with a focus on inclusion, dignity, and non-segregating design for people with disabilities.

Steve on Design- “The COVID pandemic has proven that the way we build and plan must be safe, accessible and inclusive for all.”

– Contact (LinkedIn): Steve Wright

– References: 

– Articles: 

The Ins and Outs of Good Urban Design

(Music / Open)

Janet: In this series we will be discussing specific examples of design techniques that make a positive difference for people living with certain human conditions.

Carolyn: The more a designer understands the client and or the community the more effective and respectful the design will be.

(Music / Intro)

Janet: Welcome to Inclusive Designers Podcast, I am your host, Janet Roche…

Carolyn: and I am your moderator, Carolyn Robbins…

Janet: We have a lovely show for everyone today! We will be discussing the benefits of urban planning with an inclusive focus. We’ll also explore the barriers that exist every day in terms of accessibility when designing buildings that meet employee’s needs… from the outside on the street, to the entrances, and all the spaces within.

Carolyn: … like kitchens, conference rooms, and of course, bathrooms to name just a few.

Janet: We are honored to have not one but two dynamic guests with us today. Meg O’Connell & Steve Wright to talk about designing for disabilities in the workplace and beyond.

Carolyn: Before we hear from them directly, let me tell you a little more about our guests…

Steve Wright primarily calls himself a Storyteller— which he is— but he is also an educator, award-winning journalist, and advocate for positive change. He has presented on Universal Design issues and solutions at national conferences. And advises clients on diversity, equity, inclusion, and accessibility.

Janet: In all these roles, his goal is to create a better built environment with a focus on inclusion, dignity, and non-segregating design for people with disabilities.

Carolyn: And we also are delighted that Meg O’Connell is joining us. She is the CEO & founder of Global Disability Inclusion. Meg is an award-winning disability inclusion expert who provides strategic direction, design and implementation of disability employment and inclusion programs. Her clients include Global 500 companies- including some of the world’s most recognized brands- plus foundations, universities, and nonprofits.

Janet: Meg is also involved in disability employee research.  She co-authored ‘The State of Disability Employee Engagement’ to help companies understand the workplace experiences of their employees with disabilities.

Carolyn: I think you can see why we are so excited to get their views on this topic. Steve and Meg will share their pet peeves and advice on what designers can do to design it right the first time.

Janet: I wanted to have them on together because they both have a lot to say about urban design and workplace challenges for disabilities, but from own perspectives.

Carolyn: We think you’ll agree. And with that, here is our interview with Meg O’Connell & Steve Wright…

(Music / Interview)

Janet: Hi, and welcome to Inclusive Designers. I’m your host Janet Roche, and with me today I have Steve Wright and Meg O’Connell. Thank you so much for joining us today. How are you?

Meg: I’m great.

Steve: Yeah, great to be among friends old and new and just sharing lots of practical advice to good folks.

Janet: Great. Thank you. It’s more a natural conversation as opposed to a specific set of questions… so let’s just dive right on in.

I noticed that like, you guys have a lot of different hands in a lot of different pots, we could talk about that. Maybe talking a little bit more about universal inclusion within urban settings?

Steve: Yeah, but certainly let’s definitely try to steer things, because Meg’s expertise is, you know, employment and training and inclusion on that end. And let’s be honest, it’s no exaggeration that there’s like 10 different databases or stats from Fed, etcetera, that show that people with disabilities are still under and unemployed compared to education or ability. It’s not the underlying disability, which most of the regular world thinks, it’s a lot of times the filling the gaps. Is there accessible housing? Is there accessible transportation? Can you cross the street safely? (Janet: right). So it, to me it all folds together pretty well.

Janet: Yeah. Right. So of the two of you, is there anything you’d like to promote on this show? Meg, is there something that you would like to touch on and let our listeners know?

Meg: Yeah, and I think Steve mentioned it. The bulk of the work that we do is with companies and creating accessible and inclusive work environments. So when Steve talks about urban planning, it’s getting around in our cities and streets. And for me, it’s access in our buildings where people are employed. (Steve: um-hmm). And do we have the right universal design concepts in most buildings? (Steve: hmm). The answer is no, (Janet: no, chuckles), to ensure that this space is open and available to everyone.

And ultimately that’s what we want. We want environments that work for everybody, and we don’t have to have special considerations or accommodations made because they’re already built into the environment. (Steve: right).

Janet: Yeah, in terms of universal design. Right? So, maybe we could talk about the idea of what I saw in both of your postings in Miami— by the way, just for the listeners, love Miami. Miami’s amazing. Miami’s great. especially in terms of architecture too? (Steve: mmm). Right? Like some of the art deco areas, just incredible — but there was a particular building that you both had kind of pointed to, which was the health services building right there in Miami. (Steve: yeah). And Steve, you actually went there and documented it. (Steve: yeah, yeah), Can you tell us a little bit about that?

Steve: Sure, sure. And again, just, you know, to me, Universal Design— I should give credit. The person that founded that is a fellow by the name of the late Ron Mace. He’s passed away. He was a post-polio person. Brilliant fellow in the American Institute of Architects. Brilliant person. Wish I could have collaborated with him, but, you know, I think it’s really well worth it for every listener to understand that, you know, he probably could have called it “fella in a wheelchair” design or “disability community” design, but he picked universal.

As a marketer, I praise that. But I think it showed that, you know, getting around, being able to cross a crosswalk safely, whether it’s grandmother who’s a slower walker but doesn’t use a wheelchair and doesn’t view herself as officially disabled, (Janet: right), whether it’s small children. You know, I even wonder why we have these 30-second crossings instead of 45-seconds. (Janet: right). Because if a little 8-year-old starts to dart back, you’re stranded and here comes a wave of 3-lanes of sedans plowing at you.

Janet: Right, getting ready to plow you over. Actually, I just saw it this weekend too. New York City, 5th Avenue, as soon as their feet are kind of touching the ground on the street, like you can see the thing starting to blink already. And then there’s a whole panic, right? (Steve: right). And this kid is on one of those little razor scooters and poof, literally right in the middle of the road. And we’re down to like 5-seconds (Steve: right, right). And the kid is sprawled out, you know, I mean, thank God the kid was okay, but… (Steve: Right).

… and meanwhile, I’m trying to get my father, my 88-year-old father, across the street on the other direction. And he’s decided because the little ramp that they have there was all torn up and he didn’t like it. So he’s now going out into the traffic and around the bend in order to get back on the other side. (Steve: mm-hmm, mm-hmm). So, I mean, just to your point, right?

Steve: Yeah, yeah, you could almost call it ‘welcoming design’ or ‘comfortable design.’ (Janet: right). And I, unfortunately, there are some architects and planners and engineers that push back and feel like, “well, we didn’t do this when I was growing up. Why now?” And I always point out, it’s comfortable. It’s not like it’s some special interest.

Yes, certainly, if there is not a ramp, a person with a wheelchair can’t get in most likely. And they do not want to be carried because their mobility device is an extension of their body. So it almost be like grabbing you by the rear end and the throat to carry up the steps, but…  (Janet: chuckles).

Yeah, but again, it’s just, I don’t think anybody, I don’t think Michael Phelps from the Olympics won all the medals, I don’t think anybody that, all of a sudden balloon up to 500-pounds because there were curb ramps or safer crosswalks or wider sidewalks or buildings that had welcoming entrances. It’s just this, I like healthy design, but there’s almost like this mythology that if we build it accessible, we somehow cut off exercise, which is kind of silly. (Janet: really?). Yeah. (Janet: huh).

Meg: Well, and I think Steve, to your point, the flip side is the aesthetics. (Steve: yeah). Architects are really proud of what they design and interesting features. (Janet: right). And they’re afraid of putting a wheelchair ramp in the front of the building, instead of behind the building, (Steve: mmm). will somehow take away from the appeal of what the building looks like, (Steve: right). (Janet: the aesthetics). The aesthetics of the building. (Janet: right).

And universal design marries design and function. (Steve: right). So the challenge really for architects is how do you create something that’s beautiful that is also accessible. (Steve: correct). And the most people possible have access to enter your fabulous building that you’ve created. (Janet: right). Or even the boring office building you’ve created. (Janet: laughs, yeah).

Steve: Yeah. No, you are so correct. And I have seen mosaic tiles. I’ve seen plexiglass that you see through. I, I don’t want to be mean at all to my brethren, but if you think you can only build the Spanish steps or, or some replica of it and everything else is second class, (Janet: right), or VA hospital (Janet: hmm), and smells bad and is dated and all has to be painted gray and ugly, (Janet: chuckles), you’re, you’re not a good designer. (Janet: yeah).

You know, I mean, again, forgive me for riffing, but here in Florida, we have sea level rise issues and hurricanes and horrible stories. Yeah. Every building here, even the retrofitting, the older ones, you better be out of the flood plain. You better be resilient for even no name storms that are going to dump a ton of water. (Janet: yeah).

Yeah. That might alter what they did 80-years ago. That doesn’t make every one of those buildings poisoned and terrible. And we were talking before about the cold of the North and the heat of the South. So you, you know, there were ancient buildings that were built before air conditioning. Now you’ve retrofitted. Nobody says, ‘Oh my God, it’s so horrible because there’s a compressor on the roof.’ So…

Janet: Right. Those are excellent points. Steve, I love that. I mean, it’s very simple, right? We do that all the time.

Steve: Yeah. Design is fluid (laughs).

Janet: Right, yeah.

Meg: Totally. And Steve, I know you and I have talked about this. Steve and I are both in different parts of Florida. (Steve: yeah). And Florida is the, you know, retirement capital — Arizona’s coming up strong behind us— (Janet: laughs), for the retirement capital of the United States. Less than 1-percent of the homes are built for accessibility. (Steve: right). So you have an aging population that are building houses and they don’t know any better. They’re not thinking 20-years from now, I’m not going to be able to use the stairs. (Janet: right). They’re thinking “I’m 60, I’m retired, I’m going to move near the beach,” and our builders aren’t thinking about it. (Steve: right).

And my husband and I live in an older home and we’re likely going to tear down at some point. We’ve started talking to builders. And every time I talk to a builder and say, ‘this is our aging in place home,’ (Steve: mm-hmm), ‘we’re going nowhere else after this. We have to talk about universal design concepts.’ (Steve: mmm).  Three builders. ‘What’s that?’ (Janet: gasps, wow). (Steve: right, right). ‘Do you mean ADA.’ ‘No, I mean better than ADA.’ And they just don’t know. (Janet: Wow).

Steve: Yeah. Boy you, you really throw out a perfect point, Meg, (Janet: yeah), because, uh, there’s so many contractors and architects that they, even when you tell them what you want, they want to push back. (Meg: mm-hmm).

I did an interview within my past year, year or two. There’s a woman by the name of Patricia Belmont, I believe she’s in the Texas area. Belmont Senior Living, you know, I wish I had one-one-hundredth of her pocketbook because I think she’s become very wealthy building senior housing. And very interestingly, there’s 2 things, instead of that idea of building in the middle of nowhere with cheaper land, she’s filing building vertically.

Now it is in major cities, but you know, like the one in Miami, it’s going to have a health system connected right to it, so you can have your urgent care and checkups. And it’s right by a rail station, which sometimes people say, ‘Oh, that’s so urban and frightening’ but people want to get on the train, and they’re recognizing that maybe in their mid-seventies they might not be good at driving (Janet: yeah), or they might already have low vision. (Janet: right).

And the other thing she told me, that her like marketing and design people said, ‘Oh yeah, people don’t want to think of disability even if it’s around the corner. They want to be healthy. You know, when you sell these communities that charge 5-, 6- thousand a month, you want it to be sexy, and you’re pretending you’re 38-years old or what have you, even if the client’s 68.”

And they built tub showers. (Janet: gasps, groans). And they had some folks with some falls, and I’m sorry, she, it was sort of like, you know, the A-wing had walk in, roll in and the B-wing had tub showers. And when people started seeing the ease of transfer and the ability to just walk in, you know, and they had like rain forest shower heads. Again, it wasn’t, the VA hospital substandard, hadn’t been upgraded since the 40’s or something. It was sexy. It looked like an Aloft hotel or some cool thing. So they ended up, you know, they spent money to, (Janet: to make money), yeah…

Janet: … but to make money, and to make their residents happy and to have them stay. (Steve: yeah, right). And therefore with them staying, then the prices go up (Steve: right), because it’s a desired area, desired neighborhood, desired building to go into. (Steve: yeah). So yeah, I’m with you all the way on all of that. And so it’s an important piece. (Steve: yeah).

And I actually saw this old house, and they were showing an accessibility house and I crossed my arms and said, ‘okay, show me.’ Do you know what I mean? Like, I knew very well there were going to be issues. There were but there were very few and it was a very sleek and modern building. (Steve: yeah). It had a beautiful facade that you would never even know that there was a __ ramp there. And their daughter wasn’t necessarily in a wheelchair at that time, but they still put in an elevator. They put in a curb-less shower for her.

Again, there were a few details I think could have been changed. (Steve: hmm). And maybe they would be at some point or an easy retrofit at some point if she is in a wheelchair. But, you know, I probably try to contact him at some point because I think he’s a local guy. He did a really nice job. And that’s not always the case.

And Meg, I’ll tell you, it really blows my mind that none of the contractors in Florida wouldn’t know… you know, what does it take? Maybe 3, 4, 5-years ago, okay. (Meg: yeah). You know, it was just kind of burgeoning, but I feel like now that’s a little… it’s frightening. (Meg: right). (Steve: yeah). Right.

Meg: Well and what ends up happening is what nobody wants, right? You have to leave your home when you need care. (Steve: yeah). You can’t bring the care into your home because it’s not accessible for you to get into a bathroom if now you’re using a wheelchair or walker, or your doorways aren’t wide enough. (Steve: hmm). And so if you need additional support— even if it’s temporarily maybe due to a fall or something that’s longer term, a serious illness— you’re going to be forced to leave your home because it’s not accessible. (Janet: right). And we all know, some of those facilities are great, but the majority of them are not. (Janet: right). And nobody wants to be in any of those places. (Steve: hmm).

Janet: Right. And I’ll also take a step further with that, because then now you’re taking the generational wealth out of your family. Right? (Steve: yeah). That nest egg that you built for the house, within the house, now gone and you’ll have to, I mean, unless you’ve done some super planning, (Steve: yeah), but some of the times these things happen like this (finger snap). (Steve: right). And you will have to go sell your house and then give the money to the people that are taking care of you, (Steve: correct), instead of your, you know, children, your descendants who, that’s their inheritance that then they can’t get a leg up on. (Meg: yeah, that’s true).

Steve: And there’s so many simple solutions, you know, even just like a barn door, which, you know, you pick up a design, you know, whether it’s a real high or a mainstream design, and, you know, those are all sexy and cool. And just having one of those for your kitchen, but, you know, if they’re mounted, right, you can almost move those with a little finger. And that might replace the swinging door with the hinges because sometimes those 3-inches of hinges block the wheelchair or block the assistive mobility device. (Janet: right).

I’ve even seen conference rooms, you know, switching over to Meg with what she’s done with clients for helping people self-declare and, you know, getting good employees to be great employees because they’re comfortable with the accommodation they need. But even a conference room that has a wider entrance or isn’t clogged with furniture, (Janet: right),

You know, heaven help the person who thought, ‘Oh, you know, disabled people are only a charity case,’ and then your client rolls in in a chair and they’re the richest person from Columbia, but they leave miffed because they couldn’t get around or they went down the hall to an inaccessible restroom. You’re not going to get the commission from them. I don’t care whether you design widgets or you’re a big four accounting firm, You’re just, you’re not. So, if you want to take it from there, my friend (chuckles).

Janet: Right, or at the least you’re going to be extremely embarrassed. (Steve: yeah). I think the clogging of the accessible bathroom as storage (Steve: yeah), as always, one of my favorites, it’s not necessarily a design faux pas, but it’s just people going, ‘Oh, look at this big room. You know what? We should, we should put paper in here. (Meg: yeah). We should put paper and extra chairs in here. Right. And maybe a table or two.’ Laughs. (Steve: oh yeah).

Meg: Well, and years ago, this is going back decades, I worked for a regional bank, and we had an employee who was a wheelchair user, obviously looking to use the accessible stall. And time and time again, he would go in and there’d be other employees in there reading the newspaper in the larger stall while they did their business. And so we, you know, HR sent out several notes, please be respectful, don’t do this. So, and then of course people were still doing it. So then we had to put a lock on it (Janet: aw geez), and only the employee with the wheelchair had the key (Janet: had the key), or the janitor, (Steve: yeah).

And so it’s just about being respectful to the accessibility components that are in place. (Steve: yeah). And not using the stalls if you don’t need them because it’s roomier and you have a little bit more room for you and your suitcase and your purse or whatever else. I mean, we’ve all been guilty of it…

Janet: We’ve all, I was going to say, guilty as charged, right?

Meg: Yeah. Um, but you know, don’t do it. (Steve: right?).

Janet: Don’t do it. I know. Well, you know, but that goes back to also designing bathrooms correctly, right? (Steve: right). Like just in terms of universal design. And I, I love the Europeans, when they get to the United States, they come and there’s even like a little bit of a gap between the side bar and the actual door and they’re like, you but you can see people in there.

And it never even occurred to me until somebody had pointed it out, because Europeans have more of a connected, like, overlapping piece of the door. (Steve: hmm). So, but we don’t even design those bathrooms correctly. And don’t even get me started on women, and the lack of the amount of bathrooms for women, as opposed to like, it’s even, and it’s like, ‘okay, but we’ve got, oh, other things to do.’ (laughs).

Steve: Right, you bring up a great point, Janet, it makes you wonder, like you go to an airport, you know, MIA is like a city within a city, you know, Miami International Airport. (Janet: it’s huge, right).

And there’s a lot of dead space there. And it just makes you wonder as you’re retrofitting, why not, you know, why not make 13 stalls that are all the universal design ones.

So then if it is, the privileged feeling businessperson with a right, maybe I’d understand, you know, if it’s a really old historic building with a small floor plate, you might be doing flips and twists to fit it. (Janet: right, right). But when it’s something the size of, feels like 20 football fields, (Janet: yeah).

And by the same token, you know, I, forgive me, this is one of my pet peeves. I’ll go to— because I’m kind of an activist— and I’ll go to a meeting and in the morning, you know, they’ll say, ‘dear madam mayor or madam city manager, we have immigrants and we have school kids in the summer’ and I don’t care if it’s, find 4-million in the budget and we’ll push a pile of sand from one end of the tennis court to the other for make-work jobs because we have people that need a J.O.B. (Janet: right). Kind of an honorable thing. (Janet: right).

I’ll go in the afternoon and say, ‘Hey, why don’t you bid 3- of those 4-million towards contracting for inclusion? Hire local because a lot of the labor can be doing it and a disabled person could be writing up who did the labor or tracking it so it could be inclusive’ and they look at me like I just switched to a language that was unintelligible.

And you’re thinking, wait a minute, at 10am you were ready to pay 5-million dollars to push a load of sand from one end to the other. Surely you could tweak this thing and do, you know, connect some of your sidewalks, build things that are more inclusive. (Janet: chuckles). I’m not that bright, you know, I don’t have to go to the Ivy league to come up with that answer. So why can’t you plug that in? it’s just weird.

Janet: Right. well, one would think we’re still working on it, Steve, as you well know, and you guys are working really hard to make some of those changes possible. So, I mean, it’s, you know, you talk about a pet peeve. I have a lot of pet peeves (Steve: hmm), and they’re usually around inclusive design. Do you guys want to talk a little bit about your pet peeves in terms of inclusive design and what they, people have done? They like, ‘Hey, look, here’s like the cutout for the sidewalk. It goes in the middle of the crosswalk and the street, but here you go’.

Steve: Well, I’ve got an all-time one and it, I checked, it’s in all 50 state building codes. And I’m not saying, you know, nothing’s an absolute, right? I mean, just like we said, there may be a historic property or very old building you want to save with a small floor plate. (Janet: right), So it’s not like it’s across the board, but I don’t, I think the company someday will probably sue me. I’ll open up my mail and get some ding letter, (Janet: cease and desist), but limited use, limited access lifts.

And again, I mean, that’s a little bit of inside baseball for some listeners, but they’re sort of those outdoor elevators. They’re very small and I’ve yet to see one that’s not key operated. Well, you think about it, you know, is it the doorman? Is it the janitor who can… the key goes missing within 6-weeks of it being deployed. And they tend to be used in very urban areas. And unfortunately, like South Beach, if there’s something like that, it becomes where the beer bottles get thrown or where, you know, someone uses it as a de facto bathroom when they’re 3-sheets to the wind. (Janet: yeah). It just, it happens, and you can’t use it and it’s the only way of getting in.

So you basically, you might have built a mixed-use thing with, you know, 20 restaurants and 10 bars and everything. Basically, you might as well just say, you might as well just fly an airplane over with one of those trailing ads on the beach saying, you know, we intentionally discriminate against people with disabilities with mobility issues because it’s not going to work. (Janet: laughs).

I talk to architects, and I say, ‘well, why do you do this? And they said, ‘well, it’s in the code and it passed inspection.’ (Janet: yeah). And I said, ‘but I’m a living, breathing person telling you it’s going to fail. Would you, you know, if you built a roof for a skyscraper out of laminated cardboard and somehow it kept the rain out on inspection day and passed. Would you go home knowing the roof is going to cave in on your 38-story building and say, ‘ha ha’ (Janet: oh, well), you know, ‘we passed at noon when the inspector’ (Janet: we passed the code, right. chuckles), yeah, the inspector waddled over for 20-minutes at noon in March. It’s, you know, it’s good. No, because your clients would shoot you.

So why, why… again, maybe, I’m just feeling like that those kinds of lifts should be by a variance where, you know, you’d have to prove that it’s a super narrow lot and it’s a tight lot. And I think some designers put it in because I’m guessing, you know, a little turn ramp doesn’t have a big markup if you sell them 3, 6-thousand-dollar lifts, you probably make, you know, you probably mark it up. I hate to be so cynical, but the design firm probably puts a little markup on that. So they probably love them. (Janet: yeah).

Forgive me for rambling and I will shut up, but, Michael Graves, the late architect, very famous modernist architect, happened to get a viral infection that invaded his spinal cord and used a power wheelchair for mobility for about the last decade of his life. He taught at University of Miami, so I got to meet him and there’s literally a thing that was called ‘Ocean Steps’ at the very top of world-famous Ocean Drive in Miami Beach.

And when he was the able-bodied multi-millionaire star architect, he built 3 of those LULA lifts, which completely fell apart within about a year of— a year is probably being generous— within a month of installation. So, you know, whether it was Starbucks coffee or the Russian caviar place, you couldn’t go to them and your families couldn’t. (Janet: yeah).

So anyway, he was one of the few people within his lifetime retrofitted and spent time building all kinds of product design with fatter handles and easier to move paddles. So he, he’s probably one of the few that sort of got to undo his sins while he was still rolling about the earth. (laughs).

Janet: That’s actually really interesting. I would like to hear more about that at some point. (Steve: yeah), like, because I think, you know, to your point, it was an architect going back in and kind of scrubbing down, you know, like you said, the sins that he had created which, sometimes you have to spend a, just even a little bit of time, you know, in somebody else’s, in this case, maybe a wheelchair or whatever, (Steve: oh yeah), just to have that ability to be like, wait a minute, maybe this isn’t working. (Steve: yeah, yeah).

I know that I’ve told this story before on the podcast, which is, I teach over at the Boston Architectural College (Steve: yeah), and not only when I was a student there getting my master’s, but also when I taught, one of the best things we ever did was to take a wheelchair and go around the city of Boston.

Now I know it’s controversial because, you know, it’s one of those things where, like, the person in the chair could go and easily stand up and take care of, whatever it is they need to do. (Steve: right). But, you know, there were definitely some eye openers there that were just incredible. (Steve: right).

And I think, I mean, I know it stuck with me. I know it stuck with the students. And we also had, like the dean come with us on one of the trips and we were trying to find the accessible way to get to the T. (Meg: yup). And this is the local subway system around here in case you don’t know. (Steve: yeah).

And he could not fathom that there wasn’t an accessibility at the train, this particular train station on Mass Ave here in the Back Bay. (Steve: yeah). And he just, I let him do his thing. Right. I let him walk around and he’s like, ‘well, it’s got to be over here.’

We went into Target, got into the elevator in Target because it’s over the subway and he’s like, ‘well, you got to press the button and go downstairs’ and there was no button to press. I mean, I went with him to, you know what I mean, to go through this process and he just couldn’t imagine it. And then, you know, it’s the wintertime, so now we have to walk and or then push the person in the wheelchair a mile (Steve: hmm, hmm) to get to either train station. And this is right in the heart of Boston.

And now I know that they are changing that. They’ve redone a whole bunch of stuff in that particular area and part of the promissory note was for them to go and change that train station which should include some sort of accessibility. (Steve: yeah). If not, I’m going to be very upset. (Steve: hmm). But yes (laughs).

But anyways, I mean, so Meg, tell me a little bit more about your experience, you know, talk to our listeners, and tell us a little bit more about the work that you’re doing, and maybe how other designers could get involved.

Meg: Yeah. So the work that we do is primarily with companies to help them create better workplaces for people with disabilities. So that covers everything from policies, programs, procedures around inclusion at the different touch points that companies have where they engage with their employees— from recruiting to onboarding; to learning and development; and performance management— all of those things.

And it also includes digital accessibility and physical accessibility. We have a client now who wants a physical accessibility audit. They’re in a new building. They don’t own the building, but they want to make sure that the 4 floors that they are on are in fact accessible and so that they can share their expectations with people that own the building. So we’re really helping companies move to that more inclusive design in every aspect of their business.

So, we see it all the time where companies don’t have an accommodations policy for employees that may need either different digital equipment to help them perform better at work, or just even, you know, not thinking about— I think you mentioned it earlier— having conference rooms where there is open seating for people with wheelchairs, you’re not having to move furniture around.

Making sure that people know how to turn on the captioning in the meetings, so, you know, people that maybe are hard of hearing, or English is their second language, or ‘Hey, I just didn’t catch what they say, but I can see it in the captions.’ (Steve: hmm).

We all watch movies with captioning on now, right? (Janet: laughs. it makes it better, right). You know, people are watching videos at work with the captions on, so they’re not interrupting their coworkers. In some ways, we’re seeing universal design components ramping up, like in the captioning example, that’s gotten a whole resurgence. Captioning meetings that became a real thing during COVID.

And so we’re seeing companies adopt those as standard operating practices now to be more inclusive to everybody. So that’s great. We still have largely organizations thinking a person with a disability is a person in a wheelchair, (Janet: right), and we’ve kind of done that to ourselves, right? (Janet: we have). We got the iconic wheelchair symbol everywhere.

Janet: I was going to say the iconic wheelchair, right? Yeah.

Meg: But you know, 1-in-4 adults in the U.S. has a disability (Janet: right), and 80-percent of those are invisible disabilities. So, you know, we tell folks, we coach both employers and employees, ask for what you need. It doesn’t always have to be about your disability.

Say things like, you know, we tell folks with dyslexia all the time that don’t do well with, ‘Oh, we’ve walked in a room, we’re handing out a 10-page PowerPoint deck. Now we’re all going to discuss it,’… that’s not going to work for somebody with dyslexia that really wants to engage but doesn’t have the processing time.

So, ask, ‘I need materials at least 24 hours in advance.’ You know, what do you need in your workplace to make it better for you? And then as employers and managers are getting those requests, they’re going to know what works better for their team. And bottom line is it’s not just the person with dyslexia, everyone wants that PowerPoint 24 hours in advance. So they have time to read it and be prepared with questions. Come into the meeting with something that’s thought provoking. So we’re really trying to encourage more things like that, where tell us what you need, let’s accommodate you that way, and let’s create better workplaces for everybody.

But I think that the biggest obstacle that we’ve been talking about is the retrofitting of buildings. You know, we don’t have folks thinking about that as much as they should. And then, you know, things are broken all the time. The automatic manual door goes out or I’ll see signs up that say only employees who need this should use it, so not to wear down the motor. But meanwhile, everyone wants to use it because they’re bringing in, you know, bags and suitcases and briefcases and heavy things and they have things in their arms and hitting it with their hips, so the door opens for them. So they don’t have to struggle to get in. That works for everybody.

It’s not just about the people with disabilities. So I think for full circle, it’s about how do we create universal design, meaning how do we create our spaces that work for everybody? (Steve: yeah). And the workplace is an area where we really need that commitment to creating workplaces that work for everyone. (Steve: right).

Janet: Yeah, right. A lot of people who are disabled for one reason or another might not be able to get to work or to be at work. I think there’s some more grace period now because of the fact that we can zoom and stuff like that, right? (Meg: um-hmm). So we’re not as tethered to the old desk and chair. And well, for at least a good 30-years, the cubicle, (Meg: yeah, laughs), approach that I think we probably all suffered through at some point. I know I did. But it’s, you know, it’s such an important piece, you know, and it’s also about leveling the field of equality. And so that’s a really important part of all this. (Meg: yeah), (Steve: oh). Steve, you want to jump in?

Steve: Yeah. (Janet: yeah). You hit the perfect nerve here with the leveling the playing field thought. (Janet: laughs). I think we open with this image that I like to share of the, it’s basically the board of health building for Miami. And a lot of the people that go to it are lower income, not everyone, but it’s, you know, it’s part of the safety net for inoculations and all kinds of ongoing care and checkups, et cetera.

And they’re all proud of it because it’s a Leed, Gold building. (Janet: right). So it’s got its sustainability and it’s out of the floodplain. But in building out of the floodplain, what you really see from the street is the main entrance is up a grand staircase. And now there is a ramp entrance. It goes to the same lobby. I kind of fanatically check it every other month (Janet: chuckles). And it is open, you know, because sometimes here’s one of your problems. If you build a segregating entrance for your access, a lot of places lock it. (Janet: yes). Retail- it’s very common; restaurant- very common. (Janet: yes).

Because ‘Oh, somebody’s going to dine and dash’ (Janet: right). Or, you know, been a million stories lately about how some retail places are, they’re in the best corner in Manhattan, but they’re thinking of shutting down because there’s so much theft. (Janet: right).

And nobody goes back and has the architect shaking their fist, well 18-years ago we built this alternate entrance and when you lock it, you’re going to destroy it for everyone in a chair (Janet: right). Or not just chair, even just a slow walker or Canadian crutches. It’s much bigger than that, right? Obviously, low vision people like graded ramps rather than trying to tackle something that you may have a depth perception issue or something like that. So once again, it’s, it’s much more universal than just someone in a power chair. (Janet: right).

But again, it’s just that when I gave a talk about that building. And I don’t want to knock it, it’s actually a person I know was the main designer. But just when you put that little baby sign pointing you a whole block down the street, think about back to Meg’s, you know, her bread and butter. Think if she helped coach them and do the right thing.

And again, it’s not charity because people with disabilities are very good at problem solving and they’re incredibly resourceful because we have an environment that makes you do that because we get from point A to B, you get up early and plot out and you’re a natural problem solver. It’s a stereotype, but it’s a positive one. (Janet: right).

But anyhow, even if you’re not just a visitor that gets intimidated or you’re not sure where the other entrance is, think if you’re a person with disability and you know, where do you make your points with the boss to get that corner office or to go from being an entry level to project manager?

You walk and roll on the way to lunch. Well, you know, you go down your 4 stories in the elevator. You can BS with them then. You get ready to go with a couple people. And ‘Oh, you know, here’s a little sparky in a wheelchair, you got to go all the way down, all the way back. If it’s starting to rain, you know, you, you separate from the group. (Janet: right). You’re giving all these visual cues that you’re, you’re second rate or you’re around the bend.

Janet: And that is a huge part of all this as well. You bring up a good point Steve that that also makes you feel inferior. And I mean it just doesn’t, it doesn’t work. (Steve: yeah). And when I was telling you about that class that I did, it wasn’t just the train station.

I would also bring him to a coffee shop, (Steve: yeah). and it was smack dab in the middle of the street, not, couldn’t be any more smack dab in the middle of the street. (Steve: um-hmm).

And, it was downstairs, which is not uncommon around here. And it had 3, kind of zigzag steps going down. There was no lift or anything of that sort. (Steve: hmm). They had the very, the nicest looking accessibility plates I’ve ever seen before in my life. They were brass. They were very shiny. They were basically like pointing you to go to either side of the block to go around the block to go into the alley, which is what we’ve got here.

So you’ve literally now had to go around the block into the alley where the garbage is kept, where the, the cars are kept, right? (Steve: huh). Like this is sort of the unsightly parts of Boston (Steve: uh-huh). And then I couldn’t even believe it. They didn’t even have a cutout on because there’s like a little bit of a lip between the street and the parking areas, which is fine for like a car, right? Or like, you’re walking a bicycle, but if you are in a wheelchair or if you’ve got something large, it just doesn’t work.

And the last time I did it, we got to the door, the doorbell wasn’t even working. (Steve: oh yeah). So you’ve done all this, like you said, you have separated yourself from the rest of the group. You have now gone to the back of the building. You are there by yourself.

Maybe… it’s New England… could be raining, could be snowing, could be the heat of day, right? Only find out that the doorbell’s not working! There was a telephone. They were able to call. The person came out, just kind of flung open the door, (Steve: oh yeah, oh yeah), and didn’t even hold the door for them.

It was a group of the students, and they didn’t know where they were going, so they got in the elevator. And they ended up going up all the way up to the top floor, which was somebody’s apartment, apparently. And so they started going into the apartment thinking that it was the coffee shop. It just kind of goes to show you, you know, Steve, to your point, you know, by then, I would have gotten my coffee already and I would have already gone. (Steve: oh yeah). It’s just, (Meg: yup). Yeah, it’s crazy. (Meg: absolutely).

Steve: That’s why it is so important to have public transit functional. Again, you know, all due respect to Michael Bloomberg and all those super tall buildings and saying, you know, if we zone to the sky, we’ll have money to fix the problems.

You know, and I know the M.T.A. is not the city itself, It’s like another layer of government for the transit.  (Janet: Manhattan is really bad). Yeah, as we said, you know, not even 1-in-4 stations are wheelchair accessible. Unless you own a helicopter, a CEO, you know, the fastest way to get, you know, from the Bronx to a meeting in Union Square or vice versa is that train. (Janet: yeah). You know, you see millionaires riding the train because it’s efficient, you know, you don’t, can’t take 4 hours into traffic. (Janet: chuckles). you know. (Meg: uh-huh).

And then, you know, you turn around and of that 1-out-of-4, half the elevators are broken on any given day (Janet: yeah). And then and somebody says, well, but you’ve got 1-of-4, that’s not bad. But, you know, you find these weird things where the northbound train, there is the platform with the elevator, the southbound is not. So you can’t really work there or live there because you can’t do a 50-percent commute. (Janet: chuckles). You know, you’re not. What are you supposed to (Janet: stop), you know, get a, get a wheelchair that has a bed inside it that, (Janet: laughs). you know, whatever, you know, 3-in-1, you know…

Janet: Well I will challenge you, Steve, to design that. That actually sounds pretty, pretty handy, right? (both laugh).

Steve: There you go. It’s like those, like the business class seats that I never get to sit in, the fold out, you know, but… (laughs)

Janet: … it’s just glorified larger seats, that’s all.

Steve: You know. Forgive me for, if I’m rambling or riffing, but it just. You know, we have one of the ugliest histories in our entire nation is of segregation, (Janet: yeah). You know, certainly based on race, not that, by gender too as far as pay, that’s still a gap.

But I just, I sometimes I go to an architect and they’re designing a brand-new building and it’s like, “Hey, wait a minute. You know, the access is way off the back and it’s like we’re saying, ‘Oh, it’s by the dumpster’ and, (Janet: yeah). And with all respect, the homeless person, so it might even be dangerous.

And then there’s the, the big button that’s as likely to electrocute you as it is to actually work and signify to somebody to go get it. And maybe they’re used to near-do-wells ringing the big button. So they just ignore it, even if it does buzz, (Janet: and there’s something you said for that, right, yeah).

And I look at them, I say, “you know, with all due respect” I said, “you’re an inclusive person,” I said, “you know, would you put a headline in the Miami Herald saying, you know, brand new development or retrofitted historic building, you know, people in Orthodox Jewish garb, please call 2 weeks ahead to schedule, or please, you know, wait and get rained on by the dumpsters, or, you know, Hispanic people need not have the expectation of spontaneity at this restaurant.”

“Please, please send us a registered letter and please beg and please only call when Steve’s on duty to usher you through the kitchen and through the stinky garbage and then we’ll take your money for the tomahawk steak, but only then will we…” you know, we, I would hope to God as an inclusive society that, that loves our brethren, you know, we’d all be marching or it’d be the first thing on the 6-o’clock news or the big Twitter feed saying, “oh my God, look at this place, what it does.” (Janet: right).

And yet disability. You know, it’s hard to even get the news producer to come out and do that. They just kind of roll their eyes like, well, at least they let them in. (Janet: wow) And it’s like, what do you mean them? (Janet: yeah). That’s pejorative. You know, there’s that word ableism, that’s a fairly new word, but it’s, it sounds like racism. And on any given day, it can be as toxic and hurtful and detrimental.

Janet: Yeah, all you could do is like, take that word disabled out of that sentence and put in any other group. (Steve: yeah), You know, people would just be completely outraged. (Steve: yeah).

So, yeah. And so, like Meg, I know that you, I mean, do you guys, I mean, I love the fact that the both of you probably do a lot of advocacy work as well, (Meg: yup) on behalf of people with different abilities. Is that correct?

Meg: Yeah, it is. And we try to give people to— and I’m going back a few points to like the coffee shop example— because we tell everybody accessibility and inclusion is not a facilities issue. It’s not a building maintenance issue. Everyone has a responsibility to it. (Steve: good point).

Everyone in your company needs to know the accessibility features, how to access them, where they are, where the accessible parking places in your building? Most people don’t know that. How many do you have? How do you reserve one? If your team has favorite restaurants that you go out to, or you’re a recruiter and you take people out to lunch, what are the 10 restaurants in your 5-mile radius that you know are truly accessible?

And have that list handy. A lot of times that you’re in a zoom meeting like this, you’re interviewing a candidate, you don’t know if they’re a wheelchair user. They didn’t tell you. They show up. They called accessible transportation. Well now, their meetings ran long, they need another pickup. (Steve: um-hmm). Does anybody know where to call? Does anybody know how to access that?

So just thinking about the day-to-day logistics and thinking about people with disabilities and how to make sure that they’re included, that you’re not going to that coffee shop that has four steps down and you got to go in the back.

We see this being an activity that employee resource groups for people with disabilities will do. (Steve: mm-hmm). Let’s go. Let’s send a couple of people out. Or when you go to your next restaurant, eyeball these 5 things. Like, if a 2-inch step makes it inaccessible for someone in a wheelchair or someone with a walker or other mobility issues.

So really having that list. And, you know, having them at your home too. Of knowing, ‘oh, if you have a party or a friend shows up’, and ‘oh, you didn’t realize they had an injury and now they’re on crutches’ or whatever. You know, so, we try to give folks really thinking about access and inclusion as part of their day to day. And how you would any other team event that accessibility should be a part of it, whether it’s just going out to lunch, interviewing a new candidate.

This one company that we worked with, they would welcome somebody at the main level and then their interview rooms were on the second floor, and they have this beautiful spiral staircase that went right up, (Janet & Steve both laugh), but it was an older building that had been retrofitted and the elevators were a quarter of a mile down the hallway.

So no one thought about that, you know, so now everybody’s got to walk a little farther. This takes them extra time. (Steve: mm-hmm). Now they’re going to be late for their first interview because they had to take the 10-minutes to roll down the hallway, being escorted by somebody else and go another quarter mile back. (Janet: back, right. laughs).

So thinking about those practical things of, you know, candidates with a disability and not even, I mean, somebody in a wheelchair, they actually can move pretty quickly, but what if it’s someone with cerebral palsy (Steve: right, right), or someone, you know, with Parkinson’s (Steve: oh yeah), that maybe can’t move as quickly or has more difficulty. (Steve: yeah).

Janet: …but still walking, (Steve: pulmonary issues). Pulmonary issues, right. (Meg: right). Is there, do you guys know… I’m sitting here every time I’m listening to the two of you talk— I know that there’s the WELL AP for buildings and as you mentioned, Steve, the LEED, right? That’s sustainability. It’s about air quality. WELL takes it a step further. (Steve: hmmm). But is there any other design measures that people…?

Meg: … this is what we need to create. Steve (laughs)…

Steve: We do, I know, I know, we do…

Janet: I was going to say, we got to go create it! We can go create it! Just because I don’t have enough on my plate, but I think we could. (chuckles).

Steve: No, no. There’s, obviously maybe there’s a little bit of cynicism with the U.S. green building council and how it’s kind of propagates and gotten so huge. But no, I mean, now resilience is just a ‘for granted.’ You know, those giant teacher funds that, you know, build or buy those buildings in Manhattan, they want the thing to be LEED Gold or better.

They don’t want to touch it without that, you know, went from a ‘what’s that?’ or ‘is that just something for nerds?’ or ‘is that something Brad Pitt mentioned in New Orleans after Katrina,’ (Meg: right), to ‘it’s mainstream’… it’s as mainstream as having air conditioning in a parking deck, you know, so (Janet: right). No, we need that. We need that.

Janet: Well, I even say is that that now is baked in, right? (Steve: um-hmm, um-hmm), WELL has now come since then, Trauma-informed Design, which I’m a part of, will be coming in right after that. I mean, it’s a changing field for sure. (Steve: right, right).

Meg: We need some certified sort of universal design quest that…

Janet: … quest, checklist. Right.

Meg: Yeah, that architects…

Steve: We need a triumvirate of like…

Janet: an understanding, an understanding and process… that’s the other part. (Steve: correct). (Meg: yeah).

Steve: Yeah. And you actually have an independent body, and you know, you can have your ceremony and put up your little cornerstone that says it. I mean, it should be a thing, you know, it should be like getting 4-diamonds from the AAA or so. It’s a pride thing. (Janet: right).

Now, I certainly, well, I’m not a rich man because I probably kill half my potential clients by telling them what they did wrong. And if they don’t want to move towards heaven, they don’t get, you know, I don’t work with them, but, you know…

Janet: (laughs). Well, you’re still surviving Steve, so, you know, right…

Steve: yeah, oh, I’m, life is very good, and I don’t need Bill Gates lifestyle. (Janet: yeah, yeah. laughs). But anyhow, um, no, but just, you know, to maybe end on my part on a positive, because I, you know, when you point out what’s wrong, sometimes it comes off as negative, (Janet: right). And again, I’ve always been a person, you know, that wanting to see all different people or, or that wealth of diversity was just something that seemed natural to me, and it’s just grown. I’ve been fortunate enough to work with creatives that have felt that way.

Not that the whole world we’re, we’re in a very polarized world, certainly as we live in, but not to overly do it. But to go back to that, that race based thing. First, we introduced the negativity, but, (Janet: yeah), you know, you can all tell me I’m handsome and look 38 or something, but I roll 60 next year.

So that means I’m old enough to remember when very unfortunately, some architects might’ve said, ‘Oh, this person’s African American, but, and they’re top of their class from a very good school, but they will probably be a glorified drafts person because I’m not sure if my clients are ready to see a person of color closing the deal or managing the project. (Janet: right).

Or again, maybe it’s terrible for me to say as a male, but I certainly know even at the newspaper I worked at, there were like city editors and managing editors that they would not give the most prime beat to a woman because there’s all these stereotypes of, ‘Oh, as soon as we get her trained to cover city hall, she’ll have a kid.’ (Janet: right).

Or you know, ‘there’ll be this time that she’s under the weather and that’ll be right when we are fighting with the other crosstown paper or the news to break it.’ You know, just terrible pejorative. But lo and behold, some of those women who maybe took the ‘crappier’ beat and worked through it became the publisher or the managing editor. (Janet: right).

And, that case that I happen to know with a small architecture firm when I thought maybe that was what I would do instead of criticizing and writing about it, because I can’t do the math or the, you know, the building would fall down if I were at the switch. (Janet: laughs).

I happen to know a small firm in my native Akron, Ohio, where the black person who the hiring manager knew was super bright but was a little bit trepidatious about, ‘Oh, you know, can they carry the water?’ Not only did they become the rainmaker for the firm, but they bought out the founder of the firm. He’s just getting ready to sell the business for a very tidy profit that will send his grandkids to the best schools, but you know, go off and do foundation work. So they will probably sell it to a rival firm for a tidy sum.

And I think the parallel obviously is with people with disabilities. Not that there aren’t already, but I truly think, and this is more Meg’s thing for me to shut up and pass the torch, but I think there’s people that are entry level, they’re run of the mill, they’re, you know, they’re a cog. And I think they should be at that C suite with the right training, the right accommodations, feeling comfortable asking for what they need. (Meg: right).

I just read a story that, you know, Publix is the big grocery chain in all of Florida. (Janet: right). I think they’re naming a new CEO or whatever, and they started as basically like a checkout bag boy, you know, and they moved up. So you know, maybe you didn’t come out of the Ivy League, but you worked you’re way up, and I think we’re probably maybe 30-years behind in that compared to other marginalized groups, (Janet: that’s right). As far as recognizing the strength, the problem solving. It’s not like ‘oh I hired two people I can go to heaven now I did my charitable act.’ It’s not a charitable act. It’s a, this makes good business. So with that I will pass the 440-relay torch over to my friend and colleague, Meg. (laughs).

Meg: I’ll happily take the baton. (laughs). So, I guess the only other thing that I would say is that, you know, we are seeing pockets of change when we think about accessibility inclusion. And earlier this year, Lowe’s, the home improvement store, and AARP teamed up to start featuring accessibility products, and how you could do that within your home.

Whether it’s, you know, shelves that you can pull down so if you’re in a seated position, you don’t have to worry about either not being able to reach it or even standing on a step stool, which as we all age, that gets harder to do, right? (Janet: laughs).

So we’re seeing, you know, big companies start to focus on access and inclusion, and we’re seeing hiring initiatives. You know, Michaels is one of my clients and I was on a call with them earlier today. We’re in our third year with them. They’ve hired over 350 people. And they were saying, ‘we have these 2 guys that are twins with autism in one of our warehouses.’ They’ve been working there for 4-years.

Both are now in leadership positions where everybody thought no way they’re lucky to have a job and now they’re leading teams. (Steve: hmm). And so we see real examples of when companies step into this realm and really enter into it with an ‘and yes’ mindset of ‘how do we do this?’ and ‘what’s the next thing we should be thinking about’ that they’re seeing huge successes. (Steve: right). (Janet: right). and making a lot of money off of accessibility inclusion.  (Steve: yeah, yeah).

Janet: Yeah. They left so much money on the table. (Meg: yes). And that was the crazy part. And I just want to throw out a little thing out to the universe right now, if Lowe’s wants to talk to me about making designer grab bars, I’m more than, (laughs), I’m more than open to start that part of my design empire. (Steve: yeah). (Meg: excellent).

So, well, because it’s so important. I haven’t seen any really great grab bars lately, (Steve & Meg laugh), but like when I do see them, I post them and I say crazy, sexy, cool, grab bars. (Meg: right). It’s to get people used to, and to think of what grab bars are and how they can see them as opposed to granny bars, (Steve: right). Right. And this institutional kind of look, we can make them beautiful and gorgeous. Just like we talked about with homes. (Steve: right), (Meg: right, right). And just have them be, you know, fit into your decor and not look, again, like these institutional pieces.

Meg: Right. There is a company out of the UK. I’ll think of the name in a minute, and it was started by a gentleman who had an accident…

Janet: ‘MotionSpot’…

Meg: Yes. ‘MotionSpot’ (Steve: oh wow), I knew it started with an M and I was like, I just need a minute. It’ll happen. (laughs). Yes.

Janet: Yeah. We interviewed them.

Meg: So, you know the story. It’s an amazing story.

Janet: It’s an amazing story. And they’ve been doing such an incredible job too. They take the idea of the aesthetic and the functionality and…

Meg: … design and function meet.

Janet: Meet, right. And so just, so again, if you’re listening, it will be on the website— ‘inclusivedesigners.com’ — and we will post that episode again, as well as the information for Motion Spot. (Meg: excellent).

And ‘Ponte Guilio’ is another, just grab bar group that’s an Italian company, but it’s also here in the United States. (Meg: right). And they’re also another one of my favorites to have again, beautiful, accessible bathrooms that, you know, buck the old idea of what inclusive bathrooms should look like.

So, but yeah, I know I’m keeping, I’m keeping an eye on the time, Steve, don’t you worry about it. (Steve: yeah). So is there any last minute. Did you want to finish up your conversation Meg on ‘MotionSpot’ or did you want to…

Meg: No, I was actually just bringing them up because you were talking about your grab bars and thought that they would be a great resource for you because I know they’re doing a lot in office buildings and hotels and all of those places.

And that’s another thing that we’re seeing, right? Is that there are so many companies like this popping up that slowly, and it will be very slowly, (Steve: hmm), but change happens slowly. And with companies like ‘MotionSpot’ and others that are teaching companies what they need to be doing and how to do it, (Steve: uh-huh), the more we see it in the mainstream, the better it’s going to be for all of us.

Janet: Yeah. When we talked to them, and this is important for our listeners to understand, which is that they did, it was a hotel. I know it was the Brooklyn hotel. I remember that because I come from Brooklyn— a shout out to Brooklyn— and the Brooklyn hotel was in UK, and they had made it an accessible building, period. It wasn’t just 1 or 2 rooms in this hotel. It was everything. Everyone had the same room that was all accessible.

And their bottom line, I want to say went up (Steve: yup), but I know that their profits had increased as a result of that. And that to me, I mean, if that doesn’t say it all, (Meg: right), (Steve: hmm). Right, I don’t know what does. (Meg: well, and look…) Oh, go ahead Meg.

Meg: Look at the accessible fashion industry. This was not (Janet: a thing) even happening 10 years ago, (Janet: right). It was still medical grade clothing that you would never wear outside (Janet: chuckles). It looked like a hospital gown with straps on it. And you had ‘Runway of Dreams’ teaming up with ‘Tommy Hilfiger,’ (Janet: Hilfiger, yeah), and now you’ve got ‘Target’ and ‘Kohl’s’ and ‘Macy’s’ and ‘Isaac Mizrahi’ now coming out with a line. (Steve: uh-huh). So in 10-years that that movement has started, that is a 400-billion-dollar industry. (Janet: billion, yeah). (Steve: I know).

So we tell companies all the time that we work, if you’re looking for your next innovation, talk to your employees with disabilities. (Steve: yup). Because they can tell you what problems need to be solved that no one’s paying attention to. (Steve: yup). And that’s such a perfect example to talk about. It’s not just about inclusion, it’s about being disability competitive. (Janet: I love that). Because if you’re competitive in whatever your industry is in market, people with disabilities are going to choose you over your competitors. And that’s what you want.

Everyone wants the market share and people with disabilities go, and their families shop, it’s a 15-trillion market opportunity. So it’s just silly if companies, buildings, organizations are not thinking about access and inclusion.

Janet: Ah, I just enjoy talking to you guys so much. I always enjoy talking, I call it my peeps, right? (Meg: laughs). Right. Our audience is peeps, right? We really do enjoy it. I just want to give you guys a couple minutes if there’s anything else that you feel like you want to add to the conversation or that we missed, overlooked or we felt like we just didn’t get in. Steve, I’ll let you go first.

Steve: I don’t know. I mean that that last thing, Meg hit that, I mean…

Janet: I know, she kind of knocked it out of the ballpark at that point…

Steve: She really did. That was like one of those grand slam home runs, clear the bags at Fenway, you know, go home…

Janet: She did. I was like, all right. Well now we’ve said everything. We might want to put at the beginning, cut it down to five minutes and call it a day. That’s right. (laughs).

Steve: I guess the only other thing I would say that maybe we didn’t is just, you know, I do a little bit of stuff with AARP and I’m old enough to be the member or whatever now, but you know, it’s just, I remember when they kind of started, you know, it was all these save social security, save Medicare, lobby Congress.

And now every magazine along with some celebrity that looks 15-years younger than their actual age, you know, (Janett: chuckles). There’s, all these stories about nerdy stuff about placemaking and inclusive parks and aging in place and how to retrofit your house cheaply.

So clearly there is a market there. (Janet: right). Whatever, you know, probably half the Madison Avenue advertising I see says, ‘oh, you know, 60 is the new 40’ and I get it. But BS, you know, if I pull an all-nighter for a client, I feel like I got the flu the next day. And I’m guessing most of the folks do. (Janet: laughs).

And if I go out and play soccer and wrench my knee, it feels like a, you know, 20-year-old would probably just, (Janet: walk it off), and go home. (Janet: right, laughs). And I’m like, ‘ah, should I go to an urgent care?’ (Janet: urgent care, right). (Meg: laughs). But you know, the point being, you know, what is it, something like 10-thousand people reach retirement age every day in America? And that number is just going to go up.

Janet: Yeah, it’s the silver tsunami, it’s already here and we haven’t hit the top of the crest yet, that’s the thing. (Steve: yeah). Yeah.

Steve: And, you know, with all due respect, the kids coming out with a master’s degree have 300-thousand in student loans (Meg: hmm), and are moving into a micro unit, (Meg: yup), especially if they want to live in a, you know, in a top tier city (Janet: right). And It’s the silver tsunami who has the money to invest.

So as Meg was saying, if you’re, you know, if your ‘bagel-ry’ has better bagels than Manhattan, if your croissant place outdoes Paris, how am I going to know if I only go to places that are accessible? (Janet: yeah), because that’s the way I vote with my feet. You know, I’m kind of a social media addict. I don’t TikTok, but I do all the other platforms. If somebody burns a pizza, you know, a thousand of my close personal friends know, and they tell their friends. If they make the croissant that’s half the price of Paris, and I don’t have to go fly into De Gaulle, I tell people.

You know, again, I don’t think this is just doing the right thing, I think there is a killing to be made with this. (Janet: yeah). You know, we’re, everyone on this call is old enough to remember, you know, ‘oh, bottled water. It comes out of the spigot. Who would pay for that?’ Ha-ha. (Janet: right, laughs). I mean, money isn’t everything, but don’t I wish my dad would have somehow put his money into bottled, (Janet: yeah), (Meg: laughs), you know, even if we owned one one-thousandth of the bottled water market, I’d be, you know, I would have had time to learn 5 languages and cure cancer or something in my spare hours. (Meg: laughs).

Janet: Well, you’re doing an incredible job being an advocate. (Steve: yeah). And then, but Meg, you said what is it, it’s a 15-trillion-dollar business. Is that overall?

Meg: Yes. That’s globally. (Janet: globally). It’s a 15-trillion-dollar market opportunity. (Steve: hmmm). (Janet: wow). Yeah, it’s like 250-million in the US alone. (Steve: hmmm). So really, if you’re not thinking about people with disabilities, you’re really missing an opportunity. (Steve: yup).

Janet: Wow. That’s a great, great way to end it. Listen, thank you so much both for being here and keep up the good work and we’ll be in touch when we create our universal plan…

Meg: I love it, let’s do it…

Steve: I know…

Janet: Ooh, great. (Steve: I know). I’m in on it, right. And I have a team, we can work this. We just need to get some funding and stuff like that. I’m in. And thank you for all the work that you guys do.

Meg: Well thanks for having us and inviting us on. It’s been a pleasure…

Steve: Yeah, very much a pleasure.

Janet: Right, thank you.

Steve: Thanks.

(Music/Outro)

Janet: I love how Meg is helping companies be accessible to all people of different abilities – including design and policies which help promote productivity. Even helping those that have dyslexia to make the workplace accommodating. And we need to remember that the wheelchair is not the only disability.

Carolyn: As Meg said about accessibility… “it’s not a facilities issue, a building issue, or a maintenance issue— everyone has a responsibility to it”

Janet: And Steve made some very good points too. He is so right that design that separates someone with a disability from their co-workers can make them feel inferior. I agree that we all need to design for dignity. We want environments that work for everybody, and that don’t need special considerations or accommodations because they’re already built into the environment.

Carolyn: So you are saying Steven Wright was right!

Janet: Really? Funny, but it’s true. (laughs).

Carolyn: You know I couldn’t resist, but you know, you are not wrong.

Janet: Nope.

Carolyn: But seriously, when Steve talks about urban planning, it’s getting around in our cities and streets. And for Meg, it’s access in buildings where people are employed. They both encourage using universal design concepts to ensure spaces that are open and available to everyone.

Janet: The pandemic created a paradigm change in the workforce, but we know disability inclusion in the workplace is a 15-trillion-dollar global industry.

A lucrative opportunity that many companies are leaving on the table. With 250-million dollars in America alone.

I have got to help them create these new design measures as we discussed! I am so busy, but I think it would be great! A quest if you will… A checklist along with process and understanding.

Carolyn:  And it sounds like you already have the right team to get it started.

And to our listeners, stay tuned for updates on this.

Janet: Absolutely! And we will share the link on how to contact Steve and Meg, and of course, the links to all the work they are doing, and all the many other things mentioned along the way during this discussion… all on our website at inclusive-designers-dot-com.

Carolyn: That’s: inclusivedesigners.com…

Janet: A big thank you to Steve and Meg. And, of course, to all of you for listening.

Carolyn: Along with all the regular places you get your podcasts— such as Apple, Google, Spotify, and Pandora— you can also find us on YouTube as, you guessed it, Inclusive Designers Podcast.

And of course, if you like what you hear, feel free to go to our website and hit that Patreon Button, or the link to our GoFundMe Page.

Janet: Yes, please do. And let us know if you have any questions or suggestions for topics you think we should be covering in upcoming shows!

And as our motto says: ’Stay Well…and Stay Well Informed!’

As always, thank you for stopping by.

We’ll see you next time.

Carolyn: Yes, thanks again.

(Music up and fade out)

By: Janet Roche & Carolyn Robbins

Inclusive Designers Podcast:

Accessibility is often an afterthought in product design. Even tech with the potential to be game-changing for folks with disabilities, often isn’t designed with them in mind. Is a hybrid of Inclusive, Universal and Human-centered Design the key to solving this problem?

IDP explores how to improve the design process with Dhaval Patel of Lotus Labs. We’ll hear about their innovative ‘Lotus Ring’ that aims to prove this theory and serve as an example that the process really can work!

Guest: Dhaval Patel- is the founder and CEO of Lotus, a company whose mission is to build technology that is useful to everyone, by optimizing for disability first. To that end, Lotus has built a wearable Ring that controls objects at home by pointing.

Formerly, Dhaval was a division leader at Apple, working in their iPhone, Apple Watch & AirPod divisions. He has 37 patents in sensing & haptics. His work at Apple inspired him to build technology that helps everyone, but could be especially life changing for disabled persons, seniors, and veterans.

“Legacy. What is Legacy? It’s planting seeds in a garden you never get to see.”  – Quote from ‘Hamilton: An American Musical’

– Contact: Dhaval Patel (Linked In)

– References: 

Designing for: Technology & Innovation with Lotus Labs,                                        (Season 5, Episode 2)

(Music / Open)

Janet: In this series we will be discussing specific examples of design techniques that make a positive difference for people living with certain human conditions.

Carolyn: The more a designer understands the client and or the community the more effective and respectful the design will be.

(Music / Intro)

Janet: Welcome to Inclusive Designers Podcast, I am your host, Janet Roche…

Carolyn: and I am your moderator, Carolyn Robbins…

Janet: And welcome as well to another season of Inclusive Designers Podcast. Can you believe it we are already on Season 4…

Carolyn: Season 5, Janet

Janet: Wow, Season 5? Boy have these last few years flown by!

And I just want to say I do not look a year older…

Carolyn: Me neither.

Janet: Nope.

Carolyn: Nope. (laughs).

Janet: On a side note, did you know that Stitcher is no more? No mas. Nada. Zippo – and has left the building.

Carolyn: (laughs) But we did add Pandora in its place, so you can now find IDP there as well – or maybe you are already listening to it on Pandora.

Janet: It could be, our audience is smart. Or as we like to say here in New England, ‘SMAHT’…

Carolyn: Yup, they’re ‘Wicked Smaht’ – and we do have a great show for our ‘Smaht’ listeners today!

Janet: Yes we do…

Carolyn: And this will be the first of our ongoing technology and innovation series.

Janet: Yes it is, Carolyn. Tell them about our next guest, Dhaval Patel…

Carolyn: I would be honored to: Dhaval Patel, is the founder and CEO of Lotus. A company whose mission is to build technology that is useful to everyone, by optimizing for disability first. To that end, Lotus has built a wearable Ring that controls ‘un-smaht’ objects at home by pointing.

Formerly, he was a division leader at Apple, working in their iPhone, Apple Watch & AirPod divisions. His work at Apple inspired him to build technology that helps everyone, but could be especially life changing for disabled persons, seniors, and veterans. He also has 37 patents in sensing & haptics—and you know that’s the definition of ‘Smaht!’

Janet: (laughs) Not only will we learn about the ‘Lotus Ring’ he invented, and how it works, but Dhaval is also a great believer that a combination of universal and inclusive design is the ideal.

Carolyn:  And he will share his thoughts on why this hybrid may work best.

Janet: Yes, he will. We enjoyed hearing his perspective on design, and think you will too, so let’s get to it!

Carolyn: Absolutely. And with that, here is our interview with… Dhaval Patel— engineer, entrepreneur, and forever advocate for better design…

(Music / Interview)

Janet: Welcome to Inclusive Designers, Dhaval. How are you today?

Dhaval: I am great. Thank you for having me. It’s an honor and a pleasure to be here. How are you?

Janet: Terrific. I’m doing swell. Now that you’re here, we can talk about your product, which I’m excited about doing, and hearing more about the journey and the genesis of your product and how it can help some of the listeners either for their own personal use or for their family’s use, or for client’s use. So, let’s just dive right on in. We did a little intro, but why don’t you tell me in your own words a little bit about yourself?

Dhaval: Sure! Quick audio description of myself… I’m a brown guy with black hair, mid-thirties, sitting in front of one of my favorite prints, which is the black and white print of the flat iron building in New York.

Janet: Yep, we should probably do that as well. You’re correct. We talked about this earlier. (Dhaval: yeah), blonde haired, fairly pale skin, individual who’s in her office right now. And so there’s a bunch of paintings behind me, and I’ve got my headset on.

Thank you for reminding me and for our listeners, we hope to continue to set that trend and make that something that is just a staple for what we do for each episode. So thank you for that (Dhaval: yeah). It shows us that we can all learn something all the time, right?

Dhaval: Thanks Janet. (Janet: yeah). Yeah, absolutely.

Janet: So Dhaval, tell me a little about your background…

Dhaval: Yeah, a little bit about myself. My name is Dhaval Patel. Hardware engineer by training, did my undergraduate and master’s degrees at Georgia Tech in electrical engineering with a minor in aerospace engineering, (Janet: oh), and master’s also in electrical with a minor in finance. (Janet: yeah).

Worked at a couple of different places and essentially ended up at Apple where I ended up being there for about 8-and-a-half years, (Janet: yeah), and managed a division at Apple for iPhone watch and AirPods.

And now founded Lotus, where we’ve made this wearable ring for people with limited mobility that controls objects at home by pointing. But happy to talk more about that as we go. (Janet: yeah). Yeah.

Janet: So, you have a remarkable career. So now what was the genesis for getting into this particular area and starting Lotus.

And for our listeners, we’ll have all this information on our website at inclusivedesigners.com. And so we’ll have Dhaval’s information, we’ll have all the information on both his ring and also how you can get in contact with him.

And so, take us back. So were you at Apple at the time that you came up with the idea for the ring? Was there a particular instance that started with the ring? What was the genesis behind the ring?

Dhaval: Yeah, so let me describe the ring and then also describe sort of how it came about.

Janet:  That sounds good.

Dhaval: So, in a nutshell, for people with limited mobility, we’ve created this wearable ring that controls objects at home by pointing.

Janet:  It’s as simple as that, right.

Dhaval: Yeah, but unlike Alexa, there’s no apps, no rewiring, and no internet. (Janet: right). And the reason to do all this was it really started with me. I was born with twisted knees, and over the years I’ve been on and off crutches. And one night, a few years ago in this house, I had gotten into bed only having realized I’d left the hallway lights on. But I was too tired to get out of bed, hop onto my crutches, hobble 10-feet, turn off the light, hobble back 10-feet and get back into bed.

So I slept with the lights on (Janet: interesting) the entire night, (Janet: right). And woke up in the morning thinking “if someone like me, an engineer managing a division at Apple with expertise in wall electronics” — because I’ve also worked at Lutron— and have 37 patents, “if I don’t even have smart home tech, who does?” (Janet: right). And that’s how we got going.

And initially I thought it was just a me problem. It turned out as I researched, 91-percent of US homes were built before smart homes even existed. (Janet: right). But there’s no easy way to upgrade.

Even if someone gifts you an Amazon Echo and you wanted to control your lights. Well the first step you have to rewire all your existing wall switches to connect to the internet, to be able to talk to Alexa. (Janet: right).

Then you have to put speakers in every room to control the switches you just rewired. (Janet: right). And if you somehow get past those two hurdles, you then have to pair every single switch one-by-one through another app. (Janet: right). And just the first step in this process is 11-hours and 2-thousand-dollars. (Janet: wow, yeah). And this is best case if you own the home.

Janet:  Right. That’s best-case scenario, right.

Dhaval: Yeah. Because if you rent the home, (Janet: you can’t do it). There’s no solution. (Janet: there is no solution). And as much as it affects everybody, it disproportionately affects people like me, people with limited mobility, 27-million people. Older adults, disabled persons and veteran soldiers, (Janet: right), who can spend up to 4-hours at home on self-care every day. (Janet: hmm. yeah). And so we ended up creating this ring that controls objects at home by pointing, but without apps, without rewiring, without internet.

Janet:  Right. We talk a lot about injustice and especially if, maybe if you do have some sort of disability or not as abled as other individuals, you’re more likely to be hitting the poverty level as well. So you’re also dealing with things like affordable housing or trying to find affordable housing. You know, you’re not likely to maybe have your own home where you would have that ability. So I think it’s pretty great that this ring takes away that. So explain it a little bit further, so, you don’t have to go into the technology of the ring, you’re smiling…

Dhaval: Yeah, we’ll keep it…

Janet:  We’ll keep it simple (laughs)…

Dhaval: We’ll keep it fairly straightforward…

Janet: Right. (Dhaval: yeah). But in all seriousness, what I think is fascinating, you can tell me if I’m wrong, but it seems like you can even remove the device.

Dhaval: Yeah, that’s right.

Janet:  Right. So if say, you left the apartment— and I don’t mean just, you know, for the day— but if you have to leave the apartment, you’re not leaving all of those pieces behind.

Dhaval: Yeah, you’re not leaving all of your smart home behind. (Janet: right).  Yeah, so the way it works, very simply, 3 simple step process. Step 1, you put on the ring, it has a single button on the ring and that’s it. Now, putting on the ring once, eliminates the need to have a smart speaker in every single room of your house, (Janet: right) because the ring goes with you wherever you go. (Janet: right). So you don’t need to have a smart speaker everywhere. So that’s step one.

Step two, for any existing wall switch you can attach our second half, which is a switch cover magnetically, (he demonstrates, we hear click). (Janet: right). So there’s no rewiring necessary, which like I mentioned, is also something you have to do today, otherwise, right? If you want Alexa to control your lights, you have to rewire every single wall switch to be able to connect to the internet. With this, you don’t have to do that, it just attaches to existing switches magnetically.

And step 3, all you do is point and click. So you point towards the wall switch and click the one button that’s on the ring. That’s it. The ring uses the same technology that your TV remote does, which is infrared. And so it’s very similar, just like a TV remote, all you do is point and click. And using infrared eliminates the need for apps, smartphones, and most importantly, internet. (Janet: right).

So in a nutshell, you put the ring on, snap on the switch, point and click. (Janet: that’s it). That’s it. We let you go from home to smart home in seconds. And like you mentioned, the added benefit of this is you can also take it with you wherever you go. (Janet: yeah). And we talk about this in disability advocacy a lot. As much as we often talk about sort of permanent disability, there’s everything on the spectrum from temporary (Janet: of course), and also situational, (Janet: right situational).

And so for instance, this is not just needed for people with limited mobility. It’s helpful to anyone. So if you live in a rental apartment today, which is a third of the US population— (Janet: correct)— it’s 114-million people— this is perfect for you because today, there’s no solution because of all the rewiring necessary with today’s smart home technology. (Janet: right).

And so, this added benefit of being able to take it with you wherever you go is: A, if you’re living in a rental apartment, you have a solution now; and B, more importantly, if you have a disability, then you don’t have to pay what’s often known as the quote ‘disability tax’ when you go on vacation.

Because now, as opposed to what you have to do today, you know, you may not be able to stay at every Airbnb you want to, or necessarily with friends and family in town because the, you know, the homes may not be accessible. (Janet: correct.)

And so you’re forced to upgrade to these 5-star hotels, to one of those 2 rooms up on every floor that are deemed accessible, but then you’re paying 500, 600-dollars a night. (Janet: right). With this, essentially you can convert any pre-existing space into becoming accessible wherever you go. (Janet: right). And so it’s also helpful when you’re traveling on vacation, even if you’re not just moving.

Janet:  Yeah, and you bring up a good point about traveling and, we discussed it just briefly, but it’s such an important piece, you know, in terms of way of life and quality of life. And then to be able to have something as simple as that, to be able to make something just a little more accessible for everyone I think is pretty great.

Although we did do an episode with Ed Warner of Motion Spot, and they had, really kind of helped a local hotel I believe, to put in different components to make it more accessible. And just as a comment to everybody out there listening, the hotel actually did better financially because they were the only, you know, game in town, so to speak. (Dhaval: yeah), which, you know, I get it, it really kind of goes to show you this is, it’s proven financially that it’s a good thing.

Dhaval: Yeah, and I couldn’t agree more, right? There’s no reason why you can’t align social impact with financial. (Janet: right). There’s absolutely no reason that has to be a given. It’s not a given.

Janet:  Well, there’s a lot that believe that there’s a separation between such, right.

Dhaval: Right. And, you know, I would hope through this and these and other conversations, we can sort of pierce that veil (Janet: correct). And, and in fact, that’s our thesis, which is, our thesis is: we only build technology that is usable by everyone, (Janet: yeah), just by optimizing for disability first, (Janet: right). Because by doing that, you solve for everyone anyway, except you don’t leave anyone behind. (Janet: right). In fact, you start with a person that may have a higher need to start, which is perfect for business and perfect for impact, and then you have a much bigger market that you open up also.

And so why don’t we do that all the time anyway? It just requires more planning upfront, (Janet: right). So why not do that? In fact, there are plenty of examples that exist today already, right? Closed captions. (Janet: right). if you’ve ever used subtitles on TV or while watching a movie, it was originally technology that was created back in the seventies for folks who were deaf. (Janet: right.)

But we all use it all the time. I mean, if you’ve ever been to a sports bar, or at an airport, or even if you’re, (Janet: I depend on it, laughs). Yeah, yeah. I mean, I can’t tell you the number of movies I watch where I can’t understand the accent (Janet: accent), or it’s very technical jargon. (Janet: jargon). And there’s a lot of things happening. And so I use it all the time.

And so it’s the same concept. We use these technologies for more than the initial scope anyway. And so why don’t we just do that from the get-go all the time, (Janet: right, yeah). And so that’s, that’s our thesis, and we’re just trying to adopt and propose the same philosophy, except in hardware.

Janet:  Right. Well, we’ll go march on Washington at some point and make sure that these things are just a given, baked into the bread, as we say, as opposed to, an afterthought, right? (Dhaval: yeah). Right.

I’m going to ask you a series of questions. And the first question is— I just want to make sure that I understand— so my ring, if I had my ring and I had a bunch of the devices on the outlets, I can just point and click to each one and then they would turn on and off… am I understanding that correctly?

Dhaval: That is correct. So today the things you can control are anything a wall switch controls, so lights are the most common example. (Janet: sure). But also fans. (Janet: mm-hmm). Also, appliances like window unit, ACs. (Janet: nice). And because we’re using infrared, we can also control televisions. No extra components needed because all televisions come with infrared. (Janet: right). And later down the pipeline, we’re planning on working on drapes, (Janet: ah), followed by doors.

And the reason is, we’re, instead of trying to work with any random set of objects, we’re focused on the things you have to interact with every single day. (Janet: right). In other words, what’s clinically known as ‘Activities of Daily Living.’ (Janet: right). These are the 6 things that everyone has to do every day, right? Everyone’s got to eat, go to the bathroom, shower, change your clothes, get out of the bed, and move around the house. Those 6 things are called ‘Activities of Daily Living.’

And if you think about it, to do those 6 things, and it doesn’t matter if you’re, you know, if you’re a CEO of a Fortune 500 company. You’re still having, it doesn’t matter how much money you have in other words, you still have to do these 6 things. To do those 6 things, there are 3 underlying prerequisites, right? You need a light source. (Janet: right). In the morning it happens to be blinds, in the evening it’s electric lights, but you need a light source. (Janet: sure.)

The second you have to open and close doors, (Janet: uh-huh), to do these 6 things. And the third, whichever space in your home you end up in, you have to control some appliance. The most commonly requested one being television, but closely followed by environmental controls, like fans or window unit ACs. (Janet: yup).

And so that’s why these are the objects we’re focused on because everyone has to do them every day, except if you have limited mobility, just to do these 6 things in these 3 underlying prerequisite buckets, you’re spending an extra 4- hours every day.

And keep in mind, these are non-optional things, right? So imagine sort of waking up and being stuck in traffic for 4-hours every single day. (Janet: laughs). Non-optional. (Janet: no). And so it’s a very high frequency and high intensity pain point. (Janet: right). And so that’s why we want to start there and then ultimately help everyone.

Janet:  There you go. Yeah. No, nobody wants to be in traffic for 4-hours every day. (laughs). So alright, so one of the other questions I have for you is, dealing with people who have arthritis. I’m sure you’ve kind of thought a little bit about what that means. I particularly have my Oura ring on. (Dhaval: yeah).

My Oura ring is, kind of looks a little bit like your ring, but my ring nowadays as I’m getting older and, and it’s been so hot out, like I can’t always get it off my finger. And so I don’t, have you thought about that? And if so, what are the implications with that, is there, I’m assuming that they have to be charged, is that correct?

Dhaval: Yes. So there’s a couple of questions in there, and I’m happy to answer each one. (Janet: that’s great). So, let me start off with sort of arthritis as an example. (Janet: sure). We wanted to be very intentional from the get-go to do a combination of what’s called inclusive design and universal design. (Janet: nice).

Now, for anyone who’s not familiar with it listening, inclusive design, in very colloquially speaking, inclusive design is one size fits one, (Janet: right). Universal design is one size fits all. And they each have their benefits and advantages, right? (Janet: right). One size fits one, it’s obvious. No one gets left behind. You have something that caters to your needs.

Universal design often gets touted because it’s scalable, right, because it’s one size fits all. (Janet: right). And so we wanted to be very intentional from the beginning. And this is my expertise, the thing I did at Apple was human interface, UI, UX, (Janet: right, UX, yup). And in fact, I even ran the user studies. And so that’s my expertise.

And so what we did was, for the first 9-months, we just interviewed people. We didn’t even build anything. We just interviewed people with different kinds of disabilities. People who were deaf, people who are blind, people with limited mobility, even folks with cognitive disabilities and their family members, as well as clinicians, to get everyone’s perspective.

And so this is part of what we call Human-Centered Design, (Janet: right), which is you start with the end user, not sort of your product or solution, you start with the end user. (Janet: correct). And these are very detailed interviews. We’re talking 9-hours long. Spread out over 3-days for every single person, right?

We start off in, you know, chronologically, when you wake up in the morning, what do you do? What do you interact with? What are your challenges at that point? What products do you use? Where did you get them? Why did you buy those products? How are they serving you right now? Are any of these technological, or are they sort of, you know, physical objects? Things of that nature. And we distilled everything down to what we call a hybrid combination of inclusive and universal design. Not picking one or the other, but both.

And I’ll describe how that works. (Janet: okay). So, simplest user interface is point and click. Right? That’s why your TV remotes haven’t changed in decades. That’s why your input devices, like your keyboards and mat mice are very simple, right?

It’s simple to use, which is low cognitive effort and fine motor control, meaning very little energy, (Janet: correct). Which is easy to use, right? (Janet: right). So, low cognitive effort, low physical effort. So point-and-click. Now, for some reason, if you couldn’t do that, like you mentioned, leading cause of disability in the US is arthritis.

And so if you couldn’t do point-and-click for some reason, if you can’t use fine motor control, then we also allow using gross motor control, so you can use gestures to control the same objects. (Janet: nice).

But let’s not stop there. Let’s push the ball further. Let’s say you couldn’t even do that. Let’s say you’ve had a stroke, or you’re a paraplegic or quadriplegic, then we also allow using voice to control the same objects. (Janet: nice). And the added benefit of that is that it doesn’t need to be line of sight. You can control things that are not line of sight, like in the other room. And all of this is still completely offline. (Janet: right).

And that’s what I mean by a combination of inclusive design and universal design. The inclusive design is you have all these different options, and you don’t have to pick between them, it just works simultaneously. But the universal design is the fact that the underlying technology like infrared, and like the other components in the ring, are all the same for everyone, which is what makes it scalable. And so that’s the combination that we’ve used.

Janet: Yeah. So Dhaval, for our listeners, you touched on something that was kind of interesting, the whole idea of universal and inclusive design and human-centered design and how they’re not mutually exclusive. Would you like to talk to our listeners a little bit more about that?

Dhaval: Yeah. it’s a fair question. I think if there’s one thing my Apple experience as well as my startup experience has taught me is that it doesn’t have to be one or the other. I think there’s this preconceived notion you can only pick between inclusive design or universal design. (Janet: correct). That it can only be social impact or financial impact. It can’t be both. (Janet: right, yeah).

And, and I would just encourage in whatever product or service you’re designing, there’s probably a way where you can do a hybrid approach. Just ensuring that you try to combine inclusive and universal as much as possible, if people start doing that, the field will course correct well. And maybe it’s not perfect and maybe it’s not complete inclusive and complete universal, (Janet: right), but it doesn’t have to be the opposite extreme either. It doesn’t have to only be one or the other.

And just like in this case, I think my mission with this is, if Lotus is successful with what we’ve done, where we’re trying to align a combination of inclusive design and universal design, (Janet: right), and align social and financial impact. (Janet: correct). Us being successful, Lotus being successful, will encourage other companies to follow suit.

It’s not really the financial impact that I care about. It’s more that, if we make it big financially, that will serve as proof that “hey, you can do both, and be financially impactful and be socially impactful.” Right? (Janet: right). It is a possibility. It’s not this sort of pie in the sky. (Janet: no).

And so 10-years from now my test, my vision, my hope is: if we’re successful 10-years from now, designers will look back and wonder how in the world were we ever designing products that were not optimized for disability first. (Janet: correct). Just like you would look back now at products you’re looking at now (Janet: right), and look back to products in the 90s and wonder: “why aren’t all products look nice, feel nice, lightweight?” which is what Apple did right (Janet: yeah).

In the 90s, Apple was asking the question, why are all consumer products built like toasters? (Janet: right). Why are they big and heavy and bulky and don’t look nice and, or nice to touch and feel? And ‘hey, let’s change that notion. Let’s break that underlying assumption, and people will appreciate it.’ (Janet: yeah).

And I’m willing to bet that if we are successful, people will follow suit, and 10-years from today, designers will look back, wondering how we ever build products otherwise. And for me, that’s our metric of success. And I think that’s possible.

Janet: Right. Well, I hope to have you back before 10-years so you can tell us all the other great stuff that you’re doing, yes, as opposed to waiting for 10-years….

Dhaval: (laughs) it will be an honor.

Janet: So Dhaval, one of the questions I now have with the ring, and we’ve talked a little bit about arthritis and what does that mean, but now also, you mentioned that it can be voice activated. Can you tell us a little bit more about how that works?

Dhaval: Yeah, sure. So the intent was to make sure that there was always a modality that helped anyone that needed it if they needed it. And so the intent is the ring will have a motion sensor that allows the gestures, and it would also have a microphone, which allows voice.

Now, there are a lot of privacy concerns, which is why a lot of people don’t actually use their Alexa speakers today. There’re really 2 primary concerns… one is: its online. And so a lot of folks, even the ones— there are statistics on this— about 54-percent of people that even have Amazon speakers choose not to have more than one because they don’t feel comfortable putting it in private rooms like bedrooms and bathrooms. (Janet: right). And so the 2 reasons for that, one is its online, and second is: it’s always listening and then sending that information online. (Janet: right).

For starters, we’re completely offline, so your data stays in your home, doesn’t go anywhere. (Janet: oh, that’s good to know). That’s the easy one. (Janet: right, that’s the easy part). But, I mean, it’s completely offline, right, so there’s nowhere for it to go. (Janet: great).

In addition, every ring does not need to have microphones, if it’s not necessary. (Janet: right). And so for some folks, if they want the ability to use multiple ways, we’re probably going to have that. But otherwise, a lot of the times we’ll only have the features in the ring that that set of people need. And so it’s not like everyone has to have the microphone in it if they don’t want it.

Janet: Oh, so there’ll be different iterations of the ring, different maybe levels of the ring? (Dhaval: correct). I didn’t realize that. (Dhaval: that is correct). Alright, so that’s good to know.

Dhaval: That’s right. because there were a lot of people that we interviewed who said, ‘Hey, I love all of this, but I don’t think I’ll ever need the microphone’ (Janet: right). ‘And I, it makes me feel uncomfortable, so I don’t want it’. And so, in fact that’s what happened. This is the good part about human centered design. These are the types of things you learn when you just talk to people without an end solution in mind. (Janet: right). By the way, the 9-hour interviews, they were single blind interviews.

And we had an idea, but we never told them about the idea for the first 8-hours. (Janet: wow). It was only the last hour that we would say, “Hey, this is great. We’ve had this idea that we’ve been sitting on, what do you think?” And then whatever they would say, we would cross-check it with the first 8-hours of what they mentioned. (Janet: interesting).

You know, because people tend to be very polite and very nice (Janet: right) and no one’s going to tell you, pardon the phrase, your baby is ugly. (Janet: laughs). And no one’s going to tell you that. (Janet: what were you thinking? yeah, right).

We wanted to make sure that we were data driven and any feedback that we got could be cross-referenced with the user’s own feedback. (Janet: right). And so then we were, you could be more sure. And so that was one of the things that came out, which is not everyone wants a ring with a speaker on it, or rather, more specifically, not everyone wants a ring with a microphone on it. So we want to make sure that if you needed it, it is available. (Janet: right). But you don’t need to have every ring have it.

Janet: Interesting. Well, it goes to show you, as designers we know to do more upfront research before we actually go in and start doing the design, to your point, just makes all the difference in the world.  And so I find that whole part fascinating as well.

Then, so where do you see the ring going? Is there another type? I mean, we talked about different iterations— the one that might have the microphone, one doesn’t have a microphone. We could be as silly as, is it going to be in different colors? What are we looking at, you know, down the line? Is it going to be more designed or is it going to looks more like the Oura ring? Like what are your thoughts? What do you hope to do with Lotus, and what do you hope to do with the ring?

Dhaval: Yeah. So let’s, let’s answer this in sort of 3 ways. (Janet: okay). 3 different axes, if you will. So one is, you know, how does it look and feel? So the easy answer to that is we’re definitely coming up with different sizes. We already have 3 today. It’s sort of a small, medium, large, if you will, (Janet: right).

But by the time we’re in production—we’re about 9-months away from launch— by the time we’re in production, we will have a lot more ring sizes. (Janet: right). We haven’t decided the exact number yet, but there will be a lot more ring sizes.

In addition, we already have 3 colors right now. Sort of very silver, a dark gray, and a black. We’ll probably offer more as we go. (Janet: sure). So that’s just the first axis, which is look and feel right, (Janet: first axis, right), right, (Janet: yeah).

And, for anyone interested right now, this is a brushed aluminum, so it’s very light. And so in many ways, I would say colloquially speaking, it may look and feel like the “Oura ring, for instance. Right. So it’s similar-ish material, the Oura ring I think is titanium.

Janet: Is it a problem that I keep mentioning the Oura ring? Or is it a way to…

Dhaval: No. It comes up a lot. (Janet: I’m sure). I think the way I would describe us, is, think of us as the Oura for home.

Janet: Right? Oh, there you go. Yeah.

Dhaval: That’s, that’s one way of thinking about it, right? (Janet: absolutely). And so Oura is for preventive health, we’re not focused on anything of that nature, this is specifically to be able to control the sort of universe around you from your fingertip. And so in many ways, think of it as the Oura for your home (Janet: right), and ultimately for other spaces as well.

Janet: And, just think about it this way, after you put the Oura ring on, you still have 9 fingers to, like, put on your Lotus device, right? (Dhaval: yeah). So on the other hand and be like, “boop, boop”, you know.

Dhaval: (laughs) And it’s, it’s funny you mention that. That was one of the things that came up as part of those 9-months of interviews. We asked people, what would you prefer this device be? What form factor would you like?

And there were a couple of things that popped up. One, people don’t really wear their watches to bed. They either take it out, out of habit, or they take it out because it needs to get charged every night, like an Apple watch. (Janet: correct, yup). Or, and this is real, a real quote: “It gets caught in my significant other’s hair.” (Janet: oh, laughs). And so, so that was one set of reasons.

The other is any wrist-based device, not even just at night, but any wrist-based device requires both hands in order to be able to use it. (Janet: yeah). One to lift it up, to look at the display and the other to interact with it. (Janet: sure). In addition, you have to be able to look at the device as well, so you need both hands free and to be able to look at the device, (Janet: right), not either or, both.

Janet: And it’s usually what, an inch and a half, in like size?

Dhaval: Correct. Yeah. An inch and half, or 2 inches. Yeah, exactly. (Janet: right, it’s small). And so, it’s challenging because if one of your hands is tied up like you’re carrying a child, (Janet: yeah), or grocery bags (Janet: right) or you don’t have use of one arm, then it’s difficult. (Janet: absolutely).

Or if both your hands are free, but you’re looking somewhere else, then you can’t use the device. And so the common request we kept getting is: “Can you make a device that you don’t need to look at and can be used with a single hand.” (Janet: right). And so that was the second reason. (Janet: perfect).

And then the third reason— and this is especially true for the communities of folks that we’re talking about, disability communities to be specific— they wanted things, disability communities as well as older adults actually both had the same request, which was, “can you make something that does not draw attention to us in a way we don’t want attention.” (Janet: huh). And this goes to the whole person first versus identity first nomenclature. (Janet: right). Right. (Janet: wow).

Which is, “I’m not a wheelchair user, I’m someone who uses a wheelchair.” (Janet: right). Right. And so don’t define me by the assistive technology I’m using. (Janet: interesting). And this is exactly why a lot of users don’t wear sort of the life alert. (Janet: yeah), because it draws attention to them in ways that they don’t. (Janet: no).  Why do you have that device? What, you know, I don’t have this device. Why do you have that device? What does it do?

Janet: Right. Well, I think that, that particular device has the stigma of just being old, right? (Dhaval: correct). Like that you’re unstable on your feet and you’re old… (Dhaval: right).

Dhaval: The key underlying factor is what this device is really giving you, what the ring is really giving you is independence and autonomy, which is to really fulfill the desire that each of us has, is for dignity, right? (Janet: correct). The product is not the ring, the product is the dignity that you get from the independence that it’s getting you. (Janet: right).

And to that end, there’s a famous quote that I like, that I’ve heard of, which is: “when users go to buy a drill, they’re not buying a drill, they’re buying a hole.” (Janet: oh). That’s really what they’re buying, right? (Janet: right, right, right, laughs).

And so that’s really what the technology is for. You’re really, that’s what you’re getting. The whole goal is to get dignity from the independence, (Janet: yeah), or from dignity from the autonomy, or dignity from the agency that the ring is giving you. (Janet: right). And that’s why it’s important. (Janet: huh). And so, that’s the intent.

Janet: Well, I felt like that should have been on a fortune cookie somewhere. That was quite profound as far as I was concerned, (Dhaval: laughs) but you’re absolutely right. It’s about dignity and I think your ring proves that. I mean all of what I’ve seen and what we’ve talked about. And I’m quite excited about the ring and I’m excited for you, and I think it’s going to change a lot of lives.

So, but I will ask you now the tough question. (Dhaval: sure). I’m sure you have the answer for it. So now I got to think that this is going to cost me a lot of money. Right? Always, all the new stuff is really expensive in the beginning. What are we talking about? Can I afford this on my small IDP allowance? (laughs) Can I do that?

Dhaval: (laughs) It’s a, it’s a good question. Oftentimes the assumption people have is sort of, this technology is like tens of thousands of dollars…. We wanted to make sure when we were designing this— this is truly also part of the human-centered design—we wanted to make sure it was not just physically accessible in making spaces accessible, but it was also financially accessible.

And so, 1 ring and 3 switches we think will retail for about 299-dollars. (Janet: wow, I could afford that, laughs). Yeah. Which is the same price as an Amazon Echo Show today. (Janet: wow).

And so for the same price, as 1 single smart speaker, you get an entire smart home. And of course you can always add more rings and switches, they’re all inter-connectable. There’s no pairing necessary. And so, if your friends and family have rings and they visit you, their rings will still work and vice versa. (Janet: hmm).

And so there are network effects. It’s like the telephone, where the more people that have it, the more useful your own product becomes. (Janet: wow). And so yeah, for the same price point as a single smart speaker, you can get a whole smart home.

Janet: That’s amazing. Like I said, I could actually afford that. That’s pretty great. (Dhaval: yeah). Oh, that’s wonderful.

Dhaval: They did tell us that there must be a catch. This must be 10-grand or something.

Janet: Well, that’s just it. (Dhaval: yeah). Yeah. Well, I’m glad we answered that, and I was shocked. Right. (Dhaval: yeah).

So Dhaval, take us back. I noticed that you use sort of the switchboard, the flip back and forth. (Dhaval: yeah). and in my house, I’ve got the toggles for my home. I’m assuming it works for both, correct?

Dhaval: Yeah. So just so everyone listening, toggle switches are the small switches that you have to flip up and down, (Janet: up and down), and they tend to be common in homes built pre-1970s. This is not a rule, but tends to be the case, (Janet: right).

And then there are the newer switches in homes post 1970s, which are called rockers, which are the wider, taller switches that you push into the wall, up or down. Those are the rockers, right. (Janet: right). versus toggles that you flip up and down. The nice thing is we work with both types of switches. (Janet: that’s great). Right.

Janet: So, now we know we can use it on both the toggle and also the, what did we call it? (Dhaval: the rocker switches). The rockers. (Dhaval: yeah). What about the battery life? How is the battery life on that ring? I’m assuming that it’s also, would the battery life also be on the switch plate as well?

Dhaval: Yeah, the switch cover. (Janet: yeah). Yeah. So it’s, it’s a great question. One of the reasons that we chose the technology we did, is because of the concern that users had with their risk-based devices, which is that they have to take it off every night. (Janet: correct).

So for instance, unlike an Apple watch that you have to charge every day, Or every night. Or unlike an Oura ring that you have to charge every 3-days, you only have to charge this ring once in 90-days. (Janet: wow). And the reason for that is, it’s like your TV remote. It’s only taking power for the 50-milliseconds that you push the button. (Janet: oh, right on). And the rest of the time, it’s not doing anything. It’s sort of like your TV remote batteries, right? Like when was the last thing you even changed them? (Janet: chuckles). Do you even remember?

Janet: I was just, I was laughing. I’m like, my Oura ring, it actually lasts 3-days. I was like, it’s like 5… I guess I don’t do enough, (both laugh), in order for it to run out of battery. (Dhaval: right). Oh, that made me laugh. But yeah. But you’re absolutely right, it’s a very minimal amount of time that you’re actually using it. So that makes a lot of sense. (Dhaval: correct). 90-days is fabulous. Yeah.

Dhaval: Yeah. And then on the switch cover side, it’s the same. It’s also 90-days. And again, the same reason, right? It’s only taking power for the 50- milliseconds that it’s taking to switch your switch on the wall. (Janet: right).

The rest of the time it doesn’t take any power, which is unlike any of the ‘Internet of Things’ switches that you can purchase. A, because you have to do the rewiring. But the reason that exists is anything that’s ‘Internet of Things’— anything that’s IOT— (Janet: right), has to be connected to the internet all the time. (Janet: the internet, right).

And because it has to be connected to the internet all the time, it has to draw power all the time. (Janet: correct). Hence the wires. (Janet: right). The benefit of using infrared as a core underlying technology architecture is that it’s only interrupt based. It’s like your TV remote. It only takes power for the 50- milliseconds you need it. The rest of the time it’s not drawing any power.

Janet: Right. Well, you’ve kind of teed me up for my last question here, and I have a feeling I now know what you’ll say (Dhaval: laughs), and now I know how this is all going to shake out, but I’m a big fan of technology, but I also know sometimes when we’re designing for inclusivity, and/or universal, or human-centered design, all of that really, there are detractors who have said things like, “No, no, we don’t use technology. What if you lose the remote? What if you lose the charger? What if it breaks?”

But I think in these cases, it’s usually to make sure that they can get out if there’s an emergency, that type of deal. (Dhaval: right). What do you have to say about that?

Dhaval: Let me put it this way. This is, this is going to be more philosophical than perhaps might be intended.

Janet: Well, you just did the drill with the hole, (Dhaval: laughs), so you know, you’re on roll. I’m, I’m happy to hear it.

Dhaval: Well, have, have you seen “Hamilton” the musical?

Janet: I have not, I am probably with the 10 people that have not seen it in the United States.

Dhaval: Well, it’s, yeah, it’s wonderful. I would highly recommend it. There’s this line in Hamilton, which is, “What is legacy? It’s planting seeds in the garden you never get to see.” (Janet: yeah).

And from my perspective, I want to make sure that we are building technology that continues helping people in whatever way it does, even after we’re long gone. (Janet: right). And this is not to say that it can help everyone with everything all the time. (Janet: sure).

Every technology is good at certain things and has its limitations. (Janet: correct). But I wanted to make sure that we were building something, both as a product, technology, and a company that continue with helping people even after we’re long gone. (Janet: right). And that was the intent. That’s why our thesis is building technology that’s usable by anyone, by optimizing for disability first.

So this may not be the only technology we choose to work on, and there will be other things as we, we get more and more successful. (Janet: correct). But that will always be our North Star. And I would say that’s our vision. Ultimately, it’s to build this future where there is a universe of ring controllable objects. (Janet: right).

And where caregivers, family members and clinicians can potentially subscribe to device data. (Janet: correct). So that they get peace of mind. And any person, younger or older, disabled or not disabled, renter or homeowner, can stay at home with autonomy and dignity, (Janet: right), because dignity cannot wait for better times. (Janet: interesting). That’s Lotus.

Janet: Yeah. And you know, I mean, if you come up with a ring to kind of replace the, “I’ve fallen and I can’t get up” that type of device, I think it would be much more successful at this point, you know, and there’s a stigma with that.

But I really appreciate you coming on today. It’s interesting, you’ve hit on so many pieces that we would really like to kind of reference. I mean, you hit on like all the buzz words. (Dhaval: laughs, thanks) You came at it from all different angles. And I really appreciate that. We’re going to have a lot of fun doing the resource page. (Dhaval: laughs).

I think that your resource page, it’ll definitely be well sourced of definitions of different words. So thank you for that. It was an unexpected surprise. (Dhaval: chuckles). So if you want to know more about UX, Universal, or Inclusive Design, just go to our webpage ‘inclusivedesigners.com’ and we will set all of that up for you so you can have all those definitions, and we’ll do links and stuff like that.

Dhaval: Yeah. Perfect.

Janet: And I’m a big fan of the ring. (Dhaval: thank you). And so I hope when it comes out, let us know so we can re-promote it on IDP. And so we can also make sure that it gets the visibility that it deserves. And this has been terrific to talk to you. And please come back when you’ve got other things to promote.

Dhaval: We would love to.

Janet: We would love to hear from you.

Dhaval: Sounds good.

Janet: And if somebody wanted to invest in this company is that a possibility at this point, or what can my $10 get? (laughs)

Dhaval: (laughs) We just closed our fundraising pre seed round (Janet: oh), about a couple of weeks ago (Janet: wow). I’m happy to say we were 200-percent oversubscribed or close to it, (Janet: oh, that’s amazing).

And so, we’re not fundraising anymore, (Janet: right), but it does go to show that there are lots of people who believe that this has tremendous potential, which is wonderful. (Janet: that’s terrific).

I will say, if there is anyone that wants to support us, please visit our website. It’s lotuslabs.org. That’s L-O-T-U-S, like the flower. L-O-T-U-S labs, L-A-B-S-dot-O-R-G.

And feel free to sign up to the newsletter. We have a limited pre-order availability because we want to sort of prioritize people with the greatest need first. And so we’re doing limited batches. And so if you’re interested, or you think it can help someone that you know, or a friend or family member, feel free to go on and pre-order.

Or just reach out to me. My email is Dhaval, D-H-A-V-A-L, at lotus labs dot org {[email protected]}. And just share your thoughts and comments or feedback. We love hearing from users. Like we said, we believe in human-centered design. Nothing better than hearing from the end user.

Janet: Terrific. Thank you so much, Dhaval. This was really wonderful. We appreciate you and we appreciate Lotus and thank you so much for coming on Inclusive Designers Podcast.

Dhaval: Thank you. Thank you for having me Janet. It’s been an honor and a privilege. Thank you.

Janet: Thank you, Dhaval. Have a good day.

(Music/Outro)

Janet: I find what Dhaval said about a hybrid of Inclusive and Universal design so interesting.

Carolyn: It might need a new name, maybe ‘Uni-clusive’, or ‘Inclu-versal’?

Janet: Funny, but true. But whatever it is called, I really enjoyed his philosophy that ‘technology is usable by everyone when optimized for disability first’…

Carolyn: And he also said that technology should be invisible, appearing only when needed. And that technology isn’t the end-product—it’s the impact it has on human life that is.

Janet: And do you remember what he said about using extensive user studies before starting design?

Carolyn: it has a certain Ring to it…

Janet: really?

Carolyn: you know I couldn’t resist…

Janet: I get it. I know. Seriously though, I love that in creating the ring, they believed in getting users input, their stories, and experiences – and it’s so true that it provides meaningful foundational data which is so much better than just merely using statistics.

Carolyn: Last but not least, I have to mention the wonderful quote from the play ‘Hamilton’ that Dhaval says drives him. And the quote is: “What is Legacy? It’s planting seeds in a garden you never get to see.”

Janet: Exactly… inspirational words for designers, and well everyone. And we will share the link for how to contact Dhaval, and of course, the links to the innovative work he is doing, and for all the many other things that are mentioned along the way during this discussion… all on our website at: inclusive-designers-dot-com.

Carolyn: That’s: inclusivedesigners.com…

Janet: A big thank you to Dhaval. And ‘thanks’ to all of you as well for listening.

Carolyn: Along with all the regular places you get your podcasts—which now includes Pandora to replace the now defunct Stitcher— you can also find us on YouTube as, you guessed it, Inclusive Designers Podcast. And if you like what you hear, feel free to go to our website and hit that Patreon Button, or the link to our GoFundMe Page.

Janet: Yes, please do. And let us know if you have any questions or suggestions for topics you think we should be covering in upcoming shows!

And as our motto says: ’Stay Well…and Stay Well Informed’!

As always, thank you for stopping by. We’ll see you next time.

Carolyn: Yes, thanks again.

(Music up and fade out)