Aquatic Safety for Populations with Special Healthcare Needs

Under the Americans with Disabilities Act (ADA) persons with disabilities must be provided equal access and opportunity to use all of your facility. In the aquatic arena, besides providing the necessary physical accommodations like ramps and hydro-lifts, your aquatic staff must also be prepared both to assist the special needs patrons in normal activities and to respond appropriately in case of an emergency.

There are numerous types of disabilities; each may require that your staff act differently in order to meet the needs of the specific individual. Staff must be aware of those who are known to have disabilities. Each person should be asked about their specific needs with regard to the aquatic facility and that information should be shared with the rest of the staff to ensure that the patron is consistently assisted in a supportive and professional manner. Common challenges are generally classed in the following three areas.

Physical
Because of the support afforded by water, many people whose disability impairs mobility on land can function independently in an aquatic environment. Water provides a unique opportunity for development of physical and motor fitness. Buoyancy, strength, agility, and flexibility limitations are reduced in the water but there may not be a corresponding increase in control.

• Some may require assistance from a personal caregiver or a member of the aquatic staff.
• Lifeguards should consider these patrons high-risk swimmers and should pay additional attention to them while scanning.
• Encourage the use of instructional floatation devices and ensure their proper operation.

Behavioral, Developmental and Mental
The physical skill levels of people with these challenges can range from highly impaired to unimpaired. These patrons may have the size and/or appearance of adults but generally they are incapable of consistently functioning as such. Enforcement of the rules may be challenging but exceptions should not be given so that the safety of the person and other swimmers is not compromised.

• Staff should work with the swimmer and his/her primary caregiver to ensure that the rules of the facility are understood. This process may have to be repeated often and a shadow or buddy swimmer may be required.
• These patrons should be classed as high-risk swimmers because they may not be able to make appropriate safety decisions consistently.
• Any repeated problems should be addressed with the caregiver; pool-use times may need to be scheduled during less populated periods.

Communications
Understanding the rules and swimming competently may be within the capabilities of people with communications challenges but they may have difficulty in understanding a lifeguard’s instructions or in expressing questions or concerns to the staff.

• The lifeguard must determine the appropriate alternative form of communication for each of these individuals.
• The use of an interpreter or companion may assist the person in learning rules, asking questions, or responding to emergency communications.

In general, lifeguards need to:

• Recognize individuals with various challenges and communicate effectively with them
• Be able to safely and efficiently assist each of them in case of need
• Be proactive to prevent a potentially dangerous situation from becoming an emergency
• Modify rescue protocols and procedures; regularly practice how to assist these patrons
• Increase guard-to-swimmer ratios to provide adequate protection in pools that include groups of swimmers with disabilities

The aquatic staff must remember that those with disabilities are people first – people who should be treated with the same level of respect and dignity that would be afforded to any member. When you look at a person with a disability focus on the person and what they can do rather than what they cannot.

Outside Groups
Other entities that use your facilities to serve this population should be required to provide certificates of insurance, hold-harmless waivers, indemnity agreements, and a facility agreement that contains:

• Specific day, starting time, and duration of event
• Area of pool desired and whether the space must be separated or if it can be shared
• Average and maximum number of participants
• Ratio of partners to participants; distinction should be made between water watchers on the pool deck and swim buddies in the water
• Annual health form updates; these should be reviewed by the organization to determine potential adjustments in lifeguards or instructional staff
• Partner staff should communicate to the lifeguards on the day of the activity if there have been changes in any patient’s health conditions