Going Out

Location: Top > Projects > Documentation > Going Out Last Updated: August 18, 2003

Although I am able to walk, due to my physical and mental disabilities I can have problems walking even short distances outdoors. I can sometimes make short trips to familiar places independently, I need prompting, reassurance, and guidance to make good progress on foot. I also stop frequently and make very slow progress. Although walking outdoors is always problematic, the degree of difficulty I have depends on my health and the situation. The longer or less familiar the journey, the more likely I am to have difficulties, but it is not possible to predict when or how badly something will go wrong. Typically, I avoid walking outdoors whenever possible.


I find going outdoors at all to be very difficult, distressing, and potentially dangerous. I require supervision, guidance, and prompting because I may fall, become confused, place myself in danger, forget where I'm going, be unable to ask for help, or experience anxiety and panic attacks. Although I can sometimes go to familiar places alone, I have many of the same problems in familiar places as I do in unfamiliar ones and many of my difficulties are unpredictable. I can only get as far from home as I can walk as I can neither drive nor take the bus alone.

Prior to Going Out

I have difficulty planning and preparing to go out. I may go out to perform a specific task and have difficulty finding or completely forget to take necessary items. e.g. Going to the bank without my bank card.

I don't know what order to do things in to prepare myself to go out, and often end up back-tracking because I didn't do things in the right sequence (3c) when I finally decide to go out, I often forget or don't leave enough time for what I am intending to do and arrive as shops are shutting (3d), I am often late even for things that are part of my routine, It takes several days of self-talk and prompting go out at all (1a,3f) and I can tolerate a maximum of one outing every few days.
  • Getting out of the house can also be problematic because I refuse to go out without my backpack or pouch or certain objects (6c), and I resist being prompted (5h).

    Getting Anywhere and Getting Things Done

    Getting Started

    I have difficulty getting started walking due to problems with motivation and initiating action.

    Route Planning, Navigation and Change

  • I am very insistent on taking the route I have decided on
  • I become extremely distressed if someone or something (e.g. a diversion by road works) forces me to change.
  • I usually resist prompting to move. I insist on taking the same route even after it has been pointed out to me that my route is through a dangerous area
  • Sensory issues cause difficulty with navigation
  • having to re-think my route due to difficulty planning
  • dealing with diversions
  • sequencing my activities
  • I can't plan an alternate route
  • My progress can be made very slow or even backward by following certain obsessions and ritual such as stepping on paving stones in a specific order.
  • Although I sometimes read scheduled or maps obsessively, I have difficulty understanding (4e) and following them (4g). I need help finding my way in unfamiliar situations.

    Physical

  • Fatigue, weakness, pain, and dizzy spells related to my thyroid condition cause me to stop frequently. I must expend extra physical and mental effort on coordinating my movements for walking. This effort also contributes to fatigue. I may stumble or fall (page 5).
  • concentrating too much on my movements
  • stumbles and falls (*another page) I need help when I am outdoors due to stumbles and falls (pg 5) and dizzy spells (pg 16) and my reaction to these, especially if injured (6f). I drop things I'm looking at in shops, run into people, knock things off shelves, and have difficulty avoiding obstacles (including people) (1e).

    Distraction

    I have very strong obsessions (6d) and am irresistably fascinated (7a) by lights and shiny objects. I will wander off to look at, touch, and investigate anything that catches my eye. I can become so deeply absorbed (7a) that I become unaware of my surroundings or danger (7e) (e.g. wander into the road to follow a vehicle with a flashing light).

    Coping with Being Out

    Awareness

  • Shutdown can be triggered by sensory overload
  • I stop whenever I hear a siren because I am unable to locate the source of the sound, even if it is a significant distance away.
  • spontaneously 'spacing out'
  • inability to divide my attention between walking and anything else
  • forgetting where I'm going
  • confusion
  • 'shutdown'
  • I am always distracted, wandering off, not paying attention, stopping, wasting time, etc. when trying to walk. I can become distracted by shiny or spinning objects
  • I have almost no concept of time (7b) and as I also have difficulty controlling my attention and keeping my purpose in mind (7c,d), it is difficult for me to accomplish any task or number of tasks when I go out alone.
  • I don't notice and respond to events and situations in the usual way. I am likely not to notice weather changes (2a), and even if I do I may fail to seek shelter or wear appropriate clothing.
  • I don't hear or understand public announcements and will not respond to my name being called. I don't recognise familiar people out of context.
  • Coordinating movements to walk (1e), sensory regulation (2), social interaction (5) and simply coping with the world can take all my attention (7c) so I can't concentrate on where I'm going, watching for dangers (7e), etc.
  • Fears and Anxieties

    I can become overwhelmed and terrified by crowds. "shutdown" triggered by fears and phobias. I have anxiety and panic attacks frequently when outdoors. I easily and unpredictably become extremely distressed, anxious, panicky, phobic, overwhelmed (2b) and 'shutdown' (7g) in many ordinary situations, e.g.: simply leaving the house, even when I want to go public toilets (8f) sensory hypersensitivities: high pitched noises, perfumes, etc. any social situation or proximity to people (5b), especially being bumped into unfamiliar places (5b) and unexpected events such as a change in route (5b, 3e, pg. 3) or a shop being shut. need for a spontaneous outing (I will often refuse to go, even if it is important) any disruption of a ritual (e.g. If the door I always go through is broken) windy weather, and certain common objects (e.g. Candles) These incidents can cause me to be unable to leave the house, enter some places or walk without extreme distress, and to behave oddly, self-stimulate, self-harm (9a), shutdown (7g), or otherwise lose awareness.

    Behaviour Problems

    I can have unusual or problematic behaviours when outdoors. My behaviour when I am stressed makes me obviously vulnerable and I am completely helpless in such a state. Although I am not aggressive, my odd behaviour can be disruptive. I will touch/fiddle/play with items in shops, touch othe people's cars, go out inappropriately dressed or unwashed. (5f,g) I will sometimes shout at people, even in public (6e). I withdraw into myself engage in self-stimulating behaviour (2g), and fail to acknowledge other people. (7b) Self-stimulating behaviour (2g) can cause me to collide with others, look vulnerable, disturb others, or become unresponsive

    If Something Goes Wrong

    Other Changes

    I become distressed, panicky (8b), and can't think of alternatives when something goes wrong (3e). e.g. If I have a flat bike tire, I won't go at all rather than walking; if I drop my shopping, I get confused about how to pick it up and continue; I can't plan an alternate route (3e) I stop whenever I hear a siren because I am unable to locate the source of the sound, even if it is a significant distance away.

    Danger

    I can't ask for help or directions I sometimes self-harm or put myself at risk while walking My fascination with light and shiny objects can cause me to wander into the road if I see a vehicle with a flashing light on it. I have difficulty crossing the road due to sensory issues
  • When I am walking it is difficult for me to concentrate on watching for potential hazards. I do not always recognise dangerous situations and can forget how to stay safe, especially if anxious, distracted, or confused. In an emergency, my communication problems would interfere with: approaching someone (5a), asking for help or directions (4a), speaking (4b), making myself understood (4d), understanding others (4e), and giving full and accurate information if questioned (4e). These problems also apply to non-emergency situations such as ordering food, buying tickets, taking the bus, banking, etc. I have a very hard time crossing roads safely because I can not visually estimate how fast cars are moving or accelerating, may look the wrong way (2e), or fail to recognise traffic flow patterns (3). I sometimes don't notice the road and cross without looking at all. I can put myself at risk during spontaneous walks, especially at night (9d) I insist on taking the same route even if it is through a dangerous area (6a,7e) I can climb on walls, walk along the kerb, or look directly at the sun. (6d,7e)

    Help Needed

    I need prompting to overcome these problems. Oly artificial help is orthotics in my shoes. Reliant on someone else to physically guide me away from distractions and to keep moving.
  • © Kalen Molton 2003. worldapart@paradox.freeserve.co.uk