Self-Help Devices

Abstract: Disability and mobility problems increase with age. Assistive devices such as canes, crutches, and walkers can be used to increase a patient's base of support, improve balance, and increase activity and independence, but they are not without significant musculoskeletal and metabolic demands. Most patients with assistive devices have never been instructed on the proper use and often have devices that are inappropriate, damaged, or are of the incorrect height. Selection of a suitable device depends on the patient's strength, endurance, balance, cognitive function, and environmental demands. Canes can help redistribute weight from a lower extremity that is weak or painful, improve stability by increasing the base of support, and provide tactile information about the ground to improve balance. Crutches are useful for patients who need to use their arms for weight bearing and propulsion and not just for balance. Walkers improve stability in those with lower extremity weakness or poor balance and facilitate improved mobility by increasing the patient's base of support and supporting the patient's weight. Walkers require greater attentional demands than canes and make using stairs difficult. The top of a cane or walker should be the same height as the wrist crease when the patient is standing upright with arms relaxed at his or her sides. A cane should be held contralateral to a weak or painful lower extremity and advanced simultaneously with the contralateral leg. Clinicians should routinely evaluate their patients' assistive devices to ensure proper height, fit, and maintenance, and also counsel patients on correct use of the device.

Abstract: This paper examined assistive device use by noninstitutionalized older persons with visual, cognitive, and physical impairments. One hundred fifty seven persons over 60 years of age (M = 75.5 years) were interviewed in their homes for the University at Buffalo Rehabilitation Engineering Research Center Consumer Assessments Study. Subjects were assigned to one of seven groups according to types of impairment: minimal, physical, visual, visual and physical, cognitive, cognitive and physical, and cognitive and visual. Group assignments were based on scores on the Sickness Impact Profile (physical), Older Americans Resources and Services Program Multidimensional Functional Assessment Questionnaire (vision), and Mini Mental State Exam (cognitive). Overall, subjects owned a mean of 13.7 devices, used 10.8 devices (79% of the devices they own), and were satisfied with 9.8 devices (72% of the devices they own). There were significant differences among the impairment groups in numbers of devices owned and used, and in satisfaction with devices. Subjects expressed the need for more devices, especially devices for increasing mobility and assisting with balance. Results suggest a stronger role for occupational therapists in the assessment of assistive device needs of older persons, and in recommending devices and training persons in their use.

Abstract: Recent studies report that the majority of older adults wish to live in their own homes, for as long as possible. This creates a growing interest in technologies to enable older people to remain living independently at home. The purpose of this article is to provide a narrative review of current technology appropriate for older adults’ home use. The key research questions were as follow: 1- What is the evidence demonstrating that gerontechnologies are effective in enabling independent living? 2- What are devices designed specifically for frail elderly persons ? Several publications were identified about devices targeting social isolation (videophonic communication, affective orthotic devices or companion-type robots, personal emergency response systems [security]), autonomy loss (technologies for maintenance of autonomy in the activities of daily living) and cognitive disorders (cognitive orthotics, wandering management systems, telemonitoring). Very few articles dealt specifically with the frail older person. In particular, there was extremely limited evidence on use and efficacy of these devices within this population. There is a need to obtain a consensus on definition of the technologies, and also to revisit work strategies and develop innovative business models. To meet this goal, we need to create a network of technological companies, aging services organizations, end-users, academics, and government representatives to explore the real needs of the frail older population and to develop and validate new devices promoting aging at home.

Abstract: A cognitive disability represents a substantial limitation in mental tasks (such as planning, information processing, and understanding of social cues) that reduces a person's ability to perform desired activities. Cognitive disabilities can arise because of congenital or acquired causes. Assistive technology can reduce the affect of these disabilities and provide improved quality of life. A number of technologies are currently being explored. The success of these technologies requires understanding barriers to use of current technology, including people with cognitive disabilities in the design process, and transitioning technology from research settings into the marketplace.