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WHAT IS ASSISTIVE TECHNOLOGY?
Assistive technology is any service or tool that helps the elderly or disabled
do the activities they have always done but must now do differently. These
tools are also sometimes called “adaptive devices.”
Such technology may be something as simple as a walker to make moving around
easier or an amplification device to make sounds easier to hear (for talking
on the telephone or watching television, for instance). It could also include
a magnifying glass that helps someone who has poor vision read the newspaper
or a small motor scooter that makes it possible to travel over distances
that are too far to walk. In short, anything that helps the elderly continue
to participate in daily activities is considered assistive technology.
Just as older people may have many different types of disabilities, many
different categories of assistive devices and services are available to
help overcome those disabilities. These include the following:
- Adaptive switches. Modified switches that seniors can use to adjust
air conditioners, computers, telephone answering machines, power wheelchairs,
and other types of equipment. These switches might be activated by the
tongue or the voice.
- Communication equipment. Anything that enables a person to send
and receive messages, such as a telephone amplifier.
- Computer access. Special software that helps a senior access the
Internet, for example, or basic hardware, such as a modified keyboard
or mouse, that makes the computer more user friendly.
- Education. Audio books or Braille writing tools for the blind come
under this category, along with resources that allow people to get additional
vocational training.
- Home modifications. Construction or remodeling work, such as building
a ramp for wheelchair access, that allows a senior to overcome physical
barriers and live more comfortably with a disability or recover from
an accident or injury.
- Tools for independent living. Anything that empowers the elderly
to enjoy the normal activities of daily living without assistance from
others, such as a handicapped-accessible bathroom with grab bars in
the bathtub.
- Job-related items. Any device or process that a person needs to
do his or her job better or easier. Examples might include a special
type of chair or pillow for someone who works at a desk or a back brace
for someone who does physical labor.
- Mobility aids. Any piece of equipment that helps a senior get around
more easily, such as a power wheelchair, wheelchair lift, or stair elevator.
- Orthotic or prosthetic equipment. A device that compensates for
a missing or disabled body part. This could range from orthopedic shoe
inserts for someone who has fallen arches to an artificial arm for someone
whose limb has been amputated.
- Recreational assistance. New methods and tools to enable people
who have disabilities to enjoy a wide range of fun activities. Examples
include swimming lessons provided by recreational therapists or specially
equipped skis for seniors who have lost a limb as a result of accident
or illness.
- Seating aids. Any modifications to regular chairs, wheelchairs,
or motor scooters that help a person stay upright or get up and down
unaided or that help to reduce pressure on the skin. This could be something
as simple as an extra pillow or as complex as a motorized seat.
- Sensory enhancements. Anything that makes it easier for those who
are partially or fully blind or deaf to better appreciate the world
around them. For instance, a telecaption decoder for a TV set would
be an assistive device for a senior who is hard of hearing.
- Therapy. Equipment or processes that help someone recover as much
as possible from an illness or injury. Therapy might involve a combination
of services and technology, such as having a physical therapist use
a special massage unit to restore a wider range of motion to stiff muscles.
- Transportation assistance. Devices for elderly individuals that
make it easier for them to get into and out of their cars or trucks
and drive more safely, such as adjustable mirrors, seats, and steering
wheels. Services that help the elderly maintain and register their vehicles,
such as a drive-up window at the department of motor vehicles, would
also fall into this category.
WHAT ARE THE BENEFITS OF ASSISTIVE TECHNOLOGY?
For many seniors, assistive technology makes the difference between being
able to live independently and having to get long-term nursing or home-health
care. For others, assistive technology is critical to the ability to perform
simple activities of daily living, such as bathing and going to the bathroom.
According to a 1993 study conducted by the National Council on Disability,
80 percent of the elderly persons who used assistive technology were able
to reduce their dependence on others. In addition, half of those surveyed
reduced their dependence on paid helpers, and half were able to avoid entering
nursing homes. Assistive technology can also reduce the costs of care for
the elderly and their families. Although families may need to make monthly
payments for some pieces of equipment, for many, this cost is much less
than the cost of home-health or nursing-home care.
HOW CAN I TELL IF ASSISTIVE TECHNOLOGY IS RIGHT FOR ME?
Seniors must carefully evaluate their needs before deciding to purchase
assistive technology. Using assistive technology may change the mix of services
that a senior requires or may affect the way that those services are provided.
For this reason, the process of needs assessment and planning is important.
Usually, needs assessment has the most value when it is done by a team working
with the senior in the place where the assistive technology will be used.
For example, an elderly person who has trouble communicating or is hard
of hearing should consult with his or her doctor, an audiology specialist,
a speech-language therapist, and family and friends. Together, these people
can identify the problem precisely and determine a course of action to solve
the problem.
By performing the needs assessment, defining goals, and determining what
would help the senior communicate more easily in the home, the team can
decide what assistive technology tools are appropriate. After that, the
team can help select the most effective devices available at the lowest
cost. A professional member of the team, such as the audiology specialist,
can also arrange for any training that the senior and his or her family
may require to use the equipment needed.
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Case Study |
At the age of
66, Christina did not feel old. After her divorce, she became more
active than ever in her church and began doing all the things she
had been wanting to do for years. She moved into her daughter Kelly’s
house to save money and enjoyed her garden there in the backyard.
The only thing that slowed her down was that her hearing and vision
were beginning to go. She could no longer appreciate music the way
she used to or see well enough to read for more than a few minutes
without getting a headache. At the same time, Christina’s medical
condition was beginning to affect her life at home. Kelly’s children
complained that Christina turned the television set up so loud that
they could not concentrate on their homework.
Although Christina was in good health otherwise, the hearing and
vision problems eventually got so bad that she went to her doctors
for a checkup. Her ophthalmologist told her that she had cataracts
and would need operations to have them removed from her eyes. The
audiologist said that she would need to get a hearing aid. Both
doctors also said that she would require rehabilitative services.
Fortunately, Christina was still able to take charge of the situation
and find a solution as quickly as possible. While waiting to get
her eye operations done, she had her doctors set up a needs assessment
team to explore other options she could pursue to make life easier
both before and after her surgery. Christina worked closely with
the ophthalmologist and audiologist and had physical and recreational
therapists come to the house. They spent a full week analyzing Christina’s
condition and her home environment. Then, they looked at alternatives
that would allow Christina to remain as active as possible, while
still addressing her family’s concerns. |
The following case study shows how conducting a needs assessment and
working with a team improved the quality of life for one elderly woman and
her family:
The results were wonderful. Together, the team helped Christina get a
good hearing aid that enabled her to hear well again. A special magnification
device and telecaption decoder on the TV meant that she could watch television
without having to bother the children. More assistive technology enabled
her to talk on the telephone and use the computer as easily as ever before.
In the end, the operations to remove Christina’s cataracts were successful,
and she could see better than before, but she still used the magnifying
screens and telecaption devices for convenience. Combined with her new hearing
aid, each item convinced Christina that assistive technology can make a
big difference indeed.
When considering all the options of assistive technology, it is often useful
to look at the issue in terms of high-tech and low-tech solutions. Seniors
must also remember to plan ahead and think about how their needs might change
over time. High-tech devices tend to be more expensive but may be able to
assist with many different needs. Low-tech equipment is usually cheaper
but less adaptable for multiple purposes. Before buying any expensive piece
of assistive technology, such as a computer, be sure to find out if it can
be upgraded as improvements are introduced.
Whether you are conducting a needs assessment or trying to make a decision
after such an assessment, it is always a good idea to ask the following
questions about assistive technology:
- Does a more advanced device meet more than one of my needs?
- Does the manufacturer of the assistive technology have a preview
policy that will let me try out a device and return it for credit if
it does not work as expected?
- How are my needs likely to change over the next six months? How
about over the next six years or longer?
- How up-to-date is this piece of assistive equipment? Is it likely
to become obsolete in the immediate future?
- What are the tasks that I need help with, and how often do I need
help with these tasks?
- What types of assistive technology are available to meet my needs?
- What, if any, types of assistive technology have I used before,
and how did that equipment work?
- What type of assistive technology will give me the greatest personal
independence?
- Will I always need help with this task? If so, can I adjust this
device and continue to use it as my condition changes?
HOW CAN I PAY FOR ASSISTIVE TECHNOLOGY?
Right now, no single private insurance plan or public program will pay for
all types of assistive technology under any circumstances. However, Medicare
Part B will cover up to 80 percent of the cost of assistive technology if
the items being purchased meet the definition of “durable medical equipment.”
This is defined as devices that are “primarily and customarily used to serve
a medical purpose, and generally are not useful to a person in the absence
of illness or injury.” To find out if Medicare will cover the cost of a
particular piece of assistive technology, call 1-800-MEDICARE (1-800-633-4227,
TTY/TDD: 1-877-486-2048). You can also find answers to your questions by
visiting the website at
www.medicare.gov
on the Internet.
Depending on where you live, the state-run Medicaid program may pay for
some assistive technology. Keep in mind, though, that even when Medicaid
does cover part of the cost, the benefits usually do not provide the amount
of financial aid needed to buy an expensive piece of equipment, such as
a power wheelchair. To find out more about Medicaid in your State call the
toll free number for your State. A list of toll free numbers can be reached
through the following website:
Seniors who are eligible for veterans’ benefits should definitely look
into whether they can receive assistance from the Department of Veterans
Affairs (DVA). Many people consider the DVA to have a model payment system
for assistive technology because the agency has a structure in place to
pay for the large volume of equipment that it buys. The DVA also invests
in training people in how to use assistive devices. For more information
about DVA benefits for assistive technology, call the VA Health Benefits
Service Center toll-free at 1-877-222-VETS or visit the department’s website
at:
Private health insurance and out-of-pocket payment are two other options
for purchasing assistive technology. Out-of-pocket payment is just that;
you buy the assistive technology yourself. This is affordable for small,
simple items, such as modified eating utensils, but most seniors find that
they need financial aid for more costly equipment. The problem is that private
health insurance often does not cover the full price of expensive devices,
such as power wheelchairs and motor scooters.
Subsidy programs provide some types of assistive technology at a reduced
cost or for free. Many businesses and not-for-profit groups have set up
subsidy programs that include discounts, grants, or rebates to get consumers
to try a specific product. The idea is that by offering this benefit, the
program sponsors can encourage seniors and people with disabilities to use
an item that they otherwise might not consider. Obviously, elderly people
should be careful about participating in subsidy programs that are run by
businesses with commercial interests in the product or service because of
the potential for fraud.
WHERE CAN I LEARN MORE ABOUT ASSISTIVE TECHNOLOGY?
Most states have at least one agency that deals specifically with assistive
technology issues. The Assistive Technology Act (Tech Act) provides funds
to states for the development of statewide consumer information and training
programs. A listing of state tech act programs is available at:
Some area agencies on aging (AAA) have programs or link to services that
assist older people obtain low-cost assistive technology. You can call the
Eldercare Locator at 1-800-677-1116 or visit the website www.eldercare.gov
to locate your local AAA. In addition local civic groups, religious and
veterans’ organizations, and senior centers may be able to refer you to
assistive technology resources.
The following resources provide information on assistive technology products
and services.
DisabilityInfo.gov
http://www.disabilityinfo.gov
This site is designed to serve as a "one-stop" electronic link to an enormous
range of useful information to people with disabilities and their families.
ABLEDATA
http://www.abledata.com
800/227-0216 or 301/608-8998
TTY 301/608-8912
ABLEDATA is a federally funded project whose primary mission is to provide
information on assistive technology and rehabilitation equipment available
from domestic and international sources to consumers, organizations, professionals,
and caregivers within the United States.
Solutions: Assistive Technology
for People with Hidden Disabilities
http://www.uiowa.edu/infotech/Solutions.pdf
This resource guide provides information on adapted devices for people who
have memory problems.
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