We all use technology pretty much every day, but some equipment and products can be a real godsend to people who struggle with aspects of daily life because of disability or old age. As Carers UK says: “The world is full of amazing gizmos to make life easier.”
But how do you know what is likely to be most helpful?
The first step is to cut through the jargon. Assistive technology is the term most commonly used and covers “any product or service designed to enable independence for disabled and older people”. This definition was agreed during a Kings’ Fund user group consultation meeting in 1991 and recognises the cross-over between mainstream products that are intended to be useful to anyone and technology specifically designed for older and disabled people.
Alternative descriptions include phrases like ‘life-enhancing devices’, ‘personalised technology’ (the preference of learning disability charity Hft, which showcases what’s available to support people in their own home through its Virtual Smart House) or ‘equipment for independent living’.
This last term is used by Rica, which was founded by Which? to carry out consumer research for older and disabled people and, although now an independent charity, still utilises similar methods to those Which? is renowned for in independently comparing different products and services. These include a 250-strong consumer panel, customer surveys, mystery shoppers and focus groups.
All of this underlines the point that you’re more likely to get the best possible outcome if you tackle choosing assistive technology in the same way you would any other product or service.
"You wouldn’t buy a car without comparing different models and taking it for a test drive, would you?"
You wouldn’t buy a car without comparing different models and taking it for a test drive, would you? Or buy a new TV without considering how easy it is to use and what features are important to family members?
So why should investing in technology that enhances the lives of carers and people they care for be any different?
‘Normalising’ assistive technology can have a positive impact from the outset. As the Innovations in Dementia guide Getting equipped to tackle forgetfulness points out: “We all buy and use gadgets to make our lives easier, such as TV remote controls or alarm clocks.” And as one user of technology said: “When we want something fun, we go and buy a gizmo – we think of this equipment as gizmos that will help us.”
The right tool for the job
First things first. Why do you feel it would be helpful? Occupational therapist Stephen Wey, who wrote the AT Dementia guide The ethical use of assistive technology, points out that “there are many things that may drive us to look for technological solutions but technology is just a tool that can help us to achieve certain ends”.
A professional assessment of individual needs and circumstances is a good starting point, even for identifying simple household gadgets that might make a difference, and also to explore what funding is available and if certain equipment can be obtained at no cost or a subsidised rate.
Assistive technology can have both general and specific benefits, like helping someone remain independent by reducing the risk of accidents and boosting their confidence. From a family carer’s perspective, the right technology can offer peace of mind and ultimately better physical and emotional wellbeing because they can relax more.
But technology needs to be not just right for the task but right for the individual and their particular circumstances. As Getting equipped to tackle forgetfulness points out: “Equipment is not for everyone. People have different needs, abilities and preferences.”
And these needs, abilities and preferences may change over time, so you need to take that into account, including a person’s ability to make their own choices and to learn new things. Getting equipped to tackle forgetfulness says: “Many people are happy with equipment. It often works best for people who have had equipment for enough time, have got used to it and are happy using it.”
As well as the technology as a whole, and its overall purpose, specific features need to suit the individual. As SCIE points out in its Dementia Gateway module on assistive technology, some people with dementia may welcome a verbal reminder (like a talking alarm clock); others may become distressed if they hear an unfamiliar voice. There is a limit to the usefulness of a pendant or pull cord alarm, or a falls detector that clips to a waistband or belt, if someone is easily confused or forgetful and does not remember to wear the device or use it correctly.
The Improvement and Efficiency West Midlands toolkit Maximising the potential for the use of assistive technology refers to a 2003 study that showed that there can be a ‘fall-off’ of the use of equipment of up to 75% for various reasons, including:
· Poor initial assessment of the person’s needs
· Inappropriate choice of equipment
· Lack of initial and ongoing support and instruction (for both the individual and their family carers)
· Equipment not meeting people’s expectations.
These are still issues to be addressed, particularly by care workers advising on assistive technology, and especially with the constant development of new products making it even harder to make valid comparisons and find the most suitable device.
Making choices and decisions
Getting equipped to tackle forgetfulness sums up what can be a bewildering range of choices: “Equipment can be high or low tech, simple or complex, expensive or cheap. Equipment can involve adaptations to the home or a simple purchase on the high street.”
And equipment cannot be forced on people – they and their carers need to be involved in considering what they want it to do and the options available.
For one family carer, ensuring his father still felt in control was an important part of the decision- making process when it came to home adaptations. “He’s not so good with words. When I needed to buy him a new shower, I showed him pictures of some alternatives … waited for a reaction, and then I knew I’d found the design he might be able to use.”
So before even getting into the practicalities, the concerns and wishes of those involved need to be considered, and ideally discussed among them, to find the right balance between independence and safety, for instance.
As one man with dementia says in Getting equipped to tackle forgetfulness: “We’ve just got a pendant [alarm] system. I’m not ready for it yet. But I’ve agreed that I’ll use it if I’m not well, if my wife is not well or if I’m in the house on my own.”
The ethical use of assistive technology points out that any device can be beneficial in some respect but also have drawbacks that may be hidden or not apparent until later. These might include concerns about:
· how certain devices, such as those mainly used to monitor safety, could affect someone’s privacy or freedom
· whether technology is used to do things a person can still manage to do themselves, which may make their problems worse, or might foster a one-sided focus on where they struggle rather than on their strengths.
It should be about helping someone achieve things they are finding harder to do or that could improve their quality of life and relationships.
The AT Dementia guide advises care professionals and family carers to question, for instance, whether an assistive technology option would even be considered if the person was not elderly or had dementia, and to consider how this reflects on their view of the individual and their abilities and wishes.
Assistive technology should not be seen as a ‘quick fix’. Weigh up the risks and benefits of using or not using equipment – including the fact that not being able to manage technology can have a negative effect on someone’s confidence – and whether there are better alternatives altogether, such as getting more help from other people or doing things differently.
It’s worth looking for simple solutions first. As SCIE points out in its Dementia Gateway module on assistive technology, someone might be falling often because carpets are loose or worn, they’re wearing the wrong footwear or would benefit from handrails. A telecare system that monitors for falls might not be the right response at this stage.
Approach finding the right technology to meet an individual’s particular needs like you would any other purchase. Do your research. You could see what other ‘customers’ think – the Carers UK forum, for instance, has plenty of threads on equipment, typically with very practical tips based on personal experience of things like ceiling hoists.
And hopefully in future there will be more opportunities to view and try out assistive technology in everyday surroundings, like the Gadget Hub ‘pop-up shop’ that brought devices and gadgets – plus expert advice and demonstrations – to a shopping mall in Sutton Coldfield for two weeks. Care Talk hopes to look at this project in more detail in a future issue.
There are increasing numbers of more specialist services that offer detailed advice as well as products and back-up support. The Disabled Living Foundation’s Living made easy website is a good place to start, if only to become familiar with what’s available so you can begin comparing products and matching them to different circumstances.
The foundation’s AskSARA online tool works through specific questions around every aspect of everyday life to really focus on where help is most needed. Hft’s Virtual Smart House will take you through a range of everyday household technology, room by room, and show how it can be used to support independence. The Improvement and Efficiency West Midlands Gadget Gateway includes reviews and price comparisons.
You should be able to try products out – as you would with many other things you buy. The Disabled Living Foundation has a demonstration centre in London. Or hiring equipment may be an option.
And don’t forget the simple stuff – everyday technology that can make everyone’s lives easier and that most of us take for granted.
Carers UK points to shopping and finding health and benefits information online, sharing stories and getting support on online forums, using group emails or shared group calendars, or specialised apps, to coordinate care and staying connected face-to-face through free video-call services like Skype, as just some ways technology can benefit family carers and, in turn, the people they care for.