Assistive Technology as a Key Ingredient in the Caring for the Elderly and People with Disabilities
The demographic trend characterized by population aging is slowly becoming a dominant phenomenon in most countries. The growing number of senior citizens is a positive result of improved living conditions leading to increased life expectations. The aging population has raised the responsibility of care due to the increased dependence on the family and relatives for care and support. The growing interest in population aging has been followed by an increased attention to assistive technology (AT) as a means of strengthening and improving personal care for the disabled and older adults.
Assistive technologies are crucial tools for improving productivity, independence, and capabilities of older people. Adaptive solutions of the technology provide simple and easily available adjustments that accommodate to impairments by compensating for the cognitive, sensory, and physical limitations, as well as providing independence and self-management. Nevertheless, there are discussions concerning the effectiveness of assistive technologies confirmed by the opinion that assistive technologies can functionally eliminate a disability. The other wrong opinion is that the individuals with disabilities would be powerless without AT. The paper demonstrates that assistive technology is a valuable intervention that replaces or complements human personal assistance.
Assistive technology represents any product (inclusive of devices, equipment, instruments, technology, and software) produced or accessible for compensating, monitoring, relieving or neutralizing impairments, activity limitations and participation restrictions. Assistive technologies sometimes function as replacements or complements for human personal assistance. Assistive technology (AT) can be used as a tool to assist in the performance of a functional task that people with disability cannot perform well or undertake due to their disability. Assistive technologies are divided into four major classes: prevention and engagement tools that seek to delay restrictions in functioning and provide user engagement within their environment. Assistive technologies also concentrate on compensation and assistance and work to satisfy the user needs. Care support devices may be the tools for physical support such as lifts. Improvement and satisfaction technologies, such as robotics, communication, and home automation technologies provide services that ensure the enjoyment of activities. Assistive technologies can encompass a wide range of devices designed for personal medical treatment, personal mobility, as well as personal care and protection. AT can be also devices for communication and information, furnishings and adoptions to homes, recreation, and environmental improvement.
Numerous studies have demonstrated that assistive technologies improve independence, minimize the necessity for personal care, and reduce social care costs. It is worth noting that the contribution of assistive technologies at macro and micro levels remains unknown. Indeed, the possibility for the disabled and older adults to live independently is a function of various factors. As a result, it should be considered how AT strategies interact with the existing social care structures. Nowadays, social care provision for senior citizens depends on voluntary activity. Principally, older people living within the community live from informal voluntary, personal assistance from the family, which is important for minimizing isolation and loneliness for people with disabilities and older adults.
Persons with disabilities belong to the biggest and most significant health care consumer group. According to WHO, by 2050, around 2 billion people will be aged 60 years and above, and the percentage of adults aged over 80 will be four times more (WHO). According to U.S. Census Bureau, close to 18.7% of the American population demonstrate some level of disability. In addition, around 40% of persons aged 65 and older have at least one form of disability. In the US, It is estimated that two-thirds of the 15.7 million people experience some difficulty in climbing or walking, which prevents independent living.
The design of suitable and cost-effective formal and informal care for older adults and persons with disabilities remains a priority within aging societies. A large number of older adults and people with disabilities live in the community, and there is a need to provide them with possibility to live independently. The World Health Organization estimates that over 75% of older adults with disabilities use some form of assistive device, especially assistance with mobility (WHO). Personal assistance represents the aid that older adults and people with disabilities receive from others, including child, spouse, friend, or paid caregiver. Aid from others does not enable individuals to function more independently, but it may reduce the difficulty experienced while undertaking any task. Theoretically, both personal and technological assistance are the dependent factors that should improve the disablement process, minimizing the severity of disability. Assistive technology helps to reduce task demand via environmental change or technology, replacing another individual to undertake some or all task demands, and changing the performance of a certain activity. The nature of an action, the traits of the person, the caregiver, and the device potentially impact on the methods provided to cope with disability.
The senior citizens spend much of their time coping with the growing incidences of disability. As people become older, they experience functional limitations due to their disabilities. Aging is connected with an increase in non-communicable diseases, including vision and hearing loss, memory problems, general frailty, and mobility impairments. Any impairment prevent the older adults from normal conditions, fulfilling their daily tasks, and independent living. Moreover, it leads to the situation when older adults feel increased social isolation, which in turn results in a deterioration of mental and physical health.
The socio-political arguments raised in support of assistive technologies include reduced accessibility of informal caregivers, demographic changes, impact of disability or disease on daily life, and decreased long-term care workers. Assistive technology provides independent living and aids in saving costs. Assistive technologies seek to improve the quality of life as well as improve health and social care services for majority of older adults. For the individuals who live at home with functional impairment, assistive technologies and personal assistance are provided to solve the problems of the limitations of these people when they need to fulfill the tasks needed for independent living. Older and younger individuals with disabilities compensate for their functional limitations through assistive technologies and by seeking personal assistance from human caregivers. Assistive technology can replace the personal assistance in certain cases, such as when a cane is necessary rather than depending on a human caregiver, which may help to save the costs. Alternatively, assistive technology can be a complement to personal assistance (when both are utilized together) such as when mechanical lifting device is used by the personal assistants to facilitate performance of the certain tasks.
Assistive technologies, such as mobility devices, can be considered a matter of equity for the individuals with disabilities because they provide access to work, education, and social life, improve independence and participation within the communities. Assistive technologies allow the disabled and the elderly people to preserve their autonomy and dignity in an independent lifestyle and remain valuable members of the society. The core factors influencing the need for support services include available and suitable assistive devices, the presence and readiness of family members to provide help, and the level to which the environment involves the persons with disabilities, including the elderly. The benefits of assistive technology include several elements, such as effectiveness (completeness and accuracy with which the users of device deliver certain objectives). It is also influenced by efficiency (completeness and accuracy of achieved objectives in relation to the cost) and user satisfaction.
Largely, ordinary day-to-day tasks, such as turning the door knob or buttoning a shirt that do not necessary provoke a second thought for majority of people can cause major difficulties for older adults and people with disabilities. Therefore, a simple improvement, such a lever door handle that substitute a doorknob, can be very helpful. Such devices and adjustments can improve the involvement of individuals with disabilities in activities and program including independent living, training, rehabilitation, recreation, and other elements of daily life. For majority of people with disabilities, support and assistance are vital for active involvement in the society. The absence of necessary support services can lead to the situation when people with disabilities completely rely on their family member, which in turn, can eliminate their possibility to engage in social and economic life equally. Since the main assistance and support for people with disabilities comes from family members or social networks, sometimes older adults and people with disabilities have the feeling that the society is also supporting them. This serves to improve their sense of powerlessness and dependence on technology and stigmatization.
Assistive technology users may feel overly dependent on certain devices and sensitive if the devices fail or experience feelings of anger, helplessness and frustration when the assistive technologies fail to function as expected. The negative factors may influence assistive technology non-use, adoption, and abandonment, whereby users with disabilities might show unwillingness to learn new assistive technologies that demonstrate high learning possibilities and destroy the opinion that individuals with disabilities are less able. Therefore, it is important to cancel the perceived personal and social handicap by helping older adults and people with disabilities establish new personal skills or create tools that compensate for the impairment.
Some critics state that technology keeps people, especially children, from interacting and prevents the growth of social skills. In contrast to this viewpoint, majority of technologies reinforce social development. Older adults experience decreased cognitive functions in spheres of language, memory, perception, and executive function, as well as incidence of different personality, mood changes, and confusion. In a study exploring the factors fostering the utilization of technology in daily life of older adults, Riikonen, Paavilainen, and Salo stated that, timeliness and a well-functioning social network is important to involve technology into the lives of the elderly.
Assistive technology is important for influencing the older citizens’ work, learning, thrive, and age. The use of assistive technology has increased significantly whereas the provision of personal care has decreased among older persons living in the community and experiencing difficulty in self-care activities. The changed opinion about use of assistive technologies is connected with a decreased number of persons who rely on personal care. One of the main principles of assistive technology use and need include the severity of the impairments. There exists some evidence that assistive technologies accommodate impairments and aid persons with disabilities in order to overcome or eliminate environmental barriers. Assistive technology should be provided to improve existing personal care by involving AT into the current person-based infrastructure. Assistive technology alone cannot be considered as the only contributor to such success because the personal care is equally important. Considering the fact that individuals in need cannot access adequate aid from assistive technologies, personal care can address the remaining needs. Although, a significant benefit of assistive technologies is that it gives independence to individuals with disabilities, offsetting the need for personal care is important in light of the present budget environment.
Adults with some form of impairment and who use assistive technology become less impaired in relation to the exclusive users of the personal care. Adults with disabilities are most likely to report that a task is time consuming or tiring when they only use assistive equipment. Similarly, users of assistive technology may report a need for hands-on help, which demonstrates the need to connect technology with personal care. Examining the question why older adults might be reluctant to the use of assistive technologies can provide valuable understanding about the development of technologies that satisfy user’s needs and expectations. Some of the motives for non-use of assistive technologies include lack of knowledge that such options exist and the lack of personal access to these technologies due to its high costs. The other prevention to adopt the assistive technologies is lack of resources or time to learn how to use the technologies, weak satisfaction with existing devices, and difficulties of installing operating systems.
Assistive technologies have a significant influence on the ability of senior citizens to live independently. Critics state that elimination of disability by technology is not better as demonstrated by the fact that technology users report less unsatisfied needs for personal care. Largely, individuals use technology as a supplement rather that replacement of human support. Individuals who use assistive technology are more probable to combine the technology assistance with personal support. Indeed, assistive technology does not replace personal care for older adults, but the use of assistive technology is combined with formal or informal care. Overall, assistive technologies can make the difference between being capable of living independently and being forced to seek long-term home or nursing health care. It would be wrong to consider that assistive devices could functionally eliminate disability or that individuals with disabilities would be powerless without assistive technologies. Some studies have shown that the use of equipment (technological assistance) to cope with disability help these people to require fewer hours of assistance from another individual (personal assistance).