4.14 Assistive Technology
Assistive technology refers to devices or systems that support an adult to maintain or improve their independence, safety and wellbeing. Assistive technology supports those with memory problems or other cognitive difficulties, rather than being equipment to help with mobility or physical difficulties.
It can help adults who have problems with:
- hearing and eyesight;
- safer walking;
- memory and cognition;
- daily living activities such as bathing and cooking meals;
- socialising and leisure.
It can assist an adult by:
- promoting independence and autonomy;
- improving confidence and quality of life;
- managing potential risks in and around the home;
- supporting them to live at home for longer;
- helping with memory and recall;
- maintaining some abilities;
- providing reassurance to carers and reduce stress.
There are, however, some ethical issues which should be discussed with the adult and their family when considering the use of some assistive technology (see Section 4. Ethical Considerations).
2. Different Types of Assistive Technology
This section references the different types of assistive technology equipment which is available for adults with appropriate care and support needs.
2.1 Daily living
- automated prompts and reminders;
- clocks and calendars;
- medication aids;
- locator devices and solutions;
- communication aids;
Safety devices can often be linked to telecare systems (see Section 2.4, Telecare below).
Equipment available to support an adult to live more safely includes:
- sensor lights that come on when a person is moving around, helping prevent trips and falls;
- automated shut-off devices that can operate when the gas or cooker have been left on;
- water isolation devices to preventing flooding;
- plugs and heat sensors which sense water levels and temperature, aiming to prevent floods and scalds;
- fall sensors;
- telephone blockers which block nuisance calls.
2.3 Safer walking
When an adult is prone to getting lost or leaving the house in the night (particularly if inappropriately dressed for weather conditions), consideration may be given to safer walking technology.
- alarm systems: an alarm when someone has moved outside a set boundary;
- tracking devices or location monitoring services, using satellite or mobile phone technology to locate and track a person.
Telecare refers to a system or devices, connected to a telephone line or via the internet that monitor people living in their own home, enabling them to access support or response services when necessary. Telecare systems include:
- community alarms: triggered by the adult who wears a pendant alarm in case of a fall or other concern;
- medication reminders; automatic pill dispensers can be linked to a call centre, or a medicine management service which contacts the adult if they have not taken their medication or if the dispense itself malfunctions or tablets become jammed;
- flood sensors fitted on skirting boards or kitchen / bathroom, which shuts off the water supply if there is a flood;
- extreme temperature sensors: send a warning signal if the temperature is very low, very high, or changes suddenly;
- bed / chair sensors: alarm is raised if the adult does not get up or does not return within pre-set times. Also used for adults who need help to go to the toilet in the night;
- front door alarms: system triggers if the front door is opened (can be during pre-set times or if a person does not return within a specified time);
- devices to monitor daily activity: movement sensors that can oversee an adult’s activity over a period of time. These can help relatives or community services have some understanding of a person’s activity whilst on their own at home.
2.5 Social participation and leisure
Assistive technology is increasingly being used to support an adult’s social life and provide activities and enjoyment. This in turn can help maintain relationships, skills and wellbeing.
Tablets, smartphones and their apps enable people to more easily keep in contact with family and friends, particularly with younger people who can often help others learn the skills required to use the technology. Tablets and smart phones also provide opportunities for mental stimulation, such as games, puzzles, listening to music or the radio via apps, which can support their wellbeing.
3. Potential Drawbacks
Whilst many adults find assistive technology beneficial and it improves their quality of life, there are potential drawbacks of which should first be discussed with them:
- it can reduce risk and improve an adult’s safety and wellbeing, but it does not entirely eliminate risk and regular monitoring through care and support plan reviews and risk assessments still need to continue;
- technology should not replace face-to-face human interaction, and staff should ensure that the adult does not become socially isolated as a result of relying on assistive technology;
- it is expected that the adult adapts to the technology, not the technology adapting to the individual needs of the adult. This may be a challenge to some people who are not used to such technology, and needs to be discussed with the adult and their family;
- it may take the adult longer to become accustomed to the technology than may be expected. Problems with use should be discussed with the adult to ascertain their views in order to decide whether to persevere;
- it can be quite expensive, especially some high-tech devices, although rental options are often available;
- there are ethical considerations regarding the use of devices or systems that monitor or track people, see ‘Ethical considerations’ below.
4. Ethical considerations
Assistive technology must always be used primarily for the benefit of the adult with care and support needs, in order to promote their independence, safety and wellbeing. In practice it often also benefits carers, but the adult’s needs are the priority. The adult must understand, wherever possible, the purpose of the technology, how they might benefit from it but also any potential drawbacks.
When discussing the use of assistive technology and selecting the most appropriate options, the adult must be involved and their consent sought and gained, wherever possible. Where the adult does not have mental capacity, decisions need to be made in their best interests, and must also be the least restrictive option for their needs and situation.
This is particularly pertinent with safer walking technologies. If an adult does not have mental capacity to consent to carrying such a device, they may not be able to understand the true purpose of it or a carer may conceal it in their clothing for example. This is a threat to their privacy, and is therefore not the least restrictive option (see also Mental Capacity).
Technology should only be used when it is needed or wanted. The adult’s individual needs should be considered carefully when weighing up the pros and cons of using any type of system or device.
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