Assistive Technology : Health And Social Care

Questions:

1.1 Explain how technology can be used to support users of health and social care services in living independently

1.2 Analyse barriers to the use of technology to support users of health and social care services in living independently

1.3 Explain the benefits of these technologies to health and social care organisations and their users

2.1 Explain health and safety considerations in the use of technologies in health and social care

2.2 Discuss ethical considerations in the use of technologies in health and social care

2.3 Explain the impact of recent and emerging technological developments on health and social services, organisations and care workers

3.1 Identify the specific needs of an individual requiring support to live independently

3.2 Make recommendations for how technologies might support the independent living arrangements

3.3 Evaluate the usefulness of technology for users off health and social care services  

Answers:

Introduction     

Supportive independent living

Independent living implies that people with disabilities enjoy the same freedom, choice, dignity and control as people without disabilities do at home, at work, and in the community. It means living on one’s own or by oneself or fending for oneself while exercising rights as citizens to practical assistance and support from the state to participate in society and live an ordinary or near normal life.

The seven needs of independent living are as follows:

• Peer support
• Personal Assistance
• Housing
• Technology
• Access
• Information
• Transport

Techno Aid is a company that specialises in technology that can be of help to individuals who need access to health and social care services and live independently. As more people access independent living funds and become employers of their own personal assistances, the balance is shifting from dependency towards independence.

1.1 Assistive Technology is defined in the Technology-Related Assistance Act (Tech Act) as “any item piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities” (Tech Act, 1988). Assistive technology can be made at home and custom designed for an individual, purchased at a local store, or ordered out of a catalogue that is targeted toward people with disabilities and their families. The technology relevant to an individual can be high tech or low tech. Examples of low tech technology include ramps, switches, switch-operated toys, communication boards, car door openers, Dyce (non-skid material), preachers, roll-in showers, and Velcro. Some high tech examples are computers, software, extended keyboards, electronic communication devices, power wheelchairs, and van lifts for wheelchairs.

Assistive technology cannot make the disability go away; but it can lessen the impact of the disability. (Moore, 1991). Assistive technology aims to provide independence and improve an individual’s outlook on life. Besides, it can help students access education and enable adults to secure a job. Individuals with disabilities can become an integral part of the community and engage in pursuits like education, leisure activities and work – with the appropriate technology.

However, assistive technology is not without its problems or barriers. Many times the devices that are needed are very expensive and resources are not readily available; or the equipment is purchased and no training or support system is in place to teach individual how to use it effectively; or the device simply breaks down and needs to be repaired (Moore, 1991).

The three technology devices that can prove to be useful are sensor and alarm systems and Braille books for visually impaired people and power recliner wheelchairs for the disabled

Tele care  is used to describe sensors or detectors (for example movement, flood, gas, smoke or fall detectors) that automatically send a signal through a base unit connected to a telephone line to a care facility, community alarm or monitoring service which can call for assistance  when it is needed. According to the Royal Commission on long term care, (1999) a person suffering from dementia is not required to press a button or dial a number to raise an alarm. For example, if a sensor detects gas, smoke, water or a fall, it can send a signal to a community alarm service automatically to be able to receive an appropriate response. The response could include providing reassurance, contacting an agreed key holder from the family, friend or caregiver to provide help, or if the need arises contacting the emergency services. A loud speaker on the alarm base unit allows the call center to communicate with the person. Irrespective of whether the affected individual is able to respond verbally or the distance of the individual from the loud speaker the service will send help.

The invention of Louis Braille (1809-1852), who turned blind by accident at the age of three years, changed the world of reading and writing forever for the visually impaired. When Louis was 12 Charles Barbier while giving a talk at the school that Louis attended shared an invention called the ‘night writing’, a code that used 12 dots. The code allowed soldiers to share confidential information on the war field without the need to speak. But the code was not easy for the soldiers to learn, but not so for Louis. Louis reduced Barbier’s 12 dots to 6, perfected the system by the time he was 15, and published the first Braille book ever in 1829. He continued to improvise and by 1837 he was able to add symbols for music and math. Acceptance was slow so blind students had to study Braille on their own. Even at the royal institution, where Louis taught after he graduated, Braille was taught only after his death. Braille began to gain worldwide acceptance in 1868. A group of men from the Royal National Institute for the Blind took to the task of spreading its reach. Today every country uses Braille. Braille books help blind people receive education and Braille signs help to get around when they are outdoors. And most importantly blind people can communicate easily. The development of assistive technology has brought many possibilities for the visually impaired in the areas of education and employment. Through the use of other technology enabled devices, the blind and visually impaired can perform many day to day activities on their own particularly in reading and learning.

An example of a need based innovation is the electronic battery operated wheelchair. The wheelchair is a complex piece of equipment that has been extensively engineered and studied. Most individuals with spinal cord injury become wheelchair experts because doing so increases their chances of getting a wheelchair that truly meets their need.

1.2 Analysis of barriers of the use of technology to support users of health and social care services in living independently

The major barrier in use of technology by users living independently is the difficulty faced in choosing devices from available technology suitable for their specific needs. The following example illustrates how an elderly couple was helped in making the choice.

 The two key priorities for investment in tele care are prevention from falls and mental health services for older people. Other considerations were to use technology as a contributory factor in helping to avoid residential care and avoidable hospital admissions. The following example clarifies the point. Mr and Mrs B, an elderly couple lived within a sheltered housing scheme for years. Mr B has been his wife’s carer for ever since she was diagnosed with Parkinson’s disease. Mrs B’s mobility has steadily deteriorated over years, so has her memory. Mr B has found it difficult to care for his wife and many of his and her social life has been put on hold. Mr B was becoming uncomfortable at the thought of leaving his wife for even small periods of time for fear of her safety. As a result of this he was compelled to feel isolated, and had little opportunity to socialise. Even though living in a sheltered accommodation which was well equipped with emergency pull cords and access to pendant alarms, Mrs B’s memory problems were such that she was not able to use them. In order to measure the risks Mrs B was helped to complete a questionnaire and she was examined by an occupational therapist. It was identified that Mrs B was at a high risk of falling, particularly while trying to rise from her chair on her own. All available options were discussed, and the assistive technology advised was the use of a fall detector.  This device is worn on the waist band of a skirt, trousers or in a specially designed pouch depending on the choice of apparel.

1.3 Explanation of the benefit of available technology to health and social care organisations and their users.

The benefits of using assistive technology are evident in the way their use transforms the lives of the users and their families. A general sense of independence and well being is enhanced.

The Fall Detector was particularly beneficial to Mrs B as it did not require any input from the user. If Mrs B fell, the detector would sense the tilt of her body, and this would set off the alarm automatically at the call centre. The call centre personnel would alert Mr B on his mobile telephone. After a trial of few months, Mr B was asked to give his feedback on the Fall Detector and whether it had made any difference to his insecurities about leaving his wife unattended even for short periods. His feedback said it all as he said it as “brilliant”, and added that “I can go out, have a game of cards with friends, or go to the shops without worrying”. If Mrs B does fall Mr B now feels confident and reassured since he can respond quickly in case of a fall. He says, “it has given me real peace of mind”. Mr B can now continue caring for his wife, without feeling socially bereft. Using tele care allows for actual improvements to the quality of support and helps them and their care givers to feel safe, reassured, able to have a better grip over their day-to-day lives and minimise the risks that compromise independence. This strategy will ensure the consideration of Tele care throughout the customer pathway, from the earliest point of contact right through to complex, care-managed cases, with the aim of supporting people to maintain or improve on their level of independence and  avoid hospital or residential/nursing care admissions.

Electric powered indoor wheelchair (EPIC) is an electrically powered wheelchair to be used within the client’s home. The client must have difficulty in walking or self-propelling in a manual wheelchair within the home. Adequate space is required for the wheelchair to move, including footplates and a suitable space with a power supply for charging the batteries overnight.  The client must practically demonstrate they are able to independently and effectively control the wheelchair within the internal environment, taking into account impediments, hazards and/or risks. 

Braille books are available in many libraries (like the Library of Congress) and schools for the blind. The production of Braille books made use of metal plates. Characters were stamped on both sides of the paper where the dots on one side do not interfere with those on the other side. But now, computers have made the process of publishing Braille books easier. The text is typed into the computer and, with the help of a software program; it is translated automatically into Braille. The computer then transfers the output onto printed paper or metal plates as required. Braille reading helps blind people to socialise with people for example, going to restaurant with friends and finding a restaurant that has a braille menu book encourages the service user to select what he/she would like to eat and instills a sense of independence.

2.1 Explanation of health and safety considerations in use of technology in health and social care

In the near future, propelled by the concept of internet of things, new homes, public and private, and all renovated social housing, will be fitted with the devices for care and medical services to be provided in real time via broadband from day one of occupation. A number of studies suggest that disintegrated and inaccessible clinical information raises the cost and lowers the quality of health care and compromises patient safety. Information technology has been proposed as an essential tool in solving these problems and promoting better health care. When used in social context and the area of care giving, technology contributes to supporting a better life, reinstating human dignity, right of self – determination, inclusion, and caring.

Thus the three technology equipment can be used by service users. The use of technology is agreed upon in collaboration with the user while deciding the user plan. For example, an elderly woman living on her own was suggested the use of wheel chair for her independence and the alarm for her safety. Because she is an elderly person, the chosen technology must be easy to use and suit her lifestyle and health condition. The disadvantages and the risk related to its use should be assessed, and information about how to use should be provided in user friendly formats. Within the health and social care sectors, there is huge potential for information technology (IT) to support practice with greater safety. Several things can go wrong if information is incomplete or incorrect or if glitches in the system interfere with critical processes such as prescribing medication. The use of safety standards for IT required in health and social care should ensure that risks are identified in real time and can then be nullified before the product actually used. Organisations that purchase and use IT enabled systems are advised to take measures that understand system risks and take suitable action, such as staff training, to ensure that systems are operated safely while implementing the service..

2.2   Ethical considerations in use of technologies in health and social care.

Equipment may be provided to help the individual at their residence and customized to meet their specific needs. It can be as simple as the basic alarm system base on sensors and able to respond in case of an emergency and provide constant support via telephone (Department of Health, 2005). Tele care can also be used in a preventative manner for keeping track of an individual’s health parameters or general wellbeing (for example, by using sensors on the bed programmed to record the number of times a person leaves the bed during the course of one night).

The technology involved in tele care services has been used for many years to give care to older people, usually in the form of pendant alarms. This technology has great potential to benefit people by boosting their confidence and assisting them to remain independent bur cared for in their own homes. By monitoring people’s safety, technology can also ease the lives of friends and family care givers so they can perform the task of givinging social support. It is important that giving care through assistive technology does not threaten their right to privacy. Deciding on the choice of type of technology used is critical and should suit the needs of the elderly and disabled. One needs to be alert against misuse or unintentional leaks of personal information. Oversight in these aspects could compromise people’s privacy, autonomy and wellbeing. A careful assessment of risks can be balanced by taking care at the time of installation.

Consent of patients with dementia should be taken before installation so that they are included in decision making.