Encounters between older adults and occupational therapists during the assistive technology application process

Provision status of assistive products for cognition to older adults with cognitive impairment among rehabilitation therapists

PURPOSE

This study aimed to investigate the provision and need for assistive products for older adults with cognitive impairment among rehabilitation therapists, identify any unmet needs, and analyze current issues in providing such products.

METHODS

We conducted a questionnaire survey with rehabilitation therapists involved in selecting and providing assistive products for cognitive function in older adults with cognitive impairments. Questionnaires comprising ten items about the experience and need for cognitive assistive products were sent to 300 facilities for older adults in Japan between January and February 2021. One hundred thirty-five responses were received.

RESULTS

The mean age of the participants was 39.5 ± SD7.1. There were 70 females, 64 males, and one unanswered questionnaire. In total, 72 (53.3%) of the 135 therapists had introduced or provided assistive products to their patients. The most frequently provided products were for safety and security; some were provided to support memory and orientation. 86% of therapists did not use the insurance system to provide them. The survey showed that most participants with experience providing assistive products needed information on the available resources.

CONCLUSIONS

Although the need for assistive products for cognition is increasing, they are not sufficiently supplied in caring for older adults with cognitive impairment. Their availability differed depending on the assistive product type. It is necessary to have an effective social insurance system and access to up-to-date information to provide appropriate assistive products.

A survey of the assistive technology experience of older adults in Tompkins County, NY

Purpose: To understand the assistive product (AP) related needs, unmet needs, demands and barriers of older adults (OA) this study addresses older adults in Tompkins County, NY.Methods: This quantitative cross-sectional descriptive research study used the World Health Organization's rapid Assistive Technology Assessment (rATA). A convenience sample of adults 65 or older in Tompkins County, NY. were surveyed to understand their need for AP, access to it and satisfaction with it.Results: The mean age of the 102 respondents was 73 (SD=6.91). Ninety-five % of participants reported currently using an AP. The findings reveal that while OA are using AP in their everyday lives, barriers to getting the AP that they need remain. While 49% of participants had difficulty with their cognition, the use of AP for cognitive support was only reported by 10 % of the participants. Additionally, there are many different types of AP being used by older adults. These products not only assist users with impairments included on the survey such as hearing, vision, mobility, etc. but with other concerns such as comfort, safety, and injury prevention. One limitation of our study was that we utilized a convenience snowball method to recruit participants in a local area and thus the findings cannot be generalized beyond the study.Conclusion: OA identify both the need for AP that they do not have and a variety of barriers including lack of knowledge and funding for AP that interferes with their obtaining it. Ongoing research is needed to further understand the AT related needs of this growing population as there are many different areas in rehabilitation where work is needed to increase access to AP.

Occupational therapists’ perspectives on an evidence-based, client-centered assistive technology intervention

Introduction:

Reviews within the field of assistive technology have shown that a client-centered approach is important for user satisfaction, and that assistive technology service delivery should be evidence-based, systematic, and structured. However, client-centered instruments and systematic, structured models are not used consistently. As part of a larger research project, an evidence-based, client-centered assistive technology service delivery process was developed and piloted. The purpose of this study was to investigate occupational therapists’ perspectives on this evidence-based, client-centered assistive technology intervention.

Method:

Ten occupational therapists, from two Danish municipalities, participated in focus groups. Data were analyzed based on a hermeneutic approach.

Results:

Three themes emerged from the analysis: a more refined collaboration with clients; advantages of using theoretical frameworks, structured models and instruments and challenges in using the intervention.

Conclusion:

By using the evidence-based, client-centered intervention, the occupational therapists found that the collaboration with the clients was refined—more emphasis was placed on shared responsibility. They found that the intervention was time-efficient in the long run; however, there seems to be a particular challenge in designing services that are inclusive of clients with cognitive limitations.

The Effectiveness of Assistive Technologies for Older Adults and the Influence of Frailty: Systematic Literature Review of Randomized Controlled Trials

Background

The use of assistive technologies (ATs) to support older people has been fueled by the demographic change and technological progress in many countries. These devices are designed to assist seniors, enable independent living at home or in residential facilities, and improve quality of life by addressing age-related difficulties.

Objective

We aimed to evaluate the effectiveness of ATs on relevant outcomes with a focus on frail older adults.

Methods

A systematic literature review of randomized controlled trials evaluating ATs was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Ovid Medline, PsycINFO, SocIndex, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Register of Controlled Trials), and IEEEXplore databases were searched from January 1, 2009, to March 15, 2019. ATs were included when aiming to support the domains autonomy, communication, or safety of older people with a mean age ≥65 years. Trials performed within a laboratory setting were excluded. Studies were retrospectively categorized according to the physical frailty status of participants.

Results

A total of 19 trials with a high level of heterogeneity were included in the analysis. Six device categories were identified: mobility, personal disease management, medication, mental support, hearing, and vision. Eight trials showed significant effectiveness in all or some of the primary outcome measures. Personal disease management devices seem to be the most effective, with four out of five studies showing significant improvement of disease-related outcomes. Frailty could only be assessed for seven trials. Studies including participants with significant or severe impairment showed no effectiveness.

Conclusions

Different ATs show some promising results in well-functioning but not in frail older adults, suggesting that the evaluated ATs might not (yet) be suitable for this subgroup. The uncertainty of the effectiveness of ATs and the lack of high-quality research for many promising supportive devices were confirmed in this systematic review. Large studies, also including frail older adults, and clear standards are needed in the future to guide professionals, older users, and their relatives.

Trial Registration

PROSPERO CRD42019130249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130249