Assistive%20Devices%20/%20Smart%20Technology%20for%20Successful%20Aging

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Assistive Devices / Smart Technology for
Successful Aging

• Roxanna M. Bendixen, MHS, OTR/L
• Doctoral Candidate
• Rehabilitation Science Doctoral Program

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Outline

• Key Terms Definitions
• Basic Assistive Technology / Adaptive Devices for
  Everyday Living
• Americans with Disabilities Act (ADA)
• Amputations Prosthetics
• Robotics
• Gator-Tech Smart House

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Occupational Therapy is

• Skilled treatment that helps individuals achieve
  independence in all facets of their lives.
  Services typically include
• Customized treatment programs to improve one's
  ability to perform daily activities
• Comprehensive home and job site evaluations with
  environmental modifications or adaptive
  recommendations

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OT Services include

• Performance skills assessments and treatment
• Adaptive equipment recommendations and usage
  training
• Guidance to family members and caregivers

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What OT does

• Assess the person
• Assess the environment
• Make suggestions for environmental changes
• Make suggestions for adaptive equipment
• Address fear of falling

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Who benefits from OT

• work-related injuries including lower back
  problems or repetitive stress injuries
• limitations following a stroke or heart attack
• arthritis, multiple sclerosis, or other serious
  chronic conditions
• vision or cognitive deficits
• birth injuries, learning problems, or
  developmental disabilities

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Who benefits from OT

• mental health or behavioral problems including
  Alzheimer's, schizophrenia, and post-traumatic
  stress
• problems with substance use or eating disorders
• burns, spinal cord injuries, or amputations
• broken bones or other injuries from falls, sports
  injuries, or accidents

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Goals

• Promote independence and maintenance of skills
  necessary to remain living at home
• Increase safety within the home
• Enhance quality of life

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Activities of Daily Living (ADLs)

• Are basic self-care tasks including
• Bathing
• Dressing
• Grooming
• Toileting
• Eating
• Transferring in and out of your bed, a chair, or
  on and off the toilet, and mobility (getting
  around the house)

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Instrumental Activities of Daily Living (IADLs)

• Higher level daily activities
• Household chores (housework and mowing the lawn)
• Shopping and running errands
• Paying bills (money management)
• Getting to places outside of walking distance
• Using the telephone
• Meal preparation (planning the meal and cooking)
• Medication management

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Basic Daily Tasks

• Leisure activities are also very important in our
  daily activities
• Ones perception of their quality of life is
  related to their independence in ADLs, IADLs, and
  Leisure

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• Adaptive Devices
• Assistive Devices
• Adaptive Equipment
• Assistive Technology

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Definition

• Assistive Technology (device) was first defined
  in the U.S. in the Technology-Related Assistance
  for Individuals with Disabilities Act of 1988
• any item, piece or equipment or product
  systemwhether acquired commercially, modified,
  or customizedthat is used to increase, maintain,
  or improve functional capabilities for
  individuals with disabilities.

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Key Terms

• Strategies for promoting independence and quality
  of life for people as they age include Assistive
  Technology
• Environmental Modifications
• Environmental Interventions

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Importance of AT

• Increase Independence
• Promote Social Participation
• Increase Self-Esteem
• Decrease Burden of Care
• Increase Quality of Life

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Independence

• Mismatch between the environment and a person who
  has declining ability makes it very difficulty to
  carry out our basic daily tasks and increases the
  risk of accidents, such as falls

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Independence

• An important concept for what we hope to
  accomplish in our use of technology and
  environmental interventions
• the ability to complete basic daily tasks without
  personal assistance

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Eating Drinking
Rocker knives Roller knives Universal cuffs Plate
guards Non-skid dishes Cups with lids Nosey cups
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Meal Preparation
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Grooming
Floss holders Suction cup / denture
holders Toothpaste dispenser Electric
Shaver Adaptive nail devices
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Dressing
Long-handled shoe horn / Sock aid Dressing
stick Reacher Buttonhook/zipper pulls Elastic
laces Pull-on clothes, Velcro closures, button
extenders Clip-on earrings, magnetic clasp jewelry
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Bathing
Grab bars Bath bench Hand-held shower
head Long-handled sponge/foot brush Soap dispenser
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Toileting
Pre-moistened wipes Bidet Raised toilet
seat Toilevator Bedside commode Urinal
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Transferring Mobility
Canes Walkers accessories Wheelchairs
accessories Scooters Ramps Lifts
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Mobility
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Independence
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Language Memory
Communication Boards Computer Systems Medical
Alert Tags
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Language Memory
Calendar Notebook Journal Electronic Paging
Systems Smart Environments
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Cognitive Impairments
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Wandering Behaviors
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Vision Impairment
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Personal Navigation Systems
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Travel Aids
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Talking prescription reader
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• Major and Minor Home Modifications

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Simple things we can do

• Lighting around doorways
• Nightlights in dark hallways or the bathroom
  (reduce tripping)
• Higher wattage light bulbs

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Lighting
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Simple things we can do

• Replace faucet knobs with lever knobs
• Replace doorknobs with levers

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Simple things we can do

• Raise furniture 3 to 4 to make it easier to get
  in and out of
• Use electric seat cushions
• Electric chairs

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Simple things we can do
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Simple things we can do

• Large buttoned telephones

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Simple things we can do

• Non-skid strips in the bathtub or shower (less
  slippery)

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Major modifications

• Add handrails and grab bars to bathroom

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Bathroom Modifications
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Bathroom Modifications
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Bathroom Modifications
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Bedroom Modifications
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Other problems
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• Americans with Disabilities Act

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Americans with Disabilities Act Definition

• The ADA prohibits discrimination in all
  employment practices, including job application
  procedures, hiring, firing, advancement,
  compensation, training, and other terms,
  conditions, and privileges of employment. It
  applies to recruitment, advertising, tenure,
  layoff, leave, fringe benefits, and all other
  employment-related activities.

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Americans with Disabilities Act

• ADA ensures equal opportunity for persons with
  disabilities in employment, State and local
  government services, public accommodations,
  commercial facilities, and transportation, and
  requires the establishment of TDD/telephone relay
  services.

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ADA and Disability

• An individual is considered to have a
  "disability" if s/he has a physical or mental
  impairment that substantially limits one or more
  major life activities, has a record of such an
  impairment, or is regarded as having such an
  impairment. Persons discriminated against because
  they have a known association or relationship
  with an individual with a disability also are
  protected.

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ADA Requirements

• Barriers to employment, transportation, public
  accommodations, public services, and
  telecommunications have imposed staggering
  economic and social costs on American society and
  have undermined our well-intentioned efforts to
  educate, rehabilitate, and employ individuals
  with disabilities.

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ADA Benefits

• ADA will enable society to benefit from the
  skills and talents of individuals with
  disabilities, will allow us all to gain from
  their increased purchasing power and ability to
  use it, and will lead to fuller, more productive
  lives for all Americans.

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Ergonomics and the Workplace

• Science of designing a personal environment so
  that it facilitates the highest level of function
• Work environment should fit the capabilities of
  the worker
• Prevent injury, promote health, safety and comfort

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Environmental Interventions

• Can the individual eat in the employee lounge?
• Modify cafeteria door
• Provide personal assistance
• Can the individual use the bathroom facilities?
• Move paper towel /soap accessories
• Provide personal assistance

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Informative Website

• http//www.usdoj.gov/crt/ada/adahom1.htm
• http//www.jan.wvu.edu/links/adasummary.htm

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• Amputations and Prosthetics

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Facts about Amputation

• According to the National Center for Health
  Statistics, it is estimated that more than 1.5
  million people in the United States have lost an
  extremity. This equates to almost 6 cases per
  1,000 people.
• Why do you think this is likely to increase?

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Amputations and the Aging

• It is widely agreed that amputation is surgery of
  last resort.
• Irreparable loss of the blood supply to a
  diseased or injured limb is the only absolute
  indication for amputation (Diabetes).
• The aging process has already forced physical and
  mental limitations on many older individuals, and
  the prospect of prolonged rehabilitation can seem
  overwhelming.
• Advances in the science of prosthetics have led
  to better long-range results.

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Orthotics and Prosthetics

• Orthotics and Prosthetics (OP) is an allied
  health profession
• Orthotics and Prosthetics is the evaluation,
  fabrication and custom fitting of artificial
  limbs and orthopedic braces

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Arm Prostheses

• Many arm prostheses have electrically powered
  hands and elbows
• Simple switches may be used to control these
  protheses
• Also, sensors on the skin can detect signals
  generated by muscles (myoelectric signals) to
  control the prosthesis
• In some instances microprocessors are used in
  analyzing and processing the myoelectric signals

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Leg Knee Prostheses

• Electronic knee joints for prostheses can now be
  programmed for the individual patient.
• A computer chip allows the knee joint to sense
  changes in position, speed and force, enabling
  patients with amputations to walk down stairs and
  hills with confidence.
• There are prosthetic feet made especially for
  running, golfing, rock climbing or swimming.

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Prostheses

• The Otto Bock C-Leg uses a microprocessor
  controlled hydraulic knee with swing and stance
  phase control.
• This knee joint features sensor technology that
  reads and adapts to the individual's every move.
• Dynamic gait is similar to natural walking as
  possible.

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Examples
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Examples
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Examples

• Birth defect
• Artificial legs since the age of 3
• Was very involved in wheelchair athletics
• Since receiving new prostheses, able to bike,
  walk up and down stairs, and even drive without
  modifications

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Hand Arm Prostheses

• LIVINGSKIN is made to resemble human skin by
  simulating the three dermal layers of natural
  human skin.

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Livingskin Gloves

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Examples

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• Robotics

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Robotics

• The Science of Robotics has advanced
  significantly since the first commercial robot
  was deployed in 1962.

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Robotics

• Medical surgery and follow-up care
• Police and military bomb disposal and
  surveillance
• Exploration journey into live volcanoes visit
  other planets
• Professional service inspect bridges and
  nuclear sites

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Packbot Explorer
Arm reaches 66 Deliver equipment
supplies Explosive disposal/ detect chemical
leaks Stairs, curbs, rocks, sand, mud Battle
tested Assist injured soldiers
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Personal Robots

• Vacuum the home
• Provide entertainment
• Assist with mobility
• Provide therapy

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Inkha
Robot Receptionist Eyes, mouth, head, neck move
in response to environment Laptop, hidden camera,
sensors
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Personal Adaptive Mobility AidPAM-AID
Assist frail and visually impaired individuals
with navigation in their environment Assist in
transferring Laser and ultrasonic sensors Set
your own pace
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Guido (2004)
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Lower Extremity Exoskeleton
Over 40 sensors Carry equipment weighting 70lbs
over rough terrain or stairs for extended periods
of time
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Power Suit
Decrease back strain for health care
workers Weighs 45 lbs Senses muscle
activity Inflates/deflates air bags to assist
with lifting
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Entertainment
Move / Search / Play tricks Communicate with
owner (different emotions) Voice and Visual
recognition (understands thousands of
words) Camera
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ASIMO
Assisting with various tasks Smooth walking pace
up and down stairs Responds to voice
commands Recognizes individuals
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Pearl
Medication, food, hydration reminders Scheduled
appointments Record health parameters Health care
workers can interact remotely through Pearl
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Care-O-Bot II
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Robo-Doctor
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• Gator-Tech Smart House

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UF RERC for Successful Aging

• Promote independence and quality of life for
  older people with disabilities through technology

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What is a Smart House?
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Summary of Functions

• Levels based on complexity
• 1. Basic Communications
• 2. Simple Control Commands
• 3. Automates Household Functions
• 4. Tracking location, behaviors, health
  parameters
• 5. Analyzes Data

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Additional Levels

• 6. Provides information, reminders, prompts
• 7. Answers questions, orientation, general
  information (Google it)
• 8. Make household arrangements

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Location Monitoring
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Smart Front Door
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Smart Microwave
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Smart Mirror
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Appliances
Washer Dryer Combination
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Appliances
Refrigerator / Freezer Unit
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Driving Simulator
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Gator-Tech Smart House

• At Oak Hammock
• January 28, 2005 Grand Opening
• Demonstrations
• Living Lab

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• It is important for both potential AT users and
  AT practitioners to be aware of the current
  available technology and resources in order to
  provide and receive the greatest benefit