Biomedical Engineering Reference
In-Depth Information
describe an AT provision process that is inclusive of the assistance users and their
informal caregivers, and
• To describe two measures in this area and discuss plans for their future development.
By addressing these goals, this chapter will provide clinicians and researchers with an
up-to-date understanding of progress in this area and suggestions about how to imple-
ment these developments into practice. We have provided two hypothetical vignettes to
illustrate more vividly the content of this chapter.
The first vignette is about Charlie, an 8-year-old boy with Duchene muscular dystrophy. He
lives in a two-story bungalow with his mother, Susan, his father, Harold, and his 5-year-old
sister, Lisa. He has difficulty going up stairs, walking outside of the home, and has problems
with fatigue, so his parents carry him when going places outside of the home because when
he walks he becomes too tired to do activities. The parents have restricted Charlie's and their
own activities to reduce the need to carry him places, but they both report intermittent back
pain and ongoing muscle soreness. At school, he can participate in classroom activities, but
he has difficulties going to and participating in activities outside of the classroom.
The second vignette is about Bob, a 75-year-old man with osteoarthritis in both knees.
He lives with his wife, Jean, who is a 70-year-old woman who is relatively healthy. They
live in a one-floor apartment with level entry. Bob is having increasing problems moving
around because of knee pain and has had several falls when his left knee “gives out.” He
is currently waiting for joint replacement surgery and uses a cane. Jean helps Bob get up
from low surfaces, helps Bob donning and doffing his socks, and does most instrumental
activities of daily living (IADL) tasks around the house, but she does not drive. Bob will
drive Jean to go shopping, but he usually waits for her in the car or sits and has coffee
while she shops. He is currently following an exercise program recommended by a physi-
cal therapist to try to reduce potential deconditioning. Jean has stopped social visits with
her friends so she can be available to help Bob and keep him safe around the home, and
she reports that she feels tired all of the time.
This chapter begins with an overview of current research in this area, with a specific
focus on the impact of AT on informal caregivers. The next section introduces three con-
ceptual models to help explicate the relationship between AT interventions and outcomes
for informal caregivers. The first model describes how the personal assistance strategy of
individuals with disabilities, which may include AT, simultaneously affects themselves and
their informal caregivers. The second model illustrates how AT can moderate caregiver's
primary and secondary stressors in a way that influences their participation, health, and
quality of life. The third model portrays an AT intervention process that is inclusive of
assistance users and their informal caregivers. The penultimate section introduces two
tools that measure the impact of AT interventions on informal caregivers of children and
adults. In the final section, we illustrate the steps of our AT intervention process and use of
the two measurement tools based on the vignettes of Charlie, Susan, Harold, Bob, and Jean.
5.2 Overview of Current Literature
5.2.1 AT and Human Assistance
Assistive device use is common among children and adults with disabilities. According to
the Participation and Activity Limitation Study (PALS), a population-based health survey,
half of Canadians with disabilities under 15 years and nearly two-thirds of those 15 years
