Biomedical Engineering Reference
In-Depth Information
burden, especially because he is taller and heavier than she is. So providing physical assis-
tance to Bob, especially when he falls, is not sustainable long term. They would like to find
a strategy that prevents him from falling. For his dressing of his lower extremities, Jean is
their current strategy of choice, but they would like to explore ways to see if he can become
independent with this activity again.
Step 3.
To facilitate mobility, several AT strategies are considered, but balance problems
and instability of his right knee necessitate the use a standard walker for ambulation. To
facilitate bathroom transfers, they decide they would like to have a higher toilet seat so that
it is easier for Bob to sit down. To make this transfer easier, they would also like to try some
toilet armrests so that Bob can use his arms to help him raise and lower himself. For the
bathtub, a variety of options are considered. Although it would be possible to have a bath
chair in the tub, they are worried he might fall getting over the side of the tub. Instead,
they would like to use a tub transfer bench that extends outside of the tub with a tub grab
to facilitate bathroom transfers. In terms of dressing options, they decide they would like
to trial a flexible sock aide to facilitate donning socks, and a long-handled shoehorn and
reacher are trialled to facilitate donning and doffing shoes and socks.
Step 4.
The clinicians bring the devices in for trial and over the next two weeks practice
using them with Bob and Jean.
Step 5.
Although Bob is able to put his socks and shoes on with difficulty with assis-
tive devices, he and Jean decide it is easier for Jean to put on his socks and shoes because,
as Jean indicates, “it is much faster and not that much of bother.” He decides to keep the
reacher because it does enable to him to take his shoes off by himself and pick things up off
the floor. At this point scores on the Caregiver Outcome Measure of Assistive Technology
indicate that Jean experiences less burden related to mobility and transfers because she
is less worried about Bob's safety and has not needed to help him get up from the floor,
although she does still worry about the possibility he may fall while ambulating with his
walker. One additional activity she needs to do is fold the walker and store it in the car
when they drive places, but she does not find this difficult. Because their strategy for dress-
ing is largely unchanged, scores for this activity have remained static.
Four months later (three days after discharge from the hospital), the Assistance Users/
Caregiver Dyad Assistive Technology Process Model was applied again.
Step 1.
Mobility and bathroom transfers remained important issues for him after dis-
charge from the hospital.
Step 2.
The same potential strategies existed.
Step 3.
No new additional equipment needed to be considered, and he used all of his
equipment after being discharged.
Step 4.
Additional training was required to make sure he could use all of the equipment
after his surgery.
Step 5.
Jean's re-evaluation with the Caregiver Outcome Measure of Assistive Technology
indicates that her burden for the selected issues has increased compared with her 2-week
scores and have not returned to baseline levels. Her overall burden is worse than baseline
because Bob has felt pretty sick after his surgery and she has needed to perform many
additional caregiving duties.
Step 5 repeated two months after surgery.
Bob is walking much better, so he has now returned
to using only a cane. Because he cannot flex his knee more than 90°, he continues to use
the bath bench and the raised toilet seat, especially because he is now waiting for his right
knee to replaced. Jean is still a little worried about his safety given his problems with his
other knee. She provides physical assistance less, although she still helps with his shoes
