Biomedical Engineering Reference
In-Depth Information
and socks. Her overall caregiving burden has decreased substantially. In this regard, the
surgery and assistive devices have reduced her caregiving burden.
5.5 Future Directions
Much works needs to be done to better understand the impact of AT on informal care-
givers. Conceptual models need to be proposed to help understand how AT use impacts
the lives of informal caregivers and controlled experimental research, like a study cur-
rently underway by the authors, is required to provide causal evidence of their effective-
ness (Mortenson et al. 2009). Tools such as the Family Impact of Assistive Technology and
Caregiver Assistive Technology Outcome Measure are promising, but additional research
is needed to further validate and refine them. Research is currently underway to evaluate
the responsiveness of the Family Impact of Assistive Technology Scale and develop tools
that are specific to measuring the impact of creative writing technologies and augmenta-
tive and alternative communication strategies (Ryan 2010). Work to determine the reliabil-
ity and validity of the Caregiver Assistive Technology Outcome Measure is currently being
undertaken. Mixed methods designs may be required to simultaneously evaluate the effec-
tiveness of AT interventions quantitatively and to understand what are the active ingredi-
ents, social processes, and contextual factors that qualitatively influence the outcomes of
these interventions on informal caregivers. Additional work is required to conceptualize
and evaluate how AT simultaneously influences informal and formal caregiver outcomes,
and economic studies are necessary to examine the cost-effectiveness of AT interventions.
5.6 Conclusions
Research to understand the impact of AT on informal caregivers is still in its infancy. It is
commonly assumed that AT will provide a trickle-down effect that will reduce the burden
associated with informal caregiving. Currently most research that has explored the rela-
tionship between AT use and informal caregiver outcomes has used cross-sectional sur-
vey or qualitative data, which do not permit such a causal claim to be made. Some studies
have indicated that some devices may reduce the hours of care provided, but devices that
are more complex may have a less clear-cut influence on caregiver outcomes.
On the basis of the conceptual model we have developed and our clinical experiences,
we suggest that for AT interventions to be successful in the long term they need to care-
fully consider the influence and perspectives of informal caregivers because outcomes for
assistance users and their caregivers are inter-related. Assistive solutions that may be ben-
eficial for the assistance user in the short term but negative for the informal caregiver are
not self-sustaining. Likewise, an assistance solution that has only a direct benefit on the
caregiver by decreasing physical burden (e.g., using an electric rather than a mechanical
lift) may create an indirect benefit for the assistance user because it makes the informal
caregiver less difficult and more available.
The Family Impact of Assistive Technology Scale and Caregiver Assistive Technology
Outcome Measure are two promising measures for capturing the impact of AT interventions
on informal caregivers; however, additional research is required to refine them and further
