Biomedical Engineering Reference
In-Depth Information
or stroke; it may match with a cognitive impairment that is negatively affecting rehabilita-
tion treatments. In general, depression is a very common disorder in the elderly and its
effects on rehabilitation should be considered because persistent symptoms of depression
are associated with a decline in cognitive and physical functioning (Wells et al. 2003b). In
this respect, detailed neuropsychological screening is needed to detect cognitive impair-
ment and depression and, consequently, to determine the course of further treatment
(Ruchinskas and Curyto 2003).
Aside from medical conditions, several factors may influence the success of rehabilitation
treatment (Brown and Peel 2009). When disability has been present for many years, the
goals of treatment may be directed toward compensatory strategies or the treatment of
deconditioning. Patients with low motivation require goals that are attainable and that can
be reached in measurable steps to benefit from rehabilitation therapy. For patients nearing
the end of rehabilitation, interventions should be focused on reducing the workload of
the caregiver and the patient's discomfort. Critical circumstances, such as states of severe
disability, malnutrition, the absence of a caregiver, financial limitations, and cultural
beliefs, may limit the benefits from rehabilitation treatments, precluding the use of certain
techniques and assistive solutions.
One of most commonly used interventions in geriatric rehabilitation, as well as in physi-
cal and cognitive exercise programs, includes the implementation of assistive solutions
and the use of specific technological devices suitable for an individual's disability. The use
of assistive technology enables the older person to interact more favorably with their life
environment.
In Section 13.5, a definition of “assistive solution” and an overview of today's technologies
for promoting independence and quality of life for elderly people with a disability will be
given.
13.5 Assistive Solutions: A Challenge in Geriatric Rehabilitation
In recent years, awareness about the contribution that technological aids can make in
supporting people with disabilities has increased, outlining the immense potential of
assistive technology in helping elderly people with physical or cognitive limitations to
perform activities of daily living. The International Standards Organization (ISO) 9999
(2007) defines technical aids as “any product, instrument, equipment or technical system
used by a disabled person, especially produced or generally available, preventing,
compensating, monitoring, relieving or neutralizing impairments, activity limitations and
participation restrictions.” The ICF adopts a more concise definition: “Any product, tool,
equipment or technology adapted or designed specifically to improve the functioning of a
disabled person” (WHO 2001, p. 164).
Technological development is one of the factors that pushed the WHO to reconsider
the International Classification of Impairments, Disabilities, and Handicaps model on the
basis of a linear causal relationship impairment → disability → handicap (WHO 1980,
p. 11). According to the ICF, disability should not be seen as an attribute, but as a situa-
tion in which every individual could happen to find him/herself whenever there is a gap
between individual capacity and environmental factors. To compensate for a disability, a
technological device may not be sufficient. A merger is required between mainstream and
assistive technologies with an assembly that is different from one person to another as the
