Biomedical Engineering Reference
In-Depth Information
the home and in the outdoor environment (Iwarsson and Slaug 2001). Another factor
affecting the acceptability of an assistive solution is the potential risk that using such
a device will stigmatize the disabled person. Furthermore, the use of an assistive solu-
tion can indicate a change in personal competencies and this is associated with negative
social judgments, affecting personal motivation and the adoption of a technological aid
(Gitlin 1995).
Training in the use of a device is an important component for improving acceptability
(Elliot 1991). One of the initial difficulties in the use of a device may be its installation,
which might require skills and learning steps that are not always easy for an elderly per-
son to learn, especially when there is the presence of cognitive deficits. Electronic systems,
such as a reminder, may be difficult to manipulate and their interfaces could be too small
and unclear to learn. Chiu and Man (2004) indicated that older adults who received train-
ing after discharge from the hospital showed a higher rate of satisfaction and usage of a
device than older adults who did not receive training. A training program for the use of an
assistive solution should provide client and family involvement in the selection of a device,
follow-up care, and training in its use (Karmarkar et al. 2008).
Overall, the abandonment of an assistive device is often the result of an unsuccessful
process of “matching person and technology” (Scherer 1998, 2002; Scherer and Craddock
2002). When providing an assistive solution, it is essential to conduct a careful evaluation
of the potential user and to consider several steps before providing a technological aid.
In this respect, the biopsychosocial model of the ICF can improve the selection of assis-
tive solutions and help determine the best match of elderly user to a technological aid
(Arthanat and Lenker 2004; Scherer 2005).
13.7 The Role of the Geriatrician in the Assistive
Technology Assessment Process
When the user of a center for technical aid is an older person, the geriatrician should be
involved in the assistive technology assessment (ATA) process as a professional consul-
tant. Generally, an elderly person is admitted to a center for technical aid after a geriatric
assessment. In an initial interview that is focused on gathering background information
of the potential user, the geriatrician helps in reading and interpreting the data from the
geriatric assessment.
In the multidisciplinary team, the geriatrician cooperates in deciding whether the data
are sufficient for a “matching process” and, if necessary, he/she can assess the user or sug-
gest instruments of assessment. To describe the user from an ICF perspective, the geriatri-
cian relates the geriatric assessment dimensions to the ICF code, as illustrated in Table 13.1,
because by adopting the ICF language the geriatrician is able to facilitate a dialogue with
the other professional consultants of the multidisciplinary team.
When a description of the individual's level of functioning is obtained, the user's request
is evaluated and the geriatrician informs about the hypothetical scenarios regarding the
progression of a particular health condition and helps the team to identify factors that
may influence the matching process in terms of acceptance and the risk of rejection or
abandonment. When assessing the assistive solution proposed, the geriatrician intervenes
in monitoring the health condition and in evaluating the efficacy of the device. If an envi-
ronmental evaluation is necessary, the geriatrician should also be involved.
