Who We Are Assistive Devices
Policy Statement:
Assistive Devices for Seniors
Statement of the Problem
Canada has no consistent policy on technology-related assistance for individuals with disabilities and/or physical limitations, or on financial assistance with the acquisition of such devices. Evidence suggests that financing is a major barrier to the use of assistive devices (LaPlante, Hendershot & Moss, 1997; Kozarevic & Israel, 1987). This barrier has resulted in a lack of systematic reporting requirements for assistive devices services among direct-service programs, a lack of uniform classification of assistive devices expenditures, and blurred distinctions between assistive and mainstream technology (Mendelsohn, 1997).
Scope
Assistive devices include "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities" (U.S. Technology Related Assistance for Individuals with Disabilities Act of 1988, Tech Act, 29 USC Sec.2201). Categories of assistive devices used by seniors include those for mobility, personal care, home skills, and leisure activities (Axell & Yasuda, 1993). There is insufficient evidence to support or refute the claim that assistive devices promote independence for seniors. However, it is known that assistive devices are commonly used by seniors; for example, nearly 35% of Canadians 75 years and older use one or more devices, with vision aids being used by 90%, and mobility and hearing aids increasing in use after 50 years of age to about 50% and 60% respectively (Forbes, Hayward & Agwani, 1993).
Analysis of the Evidence
The fact that seniors who require assistive devices frequently either do not receive or do not use them suggests a lack of effectiveness in promoting seniors' independence through this means. Low education (Forbes, Hayward & Agwani, 1993), rural residence (Forbes, Hayward & Agwani, 1993; Kozarevic & Israel, 1987), social isolation (Forbes, Hayward & Agwani, 1993), female gender (Forbes, Hayward & Agwani, 1993; Kozarevic & Israel, 1987), membership in populations known to be underserved by systems for health and welfare (i.e., aboriginals and rural residents) (Galvin, 1997), and advanced age (Kozarevic & Israel, 1987) are associated with non-use and/or under use of those who require assistive devices. However, it is important to note that evidence shows 79% of all owned devices are reported to be used (Mann Hurren & Tomita, 1993).
One major U.S. survey (National Council on Disability, 1993) has found that 80% of older persons reported reduced dependence on others and approximately 50% were able to avoid entering a nursing home as a consequence of using assistive devices. The one randomized controlled trial identified in the literature, a study of 22 elderly nursing home residents, identified that those who were equipped and trained to use a hand-held remote control for activating radio and light switches had three times the rate of radio use as did control subjects, suggesting enhanced exercise of independence (Mann, 1992).
Patterns of device use do not necessarily predict subjective perceptions of independence. However, insofar as self-reports of device ownership and frequency of use can be regarded as valid measures of assistive device use, assistive devices, particularly mobility devices, vision aids, and home accessibility devices and modifications, do appear to contribute to functional independence. Assistive device use by seniors is more likely if the devices are supported by service agencies (Mann et al., 1993).
Recommendations
The Canadian Association on Gerontology supports government adoption of a definition of assistive devices appropriate to the Canadian context and the development of consistent policies regarding financial support for seniors who may benefit from their use.
The Canadian Association on Gerontology encourages research funders and researchers to support and undertake rigorous evaluative research to test the effectiveness of the vast array of assistive devices available.
The Canadian Association on Gerontology recommends that positive gains might be achieved through an orientation where assistive devices are seen as supporting the goal of maximizing function and independence.
Approved by the CAG Board
October 26, 2000
References available from the CAG National Office at:
Canadian Association on Gerontology222 College St. Suite 106
Toronto, ON M5T 3J1
Telephone: (416) 978-7977
Fax: (416) 978-4771
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