USE OF ASSISTIVE TECHNOLOGY IN GENERAL AND DURING A PANDEMIC, IN PARTICULAR

People with disabilities often find it difficult performing everyday living activities independently or even with assistance, and that is where assistive technology (AT) comes into play. Assistive technology comprises of devices, hardware, software or system which is designed and developed particularly to help disable people ease their lives. It actually enables people with disabilities to perform tasks which they were otherwise unable to perform themselves with or without help, and with safety. For example, wheelchairs help provide mobility to those who cannot walk, and hearing aids provide hearing ability to deaf. Assistive technology ranges from very simple tools to high tech custom designed equipment. Basic AT includes Standard wheelchairs, basic pressure care cushions, crutches, daily living aids, furniture, bathroom/toilet aids, ramps, etc. Electric homecare beds, scooters, standard power wheelchairs, oxygen concentrators, patient lifters, mid-level pressure care, basic motor vehicle modifications, etc fall under moderately complex AT. And highly customized power & manual wheelchairs, complex seating, high end pressure care, complex motor vehicle modifications, etc. are highly complex AT.

With increase in global population over the years, the demand and use of assistive technology has also increased. More people with disabilities need assistance as compared to 10 to 15 years ago. As COVID-19 conditions continue to prevail, it is expected that the use of AT will also rise. Individuals depending on assistive technology for their daily activities are particularly affected: care and support services (for example AT services, special needs education, mobility services) are reduced or stopped at all.

According to W.H.O, more than 1 billion people worldwide need 1 or more AT products. And with an ageing global population, and a rise in contagious diseases, more than 2 billion people will need at least 1 assistive product by 2030, with many older people needing 2 or more.

As reported in ABS-2004, one in every ten Australians depends on assistive technology and numbers are increasing.  Productivity Commission inquiry report 2011 states that an estimated 411,000 Australians are facing disabilities and ageing population may increase demand of assistive technology significantly in the coming years. According to forecasts by The Australian Bureau of Statistics, those aged 65 or over will make up to almost one-quarter of the population by 2050. Furthermore, the numbers of Australians aged 85 years or older will more than double during the same period.

Individuals with disability are among the most deprecated groups in the society. These individuals have poor health outcomes, lower education achievements, less economic participation and higher rates of poverty than people without disability. Disable persons can live healthy, productive, independent, and dignified lives, and they can do it with the aid of assistive technology. They can participate in education, contribute their knowledge while working in labor market, and become an active part of civic life. Assistive technology cuts down the need for formal health and support services, long-term care and the work of caregivers. What would have happened if AT was not out there? Disabled individuals would have been left isolated and deprived into poverty, hence increasing the impact of disease and disability on them, their family, and on the whole society. For example, a young child with hearing loss can use hearing aids and learn language skills, get education leading to employment. Similarly, assistive technology can help older people stay at home and prevent the requirement of long term care from other family members. Think of a lady who lost her legs in an accident leaving her disabled for life, now runs her own small shop around the corner and making a living out of it with the help of standard powered wheelchair.

Providing assistive technology products to a user is not as simple as it might look. It is easy to make certain that the AT purchased is the right AT for a given user, its goals, and environment in which it is going to be used is suitable, can be somewhat simple and straightforward, especially at the basic level. Nonetheless, given the vast range of assistive technology  products available  in the market and the specific needs of many users who may use more than 5 different AT items at the same time, getting the right mix and  match between the user and the AT is often a complex process. Supplying assistive technology is largely a service-based industry especially when it comes to moderately and highly complex AT. AT suppliers and retailers invest heavily in hiring and training their staff (which mostly include health professionals such as physiotherapists and rehabilitation design experts), who are crucial to ensuring the ‘perfect fit’ between the user and the AT.

One of the most important stakeholders in the whole process is supplier itself, since most health professionals prescribe AT, relying substantially on the knowledge and skills of suppliers who is supplying that particular product. Likewise, users need the same information about how to use that AT. So, supplier’s knowledge regarding differences between product’s functionality, performance in different situations, and the detailed technical aspects of assembling according to individual needs of the user, is of utmost importance.

How an AT product is set-up and its adjustment varies widely, depending on the nature of the AT. Prescribers often accentuate that a senior therapist is the one who should take this responsibility, but we must admit that therapists may not always be the person with exact capacity and skill to perform this task. Particularly when serious modification are required and workshop work involved, or the set-up is highly technical or has particular requirements that are best understood by the supplier, this work should be done by the supplier. Deciding whether who can do the job in the best possible way depends on the expertise of the therapist, knowledge and skill of the supplier and the nature of set-up that is required.

It is always best to build a team of these stakeholders, and utilize their combined expertise coupled with the suggestions from the user, to identify and implement the best AT solution.