Assistive technologies that help individuals with disabilities compensate for their impairments can potentially serve as either substitutes or complements for human personal assistance. If assistive technologies can serve as a substitute for paid care providers, then prompting the technology’s use can also result in cost savings. A recent study looked at five types of assistive technologies to determine their potential impact on the amount of personal assistance required from either formal (paid) or informal (unpaid) care providers.
This study looked specifically at five categories of assistive technologies: indoor/outdoor mobility, bed transfer, bathing, toileting, and telephone assistance. The authors reviewed data from the nationally representative 2004 National Long-Term Care Survey to assess the impact of these types of assistive technologies. Within the survey, community-dwelling users of assistive technologies were evaluated in terms of three outcomes: total personal assistance received, the likelihood of receiving paid personal assistance, and the amount of paid personal assistance used.
Of the 2,081 older adults surveyed, only 9 percent reported using no assistive technology. Sixty-nine percent used mobility-related technology, such as wheelchairs, walkers, and canes. Sixty-one percent used assistive technology for bathing, such as a shower seat or handle bar. Forty-six percent used assistive technology for toileting, such as a raised seat or a grab bar. Forty-one percent used it for getting in and out of bed, such as a bed lift or a walker. Only 9 percent used assistive technology for the telephone, such as an amplifier or enlarged dialer.
Individuals who received formal personal assistance used an average of 24.5 hours per week of assistance; these individuals also received an average of 14 additional unpaid hours of assistance per week. For each category of assistive technology, a higher proportion of individuals receiving formal personal assistance reported using assistive technology than those without formal assistance. However, the authors note that this lower usage may reflect the fact that individuals not receiving personal care may not be aware of technological assistance, may not know how to obtain it, or may not be able to afford it.
As for the impact of assistive technology on personal assistance with mobility, bed transfer, and bathing, each resulted in about an eight-hour decrease in total personal assistance hours. However, this reduction in assistance hours appeared to be only for unpaid personal assistance. Little or no impact on paid personal assistance was seen for these technologies. In the case of bed transfer and toileting technologies, use of these technologies was associated with an increase, rather than a decrease, in formal care hours. Even though the level of impairment was controlled for in these analyses, the authors suggest that this modest increase may reflect a higher impairment that was not accounted for in the data collected for this study. Thus, the authors conclude, “This study did not provide evidence that assistive technologies reduced paid care.”
However, the authors do suggest that despite a lack of decrease in paid hours, paid caregivers may still benefit from assistive technologies. In particular, they suggest that the use of assistive technologies may make caregiving easier, if not less time-consuming, and decrease the risk of injury to caregivers. They also note that paid caregivers may be working in circumstances in which only a certain amount of paid caregiving hours are authorized, in which case assistive technology may be recommended in order for care hours to stay within authorized time limits.
Additionally, while potential cost savings from reduced paid personal assistance were not observed here, the reduction of unpaid personal assistance for some technologies was quite significant. Such a reduction could reduce some of the strain of informal caregiving, and permit informal caregivers who work to participate more in the workforce.
Anderson WL and Wiener JM. The impact of assistive technologies on formal and informal home care. The Gerontologist. (2013). DOI: 10.1093/geront/gnt165