Introducing assistive technologies (AT) into the existing homes of older people

The design of accessible environments, for use by all, is a legal requirement for all public buildings, under the Disability Discrimination Act 1995 (DDA, 1995) since October 1999 and the removal of all physical barriers becomes enforceable in 2004. Accessibility has transferred from being a social and moral issue to a legal requirement. The Research Group for Inclusive Environments at the University of Reading undertakes research to better understand methods to make the built environment more accessible. This paper presents the findings from the research project, Project Crystal, investigating the design of environments for better communication for deaf and hard of hearing people. At the last COBRA conference the preliminary findings from the pilot questionnaire were presented. During the year the questionnaire has been distributed more widely and a test environment has been used to investigate the effects the variables of lighting and colour have on people's ability to communicate. This paper will present some of the findings from the project, which is almost complete, and generalise on the effect wall surface design has on accessibility of an environment for people with a hearing impairment.

Enabling older people to stay at home: The costs of substituting and supplementing care with assistive technology

A wide-ranging multiprofessional research project explored issues relating to the introduction of assistive technology into the existing homes of older people in order to provide them with the opportunity to remain at home. The financial relationship between assistive technology and packages of formal care was also explored. The costs of residential care and those of a number of packages containing differing quantities of assistive technology, formal care and informal care were compared. The analyses provide a strong financial case for substituting and/or supplementing formal care with assistive technology, even for individuals with quite disabling conditions. Although needs and hence the cost of provision rise with an increasing level of disability, the savings in care costs accrue quickly. The consideration of a variety of users with different needs and informal care provision, and occupying a very wide range of housing, leads to the conclusion that in comparison with traditional care packages, at worst, incorporating significant amounts of assistive technology into care packages is cost neutral, but that with careful specification of assistive technology major savings are feasible.

Can adapting the homes of older people and providing assistive technology pay its way?

Background: Adaptations and assistive technology (AT) have an important role in enabling older people to remain in their own homes. Objective: To measure the feasibility and cost of adaptations and AT, and the scope for these to substitute and supplement formal care. Design: Detailed design studies to benchmark the adaptability of 82 properties against the needs of seven notional users. Setting: Social rented housing sector. Main outcome measures: Measures of the adaptability of properties, costs of care, adaptations and AT, and relationships between these costs. Results: The adaptability of properties varies according to many design factors and the needs of occupiers. The most adaptable properties were ground floor flats and bungalows; the least were houses, maisonettes and flats in converted houses. Purpose-built sheltered properties were generally more adaptable than corresponding mainstream properties but the opposite was the case for bungalows. Adaptations and AT can substitute for and supplement formal care, and in most cases the initial investment in adaptations and AT is recouped through subsequently lower care costs within the average life expectancy of a user. Conclusion: Appropriately selected adaptations and AT can make a significant contribution to the provision of living environments which facilitate independence. They can both substitute for traditional formal care services and supplement these services in a cost-effective way.

Introducing assistive technology into the existing homes of older people: Feasibility, acceptability, costs and outcomes

We examined how far, and at what cost, the housing stock could be modified to accommodate the assistive technology (AT) necessary to enable older people to remain in their own homes. A multidisciplinary team devised seven hypothetical user profiles for 10 case study areas, with five local authorities and five housing associations in England and Wales. Each profile was considered at two times, five years apart, with the users' functional abilities deteriorating in between. In addition, in-depth interviews were carried out with a sample of 67 older people in the case study areas about their use and experience of a wide range of AT. The interviews showed the need to listen to older people and that they welcomed AT when it addressed a perceived need. The results showed that the extent of adaptation required of buildings to accommodate a user's needs varied greatly. It was also found that there was confusion about the terminology of AT, including the idea of the 'smart house'. The study shows that the adaptability of the housing depends on a range of factors and costs.

Introducing assistive technology into the homes of older people: Some lessons from the Netherlands - A case study

The authors have just completed a study of assistive technology (AT) and how it can be introduced into the existing homes of older people. As part of this empirical study some collaboration with the Netherlands took place for two reasons. First to learn about the use of assistive technology from a country where its creative use was well established and second to learn how older people influence policy. Two Dutch consultants helped the team and a short visit was paid to Eindhoven. As a result of this collaboration new ways of using AT were found and comparisons made with the policy and legislative background. In addition lessons were drawn about the involvement of older people.

Robots with a gentle touch: advances in assistive robotics and prosthetics

As healthcare costs rise and an aging population makes an increased demand on services, so new techniques must be introduced to promote an individuals independence and provide these services. Robots can now be designed so they can alter their dynamic properties changing from stiff to flaccid, or from giving no resistance to movement, to damping any large and sudden movements. This has some strong implications in health care in particular for rehabilitation where a robot must work in conjunction with an individual, and might guiding or assist a persons arm movements, or might be commanded to perform some set of autonomous actions. This paper presents the state-of-the-art of rehabilitation robots with examples from prosthetics, aids for daily living and physiotherapy. In all these situations there is the potential for the interaction to be non-passive with a resulting potential for the human/machine/environment combination to become unstable. To understand this instability we must develop better models of the human motor system and fit these models with realistic parameters. This paper concludes with a discussion of this problem and overviews some human models that can be used to facilitate the design of the human/machine interfaces.