An Overview of Assistive Technology
This page tells you the basics about assistive technology, the types of devices and how they can support people
Introduction
Stand Alone Devices
Conclusion
Further Help
Assistive Technology (AT) is a general description for a range of
applications of (predominantly) electronic equipment used to monitor or
enable people. It can:
- Help manage or eliminate a wide range of risks to both the
individual e.g. of falling, or to the property e.g. fire, smoke, flood
alert
- Promote independence
- Do some more tasks better or more reliably than the human equivalent
- Help deliver greater privacy or dignity in certain circumstances
Assistive Technology covers:
- Telecare – the remote managing of needs for social care and possibly intervention when required
- Telemedicine/ health – the remote managing of mental or physical status and possibly remote action
- Environmental control – equipment to physically enable an individual
There is potential for all types of assistive technology to support
vulnerable people but of most immediate interest is telecare. From
origins in simple pull cords, hard wired into sheltered schemes, in the
last ten years there have been several linked developments which
together have dramatically increased the potential for assistive
technology to play a part in supporting disabled people:
- Dispersed alarm – it is no longer necessary to hard wire. Anyone
with a telephone can have a base unit. They are cheap; less than £200
for the top of the range product, with considerable capability. It is
possible to connect many devices to a base unit, which will also have
two-way speech and the ability to record prompts, be remotely programmed
and possibly even do things like dispense medicine
- Central monitoring services – have become commonplace and quite
efficient. They can take action in an emergency so it is no longer
necessary to have staff working or on call 24 hours a day simply to
answer an emergency call.
- Mobile response – either based on a central monitoring service
or stand alone. It is possible to respond to emergency calls 24 hours a
day without having permanent, on-site staff, anywhere
- Wireless monitoring devices – a large number of sensors and
other devices are readily available, 'off the shelf'. Most standard
products can be installed with minimal training or knowledge and require
no wiring. Devices can also be inter-connected and 'talk' to each other
e.g. A pressure mat stepped on lights a path to the bathroom. The
bedroom light goes off two minutes after the person has returned to bed.
If they do not return to bed after a defined period then an alarm call
is automatically triggered …. and so on. One qualitative difference
between old style pull chords/ pendants and many of these sensors is
that they are 'passive' devices. The individual who has a fall, an
epileptic fit or wanders outside a defined area no longer needs to be
conscious and able to actively trigger an alarm; the device does that
automatically. But of course, someone who needs help can still
communicate that they want assistance, when they want it by using the
alarm systems.The key building blocks of Telecare are then:
1.
A 'base unit'. This is at the centre of the network of devices. It
connects to a monitoring service of some kind via the telephone line and
can summon help automatically by dialling when 'instructed' by one of
the sensors it connects to. This is usually a wireless device and does
not require any action by the individual; it is automatic. An alarm
button can also be pressed to get help or speak to whoever is
monitoring.
The units have sensitive microphones and speakers built in. The base units can be connected to literally dozens of devices.
2.
A central control or monitoring service. When the base unit is
triggered it dials a 'control centre' which is staffed 24 hours a day.
The people in the centre know who is calling, where from, what the
problem is according to the sensor and can immediately bring up details
of the person. They can:
- Talk to the individual and ask what help is needed – they will know if the person in need of help is non-verbal.
- Call help according to an agreed protocol – this might be
alerting nearby staff from a care provider or relatives or some other
appropriate action as predetermined
- If necessary and according to the nature of the problem, call emergency services immediately.
- In some forms of provision for example, core and cluster schemes
or modern extra care housing, where staff are on the site 24 hours a
day the alert may so in the first instance directly to staff via a
pager. Alternatively, the signal goes initially to central control who
then contact staff if required. The cost of linking to a central, 24
hour monitoring service varies according to who is providing the service
and possibly the number of devices but is usually only a few pounds a
week.
3.
Sensors. There are now a large array of sensors and other devices
that can be connected to the base unit. The starting point in most
telecare installations is a collection of environmental sensors that
monitor things like heat, smoke, gas, and flood. Natural gas detectors
can automatically operate a gas shut off valve. They are used to offer a
degree of safety in the home. Home safety packages usually include an
intruder alarm. Many of these environmental sensors are 'passive infra
red' or PIRs because of how they work.
Next, there is an array of personal sensors which can be selected
according to the individual’s requirements. These include things like
pressure mats which can detect when someone gets out of bed, enters or
leaves a room. They can be used in connection with other equipment to do
a range of things like turn lights on or off. Enuresis alarms can be
put in beds where incontinence is an issue. Epilepsy is common amongst
people with learning disabilities and there are a variety of epilepsy
alarms.
4.
Response. If practical help is needed the response – according to the living situation may come from:
- Staff employed by a care or support provider nearby or on site
- Central controls own staff – not all central control providers offer a mobile service
- A mobile response service operated by the care provider or another agency
- Emergency services
- In some supported living arrangements initially from other residents
The base unit can be programmed to dial through a sequence of phone
numbers according to who is expected to respond. Alternatively they may
dial central control first who in turn may have a protocol for the
individual setting out the sequence of people to call.
A typical installation might consist of a base unit, door entry, smoke detector, movement sensors and temperature sensor.
There are many devices which either add to safety or promote
independence that are broadly assistive technology but which can but do
not always have to be part of the integrated monitoring system described
so far as 'telecare'. There is a considerable range but to give some of
the examples most helpful to disabled people:
- Environmental controls – can be used by someone physically
disabled to remotely do things like open the front door, open and close
windows and curtains. These can also be used to turn domestic appliances
like televisions on and off
- Voice prompts – these can be recorded on a base unit or operate
as a stand alone installation. So for example attached to the front door
when it is opened the voice prompt reminds the person to check for
traffic on the road before stepping out. They could also be programmed
to a different prompt after a certain time. So after 11pm they might say
'it is night time David, are you sure you want to go out?'
- Personal locator and wandering alarms – can be used to find a
person via GPS or for example send an alert if someone goes further than
a pre-determined distance from their home. A mobile phone can be used
in a similar way and there are a few models with larger keys and easier
to use to dial pre-programmed numbers. These kinds of device can have a
role in enabling someone to be more independent outside their home
securely.
This overview provides a very basic introduction to assistive
technology. The key message is that AT can now have a role in supporting
disabled people to live more safely and securely, independently. It can
help overcome some disabilities; it may help support or relieve carers.
Some applications can simply do a monitoring job better and more
reliably than the equivalent person. In certain settings they can reduce
risks for example of abuse or attack also give additional gains. As an
example someone who may be incontinent at night, living in a care home
setting, may find a member of staff physically checks their bed
periodically through the night. An enuresis alarm will do the job more
reliably, only triggering an alarm when there is a problem, with less
disruption of sleep and reducing the potential for abuse.
There are examples of using wrist care devices to treat Prader-Willi
syndrome, people who had been unable to communicate using computer based
devices, touch screen and special software programmes to build up a
network of friends or learning to write and communicate, examples of
families finding one simple bit of AT like an automatic water shut off
valve enabling the whole family to cope and manage better particularly
obsessive and damaging behaviour… The list of possibilities is
considerable as is the scope for utilising
Where to look for further information:
ICom are H&SA members that specialise inTelecare
TUNSTALL Ltd are one of
the main providers of telecare. They have produced a guide to the
application of their products by people with a learning disability .
The Disabled Living Foundation have a very helpful website with advice, case studies and a comprehensive list of products
Although we try to ensure that statements as to the law and other facts are accurate this report gives general guidance and does not aim to cater for individual cases. The Housing and Support Alliance and its sponsors cannot accept responsibility for any loss incurred as a result of relying on such statements, specific advice should always be obtained on individual cases.
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