The Engineering Handbook of Smart Technology for Aging, Disability, and Independence: Helal/HB of Smart Technology for Aging
معرفی کتاب «The Engineering Handbook of Smart Technology for Aging, Disability, and Independence: Helal/HB of Smart Technology for Aging» نوشتهٔ Helal, Abdelsalam Sumi (editor);Mokhtari, Mounir (editor);Abdulrazak, Bessam (editor)، منتشرشده توسط نشر John Wiley & Sons در سال 2008. این کتاب در فرمت pdf، زبان انگلیسی ارائه شده است.
CHAPTER 1
Technology for Successful Aging and Disabilities
Amol Karmarkar, Eliana Chavez, and Rory A. Cooper VA Pittsburgh Healthcare System
Although technology acceptance or rejection is dependent on a combination of several factors, it is not possible to accurately weigh these factors to determine the highest predictor for acceptance or rejection of an assistive technology (AT) device. Optimal use of AT devices depends on a combination of variables, including personal and environmental factors, the device in itself, the service delivery factor, and the social factor. Usability of the devices also depends on the training that the user receives. Inadequacy in training may lead to unfamiliarity with the use of the device, which in turn may result in restricted use or nonuse of the device. Three types of acceptances related to AT can be described as reluctant acceptance, grateful acceptance, and internal acceptance. Reluctant acceptance occurs when the individual is accepting the device only as a "necessity" or a medium for completing activities of daily living (ADL). In grateful acceptance, the device is viewed as a part of life and considered as one of the "assets." With this type of acceptance, AT is a medium for overcoming functional deficits occurring as a result of the disability. Internal acceptance is the highest category among the levels of acceptance of AT devices, where individuals view the devices as a part of themselves. The AT device in this case is considered by users as a medium for overcoming their physical impairments and a replacement for the impaired part of their bodies.
The acceptance or rejection of AT devices in turn is affected by several factors. These factors have a strong common component, namely, the temporal effect. The temporal component influences the usability of a device. The usability, nonusability, or both, of a device, is determined by a dynamic relationship between several variables including personal, environmental, psychosocial, and economical factors. The interaction between these factors continually changes across the time domain, which directly affects acceptance/rejection of AT device (Fig. 1.1).
Another factor that increases the usability of an AT device is the perception about the advantages and disadvantages of the AT devices. If the (perceived) benefits outweigh the (perceived) disadvantages, then, there are higher chances of that device to be utilized. On the contrary, if the (perceived) disadvantages outweigh the (perceived) benefits of the device, there are higher chances that the device will no be used.
Personal factors, including motivation, cooperation, optimism, good coping skills, and the ability to learn or adapt to new skills, work in a combination for the user. In the older population, all the abovementioned factors diminish gradually. Therefore, acceptance of AT devices can be a challenge in this population, which, in turn, may result in suboptimal use of AT devices for functional independence.
A review article indicated a relationship between (1) the type and degree of impairment and the severity of illness and (2) the use of AT devices. A variation in the number of AT devices used was observed in people with varying disorders within the aging population. The overall trend indicated a positive relationship between the severity of disorders and the number of AT devices used by the older people. The usability of AT devices also depends on environmental accessibility. The presence of environmental barriers can limit acceptance of the devices. For instance, consider an elderly individual, living in a two-story house, who has been prescribed a power wheelchair for functional mobility. There is a ramp to enter the house. The second floor, where the individual spends most of his time during a day, however, is not accessible. In this situation, the use of the power wheelchair inside the house will be limited by the presence of an environmental barrier. Acceptance of AT in older adults is also determined to a large extent by views of society. An example of this is the higher acceptability of home modifications, such as grab bars in the bathroom and a high-rise commode; than that of a mobility device such as a cane or a walker. The latter are considered to be indicative of a significant disability.
1.1 INADEQUATE TRAINING
The Department of Health and Human Services (HHS) mentioned inadequate training of use of AT for elderly population as one of the significant barriers in decreasing usability of the devices. In acute-care settings such as hospitals, the reduced length of stay limits the time availability for occupational/physical therapist to provide adequate education about the use of AT devices during discharge. This results in elderly individuals going home with different types of AT devices, but having limited knowledge regarding the use and maintenance information about these devices. Ineffective follow-up care after discharge from hospitals also results in hesitance to use AT devices at home, causing rejection or abandonment of the devices. Lack of standardization across various settings specialized in prescription of AT, and the variable training time allocated and emphasized across different settings, also leads to inconsistent levels of acceptance. Evidence is pointing at the benefits of providing training of AT in improving effectiveness of use and in prevention of primary and secondary injuries associated with inappropriate use. However, the existing research focuses primarily on effectiveness of training for operating manual wheelchairs. Also, very few studies related to aging and AT mentioned training as an important component for improving acceptance of use of the devices. Chiu and Man indicated greater improvement in the functional independence, higher satisfaction with the AT devices as well as a higher usage of AT devices, among the elderly individuals who received a home based training program after getting discharge from the hospital, as compared to other groups of elderly individuals who did not receive home based training program.
Following are some of the guidelines that can be helpful in providing training for older individuals regarding use of AT devices:
1. Client and Family Involvement. Along with client involvement in selection and finalizing AT devices, an immediate family member's involvement is also beneficial. This could be effective with elderly people being discharged from hospitals or skilled nursing facilities and returning home, where the device will be used. A smooth transition from hospital to home could be facilitated by involvement of one or more family members.
2. Follow-Up Care. Status of elderly people after being discharged from the care setting and receiving the device from a specialized clinic is not monitored effectively. If communication is maintained between providers and consumers, with responses to questions about the use of AT for specific purposes within the home environment, it could provide the encouragement required for continuing the use of AT devices.
3. Instructions and Training in Context of Use. Elderly individuals usually receive training in use of AT devices in an environment completely different from the environment where the devices will be used. Transferrence of skills from one environment to the other sometimes is not very efficient, resulting in increased level of frustration and ultimately to nonuse of the device. On the contrary, if emphasis is placed from the start on transferring skills and cross-training for all environments, transition of AT use will be more effective.
1.2 TECHNOLOGY REJECTION
Technology abandonment has been a critical issue that has a negative impact on the user's daily living and also on the clinical practice. Because of the intricate nature of the prescription procedure, the cost could accumulate; thus premature rejection of the prescribed AT devices could be an expensive business for the healthcare services. Phillips and Zhao raised this issue for the first time in their descriptive article about factors related to rejection of AT. The study indicated that a change in the needs of people was the most important factor. The easier it was to obtain an AT device, the greater was the likelihood that it would be rejected. The higher was the performance of an AT device, the lower was the rejection rate. If the users' opinions were considered in the AT service delivery process, there were higher rates of device retention.
1.3 IMPROVING MATCH BETWEEN PERSON, ASSISTIVE TECHNOLOGY, AND ENVIRONMENT
Several factors need to be considered prior to prescription of the AT device, with some of the more important ones listed below:
Inclusion of end users in design, feature selection, and evaluation process of AT devices.
Sharing information between providers and clients, and taking feedback for determining match between users and AT.
In the event that client is not satisfied with original loaner equipment, provision for replacement with newer equipment. This process can reduce wastage of human and system resources if a client is not willing to use a particular type of prescribed AT device.
Consideration of time factor—effective use of AT device could be a time-consuming procedure, which needs to include all factors where an AT device will be used. Also, this process must be adapted by the user in the physicosocial environment where it will be used.
1.4 TECHNOLOGY FITTING
When providing a mobility device, it is essential to conduct a careful and methodical evaluation of a potential mobility user with clinical input from trained professionals. An assistive technology practitioner (ATP) should consider several steps before providing an AT device. The matching person–technology (MPT) assessment process is one means for providing a more personal approach to matching person and technology. The MPT components include the environments in which the person uses the technology, the individual's characteristics and preferences, and the functions and features of the technology.
Characteristics within these three components can each influence technology use either positively or negatively. If there are too many negative influences, the chances of the technology being successfully used are greatly reduced. In fact, the technology itself can appear perfect for a given need, but if the user does not possess the appropriate personal characteristics or does not receive the needed support, that perfect technology may go unused or may be used inappropriately. The steps in a successful MPT assessment are as follows:
1. Client Evaluation. The nature and progression of the disease should be well understood and considered. Joint range of motion, especially at the hips and knees, as well as pelvic and spinal alignment, will determine the proper configuration and postural supports of an AT device. Sensory and central processing skills should also be evaluated. The risk for and presence of skin breakdown needs to be considered, for example, for proper seat cushion selection. Each cushion has advantages and disadvantages that need to be carefully considered. Pressure mapping is typically used as part of the routine screening or evaluation procedure to determine whether individuals are at risk of developing pressure sores. Pressure mapping (Fig. 1.2) is often used for relative comparison between different types of cushions and wheelchair setups to assist in the selection of such equipment. They are also useful as biofeedback to the individual regarding weight shift and pressure relief abilities and strategies. Inappropriate seat cushion provision can lead to costly and fatal pressure sores as well as affect the user's postural alignment and ability to transfer in and out of the chair. Features such as tilt-in-space and backward-reclining systems need to be considered for people who cannot physically adjust or reposition to reduce the potential for postural deformities, discomfort, and skin breakdown. When considering manual wheelchair propulsion, an ATP should also consider the stress being applied to the upper extremities, which has been associated with upper-extremity repetitive strain injuries. An external device called SmartWheel (Fig. 1.3) had been introduced in a clinical setting to measure forces at the wheelchair during wheelchair propulsion. A SmartWheel is an instrument that can be easily attached to most standard manual wheelchairs. Simulation is an assessment process in which the AT team observes the dynamic interaction between the client and the AT equipment.
2. Driving Abilities. The appropriate mobility device needed, whether a manual wheelchair, a scooter, or a power wheelchair, needs careful evaluation. For example, a power wheelchair—a heavy piece of equipment capable of reaching high speeds—can cause serious damage, injury, and even death in a collision. Therefore, the ATP must carefully assess a candidate's ability to operate the equipment, especially when the candidate has cognitive or perceptual deficits. People with these deficits should not necessarily be prohibited from the use of a power wheelchair; however, they may require training to learn to operate the device.
3. Environmental Accessibility Evaluation. A home-and-work assessment is often needed to ensure that the device will be compatible. Few power wheelchairs can be carried upstairs, or through narrow doorways, or made to negotiate tight turns in a hallway or bathroom. A proper assessment involves taking the device to the user's home, surveying the environment for accessibility, and having the potential user get into the device and drive it where needed within the course of a routine day. The home assessment should also involve having the candidate complete specific tasks. This includes transferring to various surfaces, reaching for objects, cooking, pulling up to a table or work surfaces, and completing any other important activity.
4. Transportation Accessibility Evaluation. The physical capabilities of the person to manage the device must be considered. For example if a power wheelchair or scooter must be transported, the person who will be conducting the task should have an opportunity to stow the device to verify that the operation is feasible. A consumer who will use an accessible vehicle, such as a van with a lift or ramp, will need to drive the device into the vehicle, maneuver it into an appropriate position for securement or transfer to another seat, and then exit the vehicle. It is crucial to consider a device that has the appropriate attachment points to ensure optimal safety during transportation.
1.4.1 Client Training and Equipment Delivery Model
Equipment delivery must include careful attention to final adjustment and to proper training in the equipment's safe and effective. Even though the equipment was previously specified in detail, it is important for the ATP to be present during the final fitting to verify that the seating goals and objectives have been achieved. ATP help is important to make prescriptive decisions during the fine-tuning of the adjustable components.
During the final fitting, training and delivery of the equipment should be done. The client must be properly trained in the use of the equipment. This training should include instruction in proper sitting, postural adjustment, weight shift, propulsion, chair maneuverability, transfers, soft-tissue protection procedures, vehicular transportation of the equipment, and operation of all components of the equipment.
1.4.2 Client Follow-Up
Delivery of the equipment is not the end of the process. Assessment of the effectiveness of the equipment should continue throughout the duration of use. The frequency and extent of the follow-up visits should be determined according to each client's needs [14]. To accomplish a thorough follow-up assessment, the team should review the seating (or equipment) goals and objectives, as well as the prescriptive approaches that were recorded during the client's prior assessment. With that information in mind, the team should screen the client's needs, identifying any changes or additions that would effect a change in the client's equipment. Any changes in the client's abilities or demands on the social or physical environment should be reassessed.
(Continues...) Excerpted from The Engineering Handbook of Smart Technology for Aging, Disability, and Independence by Abdelsalam Helal, Mounir Mokhtari, Bessam Abdulrazak. Copyright © 2008 John Wiley & Sons, Inc.. Excerpted by permission of John Wiley & Sons.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site. **An advanced look at smart technology to promote the independence of the elderly and disabled** Ongoing research and advancements in technology are essential for the continuing independence of elderly and disabled persons. __The Engineering Handbook of Smart Technology for Aging, Disability, and Independence__ provides a thorough analysis of these technologies and the needs of the elderly and disabled, including a breakdown of demographics, government spending, growth rate, and much more. Each chapter is written by an expert in his or her respective field, and gives readers unparalleled insight into the research and developments in a multitude of important areas, including: * User-need analyses, classifications, and policies * Assistive devices and systems for people with motor disabilities * Assistive devices and systems for people with visual and hearing impairments * Human-machine interaction and virtual reality * Assistive robotics * Technology for user mobility and object manipulation * Smart homes as assistant environments * A discussion of emerging standards and guidelines to build accessible devices, tools, and environments This book is an indispensable resource for researchers and professionals in computer science, rehabilitation science, and clinical engineering. It also serves as a valuable textbook for graduate students in the aforementioned fields.Content: Chapter 1 Technology for Successful Aging and Disabilities (pages 27–48): Amol Karmarkar, Eliana Chavez and Rory A. CooperChapter 2 International Policy Context of Technologies for Disabilities: An Analytic Framework (pages 49–59): Rene JahielChapter 3 Technology for Individuals with Disabilities: Government and Market Policies (pages 61–80): Katherine D. SeelmanChapter 4 Assistive Technology and the International Classification of Functioning, Disability, and Health (pages 81–99): Jerome E. BickenbachChapter 5 Technology for Integration of Students with Disabilities in Higher Education (pages 101–116): Marci Kinas Jerome, Kristine Neuber, Brianna Stegall, Anna Emenova and Michael BehrmannChapter 6 ISO 9999 Assistive Products for Persons with Disability: Classification and Terminology (pages 117–126): Ir. Theo BougieChapter 7 Low?Tech Assistive Technology (pages 127–142): Kathleen Laurin and Jill Sherman PleasantChapter 8 People with Visual Disabilities (pages 143–162): John Gill and Linda JolliffChapter 9 Assistive Devices for People with Visual Impairments (pages 163–189): John GillChapter 10 Assistive Devices for People with Hearing Loss (pages 191–202): Matthew H. BakkeChapter 11 People with Cognitive Disabilities (pages 203–215): Mary Kay Rizzolo and David BraddockChapter 12 Assistive Devices for People with Cognitive Impairments (pages 217–236): Helene Pigot, Jeremy Bauchet and Sylvain GirouxChapter 13 Computer Access in the Workplace (pages 237–261): Karen Milchus and Carrie BruceChapter 14 Platforms and Operating System Accessibility (pages 263–279): Barry Feigenbaum and Kip HarrisChapter 15 Voice Interactive Systems (pages 281–296): Rudzionis Algimantas, Kastytis Ratkevicius and Vytautas RudzionisChapter 16 The Communication Assistant (Alternative Communication) (pages 297–316): Leanne L. WestChapter 17 Wearable Systems Design Issues for Aging or Disabled Users (pages 317–338): Maribeth Gandy, Tracy Westeyn, Helene Brashear and Thad StarnerChapter 18 Tactile Displays (pages 339–352): Stephen A. Brewster, Steven A. Wall, Lorna M. Brown and Eve E. HogganChapter 19 Assistive Robotics for Independent Living (pages 353–374): Bessam Abdulrazak and Dr. Mounir MokhtariChapter 20 Mobile Platform?Based Assistive Robot Systems (pages 375–403): Zeungnam Bien, Kwang?Hyun Park, Myung Jin Chung, Dae?Jin Kim, Jin?Woo Jung, Pyung?Hun Chang and Jin?Oh KimChapter 21 Robot Therapy at Elder Care Institutions: Effects of Long?Term Interaction with Seal Robots (pages 405–418): Takanori Shibata and Kazuyoshi WadaChapter 22 Prostheses: Human Limbs and Their Artificial Replacements (pages 419–436): Richard F. ff. WeirChapter 23 Wheelchairs within the Context of Smart House Design (pages 437–457): Dimitar StefanovChapter 24 People with Special Needs and Traffic Safety (pages 459–477): Nahid Shahmehri, Ioan Chisalita and Johan AbergChapter 25 Blind Navigation and the Role of Technology (pages 479–500): Nicholas A. Giudice and Gordon E. LeggeChapter 26 Walker Systems (pages 501–518): Andrew RentschlerChapter 27 Accessible Public Transportation Services in America (pages 519–534): Katharine M. Hunter?ZaworskiChapter 28 Transportation Services in Europe (pages 535–548): Isabelle DussutourChapter 29 Transportation Services in Asia (pages 549–566): Joseph Kwan and Eric TamChapter 30 Modeling the Well?Being of Older People (pages 567–584): Andrew SixsmithChapter 31 Context Awareness (pages 585–605): Jadwiga Indulska and Karen HenricksenChapter 32 Middleware for Smart Spaces (pages 607–618): Daqing Zhang, Tao Gu and Manli ZhuChapter 33 Safety, Security, Privacy and Trust Issues (pages 619–629): Abdallah M'hamedChapter 34 Automated Medication Management Devices (pages 631–644): R. J. Davies, Christopher Nugent, D. D. Finlay, N. D. Black and D. CraigChapter 35 Virtual Companions (pages 645–671): Nahid Shahmehri, Johan Aberg and Dennis MaciuszekChapter 36 Textile Sensing and e?Textiles (Smart Textiles) (pages 673–692): Rita Paradiso, Nicola Taccini and Giannicola LorigaChapter 37 The Gator Tech Smart House: A Programmable Pervasive Space (pages 693–709): Dr. Sumi Helal, Raja Bose, Steven Pickles, Hicham Elzabadani, Jeffrey King and Youssef KaddourahChapter 38 Health Application and Telecare (pages 711–726): Mathijs Soede, Frank Vlaskamp and Charles WillemsChapter 39 Immersive Telecare for Assisting People with Special Needs (pages 727–736): Dr. Sumi Helal and Bessam AbdulrazakChapter 40 Smart Systems in Personal Transportation (pages 737–747): Aaron SteinfeldChapter 41 Tools for Studying Novel Proactive Healthcare Applications for Places of Living (pages 749–766): Stephen Intille and Kent LarsonChapter 42 Algorithms for Smart Spaces (pages 767–783): Diane J. Cook, G. Michael Youngblood and Gaurav JainChapter 43 User?Sensitive Design for Older and Disabled People (pages 785–802): Alan NewellChapter 44 Universal Design/Design for All: Practice and Method (pages 803–818): Edward SteinfeldChapter 45 Design for Well?Being (pages 819–832): Andreas Larsson and Tobias LarssonChapter 46 Technology Evaluation within Healthcare and Social Care (pages 833–853): Suzanne Martin, George Kernohan, Bernadette McCreight and Christopher NugentChapter 47 Usability in Designing Assistive Technologies (pages 855–866): Jean?Claude Sperandio and Marion WolffChapter 48 Smart Home and Health Telematics: Standards for and with Users (pages 867–906): Milan ErbesChapter 49 ICT Standardization for the Elderly and People with Disabilities in Japan (pages 907–920): Hajime Yamada
An advanced look at smart technology to promote the independence of the elderly and disabled
Ongoing research and advancements in technology are essential for the continuing independence of elderly and disabled persons. The Engineering Handbook of Smart Technology for Aging, Disability, and Independence provides a thorough analysis of these technologies and the needs of the elderly and disabled, including a breakdown of demographics, government spending, growth rate, and much more.
Each chapter is written by an expert in his or her respective field, and gives readers unparalleled insight into the research and developments in a multitude of important areas, including:
- User-need analyses, classifications, and policies
- Assistive devices and systems for people with motor disabilities
- Assistive devices and systems for people with visual and hearing impairments
- Human-machine interaction and virtual reality
- Assistive robotics
- Technology for user mobility and object manipulation
- Smart homes as assistant environments
- A discussion of emerging standards and guidelines to build accessible devices, tools, and environments
This book is an indispensable resource for researchers and professionals in computer science, rehabilitation science, and clinical engineering. It also serves as a valuable textbook for graduate students in the aforementioned fields.