Home' Australian Ageing Agenda : AAA Jul-Aug 2011 Contents CARER FOCUS
Project officer, Rebecca Forbes, says
the point of the project was to be
"Often the solutions to problems are
driven by the technological advancement
rather than actual carer or client needs.
Technology is invented and marketed and
there is the advertising and a 'push factor'
that says, 'Technology can solve problems'.
"We wanted to look at it from the
point of view of the carer, to see how
technology could be genuinely useful
to a carer at home, as opposed to the
residential care context.
"So we recruited participants to the
study from existing HammondCare
community care package clients, from the
Central Coast and Hornsby Ku-ring-gai
areas," says Forbes.
To ensure expertise across both the
care issues and the technology, they
developed a multi-disciplinary team model
for the study, comprising a care manager,
occupational therapist (OT) and an
assistive technology specialist.
"They all played a part. We needed the
expertise in the technology area but also
the person in the care context. There was
lots of case conferencing and discussion
with the carer and the team about what
might be useful," says Forbes.
REVIEWING THE SITUATION
Central to the project was a completely
independent initial assessment of
each situation to identify the carer's
For each client and carer in the study,
the case manager and the OT obtained the
data based on an assessment tool called
Goal Attainment Scaling (GAS). Working
with the team, the carer would isolate a
particular goal they hoped the technology
would help them to achieve.
"Sometimes it was a physical need,
sometimes emotional and sometimes
both," says Gresham. "We gave each
a score at the start and then had a six
and 12 week follow up to see if they
had achieved the expectations or not or
whether they had exceeded them."
"Rather than say, oh you need this
great gadget; that'll help you solve
that problem; we would talk through
the challenges they faced and discuss
different options and how they might
work in that situation. And the person
could think through what might be most
acceptable or work best in that situation.
"One of the assessment techniques
used to great benefit in the project was
'situational questioning'. That involves
asking, hypothetically, 'What if we could
do this? Or achieve this outcome?'"
"Exploration of those theoretical
possibilities had the effect of helping us
all to understand what we were actually
looking for, and engaging the carer in
the solution meant they could take
ownership of it."
The range of assistive technologies
used in the study included highly
engineered equipment such as a
mechanism for turning out the front
seat of a car to make it easier to get
someone in and out, as well as very
simple devices, such as magnetic locks,
spring-loaded taps and automatic safety
switches for the stove.
Other technology used in the study
included an electronic bidet, bed and
chair movement sensors, leg lifters
for the side of the bed, sensor lights,
a GPS locater, the Wii-fit game and
an electronic reading device as well
as electronic tablets and laptops with
Skype video communication technology.
Many but not all of the clients in the
study had dementia.
"We tried not to use the term 'assistive
technology' because we found it could
confuse people. "We talked about 'creative
solutions' -- people responded more to
that," Gresham says.
As a social worker on the project,
Ellen Thompson says she has a very
hands-on involvement with clients and
their carers and wanted to reduce carer
burden in a holistic way. The important
thing, she says, was identifying the
real client need and then matching a
technology solution to the need, rather
than the other way around.
"So if someone has mobility problems
we could go in and say, well, here are
some products and here's what they can
do but that would be giving them the goals
to work to. We wanted their 'buy-in', to
set the goals themselves, in this instance,"
All members of the team said that
initially they had expected people might
be a bit nervous about the technology and
require lots of support.
"The literature suggests that older
adults are a little phobic when it comes to
technology but we didn't really find that
in our study. They were happy to have
us there and open to trying new things;
anything that might assist them with their
needs," says Thompson.
"Because we identified the need with
them first and they were involved in setting
their own goals, they wanted to achieve
them and that made a big difference.
Once the technology was suggested and
explained to them it was fine.
"Some of the more complex
technologies -- like the Galaxy pads and
teaching them to use Skype for example --
were really empowering and quite exciting
for them," Thompson said.
THE PERSON AND
The technology expert on the team,
Chris Chilcott, says he wasn't surprised
by the enthusiasm and ease of adoption
found in the study.
"Initially we'd thought their acceptance
driven by the
actual carer or
there is the
and a 'push
factor' that says,
Making it easier to go for a drive
AAA | JULY -- AUGUST 2011 | 43
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