vol 4 issue 17

Gadgets: Problem or solution?

5 October 2009
By Kris Sangani
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E&T discovers how technological advances can help elderly and disabled people maintain a full and enriched life.

With an increasing ageing population, the number of people with disabilities - ranging from mild to severe - is on the increase. The challenge is for society to come up with solutions that will enable disabled people to maintain enriched lives.

The obvious and most immediate solution to this challenge is to increase the resources in social services that are on offer to match increased demand. However, this is seen to be unviable economically. Thus, many governments are looking at technology companies to engineer solutions at a much lower cost.

In the UK, for instance, the government is encouraging many disabled people to buy-in services directly, rather than rely on social care provision from local authorities. With these independent living allowances, the disabled would be, theoretically, free to buy any technology or service that would assist them.

Rather than pay for somebody to do their shopping, for example, they could shop online and use their fund to pay additional delivery costs.

Independent living

The concern lies with the obstacles facing developers who are trying to bring products and services to market. The Foundation for Assistive Technology (FAST) records over 150 projects annually which aim to use innovative technology to support older and disabled people in living independently.

They are mostly small-scale pilots or trials to test out whether the technology will work and to examine the benefits of this approach compared to conventional ways of offering rehabilitation or support for everyday activities.

"Given that we have an ageing population who will want to make the most of what technology has to offer in order to maintain their independence and safety, it's important to find out whether these good ideas are being turned into products that people can go out and buy," says FAST director Keren Down.

FAST undertook a review of assistive technology projects funded over the past four years, looking at whether the projects aimed to develop a commercial product or service and, if they did, whether they had been successful. It appears that over the past four years, only 15 projects actually led to products becoming available on the market.

The reasons for not being able to bring a product or service through the research and development process and on to the market are multiple and complex. There are also many reasons for research and development activity in this area that does focus on commercial development of a product or service, including shaping policy and practice, understanding users' views of technology, and so on.

The science-fiction future of robots assisting us is still simply that - fiction. But what many of the charities are requiring is more immediate. Thus the largest disability charities are actively involved in the development of technologies.

Organisations such as the Royal National Institute of Blind People, the Royal National Institute for Deaf People (RNID), and the Alzheimer's Society all have directors of technology whose primary remit is to work with technology companies to develop assistive technologies.

Ethical considerations

Issues of dignity and ethics are high on the agenda for the main charities who represent the views of the disabled. For example, telecare is seen as a vibrant solution for many elderly and disabled people. But rather than being seen as the future for empowering people with dementia, for example, if the balance is not right it could be seen as the latest indication of an over zealous Big Brother.

Electronic tagging, for instance, has been suggested as a way of tracking people with dementia - but it has sparked a great deal of soul searching by those working with people suffering from dementia.

Many people with dementia feel compelled to walk about, a symptom often described as 'wandering'. Up to 60 per cent of people with the condition may wander and 40 per cent of them have got lost at some time outside of their homes. Walking can provide significant benefits for people with dementia, but also presents some risks. If a person with dementia wanders alone and unannounced, it also causes distress for family, carers and loved ones.

Tracking devices use global positioning technology as a way of locating a person if they are lost. A carer, close friend or specialist team can then collect them and bring them back home.

"We know new technology is available and could offer benefits to people with dementia and their carers. There is a careful balance to strike between empowering people and restricting their movement, and this technology can certainly never be used as an alternative for high quality dementia care," says Neil Hunt, chief executive of the Alzheimer's Society.

The charity believes people should have access to devices if it is appropriate and they want them. They claim that advanced decisions about this technology could be used before people reach the latter stages of dementia, when they may have lost mental capacity.

A concern of many working with the disabled is that these advances in technology may lead to less human contact. However, there are technologies that have been developed to actually enhance contact with others.

"Few things are more important to us than the ability to communicate. While the rest of society has moved on and uses modern telephone technology such as mobile phones and the Internet, deaf people have been overlooked as mainstream markets have failed to modernise textphone technology," says Guido Gybels, director of technology at RNID.

TalkByText is a piece of software developed by the charity to provide real-time text conversation.

The software was developed by the RNID to overcome problems previously encountered with communication solutions for deaf and hard of hearing people. It has a diverse range of applications from keeping in touch with friends and family abroad to those who do not have access to a phone.

It offers users character-by-character real-time text - essential for proper conversation and, for people with hearing loss, making calls via a text relay service to hearing people's voice phones.

Technology as a barrier

But sometimes technology can be the problem rather than the solution. For example, digital rights management, designed to prevent the illegal copying of copyright material, could prove a problem for the blind when accessing written content on an eBook.

Many people with visual impairments rely on a screen reader to read the content of a digital page aloud, or they have the page displayed with a Braille device. But assistive technologies can only operate when the content is compatible - and eBooks are often incompatible.

Adobe eBooks usually have accessibility settings disabled. In some cases, the audio rights to a book had been sold to another party and the eBook publisher was cautious not to infringe. Such copyright deals do not distinguish between a trained actor's performance in creating an audio-book for the mass-market and what can be achieved by computerised text-to-speech systems.

Both technology companies and charities have concluded that a strong commercial head will have to rule to ensure that products are suitable for use by the disabled.

Additionally, stronger communication (if not collaboration) between consumer technology companies and the assistive technology sector will have to be created to ensure that consumer tech is the solution and not the problem.

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What is assistive technology?

Assistive technology (AT), according to FAST, is any product or service designed to enable independence for disabled and older people. It acknowledges the cross-over between inclusively designed, mainstream products and the technology specifically made for disabled and older people.

This definition is in line with the disability movement's support for the personalisation of services and implies an evaluation of assistive technology services though the measurement, in part at least, of personally-set outcomes.

The US has a legal definition of the term. The Assistive Technology Act of 1998, defines it as 'any item, piece of equipment, or product system, whether acquired commercially, modified, or customised, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities'.

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