Our last blog post talked about my personal experience of how my late mother-in-law used or ignored assistive technology, those adaptations or bits of kits designed to make getting older easier.
Here, occupational therapist, Maggie Winchcombe of Years Ahead, shares her thoughts and expertise:
To start with your second-to-last question first… is your experience typical? The answer regrettably is “yes”. Research, going back some 20 years, reveals that a lot of equipment issued to people is abandoned once past its initially useful phase. The reasons are varied and complex, but there are quite a lot of clues to some of them in each of your beautifully descriptive categories. You’ve definitely hit the nail on the head with your final point; “Clare really liked and used the product she chose for herself” – I think this will be the key to shifting from battling with assistive technology to embracing or even being liberated by it!
Here are my thoughts to each of your points….
Never seen the light of day?… Out of sight is out of mind
One reason most assistive products are put away out of sight is down to negativity to ageing and ageism generally. Youth culture still prevails in the UK and ageing and the prospect of being old, or seen as old, is not one we happily embrace, particularly as women. Many billions of pounds are spent on persuasive advertising of ‘anti-ageing’ beauty products each year which plays into this. We feel flattered if we’re thought to be younger than our chronological age and tend to believe that the difficulties other people experience won’t happen to us. We go into denial, so assistive products are unwelcome reminders that we are indeed that older person…much better to keep struggling on!
Another is that they need to be effective and to suit individual circumstances. You mention Clare’s home was cluttered; if the perching stool was more trouble than it was worth it wasn’t doing its job. There are lots of anecdotal stories of products like these having a second life, for example a walking frame becomes a support for climbing plants, or useful for drying clothes. Once they’ve been issued it is rare for anyone to follow up to see if they are still needed six months on and it is still notoriously difficult to return unwanted items.
Hazardous…or past its sell-by-date?
Clare’s slippery, leather recliner chair is not particularly hazardous in itself; the risks of taking a tumble when getting out of any chair will increase with age as mobility, balance and co-ordination become compromised. Stopping people from falling down in old age is a major pre-occupation of healthcare professionals because of the consequences and costs both to the individual and to the NHS. But, the way our body systems work can change imperceptibly as we age so difficulties can creep up on us and we’re not geared up to anticipate problems and plan to minimise the risks as they increase. It would help if we could get better at recognising what happens to our bodies as we age so that we can adapt our homes and manage bodily changes better; this means that we need to challenge the ‘anti-ageing lobby’ and celebrate our longer lives by educating ourselves and taking control.
Well-meaning but impractical …one size doesn’t suit all
Knowledge is power! We are all susceptible to well-meaning, but inappropriate, advice if we feel disadvantaged by inexperience and are unaware of our options, especially if we’re also in crisis. In these circumstances we particularly need to trust the ‘professionals’ dealing with us, but just because they’re in uniform doesn’t mean they’re well informed either. The paramedic thought they were being helpful by passing on anecdotal information from other patients, but what did they know about Clare’s personal circumstances that could affect how well it would work for her? There are various initiatives now underway to improve the knowledge and skills needed to give good advice about assistive products, but there is still a long way to go with this.
The walking frame was probably issued to ensure that Clare could be ‘safely’ discharged. As far as hospital staff are concerned once Clare was home she wouldn’t be their responsibility. This is widely recognised as poor practice, driven by hospital targets to move people on as speedily as possible, which is why there are now major organisational changes in play to ‘personalise’ services, by putting the patient’s priorities first. In the meantime, it’s another good reason to grasp the nettle and educate ourselves, to plan and prepare for our older futures.
Good or essential but with limitations…the difference good design would make
When we routinely use tools to help do things everyday without a second thought why is it so difficult to adopt and use assistive products when we need them? I think it’s because they are seen as ‘special’ and only needed because of age or disability, setting you apart from the rest of society. This is where inclusive or universal design should come into its own. The adapted bathroom didn’t need to look clinical – it could have been modern and stylish with unobtrusive features that meant it was safer for Clare to use for longer. Well designed easier living bathroom products exist, but you have to hunt them out. They’re at the back of catalogues and rarely seen in bath showrooms, even though they’re often useful for children and older people alike and could be marketed as being ‘family friendly’.
But you also touched on Clare’s resistance to help with personal care. The prospect of depending on others for intimate support and of ‘being a burden’ weighs heavily with most of us, almost on a par with ‘needing to go into care’; it’s an indicator of where we are on the trajectory of old age and decline and a hard one to face up to.
Quietly essential – Future proofing our longer lives
Technology has moved on so much in recent years, that it might have been possible for Clare to have considered alternatives to the Carelink alarm that didn’t rely on her wearing her call button. Sadly, too late for Clare, but with many smart energy and security monitoring systems now available there is greater potential to build in call-alert features if there are abrupt changes to an occupant’s daily routine. How many of us would think it helpful and acceptable to build in this functionality for ourselves when installing a smart energy meter in order to be able to address this need in the future?
To return to Clare’s much loved mobility scooter; I would argue that it is the one product that has become ‘normal’ or mainstream especially for a generation who have found them to be liberating [in fact they originate from shopping mall and golf course buggies in the USA, not the disability world]. Shopmobility schemes in most towns and cities have made them visible and accessible to most people. Level access precincts and shopping centres and improved accessibility standards mean that getting in and out of public buildings like community centres, libraries, health centres, churches and leisure centre is now possible where it wasn’t before. This means that people can still feel connected and part of their community; they can be independent of others if they want to, but most importantly, they’re in control.
Our autonomy is the one precious thing that none of us want to give up and makes us rail against being put into the ‘too old to do anything’ box. Being fiercely independent is a good thing, but to be able to keep our independence we will need to be one step ahead and that means facing up to some realities and taking charge of our ageing.
Do you agree? Let us know your thoughts and experiences by posting a Comment below.