TECH ACT PROJECTS REACH OUT TO AGING POPULATIONS
There are approximately 24.8 million Americans who are 65 years old or older and that number increases each year. The elderly experience changes in hearing and seeing, and limitations in their mobility. These changes make the elderly good candidates for assistive technology (AT). Tech Act projects have been reaching out to this group in a variety of ways. This bulletin explores some of the issues involved in the use of AT by the elderly and describes some strategies the Tech Act Projects have used to reach this group.
Challenges or Barriers
The elderly are strongly motivated to remain in their own homes and communities. However Tech Act projects have found that generally the elderly and their care givers are just not aware of assistive technology and the advantages of using AT to "age-in-place."
The elderly are reluctant to acknowledge that they have any functional limitations and don't describe themselves as being disabled. Thus, they are not readily receptive to considering assistive technology. Indeed the term "assistive technology" is a meaningless term. Yet when the elderly see devices that they can use as "tools" for living, they immediate relate these to solving problems in their daily life.
If the elderly do determine that a particular item would be helpful, funding is often a problem. They don't know how to begin to get Medicare to pay for devices or they may find that Medicare just doesn't pay for AT for daily living. Therefore, the elderly usually pay for many items out of their own pockets.
In designing outreach efforts to the elderly, Tech Act projects need to take into consideration these issues. Projects also have the underlying goal that their activities lead to systemic changes. In the case of outreach efforts, projects hope these efforts will build the capacity of other agencies and institutions so that the change will be sustainable. Strategies Used by Projects
Tech Act projects have used a range of strategies to reach the elderly populations in their states. Here are some examples from a few of the state projects.
Direct linkages to agencies and groups who work with the aging is important for meaningful collaboration and outreach efforts. Several Tech Act projects include a representative from interest groups focused on the aging on their advisory board. This is true in Georgia, Iowa, Minnesota, New Mexico, and Alabama. South Dakota's Tech Act project is a member of its state's interagency council on aging. The Minnesota and South Dakota Tech Act projects were invited to participate in their state's White House Conference on Aging. The New Mexico Tech Act project has participated in its state agency on aging conference since 1990. Others, such as Iowa, South Dakota, North Carolina, and New Hampshire, are collaborating directly with their state chapter of AARP.
Tech Act projects engage in awareness activities. Iowa, Minnesota, North Carolina, Oklahoma and South Dakota have developed brochures and fact sheets specifically directed to the elderly. The Minnesota STAR Program routinely places news items in the area agency on aging (AAAs) newsletters to keep their audiences aware of assistive technology. The Georgia Tools for Life Project was featured in the Georgia Magazine, which reaches a broad spectrum of the state's elderly population. This exposure resulted in an increase in I&R; calls regarding AT for the elderly. The New Mexico TAP was featured in an issue of Aging Today, a national newsletter and an issue of MAX (Maximizing Human Potential), a newsletter of the American Society on Aging.
New Hampshire devoted an entire issue of its project newsletter to "Growing Older with Assistive Technology" (Winter1995/96). The New Mexico Project's newsletter featured its "Seniors Helping Seniors" program (Summer 1994). The Arkansas and New Mexico projects routinely present at conferences for professionals. The Georgia project exhibits at statewide Alzheimer's and Gerontological Society conferences. The North Carolina project has exhibited at local AARP conferences and other meetings to promote awareness.
Training activities provide indepth knowledge for elderly consumers and the professionals who work with them. The "small changes...BIG DIFFERENCES" workshop developed by the Iowa Project for Assistive Technology (IPAT) has been used by that state and successfully replicated in others. It provides information on low-tech devices such as door levers, zipper pulls, and check writing guides. It uses a train-the-trainer model so that care providers and active seniors are trained together and then train the elderly in their respective communities.
Trainers are provided with a kit of low cost AT items that they talk about and demonstrate. The kit also includes a flip chart, table top poster, assistive technology catalogs, and project brochures. This has been an effective model because the training sessions are conducted in familiar settings, either at congregate meals or in an elderly person's own home. Some trainers take the devices and exhibit them at shopping malls during health fairs. The elderly can try out the various devices and see if they work for them. IPAT uses peer trainers (seniors), who can speak to other elders in language that is relevant and convincing. In Iowa, this training started with one kit per region. It has become so popular that there is a "small changes" low-tech device kit now in all 99 counties of the state.
Other state Tech Act projects have adapted the "small changes...BIG DIFFERENCES" curriculum to fit their state. The Alabama STAR project is in the process of spreading this training throughout the state. The Tech Act project modified the curriculum to fit Alabama's needs, then it tried out a pilot in one region of the state. With the success of that pilot, it initiated training in half of the state and plans to establish training in the rest of the state this year. South Dakota is teaming with its state AARP chapter to provide training. AARP trainers are presenting the material at local chapter meetings. The New Mexico Project developed a training module entitled HAPI (Home Access Program Initiatives) which features low tech devices presented at senior gathering places.
Tech Act projects have conducted training for professionals and consumers on other topics related to AT and the elderly. In New Hampshire, the Tech Act project developed a series of workshops, cosponsored by several state agencies and associations on AT for employment and recreation, as well as on AT to enhance sensory skills. The Minnesota STAR Project conducted several courses for professionals serving the aging and recently sponsored a forum on older Minnesotans. Iowa is in the process of training "gatekeepers," those people who are in direct contact with the elderly, such as mail carriers and delivery persons, to recognize potential AT needs with their client groups. Georgia is planning to work with the state university gerontological programs, social work programs, and public health programs. South Dakota has worked with its state medical school, office of continuing education to provide a program on assistive technology that has been incorporated into the TV series "Geriatric Forum." This is available from DakotaLink for use by other states.
Because the elderly, especially rural elderly, are primarily cared for by family practice doctors and internists, Iowa has focused considerable effort into working with this group. Last year Iowa provided AMA guidelines to each family practice office, in some cases the booklets were delivered by the AAA "small changes...BIG DIFFERENCES" elder volunteers.
Providing Devices has been a focus of some Tech Act projects. Loan closets with items for the elderly have been sponsored or encouraged by the Iowa and Georgia projects. Iowa has worked with the County Extension Service to develop a module for 4-H leaders on simple AT items that 4-H members can make for the elderly. Georgia sponsors "make and take" workshops at senior centers so the elderly can make their own devices to use.
Home modification is a major emphasis of the New Mexico project. The project employs a full time adaptive equipment specialist who specializes in ramp building and home access modifications. The project provides home access evaluations to determine needed modifications and it actually makes many of the modifications, such as building ramps and installing railings. Senior to senior services coordination is provided through the direct work of several volunteers, primarily seniors who are leaders in their communities. Services that the project provides always involve family and community volunteers and supports.
New Hampshire has been working with an occupational therapist (OT) to set up a permanent display of low-tech devices in an apartment complex, providing awareness to residents of the complex and the community as well. Minnesota and Georgia are working with local businesses ("Ramps for Champs" in Georgia, "Ramp Partners" in Minnesota) to replicate their services across the state. Iowa is working with its area agencies on aging, AARP, and local building supply centers to train professionals on home modification issues and set up resource centers at AAAs. It plans to piggyback onto the AARP September 1996 national campaign "Why Move, Improve." It also is collaborating with local hardware stores to conduct in-store demonstrations of small home adaptations. It is working with its state and county extension service to disseminate modification information and eventually the project will work with the state architect to popularize remodeling for the aging.
To fund outreach activities, the Georgia Tools for Life Project received a NIDRR grant with the American Society on Aging to conduct pilot outreach programs in the state. One involved working with the OT training program at a community college to develop a traveling exhibit to be disseminated statewide. In a ripple effect, the OTs and the community began a fund raising drive to provide AT devices for people who need them. In Iowa, some of the local aging agencies are raising funds for elders who lack funds to purchase AT items. South Dakota has worked with its housing authority to ensure low interest loans for remodeling and alterations.
The Minnesota STAR Program and the Iowa IPAT Project have worked with their protection and advocacy agencies to concentrate on issues related to the elderly in nursing homes and regional treatment centers. The Georgia project is working closely with its state ombudsman program to prevent secondary injuries at nursing homes.
These are just a few of the many strategies that Tech Act projects have engaged in related to outreach to the elderly. For more information about activities related to the elderly, contact the AT project in your state.
AARP. (1995). Why move? improve! (video). Washington, DC: AARP. A 13:30 minute video, stock number #D 1193, open captioned stock number #1204. Available for $4.50 from Home Modification Video, AARP Consumer Affairs, 601 E Street, NW (B4-211), Washington, DC 20049.
AARP. (1996) Home modification resource guide. Washington, DC: AARP. Stock number #D 15940, contains copy of "Why Move? Improve!" video, workshop facilitators guide, home assessment tools, funding resources, and more. Available for $10.00 from Home Modification Resource Guide, AARP Consumer Affairs, 601 E Street, NW (B4-211), Washington, DC 20049.
Center for Assistive Technology. (1993). Use of assistive devices for seniors. (video). Buffalo, NY: Center for Assistive Technology. This 6:30 minute video is available for $20.00 from CAT/UB Products, Center for Assistive Technology, 515 Kimball Tower, University at Buffalo, NY 14214-3079 phone 716/829-3141 (voice); 800/628-2281 (TDD); fax 716/829-3217.
Cirino, L. D. (1996). On your own terms. New York, NY: William Morrow & Co. Available from William Morrow & Company, 1350 Avenue of the Americas, New York, NY 10019 phone 800/288-2131.
Gay, J. (1995). Human diversity: Reaching the elderly population. In Vitaliti, L. T. & Bourland, E. (Eds.). Project Reaching Out: Proceedings of the Forum on Human Diversity. Arlington, VA: RESNA PRESS. Contains extensive bibliography of articles and resources. Available for $50.00 from RESNA PRESS, 1700 North Moore Street, Suite 1540, Arlington, VA 22209 phone 703/524-6686, ext 311; fax 703/524-6630.
Gibson Hunt and Associates & Irene Barbieri and Associates. (1994). Gadgets, Gizmos, and Thingamabobs. (video). Washington, DC: Serif Press. This 29 minute video, available for $49.95 plus $5.00 s/h from Center for Books on Aging, Serif Press, 1331 H Street, NW, Washington, DC 20005 phone 202-737-4650; fax 202/783-1931.
Greenstein, D. B. & Bloom, S. (1996). Easy things to make...to make things easy. Ithaca, NY: Cornell University. Available for $7.00 plus $2.50 s/h from New York State Rural Health and Safety Council, 324 Riley-Robb Hall, Cornell University, Ithaca, NY 14853-5701 phone 607/255-0150; fax 607/255-4080.
Iowa Program for Assistive Technology. (1993). Small changes...big differences. Iowa City, IA: Iowa Program for Assistive Technology. Description of program and list of awareness kit items available from Iowa Program for Assistive Technology, University Hospital School, Iowa City, IA 52242 phone 800/331-3027 (voice/TTY).
Morris, A.; Connell, B.R. & Sanford, J. (1996). Changing needs, changing homes: Adapting your home to fit you. (video). Bethesda, MD: American Occupational Therapy Association. Available from AOTA, P. O. Box 31220, Bethesda, MD 20824-1220 phone 301/652-6611, ext 2049.
DakotaLink, 1925 Plaza Blvd., Rapid City, SD 57702 phone 605/394-1876 (V/TDD).
Iowa Program for Assistive Technology, University Hospital School, Iowa City, IA 52242 phone 800/331-3027 (voice/TTY).
Minnesota STAR Program, 300 Centennial Building, 658 Cedar Street, St. Paul, MN 55155 phone 612/296-2771 (voice); 612/296-9478 (TDD). North Carolina Assistive Technology Project, 1110 Navaho Drive, Suite 101, Raleigh, NC 27609 phone 919/850-2787 (voice/TDD).
Oklahoma ABLE Tech, Oklahoma State University Wellness Center, 1514 W. Hall of Fame Road, Stillwater, OK 74078-0618 phone 405/744-9748; 800/257-1705 (voice/TDD).