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1. ccccsseceeeeeeee ees 67 Waterproof lining sheet 2 67 Waterproof mattress cover 67 Weighing ceeeeeeeeeeeeeetetteteeeees 60 Wheelchair 7 11 12 13 17 24 27 28 33 38 40 41 44 52 53 54 55 56 57 58 63 65 67 68 70 72 78 81 86 87 88 90 92 102 106 Wheelchairs 7 27 28 44 54 55 56 58 70 72 78 90 92 106 Windows 34 38 41 42 65 67 Wipe one s bottom cccceeeeeeeeeeee 53 World Wide Web 42 70 71 EUSTAT User Manual March 1999 117
2. _ Keyboard with extra large numbers Figure to the left Letter and symbol boards EUSTAT User Manual March 1999 47 KNOWING ASSISTIVE TECHNOLOGY Number memory Figure to the right Environmental control Here are some examples A keyboard attached to the telephone which have extra large numbers Telephones which have a number memory are available with raised keys and extra large figures Keys could be marked in different colours or photos or drawings could be fixed on the keys This not only caters for people who have visual impairments or people who are hard of hearing but also people who have memory loss etc could benefit The handset can be placed ina telephone holder which rests on the table Also voice operated telephones are available They connect whether the receiver is lifted off or not enabling you to walk around the room while talking If you are hard of hearing an extra bell or a call indicator can be of use The call indicator flashes when the telephone rings Telephones which ring very loudly are also available allowing you to choose the ringing sound from a scale of tones Extra loud ringing could also be achieved by connecting an amplifier to the ordinary telephone Telephones with text input and or output which means people with hearing impairment can write to each other instead of talking to each other These telephones come in a variety o
3. 3 Decisions and solutions Testing possible assistive devices and finally choose Instruction and training in the chosen assistive devices Use the forms of Validation of Assistive Technology and Terms of Sale Written Guarantee in this manual pages 70 105 106 And use advisory centres advice from other peers and professionals courses EUSTAT User Manual March 1999 THIS MANUAL If you wish to know whether assistive technology can be a solution to your difficulties in practical aspects of daily living you might find this manual useful The information in this manual gives you much better possibilities to overcome and solve problems in the process of getting assistive technology The manual provides you with knowledge about the tools and possibilities to receive the necessary informa tion This manual This manual is written for adults young and elderly It describes how to achieve assistive technology and provides the reader with a broad and general knowledge in the area of assistive technology If you are experiencing difficulties in any practical aspect of daily living and wish to know whether assistive technology can be a solution to your difficulties you might find this manual Although there are large differences between the assessment of assistive technology for a young person e g after a car accident and an elderly person to whom the daily activitie
4. 64 Stick we 11 23 33 34 35 40 45 Training 4 7 9 12 13 17 25 46 47 49 51 52 54 65 67 26 27 28 29 30 34 35 44 54 Stick GMP iz 22 88 iste eet ees 67 70 74 75 77 78 80 85 86 87 Sticks with three or four feet 54 88 89 90 99 102 105 106 108 Stigma o e 80 81 84 Training centres e seeieeieeeeeeeeeee 75 Stra Wie es aTa aa anak 62 Homes and institutions Substitute is the scanning 45 for mobility impaired persons 75 SUCCESS 2 3 5 8 25 26 28 30 Employment centres 75 31 33 34 35 36 37 39 40 41 Eye ear and throat clinics 75 42 43 94 95 97 109 PiblaneSi ccna seas eee 75 SUCKER tonera eee 59 Professionals supporting activity of Sucking DIOWING eee eee 46 67 daily Milles ecctec al eta tee creel tla Saks 76 Suction pads ccccccceeeeee 59 60 61 Transfer 41 44 47 56 Surf on the NET n on 71 58 59 65 67 84 88 90 111 Sweeping Guteriones uanloucualeuee date 63 Transfer board cceceeeeseeeeeeeee 56 Switch or joystick control 45 46 Transfer turntable oo 67 116 March 1999 EUSTAT User Manual APPENDICES Transport 7 16 27 36 44 54 Writing 006 33 42 44 45 46 55 58 73 78 85 88 92 101 106 Written Guarantee 4 6 7 27 28 TRAY suntan derided 23 55 58 62
5. Not standing too long Counts for almost all activities EUSTAT User Manual March 1999 23 CHOOSING AND GETTING ASSISTIVE TECHNOLOGY You have described your Needs needs when you have made the analysis of the daily activities When this analysis of the daily activities has been made you have described your needs See Steps to go to get assistive technology page 14 And Defining your needs and goals page 15 Going through the analysis of the forms of daily activities you are able to find the important issues about your wishes for your life with assistive technology goals You have e A list of the activities you want most of all to perform priority number 1 s e List of activities you do not have to perform by yourself but they have to be performed priority number 2 and 3 A list of activities which does not matter to you e Description of the problems you have performing your activities e Description during which circumstances you perform the activities This influences the selection of assistive technology or other solutions Description of the coherence of your different activities relation with other activities Goals So now you can begin to define your goals objectives In which way do you want your solutions to be like for improving your daily activities Ms Hansen goes on to define her goals for her total daily activities Going through the ana
6. 1 2 3 4 Go through your daily life and list all your activities which give you problems in performing Then go through an ordinary week then a month and then a year and list the activities you have not mentioned in the first list Remember the activities you like to do of yours which are not mentioned here Put on new activities which you would like to do You can use this form as a guideline The form has been constructed for this manual so you are welcome to change enlarge or minimise it in a way that suits you best 100 May 1998 EUSTAT User Manual Activities of daily living Page __ out of __ Main groups of activities List all specific activities which trouble me cannot perform them ache are too slow tire me can perform them but give a unsatisfying result etc 1 Getting around getting in and out of the house 2 Get in and out of bed and changing position in bed 3 Going to the toilet Body care Sexual activities Clothing Preparing breakfast lunch and dinner Eating breakfast lunch and dinner Cleaning after breakfast lunch and dinner Communication Using computer Budget making and planning household Watching television and video listening to radio Transport to work or college to leisure to shops etc Shopping Performing your job and education Leisure activities Housecleaning Laundry Care of children Mainta
7. If you cannot lift mugs or glasses use a straight straw or flexi straws to bend at an angle that suits you best Use an ordinary pen holder to keep the straw standing upright in the glass Alternatively straws with a non return valve in the tip ensure the straw stays full of liquid If you find it difficult to lift the tea pot use a pot tipper Alternatively use a thermos with a pump To feel free to take dinner wherever you wish use a trolley or the free hand tray with a non slip mat If you are a wheel chair user a staytray could be a good solution The staytray has a bag attached underneath which moulds to your lap ensuring a secure base If you use a walking frame or a wheeled walker fit it with a basket or a tray Taking medicine If you only have a little strength in your hands and fingers lids on pill boxes may prove difficult to open and a pill box opener could be of help A tablet splitter may be used for cutting pills in two and a tablet presser could be used when pressing out the pill from the packet A device for dosing medicine exist in shape of a box with rooms for each day of the week Hence the nurse can dose medicine for one week and you do not have to worry about having forgotten to take your medicine All these small devices are available from the pharmacist or chemist Washing up A dishwasher could prove a good solution However consider carefully where to put it how high ab
8. Pages 108 109 EUSTAT Consortium and the products of the project Pages 110 111 An index to easily find what you are searching for in this manual Pages 112 117 In appendix 2 and 3 you find the two forms Activities of daily life and Analysing the activity They are blank and can be copied for use in the actual situation of achieving assistive technology Pages 100 103 EUSTAT User Manual March 1999 BE PREPARED FOR THE PROCESS OF GETTING ASSISTIVE TECHNOLOGY This information empowers you in getting control of the service delivery process You are the only person who knows what is right and good for you Do not be overwhelmed by the advisers many wise and reasonable arguments It is your life your activities your home and your way of living which it is all about Be prepared for the process of getting assistive technology It is an advantage to consider the issues in this chapter before you start the process of getting assistive technology Having this information empowers you in getting control of the service delivery process Don t give up get help If you every day are bothered with a task or an activity which is very difficult or just not possible to do then do not believe that it cannot be solved in a better way Do not just accept the way things are but begin a process to find a better solution to your problem Nowadays almost anyt
9. Then she looks at the columns in the form where she has prioritized her activities and discovered which kind of the activities she finds most important e She wants to do intimate and personal activities like washing going to the toilet dressing eating etc by herself e Itis also important for her to continue her job e She wants to have several leisure activities Conclusion She wants to do the activities which she finds most important by doing these she can keep her privacy her job and good leisure activities The next step is now to find solutions for complying with the needs and reaching the goals 24 March 1999 EUSTAT User Manual CHOOSING AND GETTING ASSISTIVE TECHNOLOGY Starting the project Ms Hansen is the expert of her own activities and what she wants in the actual and future situation Now it is time to contact persons who know more about assistive technology and acces sibility in order to get the most optimal help and solutions on her activity pro blems See Don t give up get help page 10 Informative resources and personal advice on assistive technology page 70 While filling in the form she has already thought of various assistive devices but she has no knowledge of the existing possibilities the latest models and ways of changing routines and methods of performance See Knowing assistive technology page 44 And People and assistive technology Som
10. With shaky hands it is difficult to achieve precise writing and a heavy pen may help you A heavy ruler with a rubber layer on the back lies better keeps down the paper and eases the tasks when drawing lines with the use of only one hand Clearly lined paper and a thick ball point pen could prove to be a good solution when having visual impairment Using computers A computer offers you a number of writing facilities which you will be able to execute no matter what motoric disabilities you have If you cannot use a standard keyboard a wide range of keyboard substituts emulators is available A tiny keyboard mini keyboard for people who have motoric disabilities reduce the radius of where you have to reach Large keyboards maxi keyboard for people only capable of hitting large areas due to large uncertain movements Special keyboards are available for people using only one hand using a head stick or who have crooked hands etc A mousetrap where you use the thumbs to manage the mouse can be a help for people with little strength in the fingers If you cannot control your hands sufficiently to press the buttons you could try a head stick a mouth and chin stick or a hand stick If you write with the stick or with one hand only you could perhaps benefit from the one finger system The system is a small program which enables you to execute two button functions such as capital letters by pressing one
11. e Activities she can easily do alone such as personal care and eating e Housekeeping and cooking she does not trust herself and she feels totally insecure in front of her stove Therefore a housekeeper has been hired and her husband helps her to prepare the evening meals She now knows the time from a talking watch e Her husband would like to buy a telephone with big characters to make his wife feel more easy when he is not at home e This meeting also brings out her fear when she walks outside For that reason she only goes out with her husband She later accepted an assessment with a mobility instructor who noted a slow and uncertain walking a fear to cross the junctions and not to recognise familiar faces Typology of the solution The occupational therapist s tests show that the enlarging of the picture by an electronic magnifying glass enables her to read her magazines and improves her speed and comfort in reading Putting her in front of an image enlarging video system CCTV page 46 made her react How big it is Where can put it This made the advisers turn towards a camera system on a portable arm which was less cumbersome and could be installed on a TV set she already had She could also use this system when the children visit her at weekends The sewing problem is rapidly solved with an open eye needle However Germaine will have to change her habits and choose good tactile marks to sew a but
12. 0 cccceee 74 37 39 40 41 54 70 72 74 86 93 Centres specialised Assistive communication technology 46 on assistive technology 000 73 Associated Services ee 87 88 SRR Ose cree necaedeet ai eat ottaat 10 109 Asthma tilters 0 eccceceeeeeteeeeeeeeeees 63 Certified aone kok Ar eke 31 93 Attendant propelling eee 55 Checklist for Validation Attitude ee 24 27 40 80 of Assistive Technology 6 7 105 81 91 96 98 104 105 CHOPPING Awciaze seine decreed aecrelengecse 59 Audiologist ee eeeeeeeeeeeteeeeeeees 77 78 Cleaning the house c cceeeeee 44 Authorisation for financing 4 29 30 Client program c ccsecsesssesseeeees 71 Automatic door opener 65 Climbing wo eee 18 44 58 Automatic speech recognition 33 Cognition s es 5 44 49 77 Axillary crutches s s s SA TEOM ae T EE 51 Combi fork Spoon ceeeeeeeees 61 B Combi Knife fork sceceesceeteseeeeteees 61 Bath 16 21 22 30 49 50 51 65 Comfort wheelchairs 00cee 55 Bath Drusheciiieeeu sakes 51 Communication 5 13 16 27 33 Bath rails cccccceeseseeeeeeeeeeees 49 50 44 45 47 72 73 74 77 83 86 88 Bath Seatide ni A 50 53 89 101 106 107 109 Bathing oonan o 44 49 95 Communication centres 74 Bed aoaaa 16 19 26 41 45 53 65 Commu
13. Cannot rise from the toilet Standing in the bath have to sit while dressing and undressing and it is difficult to put on socks and shoes cannot stand for a long time and bring things to the table Difficult to sit too long cannot stand for a long time and bring things from the table It is difficult for me to sit properly It is difficult for me to sit properly It is difficult for me to sit properly cannot sit properly in my car cannot walk very long It is difficult for me to carry the goods It is difficult to sit in my working chair and anywhere else Sailing is difficult Going for walks All activities are difficult Going to the launderette Riding a horse 16 March 1999 EUSTAT User Manual CHOOSING AND GETTING ASSISTIVE TECHNOLOGY Form of analysing the activity In the next form of which you fill out one for each activity you are going to analyse your activities in order to find the best solutions for you whether it is assistive technology training adapting housing or use of personal helper When you have worked with each activity in this form you have described your needs and then you can define your goals 1 First you describe which problems you have in performing the activities 2 Next you have to describe under which circumstances you perform this activity Whether it is on the beach in school while doing the laundry Are there special cond
14. Evaluates problems of incontinence and pressure sores and need for nursing and personal help Physical Therapist Assesses seating and positioning and evaluates muscle strength range of movement flexibility balance and co ordination Train physical body functions Occupational Therapists Assesses and train daily activities Professionals supporting activities of daily life e Mobility and handling e Communication e Cognition e Seeing and hearing Medical professionals e Doctor e Nurse e Physical therapist Occupational therapist e Audiologist e Eye specialist EUSTAT User Manual March 1999 77 INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Technical professionals e Technicians of assistive technology e Rehabilitation engineer e Computer programmer e Accessibility constructor Truss maker including assessment of seating and positioning assistive technology and home environmental accessibility Audiologist Evaluates and recommends treatment and assistive technology of a hearing loss Eye specialist Evaluates and recommends treatment and assistive technology of visual pro blems Technical professionals The technical professionals in the area of assistive technology are absolutely indispensable although you as an user not always see them Their competence ensures that the assistive devices work and that a great variety of personal ada
15. advisers and a driving instructor in which several adaptations are being tested The car is equipped with power steering and an extra empowered brake Furthermore it is getting A special grip on the steering wheel for left hand operation A special produced aggregate to operation of the accelerator pedal and the brake pedal in one grip with the right arm stump the arm stump rests in a cup which is open in the left side The accelerator is operated with a push downward the brake with a push forward e Switches at the steering wheel s knob A support grip on the gear lever e The accelerator pedal is removed and the brake pedal is shielded The steering wheel manoeuvring is tested with both an ordinary steering wheel knob and a special grip During sudden turns Birthe cannot hold onto the ordinary steering wheel knob It is too thick according to her fingers and the grip Instead a special grip is mounted which she can hold onto and more easily turn the steering wheel The operation of the accelerator pedal and brake is going well after a short period of adjustment Birthe can speed up fast keep a constant speed and adjust the speed when going through curves etc The operation of the brake does not cause any problems The aggregate is designed according to the ordinary accelerator pedal and the ordinary brake with an extension towards Birthe The cup for the arm stump is placed on this extension The aggrega
16. Some societal issues of assistive technology Pages 80 83 This chapter provides information on some important societal issues about assistive technology The aim is to empower you to better understand and communicate with the professio nals in the area and hence make it easier for you to obtain your goals Issues such as design for all ISO classification standardisation testing cost analysis are shortly described in this chapter 6 The next challenge From user to peer counsellor Pages 94 98 This chapter of the manual gives you ideas of using the manual for peer counselling In the appendix of the manual you will find 1 Adiagram showing the steps for achieving assistive technology Page 99 2 The two forms Activities of daily life and Analysing the activity which are described in the chapter Choosing and getting assistive technology They are blank and can be copied for use in the actual situation of achieving assistive technology or for training of users Pages 100 103 Apage called Goals with explanation for listing your goals Page 104 A Checklist for validation of assistive technology both for use in a real situation and for training can also be found in the appendix Page 105 Alist of Terms of sale written guarantee Page 106 A list of a few relevant addresses and homepages Page 107 Credit to sources used in the manual
17. These rules provide a common framework for policy making and call for action defining a range of target areas each with specific aims In target areas for equal participation rule no 4 Support services says States should ensure the development and supply of support services including assistive devices for persons with disabilities to assist them to increase their level of independence in their daily living and to exercise their rights In rule no 5 Accessibility it is stated States should recognise the overall importance of accessibility in the process of the equalisation of opportunities in all spheres of society For persons with disabilities of any kind states should a introduce programmes of action to make the physical environment accessible and b undertake measures to provide access to information and communication The HELIOS guide of good Practice The HELIOS programmes of the Euro pean Commission to promote equal opportunities and the integration of disabled people had 57 working groups with the aim to identify innovative and effective practice regarding integration and equal opportunities for disabled people in Europe Then transferring the knowledge to enable the practices identified to be replicated or adapted for use in other European countries 14 groups of users professionals and researchers worked in the area of social integration and independent living Very g
18. air condition phoning through a special infrared controlled phone and even TV and hi fi control In this case the assistive device which is programmable simply substitutes the standard infrared remote control that is normally sold in connection with the TV or the hi fi set The remodelling of the furniture in the bedroom the kitchen and the work site is a challenge for a professional interior designer like Elena She prefers to design them herself and having them built by an artisan she knows Only the bed is chosen in the assistive technology market since she needs powered adjustment in order to independently change position when she wishes The most creative technology set up is the computer work site The main workstation is a powerful Windows based computer which Elena operates by means of a head mounted mouse emula tor which allows control of the cursor by lightly moving the head right left and up down The click button is emulated by puffing on a pneumatic switch In conjunction with other pieces of software like a virtual keyboard appearing on the screen and a voice control which is particularly helpful in speeding up when writing text on a word processor Elena is able to control most Windows applications e the basic productivity tools such as word processor spreadsheet data base and presentations builder a computer aided design software Installations like the elevating platform the ceiling mounted
19. discuss equally and qualified with the profes sionals about your goals and solutions incontinent and ostomy patients aids for dressing and undressing clothes shoes body thermometers timepie ces and personal scales e ISO 12 Aids for personal mobility This includes walking aids special cars car adaptations wheelchairs transfer aids among others ISO 15 Aids for housekeeping Including aids for eating and drinking e ISO 18 Furnishings and adaptations to homes and other premises Including furniture with or without castors for rest and or work and accessories attachments for furniture and aids and fixtures for adaptation of residential vocational and educational premises ISO 21 Aids for communication information and signalling Including aids for reading writing telephoning and security alarms e ISO 24 Aids for handling products and goods ISO 27 Aids for Equipment for environmental improvements tools and machines Furnishings and adaptations to homes and other premises e ISO 30 Aids for recreation Aids intended for play hobbies sports and other leisure activities Including aids which could also be used for therapy and training The classification of assistive technology is an ongoing process The advances in this area are rapid many new technical devices have to be incorporated in the ISO classification As stressed before both at national and international levels many
20. initiative of the rehabilitation centre through the standard procedure of the National Health Service Before the accident she had already several customers the major being a furniture factory located 200 km away from her home She used to make many visits to the customers especially to this factory which was in the process of reorganising its production by using computer aided design and manufactu ring technology Now Elena would like again to live in the flat where she lived before the acci dent and also to resume her work She has four main problems which have to be solved access to the flat which is located at the first floor of a building without elevator adaptation of the flat for living and working personal assistance for basic functions and the organisation of the work Initiative Elena has a positive attitude towards her disability she is self determined and persistent Her professional experience in architecture is an advantage in evaluating possible technical solutions However her knowledge of assistive technology is limited to what she learned from the rehabilitation team on basic aspects of seating mobility and personal care management which are already accommodated in a satisfactory manner Therefore she decides to apply an advice centre of assistive technology to get an overall guidance and a specific assessment for the new life she is undertaking Meanwhile she also explores possible job perspectiv
21. page 36 Tuborgvej 5 2900 Hellerup Tel 45 39 62 90 00 Fax 45 39 62 54 39 PTU has provided the facts for elaborating the case story of a car adap tation Ribe Amt Hjzlpemiddelcentral Case story of communication Henrik page 33 Hoegevej 11 6705 Esbjerg Denmark Tel 45 75 14 25 11 Fax 45 75 14 15 19 This centre of assistive technology has produced the case of Henrik EUSTAT User Manual March 1999 109 APPENDICES Appendix 9 EUSTAT Project Consortium and public EUSTAT documents Addresses of the EUSTAT partners Belgium ANLH Association Nationale pour le logement des personnes handicap es Rue de la Fleur d Oranger 1 bte 213 1150 Bruxelles Tel 32 2 7721895 Fax 32 2 7792677 E mail Autonomia arcadis be Homepage Http wal autonomia org Denmark Danish Centre Gregersensvej port 38 DK 2630 Taastrup Tel 45 43 99 33 22 Fax 45 43 52 70 72 E mail hmi hmi dk Homepage www hmi dk France Gihp Aquitaine Groupement pour insertion des Personnes Handicapees Physiques Aquitaine 436 Avenue de Verdun 33700 Merignac Bordeaux Tel 33 5 56123939 Fax 33 5 56123792 E mail Giph dpi quaternet fr Italy Pris Centro Studi Prisma Via Piave 5 32100 Belluno Tel 39 437 941312 Fax 39 437 941312 E mail Prisma dolomitinet bl it Siva Fondazione Pro Juventute Don Carlo Gnocchi ONLUS IRCCS Servizio Informazioni Valutazione Ausili SIVA
22. to work just as precise and just as fast as his fellow students do with their ordinary 34 March 1999 EUSTAT User Manual PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS mice Besides being a full time student at the Technical School Henrik is now also employed as the coach of the first divi sion men s gymnastics team of which he used to be a member Furthermore Henrik also creates various gymnastic programmes including jump co ordina tion groupings on his computer at home Germaine Assistive technology for impaired vision Germaine is a very active 70 year old woman She is visually impaired and lives with her husband in a small city in France She has been affected of a macular degeneration with a glaucoma complication for 3 years which unables her to see all details and read her favourite magazines Initiative Germaine regularly consults her ophthalmologist and her optician but both are unable to give her an adequate visual aid She is directed by her optician to an occupational therapist at a social rehabilitation centre for daily living sup port Germaine who is supported by her husband in this approach decides to contact the centre Assessment The first contact with the occupational therapist determines e Her expressed demand to read magazines mail and watch photos e Favourite activities she had to give up for a year ago such as sewing How could thread a needle
23. you try or get advice about assistive technology 2 People and assistive technology some stories of success Pages 33 43 In this part you will find five stories about people and how they achieve and use assistive technology There are stories from Belgium Denmark France and Italy which nicely illustrate how assistive technology can be used at a personal level but also in an European view 3 Knowing assistive technology Pages 44 69 Here you will find a general description of assistive technology grouped and described according to the activities of daily living The chapter is meant to be practical and is illustrated with photos in order to show at a general level the varieties and possibilities assistive technology offers It does not offer a detailed description of all the specific models of assistive devices March 1999 EUSTAT User Manual THIS MANUAL 4 Information resources and perso nal advice on assistive technology Pages 70 79 There are many different ways to get information on assistive technology This chapter describes information tools sites and what kind of advice and help you can get from professio nal advisers in the area of assistive technology The description is made in a general way in order to be useful all over Europe The chapter provides knowledge about usable tools and information when you want to know more about assistive technology 5 For you who want to know more
24. 32 92 97 99 106 Tripod and tretrapod sticks 54 Trolley 06 54 55 57 59 62 63 Z TOUSEIS aiscie oes Uefa Pa AS Aa SRSA 61 Se ee a POE 51 52 Truss maker cccceeeeeccceeeeeeeeeeeeeeees 78 Tumble drier 00 eeeeee cece eee eeeeeeeeeees 64 Turn on turn off watch 08 49 Turning eeaeee 38 44 46 47 56 58 59 61 67 Turning CISC seeeeeeeeeeeeeeeeeeees 56 Turning SPACE n n eeren 58 Typewriters eecceeeeeeeeeeeeeeeeeeeeeees 47 Typology of the solution 4 29 30 35 U Urine and faecal collectors 54 URL addressS 0 ceeccccecceeeeceeeeeeeeeeeees 71 User involvement 5 31 84 85 User organisations regarding sports 74 USERTit ae Sedans 84 108 V Vacuum cleaning 00seeeeeeees 63 Velcro fasteners ccccecceeeeeeeeeeeeees 52 Vibrators and massage devices 54 Visual keyboard program n 34 Vocational Evaluator ee 79 Voice Control Program 33 34 Voice operated cccccccccceceeeeeeeees 48 W Walking 11 13 17 18 23 24 35 36 44 49 54 58 62 65 68 81 90 92 102 Walking sticks n eneee 54 Wall mounted rails ccccccceeeeee 53 Washbasin irrien iai aii 50 Washing 12 24 44 49 50 62 64 95 Washing machine 00 12 64 Water bed frame
25. 77 78 OPENETS imei eain ai 39 60 61 Other professionals 76 78 79 Overbed top cc cseccceccceeeeeeeeeeeteees 66 P Pada eihar arisa 54 59 60 61 63 Pads for chairs and beds 54 Page turner i is 34 46 47 Pan Nolder neren a NEA 59 Participation 2 12 33 36 84 85 90 91 107 109 Peeling assier asee lod aes a 60 Peer counselling 05 5 94 95 Peer mentoring cee 94 95 Personal Advice 25 44 70 71 72 73 74 75 76 77 78 79 97 Personal care 5 35 40 44 49 90 Personal helper 4 13 17 27 28 81 98 102 105 Personal mobility 5 44 54 65 90 Physical therapist ee 77 Physiotherapist 13 25 29 75 76 Pictures for days and activities 49 Pill DOX Opener ceeeeeeeeeceeeeeeeeeees 62 Pillow raiser ceeccceeeeeeeeeeeeeeeeeeeeees 66 Playing games s sseeeeeeeeeeeees 68 Plug pulling devices 0 64 PONCY 32283 enclose eee 5 84 Pot tipper er 62 Potato peeler cccccceeeeeeeeeeee 59 60 Powered wheelchair 7 55 56 PRIS ekaa ete teas 3 Psychologists cee 25 77 78 Public OPINION ccccccceeeeeeeeeeeeees 81 Q Quality assurance 1 0 0 eee eee 5 91 R R d Oieee 16 34 44 47 48 49 65 67 101 Rail ariana eae i 49 65 66 Raised toilet 5
26. Etc Future Does your situation change during the next 5 10 years How does this influence the activities Characterise your claims for solutions give perhaps some ideas What do you want in order to manage this activity The wish the dream the feeling when performing the activity What do your family and friends think Importance of the activity 1 Very important to me 2 Not very important 3 Does not matter if can get personal help 4 Does not matter at all Descriptions Getting around getting in and out of the house Getting upstairs to my bedroom Pain in my knees and hip each time use the staircase Inside and outside stairs many times each day At wintertime it is slippery and am afraid to fall might move to a smaller flat with no Stairs if can get one The pain in my hip and knees will be there anyway Must not cause pain or stress too much It must be easy and safe to move around No stairs a lift Bedroom moved downstairs Chairs to rest Handrails to give security Very important Third column Relation with other activities Write the name of the related activity and shortly describe how the relation is Relation with other activities All activities where use my legs get pain each time am standing up climbing stairs and walking In the bathroom Here am afraid to fall too Pain when climbing stairs All activities must be
27. It might seem very easily to get assistive technology when you have read the story of how Ms Hansen is achieving what is necessary for her Our intention with this manual is to give you information on how to get assistive technology and not to confuse the impression with lots of problems and shocking stories of how did not succeed But the real world has its depressing experiences and in order to minimise these stories here comes a list of what to be aware of when working together with the service delivery system to obtain the right assistive device for you e Clarifying your needs and goals e Getting information of assistive technology and the legal basis of the delivery system e The advisers of the service delivery system may not always give you the complete and necessary information They want perhaps to keep the costs within the budgets limits e The dealers are not philanthropic they want to earn money Funding is often too little or the assistive devices are too expensive e Be well prepared with facts and arguments e Use if possible a peer counsellor Contact your local organisation of disabled persons When you deal with all the professional advisers in the area then make up your own mind and do not compromise until you understand and feel you have got the necessary information Professionals often think that they know better which they actually often do However they are not wiser than you co
28. Tide Office Brussels Belgium fax 322 295 1300 or 322 299 0248 108 March 1999 EUSTAT User Manual APPENDICES Literature sources World Health Organisation Geneva ICIDH 1980 and ICIDH 2 1997 Section of Classification page 89 International Classification of Impairments Disabilities and Handicaps and International Classification of Impairments Activities and participa tion E mail Ustunt who ch and homepage http www who chiicidh Anderberg P J6nson B Rehabilitation Engineering research Theoretical and Methodological Considerations Paper for AAATE Congress 1997 Thessaloniki Greece The Paper was produced by CERTEC Centre for Reha bilitation Engineering Research at Lund Universitet Box 118 S 22100 Lund Sweden The ideas developed in this paper are found in the manual in section Make a goal and go for it Page 10 http www certec th se Andrich R Alimandi L Teleworking Guidelines for workers with disabilities European Commission Project DG13 TWIN Siva Milano 1996 This book gave inspiration to Elena s success story Page 39 Sources of case stories EUSTAT partners ANLH Belgium Steve Adaptaion of a house page 38 GIPH France Germaine Assistive technology for impaired vision page 35 SIVA Italy Elena Assistive technology for being able to work page 39 See adresses page 110 PTU Case story of car adaptation Birthe
29. Via Capecelatro 66 1 20148 Milano Tel 39 02 40 30 83 25 Fax 39 02 49 48 91 9 Email siva siva it Homepage www siva it Portugal CAPS Centro de An lise e Processamento de Sinais COMPLEXO Instituto Superior T cnico Av Rovisco Pais 1049 001 Lisboa Tel 351 1 8419364 Fax 351 1 8465303 Email pclma alfa ist utl pt Other public Documents produced by the EUSTAT Project Assistive Technology Education for End Users Guidelines for Trainers Available in English Danish Dutch French Italian Portuguese This book also known as the EUSTAT Guidelines is intended for people who organise and carry out educational programmes for end users of Assistive Technology AT These may be user organisations self help groups rehabili tation or social services mixed user and professional organisations or AT providers The book helps reflect about establishing priorities focusing goals and clarifying the role of AT in the users empowerment process It also offers methods and tools for designing and implementing educational initiatives This book is divided into six chapters Chapter One Guidelines in brief clarifies the objectives of this book and the intended readership It also offers a general overview of the concepts explored in the other chapters so it can be used as a checklist for organisers of educational initiatives Chapter Two Basic concepts clarifies some basic terms related to disability and A
30. a bed rope ladder or a bed tape could prove a good solution Alternatively a solid bed rail or a wall mounted hand rail comes in handy Free standing lifting poles and poles for mounting on beds are available All adjustable beds provide binding for lifting poles A glide cushion or glide sheet allows you to turn from side to side without having to struggle The gliding effect is achieved when two layers of smooth material glide against each other Smooth bedlinen or night clothes made from silk provide the same effect If you struggle to get out of bed bed raisers under each leg could provide better access and more comfortable conditions for a helper If lying flat is uncomfortable or if you have breathing difficulties the bed wedge or the pillow raiser could be a nice solution If your feet and legs have a tendency to swell the foot raiser is very useful If the above mentioned solutions are insufficient manually or electrically adjustable beds are available Height adjustable beds are available or you could benefit from a bed which is adjustable in parts allowing neck back lower back thighs and legs to rest ina chosen position 66 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY Depending on whether you or a helper is going to work the adjustment gear and on your individual needs you can choose between manual or electric adjustment or a combination of bo
31. a duty of professional services Conversely a community where the image of disability is positive and balanced may offer a very supportive environment for any initiative that the person may wish to take in order to solve his her problems Here people may expect to meet disabled people in the street with assistive devices and expect them to ask for help when it is necessary Any passer by is pleased to offer the required help Topics as offering the bus seat to an elderly person or helping a disabled colleague to eat or go to the toilet tend to be considered in such communities no more that civilised behaviours that anybody can expect from ordinary polite people t is important that the disabled people understand what the societal expectations are towards them in order to be prepared for difficult or alien situations As for the primary network the user may act as an educator of the community and promote changes in its expectations Design for all Although the advancement of technology plays a vital role in the modern society contributing to a better life quality of large groups of citizens it can also bring segregation to specific groups e g of elderly people and people with disabilities An example of this are the hearing aids that can be magnetically coupled to the existing analogue telephones allowing people with hearing impairments to participate in a telephonic conversation however not to the new generation
32. a rubber grip on the other end to assist in turning the pages The page turner works on the same principle as when you turn the pages with a slightly moistened thumb The page turner can be fitted individually for example to headsticks if you are not able to use your hands at all Alternatively the electric page turner could prove to be a good solution The page turns when activated by the touch of a switch The switch can be individually adjusted to act on the touch of a finger a whole hand grip a foot an elbow chin by blowing pulling a string or whichever way you prefer If you are blind you can learn to read by the Braille system Both electronic and mechanical Braille typewriters exist which produce hard copies in Braille Also programmes which transfer Braille into artificial speech exist Finally you could also benefit from an ordinary tape recorder if you want to read taped books newspapers etc Talking A wide range of speech devices are at hand Anumber of these resemble a small typewriter You write your message and your communication partner reads the message on the display or on paper strips Alternatively word saving talking machines are available The vocabulary and a number of phrases saved in the machine is recorded by someone else When you want to talk you press the relevant buttons showing words pictures photos or symbols Unfortunately you might not find many in your native language if it is
33. about relevant assistive technologies of communication for impaired people and to make assessment for actual needs Centres of assessing driving possibilities In some countries you may find centres which are specialised in assessing and finding solutions of driving for people with disabilities Here people can test their ability to drive a car and the advisers at the centre can describe the necessary adaptation as well as the relevant assistive devices for driving Here the solutions can be tried out in praxis too Hearing and vision clinics Hearing and vision clinics are commonly available Many clinics are situated in connection to hospitals The clinics are staffed with specialists that measure hearing and vision assess assistive technology of hearing and vision give advices about legislation and funding Incontinence advice centres These sites assess your need for training and assistive technology for people not being able to control the passing of water The sites give all kinds of advice in the area of incontinence and daily activities They are often connected to hospitals or centres of assistive technology Orthopaedic clinics Individual adapted orthoses and prosthesis are often made by special clinics Here you can get advice in selecting the appropriate orthoses or prostheses Resource centres in the area of disability Relevant user organisations User organisations working in favour of all kinds of dis
34. adaptations page 11 Controlling the environment page 67 See information sites page 70 Design for all page 82 ADA the Americans with Disabilities Act page 85 We all know walking sticks and there are many different models adjustable sticks sticks with many different handles a selfstanding stick folding sticks sticks with three or four feet tripod and tretrapod sticks elbow crutches and forearm through crutches and axillary crutches Sticks with rest seats are available too Walking frames have usually four legs and two handles They reduce weight bearing through the legs and assist the balance They might be height adjustable allow folding have different kinds of grips and can be adapted for people with only one hand You can often put wheels on the front legs and you can have a reciprocal frame which is hinged at the front allowing each side to be mowed independently which allows a normal gait pattern You can also have high walking frames with an armrest and handgrip in the front 54 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY Rollators and trolleys are useful to support and give confidence to a person who is walking unstable A standard rollator has two non swivel wheels at the front and two ferrules at the rear A four wheel rollator has two fixed wheel at the rear and two fixed or swivelling wheels at the front They are adjustable in h
35. basis of what she read in the database and in catalogues and on Karen s experiences and explanations The technical aids centre had all relevant information See Userinvolvement page 31 And Get success page 31 When trying assistive technology it is important to be very thorough and con sider following questions e Does it solve your problem e Does it fulfil your quality claims In the case Ms Hansen minimise pain good design and easy to use e Does it have a good design and is the usability high e Do you like it and are you pleased with it e How is the usability for your helper e Can you manage the cleaning yourself If not who can then make the cleaning e Can you manage the maintenance yourself If not who can then make the maintenance e Can you handle the repairs yourself If not who can then make the repairs 26 March 1999 EUSTAT User Manual CHOOSING AND GETTING ASSISTIVE TECHNOLOGY e Do you have the necessary instructions and training possibilities e Can you easily get help and advice if you have problems with the assistive technology Ifthe assistive device brake down can you get a substitute at once e What is the attitude of your family and personal helpers to this specific assistive device If the answers to some of these questions are no or problematic in some way it is important to discuss the problem with your adviser in assistive technolog
36. bath brushes or bath sponges with extended bent or angled handles are available If you have difficulties in reaching your feet a specially designed toewasher can be used which consists of a pad made of lambs wool fitted on a long wire stem with a easy to grip handle Dressing and undressing If you have experienced loss of motor function or if you are left with only one hand various small gadgets together with well fitted clothing will make it easier for you to dress and undress Generously cut sleeves and sleeve holes make it easier for you to put on jackets coats etc Tight clothes and clothes which have to be pulled over the head are difficult to put on Front fastenings are easier to deal with such as a bra with front fastening Clothes made from slippery materials or clothes with slippery linings are easier to put on and take off If you have difficulty in reaching your back or the back of your neck the dressing stick could prove to be a nice solution The dressing stick might also prove useful when the sleeve hole is just that tiny bit too far away to reach or the shoulder strap or the socks are difficult to deal with Dressing sticks or hooks are available with different types of hooks and rubber grips on the other end to assist in pulling on or pushing off clothing If you want to construct a DIY Do It Yourself stick yourself use a doweling rod or tube fitted with a hook on the end A reach
37. board has suction pads underneath or a non slip rubber layer available in all sizes to prevent it from slipping Similar cutting boards with clamps hold items of various sizes such as bread potatoes bowls and glasses Adjustable strainer lids Figure to the left Pan holder Figure to the left Cooking basket EUSTAT User Manual March 1999 59 KNOWING ASSISTIVE TECHNOLOGY Cutting boards A carving apparatus Angled shaped easy to grip handles A carving apparatus assists in the cutting the bread or carving the meat The knife is placed between the two upright posts to control the cutting action A buttering board with raised L shaped or angled shaped edges in one corner allows the bread to be spread using only one hand Tools with angled shaped easy to grip handles are more comfortable for people with little or reduced strength Knives for carving meat and bread forks for or stirring and knives for cutting cheese are all available with angled shaped handles Electrical knives or electrical slicing machines could prove a good solution If you have visual impairments either a cutting board with adjustable edges or the carving apparatus with its adjustable carving block is a good solution slicing the bread or meat to whatever thickness you wish Rinsing and peeling If you only have the use of one hand or in general find it difficult to susta
38. counsellor Other professionals e Administrative workers e Dealers and producers e Consultants from disabled organisations e Researchers in the field of assistive technology EUSTAT User Manual March 1999 79 FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY The concept of assistive technology contains the concrete assistive devices but also the services and practices Assistive technology might have unconscious impact on the user the surroundings and the society which comes from a society s general attitudes toward disability and disabled people The assistive device might be a stigma to label a person Descriptions in the mass media show the attitudes of the society in general towards disability and assistive devices For you who want to know more some societal issues of assistive technology The aim of this chapter is to provide information of some societal issues of assistive technology which can be valuable for you in co operating with and understanding the professionals in the area of assistive technology Only some major issues are mentioned in brief If you are eager to know more details you are encouraged to read the other EUSTAT book Assistive Technology Education for End Users Guidelines for trainers where these concepts are developed in depth See EUSTAT Consortium and public EUSTAT documents page 110 Definition of assisti
39. for use by a helper who cannot manage a mobile hoist and in some cases the user can use it by himself It is also suitable where space is too restricted Biking A tandem is a two seat bike which can be used by disabled and blind people with normal force in legs A hand driven bike exists for people with little or no force in the legs A little help engine can be attached to the bike to help getting up hill Users of manual wheelchair can get a front wheel connected the wheelchair and in that way bike with the hand and arms sitting in the wheelchair EUSTAT User Manual March 1999 57 KNOWING ASSISTIVE TECHNOLOGY Going by car Because the accessibility to the streets and the public transport in general is very poor it is necessary for many disabled people to have a private car to go shopping to work to visit family etc See Design for all page 82 If you hear and see well it is possible for you to drive a car although you have severe physical impairments The advanced technology makes incredible things possible but it always require much effort and time to access a car If you cannot drive a car then the solution could be to have a car fitted for your wheelchair and a helper to make the driving Anyway a private car can be adapted with several different ways to manage the driving for one hand for weak hands and arms from your wheelchair etc The car can get specialised seats cus
40. forms because nobody can do it better It might be a good idea to work together with another person just to discuss the possibilities during the analysis Anyway it is important to discuss the goals when they are made in order fully to understand the background and the impact of them See Ms Hansen s needs and goals page 24 Starting the project Here it gets fun What can be done to reach the goals Go through each goal to find out what to do about it If a group is working together then make some groups of similar goals and work on how to solve them Here you can start to use the other parts of the manual e Which kind of assistive technology is 96 May 1998 EUSTAT User Manual THE NEXT CHALLENGE FROM ENDUSER TO PEER COUNSELLOR available Chapter Knowing assistive technology page 44 People and assistive technology Some stories of success page 33 Study the special parts of the chapter you need Divide the chapter among more of you and give the knowledge obtained from studying the chapter to your colleagues Discuss the results of this exercise and list what you further want to know e Where can you get information on assistive technology Chapter Infor mation resources and personal advice on assistive technology page 70 Discuss and list some questions to be answered problems to be solved and needs of necessary knowledge in order to reach your goals and find out where
41. hoist and the bathroom furniture are chosen after seeing the proposals from more firms Elena chooses a wheelchair mounted environmental control that communicates via infrared with satellite units disseminated throughout the home The workstation is a powerful Windows based computer which Elena operates by means of a head mounted mouse emula tor which allows control of the cursor by lightly moving the head right left and up down The click button is emulated by puffing ona pneumatic switch EUSTAT User Manual March 1999 41 PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS Now Elena lives in her flat and has agreed ina job contract with a factory compatible with the computer aided design and manufacturing software used by the factory e a Internet connection to electronic mail and World Wide Web e A desktop video conferencing system to visually communicate with the one of the factories and others who have a compatible system Financing Financing is a serious problem because in Italy almost none of the above equipment is included in the list of assistive technology provided by the National Health Service The Court Case that took place in relation to the road accident was partially successful for Elena in that she received some indemnification but not the full amount she had claimed With respect to funding the needed investment can be divided into four components 1 Wor
42. is aware that this makes the walking more slowly but this is what Ms Hansen prefers Lyra BREE EISS Finding new ways If you want to go on with your daily activities and functions but you do not want to or you cannot handle them in the same manner as your non disabled friends then you can try to maintain your intention but find another way to perform the function Ms Hansen used to enjoy the walk to the mailing box with her letters but now the walk is too hard for her together with her other activities She has found a good solution to this problem of mailing letters Now she uses electronic mail instead where she sends the letters from her computer The heart of the matter All activities cannot be the same as before the achieved disability You must find the heart of the matter for your daily activities finding what the activity gave you finding the wish the need or the dream of the activity Maybe it is meaningless to try to maintain a special activity possible at any cost Ms Hansen used to enjoy sailing very much She liked the challenge of the sea feeling her body working and strong feeling her powers So to her an automatically operated sailboat which she can control simply by pushing two or three buttons is meaningless Because that was not what she experienced in sailing it is not her need and wishes In this case she has to look deeper What was the driving force for the sailing act
43. leg is not functioning as it did before It might even become worse so she will need assistive technology to live an autonomous life and not strain her left leg her knees her back and arms to much Ms Hansen wants to be sure to get the right assistive technology so she starts to go through the steps which forms the way to efficient personal assistive technology Steps to go to get assistive technology Here the process of getting an assistive device begins This process has four important parts 1 Defining your needs What is necessary important for you in order to do what you want 2 Defining your goals In which way do you want your solutions to become 3 Starting the project Finding actual possibilities for solutions 4 Deciding the solutions Trying out and taking decisions among possible solutions In the following each step is described in 14 March 1999 EUSTAT User Manual CHOOSING AND GETTING ASSISTIVE TECHNOLOGY details and after these steps you will get some information on maintaining and follow up the achieved assistive technology See The story of Mr Europe page 7 And the diagram showing the steps for achieving assistive technology page 99 Defining your needs and goals It is important to give a detailed description of your daily activities from all actual points of view to find any activity which gives you problems your needs and hence to describe the best ways to
44. medicine that patients are perceived as isolated sets of symptoms rather than whole people and in assistive technology their wider needs for products are often not considered in detail The results of this can be inappropriate adaptations of existing products which do not take the person s whole needs into account and in many cases their styling as medical products can stigmatise the user This often leads to products being rejected and abandoned even though they may be of clinical benefit This part about usability are taken from USERfit see page 108 Policy in the area of disability and assistive technology Disabled and elderly people have interests and needs which vary widely and this means that the policy makers must meet these interests and needs if the society wants to give the disabled and elderly people the possibility of being equal and fully participants in the society For example a user must be able to handle and make decisions in his daily life and be able to access any place physically and to get citizen social and cultural information at any time from any place like all other participants in the society Many political papers stress the importance of disabled and elderly people living an autonomous life and here come some examples Standard rules of United Nations All member states of EU have signed the Standard Rules of the United Nations on the Equalisation of opportunities for Persons with Disabilities
45. of your hand Finally a pair of electric scissors are a good solution If you have the use of one hand only a number of gadgets are available to compensate for the other hand An embroidery frame to rest on the table is available Electric knitting machines are fully workable with one hand only An electric sewing machine is normally operated by foot If for some reason this is not possible the foot control could be mounted on the table and fitted with a grip which can be operated by the elbow Playing music A computer device can make it possible for you to compose your own music and play it on a synthesiser There are many different programmes to choose among Gardening Garden paths should offer a firm smooth surface whether you use a walking aid or wheelchair Beds could be raised making them much easier to do You should use automatic watering A garden kneeler with good grips spares the knees and makes it easier to get up 68 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY Garden tool sets are available comprising spade grass and leaf scooters weeding fork etc which can be fitted with a variety of special handles Tools fitted with an extra grip or handle are available A sowing roller eases the task of sowing Figures to the left Garden tools with special handles Figure to the left Garden tool with extra grip EUSTAT User Manual Mar
46. of the digital phones that are replacing the older telephones Another example of this possible discrimination provoked by the advancement of technology is the increasing use of visual displays graphic screens and user s interfaces that are inaccessible to persons with visual impairments Also to day elderly people who in general are not particularly computer literate can find it difficult to use new technology Pro blems similar to those mentioned above must be solved in order not to make the future even more difficult for disabled and elderly people There is one important mean of ensuring that elderly people and people with disabilities benefit from technologies the principle of universal design or design for all This principle takes into account a broader average of users when designing mainstream products and services This leads to end products and services that will meet the needs of most users including many of those with disabilities or elderly people However it must be stressed that designing for the broader average will not always accommodate the needs of those 82 March 1999 EUSTAT User Manual FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY eT with severe disabilities or very particular requirements In this case the access to technologies for such users can best be achieved by designing special products and services or in many cases adapting or inte
47. on mop brush and vacuum cleaner save you from bending forward while working Sweeping and mopping the floors If you find it difficult to bend forward or you are a wheelchair user ensure dustpans and brushes are fitted with long handles A full bucket is hard to carry Instead put it on the trolley and fill it up Filling it is easier if you have a spray head by the sink If the hose is sufficiently long you could fill a bucket standing on the floor A bucket holder on wheels eases the task of moving the bucket Instead of using the ordinary mop the squeeze able mop could prove a good solution If your fingers are a bit weak wringing out the cloth could be difficult To ease the task choose a synthetic cloth made of soft absorbent material the good old fashioned cotton cloth being far too difficult to handle Alternatively you could choose an absorbent sponge Vacuum cleaning Before purchasing a vacuum cleaner consider which special functions you require A self winding cable could prove a good solution if you find it difficult to bend down If you are having difficulty in carrying or lifting consider a lightweight model on wheels Vacuum cleaners come in many shapes tall and upright small and rounded or flat The flat models pass over doorsills edges etc without tipping Some models are provided with an extra switch on off button at the top of the hose Models with adjustable hosehandle pr
48. on a more long term relation of personal confidence is the so called peer 94 May 1998 EUSTAT User Manual THE NEXT CHALLENGE FROM ENDUSER TO PEER COUNSELLOR mentoring The concept of mentor contains the idea of a wise and trustworthy person who can serve as a personal adviser With reference to assistive technology an expert user may serve as peer mentor when he assists a novice user to get the best from the new situation of life and the new assistive devices At last it is important to stress that peer counselling and peer mentoring should be used when the help is provided to a peer on the basis of personal experience and not on the basis of higher level knowledge in the field Some peers can be perceived as models and be used as self identification for other peers because they appear as having solved some important problems in a satisfactory way This kind of model is called role modelling and is an important part of the peer counselling activity too Using the manual for peer counselling The Danish priest and poet Grundtvig who in the middle of the 19th century founded schools in common education for adults in Denmark has said that we only learn something if our heart is in it Therefore it would be a good idea to start the counselling to make a personal analysis of the daily activities like the one done in the chapter Choosing and Getting Assistive Technology page 14 because the daily act
49. on her left hand when she holds the grip on the steering wheel 7 Switches for indicator lights and windscreen wipers is built into the headrest 8 The switch for operation of the rear window wiper is moved to the left side of the steering wheel in order to operate it with her left hand 9 Electrical operated parking brake 10 Timer setting car heater When Birthe s car was ready she had driving lessons and passed the driving test Now that she has her own car she can easily get around by herself to all her activities and to improve all her social contacts Steve Adaptation of a house Steve is Belgian and lives in the Walloon region He is 31 years old and following a progressive illness he is getting around in a wheelchair He plans to live with Charline who he met in the sports centre Being a bit crowded for the two turtle doves they decide to buy a house Steve has a lot of difficulties in doing several small tasks e g drawing the curtains turning on the light but he makes it a point of honour to do it all alone even though he is getting excessively tired and spends lot of time on these matters See Furnishing and adaptation to homes and other premises page 64 Initiative However one day Steve was paying his friend Antoine a visit and Steve realises that Antoine has a brilliant system for electric blinds and door openers He realises that all things considered the time spend on these diffic
50. on the achieved assistive devices ccccecccccccceeseeeaeseeeeenees 27 Terms of sale written guarantee ccc cecceeceecceeceeeceeeceeeeeeeeeeeeeeeeeteneeeees 27 Having assistive technology eeeeeeeeeceeecceeceeeeeeeceeeeeeeeeeeeeeeeeeeeeeeees 27 Personal helpers ciii2 0c ini e oie til eget at RRS Oe EA 28 The service delivery system c ccccceeeeeseeeeeeeeeeeeeeeeees 29 Steps in a typical service delivery system eecceeceeeeeeeeeestertteeees 29 Thesstory of MS Europe esis ciccsccvsecessevescedavs ea ea E E Ea E E caedevedee 29 FUIPIGIING f2cccsu2 a aa oe inde suena eaahee reaetauanheonc corns enti austesesaanetaane 30 User involvement sarera Side ert el eon raw A Ea a Sn tek sre E aina aa 31 Get SUCCESS aE a AE AE ARA EA Aaea AE AEEA EAAS E ETATO AARE 31 People and assistive technology some stories of SUCCESS e aeaa a iced A en aE E eaaeo r aniei aein 33 Henrik Assistive Technology for Communication ceeeeeeeeeeeees 33 Germaine Assistive technology for impaired vision 0 eee 35 Birthe Adaptation of a Car ou cccccccccccccccceeseseseeeececececeseesesnsnenaeeeeeseeeens 36 Steve Adaptation of a NOUSEC cece cccccccccceeeceeeseeessececeeeeeeeesaeaeaaseneeeeees 38 Elena Assistive technology for being able to Work cccceeeceeeeeeeees 39 4 March 1999 EUSTAT User Manual CONTENTS Knowing assistive techn
51. possibility you may contact a local organi sation of disabled people and ask them to help you And of course you can make some research on the Internet 72 March 1999 EUSTAT User Manual INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Catalogues All producers and dealers have brochures and catalogues of their available assistive technology You will always find a large and often a complete catalogue collection of national available assistive technology in the service centres of assistive technology You can also get them by contacting the dealers yourself and you can often find the larger producers on the Internet and many producers have also videos on their assistive technology available The catalogues have often illustrations of the assistive devices and describe them in more or less promising way because it is advertising material They give you an idea of what to find and you can compare the different models but it is a good idea to talk to a neutral adviser of assistive technology before you decide anything on the basis of catalogues from dealers and producers CD ROM s CD ROM s have the shape and size as music CD s and you can use them in your computer if you have a CD ROM drive They may contain databases movies and other information More and more are available so again ask at your service centre of assistive technology Information sites To find information on
52. reason Let s try to explain The term cost is an economic concept not a financial one Economics deal with resources finance with money When we say cost of assistive technology we want to indicate the flow of resources generated by the use of technology including all services and support involved We will not be able to find the best ways of organising AT unless we go behind the financial figures A device related assistance e g a mobile wheelchair stairclimber that requires to be operated by a helper provided free of charge by the family to a disabled 86 March 1999 EUSTAT User Manual FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY member may involve no disburse of money However it is a resource that has to be considered in cost analysis although invisible in financial records It may be measured in non monetary units like e g man hours Moreover when performing comparative cost analyses it is also possible to convert them into monetary figures This conversion is called valuation but it should be clear that such figures are the calculation tool for social efficiency estimations and have nothing to do with the banknotes we actually extract from the wallet We speak of social cost when we consider the sum of all resources used by all actors taking part in an individual assistive technology programme e g the user the family the municipality the insurance or the N
53. specific assistive technology might be difficult The absolute best thing to do is to contact a centre on assistive technology If that is impossible there are many other places where you can try to get information and hopefully you will eventually find what you need In this chapter you will find general examples of sites grouped in the following way e Centres specialised on assistive technology e Resource centres in the disability area e Community services e Informal resources Centres specialised on assistive technology National resource centres In all European countries one or more national regional local resource cent res exist The aim of the centres is to provide information on assistive technology accessibility and assessing for driving a car etc Some centres also have consultants where your need for assistive technology can be assessed etc They might also have a national database and catalogues of assistive technology National centres of accessibility and design for all environmental accessibility accessible housing transport city plans cultural institutions etc and Design for all design of mainstream products and services which meet the needs of most users including people with disabilities and elderly people are some of the most important factors for people with disabilities to have a free choice of activities and to take active part in the society Centres handling and researching acce
54. technology provides you in a short and easy understandable way with such knowledge You can read each subchapter and discuss with your peers which impact these issues might have on assistive technology and how you practically can use the knowledge given in this chapter Here are proposals for other questions to discuss Which attitude do your community have on disability and assistive devices Page 80 Which attitude do your family and perso nal helpers have on disability and assistive devices Page 80 Which attitude do you yourself have on disability and assistive devices Page 80 ASP PK VARA ASG OWI NV STAY MYT Which impact does these attitudes have on your self esteem your activities and your way of life Page 80 How can you work for better usability in your future devices Pages 83 How is the usability of your assistive devices Pages 83 Are the costs higher or lower if you did not have your assistive devices Page 82 What impact would it have on your daily life and activities if law claimed the idea of design for all Page 82 Give examples Which factors in your daily life give you a kind feeling of disablement according to the ICIDH2 classification Page 90 What does the CE label mean to you Page 92 98 March 1999 EUSTAT User Manual APPENDICES Appendices Appendix 1 A diagram showing the steps for achieving assistive technol
55. that a person can sit and work Between the hob and the oven there must be a heatresistent top on which to push hot pans and baking trays The kitchen sink must be low so that there is room for the thigh of the user and the drain ought to be in the back of the sink There must be insulation underneath the sink to avoid burns on the thighs of wheelchair users without tactile sensation in their legs To the wheelchair user it can be an advantage that the shelves in the upper cupboards are made of glass so that their contents can be seen from below and drawers in the lower cupboards are to prefer because it is easy to see the contents March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY Cooking An adjustable stool and a trolley for transferring things could prove a good solution when working in the kitchen For people having visual impairments contrasting colours make it easier to distinguish between food dishes and utensils Electric kitchen tools such as the food processor for chopping blending and whisking are a great improvement freeing you from a number of minor working tasks A number of similar electric kitchen tools are available such as electric potato peelers electric slicing machines electric kettles egg boilers and lemon squeezers If it is difficult to remember to switch off the electrical machines different types of automatic switch off devices are available While co
56. the faces of her relatives Birthe is an 18 year old high school girl who has congenital deformities of both arms and legs She needs a car for transportation system because it is easy to use and automatically focuses so she has the possibility to focus on remote objects in her environment Little by little she realises that with training and thanks to this sophisticated system she will be able to read her mail magazines watch photographs again and also she will be able to see the faces of her relatives again and in particular the face of her granddaughter With the help of the mobility instructor she tests different canes and finally chooses a strong one where the weight is well balanced The centre of gravity is highly situated and allows an easy use and Germane will possibly be able to use the cane to walk on pavement or stairs Financing The small assistive devices such as the talking watch or the open eye needle are not very expensive Germaine and her husband will pay for them As far as the cane is concerned a medical prescription by the ophthalmologist is needed and is partly paid by the Social Security and the mutual insurance The camera system is however a very large investment Despite the intervention of the social worker the medical prescription and the occupational therapist arguments the Social Security refused to reimburse the medical expenses considering the earnings of the couple F
57. this area so ask at the information sites about assistive devices for leisure and holidays Figure to the left Stick grib clamped onto the egde of the bed EUSTAT User Manual March 1999 67 KNOWING ASSISTIVE TECHNOLOGY Figure to the right Embroidery frame Card holder Sprung scissors Figure to the right A garden kneeler See Information s Sites page 73 Professionels page 76 Doing sports and fitness Sport for disabled people is possible in many ways adapted sailing boats go carts skiing and swimming equipment and assistive devices for running rugby basket tennis tabletennis biking and horseriding etc Ask your adviser or your disability organisation for advice if you have problems managing your favourite sport Playing games Many games chess mill ludo come with magnetic backs or in extra large sizes You can play all sorts of games on the computer which can be adapted for you according to your needs If you use one hand only or in general find it difficult to fan cards out they could be put in a card holder The cards can be shuffled in a battery operated machine If you cannot spot the figure on standard cards cards with large figures or giant print cards are available Doing needlework Sprung scissors need only a little strength to operate or alternatively scissors fitted on boards resting on the table are operated easily by the whole
58. turn off your cooker then you might use a turn on turn off watch which turns off your cooker or another electric device at a certain time after you have used it It is sometimes difficult to read the labels of different bottles used for cooking cleaning or personal nursing then you can get hold of small stick pictures for marking the bottles In the same way you can put illustrations on your cupboard or at other places in order easily to find what you seek If you like cooking and has difficulties in reading or understanding the recipe you can use recipes in illustrations or have it on a tape recorder to tell you what to do Like that you can use tape recorded books and newspapers if you have difficulties in reading these things If you like walking but often get lost then use a mobile telephone where the numbers for the persons who can help you are laid in one key which you for example can mark with colours or small pictures About telephoning see page 47 Aids for personal care Personal care is a very private and important matter for every one of us By reading this chapter you can obtain information on the most common assistive devices which are available for personal care Washing bathing and showe ring Here it is a good idea to have a thermostat mixer taps which automatically regulate the temperature avoiding scalding people who have reduced sensation Having a bath Using the bathtub mig
59. visual keyboard pro gram had many smart features such as word prediction and was also considerably faster to use than the program they used now Therefore this new program was chosen Financing Now it was time to apply for the necessary funding From the very beginning the local government authorities where Henrik lives had been most co operative and both Henrik and the local authorities were willing to become pioneers in the field of voice control An application was submitted by the Technical School to the Danish Ministry of Education and the Directorate for Vocational Education and Training which formally sees to the procurement of equipment for students with special needs Delivery The equipment which had been adapted and tested was delivered to Henrik s house The Technical School procured the same equipment as Henrik had at home The equipment also included a CD ROM drive as there are concrete plans originating from the Ministry of Education to make Henrik s textbooks available on CD ROM This would mean that in some instances the computer would dispense with the need for electric page turners See CD ROMs page 72 Follow up Twelve months later the equipment works well and meets Henrik s requirements The voice control is primarily used for computer commands because the software could only handle approximately 300 words With the small touch sensitive mouse as his chin joystick Henrik is able
60. you might find a magnifier makes things easier when reading or working A wide range of types offering various degrees of magnification is available Some magnifiers are hand held some can be attached to lamps and some hang from the neck and rest against the chest Magnifiers are available with or without built in light If you are partially sighted and cannot benefit from a magnifier and a strong light the CCTV system Closed Circuit Television system could prove to be a good solution See case story of Germaine page 35 A CCTV system makes it possible to read for example a newspaper and a book by putting the text the book newspaper or whatever you want to read on the shelf under the screen and the text is shown in large clearly visible letters or figures on the screen The screen is similar to a televi sion screen If you find it difficult to keep your grip when reading the newspaper place it on a table mounted newspaper stand Books and magazines could also be placed on a slanting board resting on the desk or table or alternatively placed on a book stand fitted on to the arms of the chair or on a movable stand which you can wheel around If you have difficulty in turning the pages a page turner could prove a good solution The page turner is a stick fitted with a nice large easy to grip handle in 46 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY one end and
61. 2 53 RAMPS itz Seresveaveriees masa 64 65 REACNEM EAEE EE P EE EE E A 51 Reading 35 36 44 46 49 71 Recipe Sai eir a arai 44 49 Recreation 00 5 13 45 67 90 Rehabilitation Counsellor 79 Rehabilitation Engineer 78 109 Relevant user organisations 74 Hospitals ccccccceeeees 74 75 77 Rheumatoid clinics c 74 SKIN CHAICS na 74 Remote control a a 41 48 Research and development Progra Sei anat tesneni 93 Researchers aiian 79 84 89 93 Resource centres in the disability area 73 74 FRIFISING2 3 5412850 S oot cate cab te eet 60 Role modelling eee 94 95 Rollator Sei n 54 55 70 Running cost eee eeeeeeeeeeeeceeeeeeeeeeeeees 88 S Sales agreement 7 27 106 Scales siete decee eee es 60 90 Scooters icce 55 56 69 Seat raising mechanisms 56 Selection 4 24 29 30 33 36 37 39 41 86 89 102 111 Self propelling cccceceeeeeeeeees 55 Self shaping handles 08 61 Sensor operated security lights 65 SEVER cate aes E 71 72 Service Delivery 2 4 7 8 10 14 25 29 30 31 32 72 80 84 85 96 97 99 108 Service Delivery System 2 4 7 8 25 29 30 31 32 72 80 96 97 99 EUSTAT User Manual March 1999 115 APPENDICES Sexual ac
62. 89 Floor fitted support rail 49 Disablement 0 0 000 90 91 98 Foam mattresses 67 DIY oieri rg caste heehee tists 51 Folding sticks ssseeeeeeeeeees 54 Doctor aiie 7 13 29 75 77 FOINOW Up ou cece ecceeeeeeeeeeees 34 36 39 42 Doing the laundry 17 62 102 FOOU raISE sess cse essentials 66 Doorbell ccccccccececeeeeeeeeeeeeteeees 67 Forearm through crutches 54 Dosing medicine 00 62 FOP 0 Mak actct act EESE 60 61 69 Dressing and undressing 16 44 51 90 FOM ooien 55 92 95 102 104 Dressing stick ccseeeteeeeeeeeeees 51 Funding 5 7 28 30 34 42 74 97 DUMMIES a a a aiiai 54 Furnishing sssaaa 38 45 64 90 Du st panS ensisi etn fiaech dine 63 Furnishing and adaptation 38 Furnishing the house cseee 45 E Easy to grip material 0 000000 45 G Eating 16 24 35 44 90 61 101 Garden kneeler 0 cccceeeeeee eee 68 Educational professionals 77 Garden tool sets c cccccceeeeeeeeeees 69 EUSTAT User Manual March 1999 113 APPENDICES Gardening ccccccceeeeeees 45 67 68 Insulation underneath the sink 58 Getting around in the house 64 Internal rules cc ceeccceseeeeeeeeeeeeees 31 Getting in and out of bed 65 International Standard Or
63. CHOOSING AND GETTING ASSISTIVE TECHNOLOGY At the technical aid joints bend how safe and stable are the centre they have movements and the gait of hers See exhibition of assistive Assistive technology or other solutions devices which you can nage 13 Ways to fill the gap between ty and they have you and your wanted activities page catalogues from the 13 HEEN ie ef After that they talk about Ms Hansen s own analyses of her activities Once more they go through all her activities her future situation and the accessibility in her surroundings the possibility for training and changing ways of doing the daily activities in order to avoid getting When trying assistive pain and being tired and at last the need technology it is important for personal help Ms Hansen and Karen to be very thoroughand agree about the personal goals and now consider Ws questions they begin to look for relevant assistive listed o this page technology See You are the expert page 10 Make a goal and go for it page 10 At the technical aid centre they have an exhibition of assistive devices which Ms Hansen can try and they have all the catalogues from the producers and dealers of assistive technology Karen can advise Ms Hansen in making the best solution for her and Ms Hansen can borrow some of the devices to try at home In particular it is important to find a good working and resting chair for Ms Hansen
64. E TECHNOLOGY SOME STORIES OF SUCCESS exchanging ideas by fax on possible modifications to the drawings e Visiting the factory once a month for attending the team meeting and evaluating the products This is done by renting an adapted taxi and a personal assistant which is not being provided by the social services but paid by Elena and accounted as professional expense To find updated information on materials techniques and products Elena subscribed to some CD ROM page 72 and on line databases She also takes part in architecture design interest groups at an international level on the Internet Elena has entered successfully in this new dimension of life and says that although some restrictions still exist her opportunities have dramatically expanded She has an active and integrated life and feels ready to undertake new steps such as the challenge of independent driving EUSTAT User Manual March 1999 43 knowing assistive technology The descriptions here are meant to be illustrative and to give examples This is not a complete catalogue of assistive technology Let not your fantasy stop you get hold of all the information you can get and afterwards set your goals Accessibility in the environment profound assessing analysis personal adaptations instruction and training and following up on assistive technologies play a huge role when getting an assistive device Knowing as
65. ERVICE DELIVERY SYSTEM Do be very careful with the sales arrangement especially about guarantee paying and insurance If you are going to speak for your case then it is important to learn public procedure sales arrangement especially about to speak for your case what you must be guarantee paying and insurance See prepared to do then it is important to try CE labelling page 92 Decisions and to learn to public procedure Ask for the solutions page 26 Terms of sale routines of the agency municipality and written guarantee page 27 try to find out where to get this informa tion To manage the financing part of the The only expert who can help you service delivery system it is very getting a life which you dream of is important to know the laws as well as the YOURSELF hidden and internal rules If you are going ae 32 March 1999 EUSTAT User Manual PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS People and assistive technology some stories of success In the previous chapter Choosing and Getting Assistive Technology examples of achieving more complex and advanced assistive technology were not mentioned However as this is a very important topic five cases now follow which all include real persons and their backgrounds Although the case stories have been elaborated and rearranged they illustrate the process of getting more complicated and advance
66. EUROPEAN COMMISSION DG XIII Telematics Applications Programme Disabled and Elderly Sector GO FOR IT A Manual for Users of Assistive Technology Deliverable D05 4 Project DE 3402 Empowering USers Through Assistive Technology FOREWORD Knowledge is one of the key factors for empowerment in the process of getting assistive technology The aim is to provide methodologies in achieving assistive technology and to provide a broad and general knowledge in the area of assistive technology The target group is adults young as well as elderly Foreword This manual has been produced by the EU financed EUSTAT project The main aim of the EUSTAT project was to develop training models and educational material for persons with disabilities and elderly people in order to empower them in making informed and effective choices of assistive technology Knowledge is one of the key factors for empowerment in the process of getting assistive technology The more the users of assistive devices know about assistive technology the greater influence they can exert in the process of purchasing assistive devices and getting successfully through a service delivery system Empowering the users of assistive technology can ensure that they get the right assistive devices in order to achieve more freedom in choosing activities in getting full participation in all aspects of their social life and in stimulating self determinati
67. T that educators should know before undertaking any educational initiative Chapter Three Setting objectives and adopting methods helps organisers of educational programmes to set 110 March 1999 EUSTAT User Manual APPENDICES objectives label them according to a consistent terminology and take decisions about priorities and critical factors Chapter Four Organising educational initiatives addresses the organisation of educational initiatives including the design process the selection of topics to cover pedagogical methods and styles and practicalities Chapter Five Gearing to the audience discusses factors to consider so as to meet the learning pace of trainees and ensure that the knowledge delivered will be useful in their daily life context Chapter Six Case studies offers three case studies that may be useful as concrete examples of educational activities for end users These are based on experiences carried out by three EUSTAT partners in Belgium France and Italy in 1998 Programs in Assistive Technology Education for end users in Europe Available in English This book is the result of a wide interna tional survey aimed at identifying classifying and describing existing examples of educational programs in AT for persons with disabilities and the elderly The survey was carried out at international level mainly by means of questionnaires On site visits were also made in order to collect furth
68. User Manual KNOWING ASSISTIVE TECHNOLOGY doors etc while sitting in your chair See Environmental control systems page 67 If you have partial sight the television magnifier a large magnifier screen put in front of the television could prove a good solution Aids for cognition If somebody has difficulties in understan ding managing and foreseeing happe nings remembering and organising the activities in daily life or in other areas then perhaps they can profit from using cognitive assistive technology It is very important to make a profound analysis of the actual person s problems in handling the daily activities in order to find perso nal and adequate assistive devices See information sites and professionals page 70 The technology and the assistive methods and devices in the area of cognition are of great variety and are often adapted specifically to the problems of the person The following examples are therefore not at all complete and has the aim to give the reader an idea of the which kind of assistive devices people who have difficulties with cognition needs A normal calendar or a home made one with pictures for days and activities might be a help if it is difficult to oversee the activities of a day or a week You can also put your alarm clock to ring when you have to remember an appointment or a television program which you want to see If you now and then forget to
69. a story of success Often testing more different assistive devices and adaptations are necessary in order to find the best solution for you and then per haps only a part of your dream has been fulfilled See Decisions and solutions page 26 The assistive technology offers you new possibilities but at the same time it might give you constraints e g if your computer for communication brakes down then you are unable to communicate for a period Taking advanced and complicated assistive devices like electric wheelchairs and computerised communication aids into account then it is important to know that the process to find the right one is a long and hardworking task for both the user and the adviser It might take months to end such a process of selec ting assistive technology And then start ing your normal life with your new assis tive device might still cause problems which you have to manage and solve On the other hand you might find out that you have made the wrong solution and you want to change it See Terms of sale written guarantee page 27 Having assistive technology often means that you have to maintain and repair it The consequences of functioning and the claims of service for the assistive device are very important to consider and plan for before you start your career as efficient user of assistive technology If your electric wheelchair brakes down again and again you have no opportunity to ta
70. abilities both national and local exist Those organisations have gathered a huge amount of both personal and professional knowledge in a general and specific field of disability and assistive technology Hence the user organisations are perfect places to get valuable information on almost all questions in connection with your impairment User organisations can be found in the telephone directory Some times special books listing all kinds of user organisations are also available User organisations regarding sports In some countries special user organisati ons concentrating on sports are available From such a user organisation information on assistive technology for leisure time and sports can be obtained Rheumatoid clinics If you suffer from rheumatism some special clinics exist which can assist you in locating the proper assistive devices Sometimes the clinics are placed in connection with hospitals sometimes in connection with centres for elderly people Skin clinics Special skin clinics are available in most European countries They can give you advice on relevant material or surface of your assistive devices if you have severe skin problems 74 March 1999 EUSTAT User Manual INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Hospitals If you do not have any idea of where to go then perhaps you can ask at a hospi tal They have often all kinds of expertise and might be abl
71. acit 57 66 HEART eee 29 31 80 85 93 108 Local authorities cceeee 34 75 Heatresistent top ccccccceeeeeeeees 58 Medical practitioner consultation 75 Heavy Cutlery oasis irarri 61 Physiotherapeutic consultation 75 Heavy pen sssssssssrrirssessnrrirrnennnnenttt AS Lock the SOCKS u 64 Heavy ruler acii 45 Long barbecue gloves secesseeesseee 59 Height adjustable 05 54 66 Loop amplifier System secesseeeseeee 47 HELIOS oei nad Mais 84 Loose a E N 61 Homepages 6 9 70 71 107 Lower cupboard cccscecsseccsessseeesseeee 58 Housekeeping 5 35 44 58 70 72 90 M Magnifier cccceeeeeetteteeeeees 46 49 l Magnifier screen cceee 49 IGIDA Zore N 90 Magnifying programs sssssssssseee 0 46 IEC ssnsusnsusussnsnnsususnsunnssnunsasusnsusnssnnnnn 92 Maintenance cost e 2 ses oF 5 41 87 88 Impact of assistive technology 5 80 Management and follow up 5 29 30 81 97 Manual wheelchairs 00 cee 55 Impairment 2 29 36 45 46 Maxi keyboard ceeceeceseseseseeeeee 45 47 48 59 60 74 80 82 89 90 Measuring cccccccecceeeeeeteeteeeeeeeeeeee 60 91 107 108 109 Measuring spoons and cups 60 Incontinence 40 44 54 72 73 Medical Devices Directive 92 Indoor scooters cce
72. activities 20 March 1999 EUSTAT User Manual Analysing the activity Page 4 out of 6 Activity Problems with the activity Why when where how Describe the circumstances and the place for the activity Inside outside Large room small room Summer winter Often seldom Alone or together with others Etc Future Does your situation change during the next 5 10 years How does this influence the activities Characterise your claims for solutions give perhaps some ideas What do you want in order to manage this activity The wish the dream the feeling when performing the activity What do your family and friends think Importance of the activity 1 Very important to me 2 Not very important 3 Does not matter if can get personal help 4 Does not matter at all Descriptions Having a shower Standing in the shower feel insecure and get tired in my legs At home in the bathroom at hotels at friends at swimming bath Once or twice a day It might get worse Must not cause pain be safe not too tiring and be easy without too many complicated solutions and nice looking too A bath chair Suitable for my hip 1 Very important Third column Relation with other activities Write the name of the related activity and shortly describe how the relation is Relation with other activities Any time am standing Counts for all activities Counts for a
73. aids for walking transfer turning and lifting aids for stair climbing wheelchairs bikes and cars public transport e Aids for housekeeping including aids for cooking aids for eating aids for cleaning the house and aids for doing the laundry 44 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY e Furnishings and adaptations to homes and other premises including entering leaving and getting around in the house furnishing the house getting in and out of bed and controlling the environment e Aids for recreation including aids for sports and fitness aids for playing games aids for doing needlework aids for playing music aids for gardening aids for smoking and aids for hunting and fishing Aids for communication We all have a need to communicate with other people Normally we communicate by talking or writing to each other however much communication takes place when we listen watch sense read or use sign language or mime If you have lost the ability to talk or write a number of alternative measures are available to compensate for the loss See Information sites and Professio nals knowing about communication pages 72 and 74 Writing If you have reduced strength in fingers due to arthritis or rheumatism it may be managed by using a thick pen either a special pen or simply an ordinary pen wrapped in plastazote tubing or in any type of chunky easy to grip material
74. al s total living situa tion and determine need for additional community resources and they train daily activities and assesses relevant assistive technology They are generalists in the area of assessing and choosing assistive technology and they often are specialists too in some specific area On the other hand they often have to consult other professionals when the problems are very specialised in an area where they do not have their competence In this group you might find professions such as occupational therapist physiotherapist nurses psychologist social worker and also sometimes engineer 76 March 1999 EUSTAT User Manual INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Communication If you have specific problems in communication therapists of speech and language can help you They can assess understanding and use of language and interaction patterns with different communication partners They can assess muscle control for speech pronunciation of speech sounds and prognosis for improvement and they evaluate use of non verbal communication and recommend types of specialised communication aids and techniques You will also find psychologists working in this area as well as different educational professionals Cognition If your problems are in the area of under standing managing and foresee happe nings remembering and organising your daily life or in other areas of cogn
75. al vocational as truss maker and he she makes special shoes belts bandages stays seats etc Educational and counselling professionals When you need training or education in some specific area in managing your daily activities you will meet educational professions but also many other profes sions from the area of assistive technology and managing daily activities such as doctors nurses social workers occupational therapist psychologists etc They have been trained as educators to teach in their specific competence In relation to counselling where you need professional advice on personal matters you will mostly meet psychologists and social workers But the other professionals give of course counselling in their specific competence Here are some educational professi ons which you might need in your way through the world of assistive technology 78 March 1999 EUSTAT User Manual INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY esin NNI ley Educator He she contributes information on classroom performance and academic performance and defines communication skills needed to complete academic and vocational courses and to interact with classmates Vocational evaluator This professional evaluates the possibilities to perform your vocational job Vocational Evaluator or Rehabili tation Counsellor He she assesses an individuals potential to hold a job and assists with
76. an the door and the blinds but also to put the computer on the percola tor the lamps He does not take all the options yet because he does not really need them for the time being but he will not forget the progressing of his disability Steve contacts several firms in order to receive an analysis and chooses the quality and price which suits him Authorisation and financing Steve can expect a part of the funding of the devices but not entirely For the balance he receives a subsidy from the region because he is adapting his house For the future adaptations of which he will need he plans to introduce a financial aid application to an organisa tion which encourages projects of autonomy Delivery In his demand Steve stated clearly that the dealer was responsible for the system installation and an article which includes the maintenance and the possible repairs was made Management and follow up One month of test is planed before the definitive purchase During this month Steve could call the firm in order to achieve the necessary modifications and thus be sure of his purchase See Housing and environmental adaptation page 11 Usability in design page 83 Design for all page 82 Elena Assistive technology for being able to work Elena is a 42 year old Italian architect who has been working as a freelancer in the field of furniture design for approximately 10 years Two years ago she suffe
77. and these she has to try at home Together they select a number of different assistive devices to try They decide that it is important for Ms Hansen to get another flat and that Karen as soon as possible visits Ms Hansen s home to see the actual surroundings the ways she manages her different activities in order to advice her on better methods and eventually some extra assistive devices Although Ms Hansen has been very thorough in her activity analysis there might be something she has not noticed and something a professional in the area like Karen can notice as pro blems Together they make a list of the solutions so Ms Hansen at home in peace and quiet can study and think through the list Nothing will be decided until Karen has visited Ms Hansen and until Ms Hansen is sure everything is all right for her After this meeting some assistive devices are brought to Ms Hansen s home in order to help her in the most important activities and in order to try them See Instruction and training in the use of assistive technology page 12 Decisions and solutions Ms Hansen tries different assistive devices at home and at the technical aid centre Unfortunately she could not try the bed at home which in her case was very important The technical aid centre did not bring beds home for personal testing so she tried to evaluate the beds at the centre which was not easy She had to make her decision on the
78. anual ACKNOWLEDGEMENTS Acknowledgements This study was carried out by the EUSTAT Consortium SIVA co ordinating contractor Fondazione Don Carlo Gnocchi ONLUS IRCCS Milano Italy Mr Renzo Andrich project leader Ms Serenella Besio ANLH partner Association Nationale pour le Logement des personnes handicap es Bruxelles Belgium Mr Cleon Angelo Ms Anne Catherine Jooris Mr Franco Cortesi GIHP partner Groupement pour l insertion des personnes handicapees physiques Bordeaux France Mr Christian Berard DC partner Danish Centre for Technical Aids for Rehabilitation and education Taastrup Denmark Ms Lilly Jensen Ms Maria Holm CAPS partner Centro An lise Processamento de Sinais Instituto Superior Tecnico Lisboa Portugal Mr Luis Azevedo Ms Margarida Nunes da Ponte PRIS partner Centro Studi Prisma Belluno Italy Mr Beppe Porqueddu Mr Angelo Paganin The main author of this book is Lilly Jensen Maria Holm Margarida Nunes Luis Azevedo Christian Berard and Renzo Andrich also contributed to some sections In the various sections of the document all members of the EUSTAT consortium have as a whole provided valuable input and views Anne Cathrine Jooris Cleon Angelo Franco Cortesi Beppe Porqueddu and Angelo Paganin have also contributed with case stories Users from Belgium France and Italy have made a very profound useful and enthusiastic validation of th
79. ape Apes re quae bp parei RaT Et ee A Bai ocr ima ikai imapa com Fret Fn n E Speers Ss Friaren ea meier meien aea re a tte PAPERI ALH CIRI EIIFE LILLI Hanlin HHE G APF LLOATHHL TA LBA THIER TEID PFE ie Hi Haiii APPa FI LF F MN Ii Hh EUSTAT ieg Brough Amini ve On this page you can press the underlined link Home Page du Project which leads you to a homepage served in Italy by a SIVA computer EUSTAT User Manual March 1999 71 INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Many books on all sorts of issues in assistive technology are available Go to the local library A database is a compu ter based system of collected knowledge which is systematised so that you can search for specific items Jumping around from one homepage to another using a link like this is what we call to surf the Internet How to use the Internet To search for information on assistive technology you have mainly to use your browser Since the map of the Internet servers evolves rapidly every day because new servers are added and other servers are removed either temporarily or permanent you will need to know where to find the information Most likely there is not one server where you can find all the information that you want because a server generally deals with only a topic or a sub topic You will have to learn how to use a searc
80. ards feel and express the qualities you want for your solutions On the other hand you can think and perhaps write down how you would like to live in the future This might help you to realise which ways and qualities you want of the solutions In order to get ideas for solutions the relevant stories of success in the manual pages 33 and the chapter of knowing assistive technology page 44 can be read not as a whole but in the areas you need information e g washing and bathing or getting around When the form of daily activities has been filled in it is important to have a talk about the difficulties in doing this and listing the new knowledge gained by this activity in order to notice and stabilise the It is a good idea to start the counselling to make a personal analysis of the daily activities When the form of daily activities has been filled in it is important to have a talk about the difficulties in doing this EUSTAT User Manual May 1998 95 THE NEXT CHALLENGE FROM ENDUSER TO PEER COUNSELLOR It is important to discuss the goals when they are made in order fully to understand the background and the impact of them How is the service delivery system in your country education achieved Here it is possible to have interesting and educational discussions about e Closing the gap between you and your wanted activities Page 13 Different ways of solutions imitat
81. ation process These organisa tions should be subsidised to ensure user participation despite their limited resources Service delivery should be organised in such a way as to allow individual users to give feed back on the best adaptation of a device to his her specific needs through practical testing professional provision methods and dialogue between user and intermediary adviser The design for all concepts may limit the need for specific assistive technology devices That should not only include physical accessibility but also consider intellectual accessibility The knowledge and experiences of users are of primary importance in this area Special actions were proposed to ensure user involvement e Establish formal user involvement in the organisation of actions Ensure financing of user involvement as part of the action budgets along the same lines as other professional participation e Identify and study methods for real user involvement e Provide necessary training and qualifying schemes ADA The Americans with Disabilities Act of 1990 The purpose of The Americans with Disabilities Act is to establish a clear and comprehensive prohibition of discrimination on basis of disability The law is separated into five parts Employment Public accommodations Transportation State and local government services Telecommunications relay services If you find that any of the above services are not accessible yo
82. ational Health Service Social costs that can be recognised as directly linked to the individual assistive technology programme are called direct social costs e g to the cost of the equipment to the device related assi stance etc There may be also indirect costs linked to secondary consequences e g the user s increased working capacity due to better assistive technology Now let s go one more step forwards When we decide to adopt a new assistive device we do not just put new resources in we might also bring about a modification in the resources already used before The provision of assistive technology changes a life situation For instance investing into an electronic wheelchair may replace for the need of personal assistance during mobility In other words for a person with disabilities it may be irrelevant to know how much is the absolute cost of an assistive technology solution It is more interesting to know how much additional investment is needed to move from the old situation to a new situation If we want to know the economic consequences of the choice of assistive devices we are interested in the diffe rence between the social cost of the new situation and the social cost of the old one In economic language we are interested in the additional social cost The additional social cost of an assistive technology solution may therefore be 1 Positive the new solution requires more resources than t
83. bably ask you if you want electric or manual chairs and after your answer here it will probably ask you if it is for indoor outdoor comfort etc And so you go further down in details until you find what you are searching if of course what you seek is contained in the data base You have to ask at a service centre of assistive technology if there are any databases available for you Many organisations have private databases on books relevant organisations and per haps on assistive technology Some countries have a national database It is a hard and great work to elaborate and maintain a database therefore you often have to pay for using it On the Internet you can find databases too Books videos catalogues CD ROM s Books videos Many books and videos are available on all sorts of issues in assistive technology e Specific assistive technology wheelchairs aids for housekeeping lifting communication incontinence etc assessment service delivery system e accessibility research and development projects e legislation e etc The best way to find these books and videos is to go to the local library and let the librarian help you find what you are looking for Another way to find the literature is to contact a service centre for assistive technology and ask them to help you The local library might not have such specialised books and videos and is perhaps not able find them As a third
84. benefit from your valuable suggest ions and guidance On the other hand knowing a subject does not necessarily mean that you are able to transmit such knowledge to others This chapter gives you some hints for bringing your knowledge on to other persons The world famous Danish philosopher Soeren Kirkegaard said about helping and advising other people If you are going to help somebody you must first of all understand what they understand and see the situation like he sees it So trying to help means among other things to be silent and listen to ask questions to understand and to accept to know less than the other person does because it is his private situation which is in focus Your knowledge must be given at the right time in the right connection and in the right amount to let the other person work in his own way to solve the problems The aim of all help is to empower people and not to give them our own solutions Counselling Little Peter comes to his mother and says mammy from where do come The mother hesitates blushes and start to stutter because she thinks that Peter wants to know how a baby is made But little Peter gets impatient and says My friend Hans comes from the town Vejle From where do come Characteristics of counselling In the above funny little story we see a bad counsellor who tries to help from her own point of view and that is not what counselling is about Here ar
85. button only If however you have severe motoric disabilities and cannot work a standard keyboard you can use a keyboard substitute by using switch or joystick control One such substitute is the Keyboard for large uncertain movements Figure to the left Thick pen EUSTAT User Manual March 1999 45 KNOWING ASSISTIVE TECHNOLOGY Switch or joystick control Figure to the right Table mounted newspaper stand Magnifier Figure to the right Page turner d scanning field where the cursor moves horizontally from one letter figure or commands such as new line new page or write capitals to the next When the desired letter or sign is reached you select it by activating the switch or joystick and the letter is copied to the text you are writing Switches are operated either by foot hand elbow cheek neck by pulling a string by sucking blowing or whatever else is considered appropriate for the user This way of writing is of course an extremely slow process but if this is the only way to communicate the time it takes is of less relevance In general the computer is a valuable piece of assistive communi cation technology If you have visual impairments magnifying programs which show very large and clear text on the screen are available and they often offer the added benefit of being able to choose fonts and colours yourself Reading If you have low vision
86. can often be fitted for your personal use Some have a rigid frame and therefore they cannot be folded in the conventional way but often the back can be folded However they can be dismantled by means of removing the quick release wheels and thus be transported by car Other models are very active which means that the place of the wheels the seat the backrest the armrest etc can be adjusted for you special wishes form and size Powered wheelchairs only meant for use indoor exist as well as wheelchairs meant for both indoor and outdoor use are available These wheelchairs may be larger and heavier than manual wheel chairs as they include batteries Most of them cannot be dismantled A minor part can however be relatively easy dis mantled once the batteries are removed and they can be folded and transported in a car Some models are like a normal working chair with power There is also a range of indoor scooters which many people prefer to a conventional chair Most powered wheelchairs have the possibility of having computerised steering which means that you can choose your wheelchair to have different ways to perform the driving for example a decided top speed to stop slowly or fast to turn in a soft curve or a very sharp one to accelerate quickly or slowly This Powered wheelchair EUSTAT User Manual March 1999 55 KNOWING ASSISTIVE TECHNOLOGY A scooter gives anybody the oppor
87. ch 1999 69 INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Very few people and centres working in the field of assistive technology have knowledge of all kinds of assistive technology This chapter has three parts Tools sites and professionals in the area of assistive technology The main structure of the Internet and how it works is described Information resources and per sonal advice on assistive technology In the following you will get inspiration and ideas of the opportunities for obtaining information on assistive technology The information is given in a broad and general way in order to show you the variety of possibilities there are for seeking information Assistive technology includes many technologies and products which are of a varying size e g from large assistive devices such as wheelchairs rollators and adjustable beds to smaller assistive devices such as hip protectors devices for housekeeping toiletting etc Also the level of technology varies much from one assistive device to another Very few people and for that matter centres working in the field of assistive technology have knowledge of all kinds of assistive technology Therefore it may be a problem locating the exact information that you need So ask everyone you can think of for more help on locating the right expertise For a beginning you might ask for information at the library and try the number information
88. ct meaning that in some countries you have to pay for the service or assistive device and then afterwards you get your money refunded In other countries the service or assistive device are directly paid by the funding organisation state or insurance See the different ways the funding is raised in People and assistive technology Some stories of success under the section of Financing pages 33 43 30 March 1999 EUSTAT User Manual THE SERVICE DELIVERY SYSTEM User involvement Many studies in the area of assistive technology have emphasised the impor tance of user involvement at all levels Especially where issues on disability are treated in order to influence results and policies and to qualify all initiatives taken The service delivery system must allow end users to take active part in assessing and selecting the best adaptation of a device to his her specific needs It is done through practical testing professio nal provision methods and dialogue between the user and the adviser A good service delivery system is illustrated among other criteria by active user involvement and influence says the HEART project Page 108 Therefore it is important that you make your opinions clear and give advice in order to get the best result for yourself and to educate and qualify the advisers of assistive technology Because you are the expert of your way of life and your feeling of needs Get success
89. d assistive devices We have chosen to present success stories They may seem ideal but unsuccessful stories do not illustrate how assistive technology can give you more freedom in choosing activities and in getting full participation in all aspects of your social life which is one of the aims of this manual Henrik Assistive Technology for Communication Henrik is a 26 year old man living in Denmark A couple of years ago Henrik an elite gymnast was injured during trampoline practice and sustained quadriplegia Today Henrik is paralysed from the shoulders and down and is now a wheelchair user Initiative As part of Henrik s rehabilitation pro gramme the regional communication centre received an enquiry from the local government authorities where Henrik lives to find suitable communication equipment for Henrik He needed writing aid to compensate for the lack of function in his arms and hands See Aids for communication page 45 Assessment In the first few months Henrik the social worker and the regional communication centre discussed and pinpointed Henrik s abilities and needs Initially the ideas were somewhat vague Henrik needed a writing aid for instance a computer But which one And how would Henrik be able to operate it What would he use it for Henrik and his social worker had discussed the possibility of Henrik activating the keyboard by means of a mouth stick Henrik has a powered
90. d norms Activity In the ICIDH 2 the term activity is used in the broadest sense to capture everything that a person does at any level of complexity from simple activities to complex skills and behaviours Activities include simple or basic physical functions of the person as a whole grasping moving a leg or seeing basic and complex mental functions remembering past events or acquiring 90 March 1999 EUSTAT User Manual FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY knowledge collections of physical and mental activities at various levels of complexity driving a car personal social skills interacting with persons in formal settings Participation Participation is the interaction of impairments and disabilities and contextual factors that is features of the social and physical environment and personal factors Participation consists all areas or aspects of human life including full experience of being involved in a practice custom or social behaviour Domains of participation personal maintenance mobility exchange of information social relationships occupation economic life and civil and community life are social in the sense that the character of these complex experience is shaped by society Contextual factors Contextual factors are the complete background to a person s life and living as by external environmental factors and internal per
91. d on a raised base available in a number of sizes Alternatively a raised toilet seat may be mounted onto the toilet Raised toilet seats are available in a fixed as well as a removable model and a free standing model is also available Some of these versions are adjustable If you are in need of an even higher toilet a toilet chair to wheel over the existing toilet might be a solution A raised toilet seat slanting slightly down towards the front is convenient for people recovering from hip operations If 52 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY necessary a model accommodating persons in need of only one slanting side is available Arm rails can be fitted on the toilet on the wall in the floor or be free standing Most wall mounted rails fold up against the wall to be out of the way when the wheelchair user moves sideways between toilet and wheelchair If none of these solutions provide adequate support the adjustable toilet seat could prove a solution The toilet seat operated by a motor allows for the seat to be raised and also positioned at a slanting angle Toilet seats are available in various shapes with an open front also usable as a bidet seat with extra width and anatomically well shaped seating comfortable for heavy people a curved bowl shaped seat which stabilises the balance etc Loose covers to fit onto the seat are available in a number of types such a
92. databases catalogues books etc use this classification of assistive technology as a basis for their organisa tion and description International classification of impairments activities and participation The WHO World Health Organisation has revised the international classification and 1997 published a draft called ICIDH 2 This new classification ICIDH 2 has 5 central dimensions Health condition Impairments Activities Participation and Contextual Factors These dimensions interact with each other and this interaction may end up with disablement Here are the definitions of the dimensions and of disablement MLA Health Condition A health condition is an alteration or attribute of the health status of an individual which may lead to distress interference with daily activities or contact with health services It may be a disease acute or chronic disorder injury or trauma or reflect other health related states such as pregnancy ageing stress congenital anomaly or genetic predisposition Impairment Impairment indicates a loss or abnormality of a body part i e structure or body function i e physiological function The physiological functions include mental functions Abnormality here is strictly used as a referring to a significant variation from established statistical norms and should be used only in this sense i e as a deviation from a population mean within measured stan dar
93. does not want the family to help her The consequence is that Ms Europe does not take showers even if she wants to However Ms Europe is an independent lady who do not put up with anything and therefore she goes to the doctor to express her need i e Ms Europe takes the initiative to begin the service delivery process In this case it is Ms Europe who has taken the initiative but the initiative could also have been taken by her family by her doctor a social worker a physiotherapist or others Ms Europe turns to her doctor because she has great confidence in him She could also have turned to the hospital to the local organisation for elderly people or to the rehabilitation clinic etc See Starting the project page 25 Assessment The doctor was however not able to assess the need of Ms Europe but he knew where she could get help and referred her to the local social service centre The service delivery system includes the actual delivery of assistive technology training housing adaptation evaluation on needs etc The way through the service delivery system has 7 steps which are mentioned on this page EUSTAT User Manual March 1999 29 THE SERVICE DELIVERY SYSTEM Before selecting a specific product the needs which the technology shall fulfil are analysed and described into functional requirements Public funding of assistive technology is described in relevant social leg
94. dressing much less complicated for you as well as for your helper Putting on and removing socks and shoes If you find it hard to reach your feet and pull on socks and shoes put your foot on a footstool If that does not help use a sock puller Sock and stocking pullers are available in a number of types accommodating one sock stocking or both socks at a time or for pulling on tights Some types are easier to use than others but in due course you will get accustomed to them A long handled shoe horn assists in putting on shoes without having to bend The most comfortable solution is to wear shoes without laces however if wished elasticised laces could be fitted converting the lace up shoes to slip on shoes forever avoiding the need to tie them Clothing for wheelchair users Clothing designed to fulfil the needs of wheelchair users exist in many forms Wheelchair users coveralls are designed for people who sit and can be used by wheelchair users instead of ordinary outdoor clothes The coveralls cover the upper body legs and feet however also knee coveralls and feet coveralls exist For people using a wheelchair specially designed clothes are available Toilet Using the toilet To make the toilet more accessible the correct height of the toilet is vital There are several means of providing a higher sitting position A raised toilet may replace the existing toilet or the existing toilet could be mounte
95. ds You have e A list of the activities you want most of all to perform priority number 1 s e List of activities you do not have to perform by yourself but they have to be performed priority number 2 and 3 A list of activities which does not matter to you e Description of the problems you have performing your activities e Description during which circumstances you perform the activities This influences the selection of assistive technology or other solutions e Description of the coherence of your different activities relation with other activities The form has been constructed for this manual so you are welcome to change enlarge or minimise it in a way that suits you best 102 May 1998 EUSTAT User Manual Analysing the activity Page __ out of _ Descriptions Activity Problems with the activity Why when where how Describe the circumstances and the place for the activity Inside outside Large room small room Summer winter Often seldom Alone or together with others Etc Future Does your situation change during the next 5 10 years How does this influence the activities Characterise your claims for solutions give perhaps some ideas What do you want in order to manage this activity The wish the dream the feeling when performing the activity What do your family and friends think Importance of the activity 1 Very important tome 2 Not very im
96. e 59 60 Entering leaving and getting around in the house 64 D Entering the house 0 008 65 DAILY hona onn 3 108 Environmental adaptation 12 Databases 40 43 70 72 90 Equipment cost 88 DGS Sepa eo ee ce 3107 TEMS cesacacedincdevseassanctoceas atten ETEN Aini 92 Dealers and producers 73 79 European Committee for DeCiSION ceccecsseeceesseee 14 26 30 86 Electro Technical Standardisation 92 Definition of assistive technology 5 80 European Committee for Delivery 2 4 7 810 14 25 27 Standardisation CEN 5 92 29 30 31 32 34 36 38 39 42 72 European Union Directives 92 80 83 84 88 96 97 99 106 108 EUSTAT eian eas 3 6 110 111 Desigtti csiwivcvess 5 9 10 12 24 26 27 Eye specialist eee 77 78 37 39 42 44 54 73 82 83 96 105 107 108 111 F Design for All 5 9 10 11 12 Felt pads cen eee eee 63 27 39 44 54 58 64 73 82 85 Fibre mattresses cceeceeeeeeeeeeeee 67 98 107 Filling the gap eceeeeeteeeeeeeeees 13 DiaPOlS e R nica densities dette dense 54 Financing 11 29 30 34 36 Disability 5 11 12 29 39 40 68 73 38 39 42 85 74 76 80 81 84 85 89 93 98 Fitting training Cost n 88 107 110 Floor iiS eaen Widener 64 Disabled person 11 57 76 81
97. e a dish with raised edges or an inward turning rim Cutlery A range of cutlery is available to serve most needs If your grip is weak or restricted aim for large chunky but lightweight handles If you have reduced strength in your arms use angled shaped or slightly shaped cutlery with extended handles or alternatively use an L shaped knife to achieve a good downward cutting pres sure gripping with your whole fist A range of loose grips is available Self shaping handles are available These handles are heated and pressed into shape while still warm If you are having shaky hands use heavy cutlery to prevent spilling the food If you only have the use of one hand combi cutlery is available such as combi fork spoon or combi knife fork L shaped knife EUSTAT User Manual March 1999 61 KNOWING ASSISTIVE TECHNOLOGY Figure to the right Free hand tray A pot tipper Cups mugs and glasses Mugs are often available with one or two large generous handles however glass holders with one or two handles may also prove a good solution Mugs with lids and spouts come ina range of different types Plastic wineglasses with thick stems are easy to grip and lift If however you have shaky hands glasses or mugs should be heavy and mugs with two handles and a heavy base or anti splash top are recommended Insulated mugs keep contents hot but insulate heat from hands preventing burns
98. e additional social costs involved by the selected solution Assistance related costs Clarity is important in this category Not the overall requirements for personal assistance must be considered but just the amount of personal assistance associated to the solution provided For instance a mobile stair climber is useless if no attendant is available to load the wheelchair user and drive him on the stair Assistance related costs may not be expressed primarily by monetary values but be better defined by other variables like e g man hours For the purpose of valuating such resources i e to assign them a monetary value in order to make them comparable with technology related costs it is suggested to divide them into three categories A Personal assistance manageable by everybody B Personal assistance that does not require any professional qualification but must have qualities as strength and control e g a young strong person C Personal assistance needing profes sional qualification e g a nurse a technician etc In the market of personal assistance services it is apparent that one man hour of a paid helper is valued differently depending on the category in the calculation of the market price the over time non active time spent in e g travelling to the user s site should also be considered However these figures may vary widely from one country to another and it is not possible in this manual to
99. e drives the wheelchair for more than an hour He then contacts the social service centre again because he realises that it might be a good idea to have a powered wheelchair for long trips in the nature or for shopping Together with the adviser of assistive technology he finds the right powered wheelchair He is trained to manoeuvre the wheelchair to maintain it and a solution is found for the wheelchair transport in his private car He is very carefully to have a precise sales agreement and this time he was unfortunately not able to get all the costs of the powered wheelchair and the car adaptation funded However he is now able to manage his daily activities without overstraining his back He found the best solutions for him after all The diagram on this page shows the steps for achieving assistive technology and where to find the information in this manual See steps to go to get assistive technology page 14 This diagram shows the steps to go for achieving assistive technology See also page 14 1 Defining your needs and goals Use the forms Activities of daily living Analysing the activity and Goals pages 100 104 2 Starting the project Getting information being assessed Here you start to go through the steps of the Service Delivery System Use this manual pages 29 33 70 And use advisory centres advice from other peers and professionals courses 4
100. e important than she had thought She began to walk in her neighbour hood again meet people talk and get some exercise Because of this progressive confidence in herself her husband is much more confident too Germaine believes that one day she will be able to cook again and also to have her granddaughter on visits from time to time Birthe Adaptation of a Car Birthe is an 18 year old high school girl Birthe has congenital deformities of both arms and legs She lacks both feet crus and knees as well as her right hand forearm and elbow Her left hand is defect and she uses prostheses on both legs Initiative Birthe is a very active and open minded person She needs a car in order to get to the high school and to attend leisure activities visits and other social activities She is now 18 years old and can geta driving licence 36 March 1999 EUSTAT User Manual PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS She contacts her consultant at the local council and she is then referred to the PTU a Danish car assessing centre At the centre a valuation is made of her possibilities of getting a driving licence and the possibilities of adapting a car to meet her needs See Going by car page 58 Assessment At the centre Birthe s reaction time her strength at the steering wheel and a hand operated brake are being tested She has a test driving lesson with the PTU s
101. e manual Furthermore students and users from Danish Centre have given comments to the manual All inputs have improved the manual essentially The EUSTAT Consortium also wishes to thanks warmly the external peer reviewers who provided an extremely useful contribution with constructive criticism and Tina Lensvold who helped to revise the English text The photos of assistive technology in the chapter of knowing assistive technology are kindly given to EUSTAT from the DAILY project see page108 The drawings are made by Jesper Deleuran who is the house artist of Danish Centre Lay out by Henriette L gstrup and Klaus Lasvill Mortensen Danish Centre Lilly Jensen at Danish Centre has made the editorial work The manual is available in English Dutch French Italian and Portuguese Copies of the manual can be obtained from Siva via Capecelatro 66 1 20148 Milano Italy Tel 39 02 40308325 Fax 39 02 4048919 Email Siva siva it Homepage www siva it The manual can also be downloaded from www siva it research eustat Users from Belgium France and Italy have made a very profound useful and enthusiastic validation of the manual EUSTAT User Manual March 1999 CONTENTS Contents The story of Mr Europe wiser emo 7 This manua aeaaaee ta aaral daai Ankaa pa daadaa aaier iddiada 8 What to find in this manual ccccccccceceecececcecceccecceeceecceceecceceeeseecteatesass 8 Be
102. e on the market has the social and personal impact that it allows disabled people to a great extent to choose their own lifestyle and pursue personal goals But assistive technology might also have more unconscious impact on the user the surroundings and the society which comes from a society s general attitudes toward disability and disabled people 80 May 1998 EUSTAT User Manual FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY Attitudes towards Assistive technology The presence of persons with disabilities in the mass media especially television is growing The assistive devices the wheelchair cane of the blind the walking frame are often used as a symbol to illustrate a weak and help dependant person So the assistive device here is a stigma to label a person Television might insert disabled people in a dramatic context or associate them to a sad comment On the contrary the disabled people may be avoided as the sight of such persons is not nice for other people to look at On the other side the mass media might describe the disabled person as the happy handicapped man who is fighting and keeping a stiff upperlip although he is so unlucky to be disabled Such descriptions in the mass media show the attitudes of the society in general towards disability and assistive devices and of course often the disabled people feel that way themselves The step from being a
103. e some characteristics of counselling e An intense relationship The counsellor and the user meet together for a serious reason and build an emotional and intimate relationship e New information new viewpoints new interpretations new original images of the future concerning the problems of the user are achieved e The conversation uses a language which is fitting the user s needs adopting precise terminology avoiding negative connotation is open to different possibilities and is turned to the future e Opportunity of successfully testing new instruments new technologies and methodologies during the counselling session thus nurturing the feelings of ability and self control The aim of counselling is to help the individual user to make choices and take initiatives by giving information helping to understand one s own situation and favouring motivation Peer counselling peer mentoring and role modelling A person with disabilities who has achieved thorough knowledge and experience in using assistive technology can be of invaluable help to other disabled peers in finding solutions to their needs They may help to understand one s own situation give information favour motivation and serve as a model Peer counselling means counselling carried out in a short period on the basis of personal experience and it is limited to aspects of life that are common to the two actors Another peer help role that is built
104. e sores In the shower unit hand rails should be fitted to ease the acts of sitting down and getting up SS gy If you cannot reach the mixer taps when seated in the shower a shower handset is available with a turn on turn off device on the spray head Washing hands and face If the washbasin is used by people sitting as well as standing an adjustable washbasin should be considered Manually operated as well as electrically operated washbasins will of course need to be supplied with a flexible drainpipe allowing for the up and down adjustments Small knobs and handles are easier to turn if you use a tap turner with extended handles Alternatively either the old handles or the entire mixer tap can be 50 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY replaced by long handles or a model more suitable for the user Extended handles are available for one handled taps as well as two handled taps Using comb bath brush etc If you find it difficult to use small items such as comb and toothbrush handles should be large or angled You could either wrap the handles in plastazote a soft foam material to obtain a comfortable size or buy items already fitted with larger handles For a knife or scissors the plastazote can be cut to the preferable length and is available in a number of sizes If you have difficulties in reaching the back of your neck and your back combs and
105. e stories of success page 33 She realises that for each activity she has to consider if her goals could be reached by training changing the sur roundings having assistive technology or using personal help See Assistive technology or other solutions page 13 And Ways to fill the gap between you and your wanted activities page 13 But before she contacts the expert in the technical aid centre of the municipality she wants to know more about the possibilities on her own hand She talks to a friend who works as a nurse and afterwards she visits to the library to find some information about assessment of assistive technology and overviews of assistive devices Unfortunately there is not much material but she finds addresses of organisations of disabled people and she phones to some of them to learn more about the process of getting assistive technology She is informed about fairs which exhibits assistive devices and of the local groups of disabled people where she might find somebody who has problems like hers and then can advise her from their own experience One of the organi sations of disabled people gives her some web addresses When she search at the Internet se page 70 she finds dealers and other information on assistive technology Empowered she visits the local technical aid centre bringing her perso nal list of activities and goals See The service delivery system page 29 Ana
106. e sure to have written instructions of use cleaning and maintaining and be aware of having the necessary training in the use of the assistive device Get a written sales agreement with 2 9 A specific description of the assistive device Description of special adaptations Description of special equipment and accessories Precise time of delivery Notes about free repairs during the period of guarantee including maximal duration for these repairs substitution of the assistive device during the time of repair paying of transport during the time of repair Period of guarantee and period of having spare parts available for a number of years after delivery Maintenance and service agreements Sales price with clearly definition of what it covers special adaptations accessories and repairs in the period of guarantee How the payment is executed 10 Other issues relevant for you All these issues are especially important to have in mind when getting an advanced and or complicated assistive device like wheelchairs car adaptations communication aids etc Ask the technical aid centre to help you define the precise issues in the sales agreement 106 March 1999 EUSTAT User Manual APPENDICES Appendix 7 Addresses and homepages Please notice that these addresses and home pages have been found during1998 They might already have changed Some Pan European organisations in the area of assisti
107. e to tell you where to go In the contact you can either ask for a nurse a social worker a doctor an occupational therapist or physiotherapist or just someone who knows about assistive technology Community services Local authorities In some European countries the local authorities are in charge of the provision of assistive technology Here it would be appropriate to contact either the social or health department in your municipality Medical practitioner consultation You can also ask your doctor about whom to contact in your country to obtain information on assistive technology Often the doctor is the first person who is contacted when it concerns impairments such as e g bad back Physiotherapeutic consultations If you have a physiotherapeutic consultation near by Perhaps here you can obtain some information on assistive technology or at least get information where you can find further information Training centres At training centres mobility impaired people are rehabilitated The training centres have a profound knowledge of assistive devices and will be able to assist you in finding more information on assistive technology Homes and institutions for mobility impaired persons A number of homes and institutions for mobility impaired persons exists They can be found in social registers handbooks etc Here you can also receive information on assistive technology home and car adaptations etc Employme
108. e with disabilities and older people HEART was funded by TIDE Technology for the Integration of the Disabled and Elderly and it was a European Commission initiative to develop new technological tools and applications for people with disabilities and older people to enable them to leave independently and participate fully in the social and economic activities of the community The HEART Study focused on six areas in assistive technology with each area pursued by a line Line A testing and Standardisation Line B Industrial Coherence Line C Service Delivery Line D Legal and Economic Factors Line E Training of Professionals Line F Research and Development The reports can be ordered from Handikappinstitutet Box 510 S 162 15 V llingby Sweden Tel 46 8 620 17 00 Fax 46 8 739 21 52 www hi se And from FTB Grundschitteler Strasse 40 D 58300 Wetter Ruhr Germany Fax 49 2335 9681 19 USERfit Usability section on page 83 A practical handbook on user centred design for Assistive Technology Text from page 12 and page 17 is used in the section of usability USERfit is a product from the project User Requirements Elaboration in Rehabilitation and Assistive Technology funded by TIDE Technology for the Integration of the Disabled and Elderly which is an EU research program The consortium included HUSAT Research Institute UK COO SS Marche Italy SINTEF Unimed Rehab Norway Copies are available from
109. ea This means that it is important to you to know what information and kind of help you need and then ask for an adviser who has the right competence that you need instead of looking for a special profes sion You will find that sometimes e g an occupational therapist a nurse an engineer or a psychologist can give you sufficient help on the same task In many European countries the doctor plays an important role in determining the users need of assistive technology and in other countries it is other specialists e g rehabilitation therapists special doctors social workers etc The professionals described in this chapter are grouped in five categories 1 Professionals supporting activity of daily life 2 Medical professionals 3 Technical professionals 4 Educational and counselling professionals 5 Other professionals Professionals supporting activity of daily life Mobility and handling Professionals supporting activity of daily life know how to assess the functions of your body e g muscle control and strings joint movements and co ordina tion of handling They assess your immediate environment and your home to see if you can manage with your disability and hence they evaluate accessibility and the need of assistive technology They have a general knowledge of the market of assistive devices and they test the assistive devices and train you in using new assistive devices In short they explore an individu
110. ed in five Supporting activities of daily life Medical professionals Technical professionals Educational and counselling Other professionals They can send brochures and give answers to many of your questions on their specific assistive technology for sale Other users of the assistive technology you need If you occasionally meet other people using e g assistive technology you need information about you may approach the person and ask him her for information Even if he she does not use precisely your wanted assistive technology then perhaps you are able to get some gene ral information of the area People who might know about assistive technology Perhaps your neighbour has a daughter who is an occupational therapist Maybe a friend of your friend works at a hospital Maybe your greengrocer s mother s husband is a personal assistant for a disabled person Perhaps a friend of your son is a dealer for a firm producing assistive technology and so on The point is use all resources you know to get the right knowledge in order to empower you for having the optimal assistive device that you need Professionals In this chapter you will be informed of the various professionals within the area of assistive technology and the kind of help you can get from the various professio nals is described shortly The different professions have competencies which varies from country to country and from area to ar
111. ed in the diffe rence between the social cost of the new situation and the social cost of the old one for mobility communication and relation you soon experience that the pricelist figure is just a component of the initial investment How much do installation personalisat ion and training cost How much do maintenance and repair cost how many secondary costs will you bear in relation to the use of such device Will that wonderful electronic wheelchair which allows you really good independence at home and in the neighbourhood require to rent an adapted van when you need to go far away since it is too bulky an amount for human resources Furthermore how much does the assessment selection prescription and delivery process cost And finally how much would it cost to renounce the technical aid to give up solving those problems that the device would allow to overcome When evaluating alternative solutions to the same problem the balance between costs involved and expected outcomes or benefits is an important decision parameter However it is important to look at the overall costs borne throughout the whole period of time over which the assistive technology solution is used and not to just the apparent initial cost The long term perspective often reveals unexpected surprises for instance that the apparently most expensive solution in terms of initial cost gave rise to a tremendous cost reduction in the long ru
112. eeeeeeeeeeeeeeeees 55 Medical professionals 76 77 HONS OU eee aa UP OCG Medicine ceansa 54 62 84 Information resources 5 9 44 70 Milk containers 61 Initial costs 0 0 ee eee eeceeeceeeeeeeeeeeeees 88 Mini keyboard sed Sp elt a ae oon Bolt 45 IMANE en Bs de PRI 98 Mobile hoist otidin 57 65 36 38 40 82 92 93 94 108 110 A e E E A TEA N A 63 Insulated MUGS cccceeeeeeeeeetteees 62 Mopping the floors sccssccssseeesseeeseeeee 63 114 March 1999 EUSTAT User Manual APPENDICES WV Col UES gt 1 k 0 45 Mouth and chin stick cceee 45 MUS i ccs AU oh Be bane 62 MUSIC oeeie naine aiii 45 68 73 N National resource centres 73 Accessibility and design for all 73 Needlework niecce 45 67 68 Needs 0 4 7 12 13 14 15 17 24 27 29 30 31 33 34 36 37 38 39 40 41 44 49 52 54 57 58 61 64 67 68 73 74 82 83 84 85 88 92 93 94 96 97 99 102 107 Netscape icici eie aiiies eee 71 Newspaper Stand cccccceeeeeeees 46 Newspapers ceeeeeeeeees 44 47 49 Noise maker ccceeeeeeeeeeeeeeeeeeeeees 59 Non slip Mat cccceeeeeeeeeeeeees 61 62 Non slip Strips cccssseeseeeeeeeeeeeeees 50 Number memory 2 00 0eeeeeeees 48 NUSES eiois cece nicctieich eth ead 76 77 78 O Occupational therapist 27 30 35 36 75 76
113. eeeeeeeeeeeeeeeeeteeeeeenees 85 ASS SANG AU OM cry tw ae ese Gece dad Sete ea eect S 89 Standardisation and quality assurance cece cece ceeeeeeeteettettttttteeaees 91 Research and development ccccceccccccccceeeeeseseeeseeeceeceeseesseseaneeneeeeees 93 The next challenge from enduser to peer counsellor cccceeeeeeeeeeeeeeeees 94 Counselling sena E e Eae tages chads E rA tian toagacundee ned eee 94 Using the manual for peer counselling 0 ceeceeeeeeeeeeeterceeeeaeeaeeeeees 95 Analysis of daily activities 0 0 0 0 ccc cccccccceeceeeeeceeeeeeeeeeeeeeeeeeeeeeteeeteeeeeeeees 95 Defining VOur GOalS wien 28 sacle et aie i Ac a in UE a ae 96 Starting the Project rss aea a a a a aa N ae Eaa E A 96 Decisions and SOMOS nesmen nay e E D E E a 97 For you who want to KNOW MOSE ceeceeeeeeeeeeeeeceeeceecaeecaeeaeeeeeeeeeeees 97 PDD CINGICSS oi aiian aaan aaa aeaa aaa aAa aE 99 Appendix 1 A diagram showing the steps for achieving assistive technology 99 Appendix 2 The form Activities of Daily Living n1snnseeneeeeeeeeeeerreeereerreerrrerrrrrene 100 Appendix 3 The Form Analysing the Activity 00 cccccccccceceee tee eeeeeeeeeeeeeteeeeeeeees 102 EUSTAT User Manual March 1999 5 CONTENTS Appendix 4 G l Sasa tiie Wane ieee van ce a ies ee co 104 Appendix 5 Validation of Assistive TeChnOlogy cccccccceeertteeeeeeseeeette
114. eelchair for shopping and going on trips in the nature and then the car is not suitable any more 5 After that you must characterise in which way you feel your needs can be fulfilled or your problems might be solved in order to find your special wishes for the solutions This part might be difficult to describe precisely but sometimes it helps to list how you do not like the solutions to be After that you might be able to tell which qualities or ways you feel is necessary in order to reach the right solutions for you Here it is important to discuss it with your partner children parents or other near relatives or friends what they think and feel about having assistive technology If they do not feel happy then find out why and have a discussion of mutual aims if you find it important 6 You also have to give the activity a score to tell how important the activity is for you This allows you to use your time and energy for the activities you find most important and you can focus on them when working with the solutions of the problems of the activities of daily living 7 In the column on the right side of the form you note if any of the problems circumstances future situation etc have relation to one or more of your other activities This allows you to find some general trends in your analysis which helps you to define your goals When this analysis of the daily activities has been made you have described your nee
115. eight and they all have one or another sort of brakes and rollators with trays baskets and rest seats are available A trolley is for indoor use and is just of frame with four wheels and shelves Around in a wheelchair Within the area of wheelchairs you may first distinguish between manual and powered wheelchairs A manual wheelchair can be designed for self propelling or for attendant propelling i e for transport A wheelchair which you drive yourself by moving the wheels with your hands is a self propelled wheelchair Here most models also have handles to be pushed when you prefer The attendant propelled wheelchairs can be designed for transport only or for sitting the most of your time and then they often are called comfort wheelchairs and have seats like comfortable restchairs Many models of the manual wheelchairs can be folded in order to be transported by car Small power motors are available as supply for manual propelled wheelchairs which gives the possibility to have power when you need it or to help the driving for a helper with little strength For daily use or for those who live an active life lightweight and high performance wheelchairs have been developed These are self propelled manual wheelchairs but are usual lighter and easy to propel but they may also be less stable They require less energy to move and thus they enable the user to cover difficult terrain or longer distances They
116. er informa tion and insight about a number of outstanding programs that adopt different approaches This book is divided into two parts Part One is devoted to analysis of existing educational programs in AT It contains a detailed section by section discussion of the data obtained from the survey description of seven programs visited on site and 87 programs analysed on the basis of the questionnaires Part Two presents the obtained data in both numerical and graphical form Critical factors involved in end users education in relation to Assistive Technology Available in English The term critical factors refers to aspects that deserve careful consideration when approaching the transfer of knowledge to end users so as to achieve empowerment or prepare the ground for it This report identifies describes and analyses such critical factors and gives rise to a conceptual framework for the development of educational initiatives The main concern of this study is the process that leads from expression of the need to the choice of AT Chapter 1 introduces the philosophy of the EUSTAT project clarifies some basic concepts and describes the contents and methodology adopted Chapter Two deals with the relationship between AT and end users and describes knowledge transfer as a key factor for bridging the gap In Chapter Three a systematic classification of critical factors is given This is based on a model of the educational proc
117. er is a useful helping hand when reaching out for clothes or pulling on sleeves Reachers are available in a number of types made of various materials and with different types of grips Some can also be folded Using buttons and zippers Buttons and buttons holes should be easy to do up However a button hook can prove useful when passed through the button hole it grips the thread of the button and with a twisting motion you pull it back through the hole Alternatively buttons could be replaced by Velcro fasteners which require no accuracy and can be handled with one hand only If you wish to replace the Dressing stick Figure to the left Toothbrush Reacher EUSTAT User Manual March 1999 51 KNOWING ASSISTIVE TECHNOLOGY Button hooks Figure to the right Raised toilet seat Sock puller buttons in a shirt with Velcro fasteners stitch up the button holes and sew on the buttons on top of what used to be the holes The shirt will not look any different but it will be much easier to button up Zippers can prove hard to work To make this easier a zip puller loop could be fitted alternatively you could use a dressing stick or hook If you have from severely reduced strength or if you have prosthesis or callipers your clothes could be fitted with zippers in the seams to avoid buttons completely and to make it possible to fully open trousers and sleeves This will make dressing and un
118. es As a freelancer in Italy she cannot rely on the same level of welfare protection as it would be for a hired employee Therefore a major point is to find a solid and long term of employment She begins to contact previous customers and finds that the above mentioned factory is seeking external contracts for the design of a new line of furniture After a meeting the production manager is willing to offer Elena a contract since she has the right expertise but at a first glance it is not clear how the work could be organised The problems that both Elena and the firm would encounter look insurmountable within a traditional work organisation Assessment Elena has two meetings and a home visit with assistive technology counsellors of the advice centre of assistive technology a department of the rehabilitation facility which Elena regularly attends for follows up treatment During those meetings she has the opportunity to discuss specific problems to look into databases of assistive technology to find out informa tion on related issues and create with the guidance of the team a list of specification to be taken into account in designing solutions The result of the assessment is that e The possibility of access to and living in the flat seems realistic e A right tele working arrangement could allow her with her professional expertise a rewarding and profitable job Other possibilities are also considered for t
119. ess that embraces the sequence of logical steps through which a body of knowledge takes shape in the mind of someone organising an educational initiative is delivered to end users and gradually brings about their empowerment Chapter Four lists supporting literature and also includes a comprehensive review of selected handbooks on AT deemed useful for end user education For More Information refer to the EUSTAT website www siva it research eustat EUSTAT User Manual March 1999 111 APPENDICES Appendix 10 Index A ARATE Coina a 93 107 109 A headset eeeeeeeeeeeeeeeeeeeneeeeees 47 A wall mounted tin opener 60 Accessible 0 00 0 82 84 85 92 Accessibility constructor 5 78 Activities of Daily Life 9 77 Activity 1 4 6 9 10 11 13 15 16 17 18 19 20 21 22 23 25 26 28 42 76 89 90 91 95 96 102 ADA eb kise se Seri atte es 54 85 Adjustable doorsteps ceee 65 Adjustable stool cccceeeeeeeeees 59 Adjustable toilet seat 05 53 Administrative workers 0008 79 Advice Centres 00 ccceeeeee 73 74 Air or water mattresses 67 Alarm CIOCK asninn a n 66 49 Alarm clock inni neea uaaa 66 Analysing the Activity 6 7 9 17 18 19 20 21 22 23 95 96 99 102 103 104 Bed raill nn
120. f incorporating the computer control in the joystick was explored Henrik had a demonstra tion of The Voice Control Program EUSTAT User Manual March 1999 33 PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS Henrik needed an alternative to the word processor if his voice should fail He found a small touch sensitive mouse where the direction and speed of the cursor can be controlled by placing a fingertip on the rubber membrane of the mouse A speech therapist assisted Henrik and his helpers in identifying and selecting words phrases etc for the voice control which he found most promising Henrik and his social worker had a demonstra tion of The Voice Control Program Despite a few start up difficulties Henrik was very impressed However when the program is opened for the first time control by voice is not possible because the software lacks the desired commands Also words sentences and a special alphabet a so called radio alphabet e g alpha bravo charlie used for spelling must be keyed in and voice recorded Since the program operates via voice recognition of one voice only it is imperative that the person in question pronounces words and commands in the same way every time The program operates in Windows which means that a user is able to use all the text based programs in Windows Henrik and his social worker were very enthusiastic Henrik had some reservatio
121. f types and offer the freedom of communication to deaf people to people who are both deaf and blind or people who have severe speech deficiencies Security and safety alarms If you are mobility impaired and live alone a security and safety alarm system could prove a nice solution The system consists of an alarm call connected via the local or national tele company and activated by the touch of a button The sender can be worn ina string around the neck or in the pocket If activated the alarm call is received at the nearest police station or at the local services Some alarm systems offers the possibility of direct contact with staff at the local services Listening to the radio and watching television The control panels on radios and televisions may vary so you should look around before deciding what to buy Small knobs may prove difficult to turn if you have arthritis or rheumatism If you find it difficult to move around a remote control supplied with most radios and televisions today could prove a good solution Small buttons on the remote control are likely to prove difficult to work if you have problems controlling your finger movements Radio and television controls can also be adapted to an environmental control which much resembles the ordinary remote control However the environ mental control enables you to work not only radio and television but also light 48 March 1999 EUSTAT
122. find solutions your goals They must correspond with your lifestyle and your family your wishes and dreams The variety of your activities contains a joint and total view of your situation Here are two forms which function as tools for describing and analysing the daily activities in order to find the best solutions to solve problems of activities of daily living Form of activities of daily living In the following form you must list your daily activities which give you any kind of problem performance You must list activities that you would like to do and the activities you would like to change or end either because you cannot perform them now or because they give you too many problems pain or stress Go through your daily life and list all your activities which give you problems in performing Then go through an ordinary week then a month and then a year and list the activities you have not mentioned in the first list You can use this form as a guideline however making it complete with all your own activities which are not mentioned here and finally remember to put on new activities which you would like to do The form has been constructed for this manual so you are welcome to change enlarge or minimise it in a way that suits you best You find a blank form for your personal use at page 101 Ms Hansen has filled in the forms on the following pages Two forms function as tools for describing and ana
123. ganisation 89 GIA ee a t emaa nana 3 71 Internet Explorer cccccceeeeeeeeeees 71 GIASSES oo eee 11 59 62 75 Ironing board 0 ceeeeeeeee eee ee eee 64 Glid CUSHION ccccceeseteeeeeeetteeees 66 ISOS riinan an 9 89 92 Glide she firi a 66 ISO classification cccccccceeeeees 89 Goals anpa da ead 102 104 Grating r ee nien kene 59 J GUD E 45 46 51 59 61 Jaropenersse ctent arcelsauneere cen 60 62 65 67 68 78 Joystick oo 33 35 40 45 46 H K Hand rails poera 49 50 Keyboard attached to the telephone 48 Hand stick tiini ana 45 Keyboard substitute cccceeeee 45 Hand driven bike 00 0 0 ee OE Kitchen usisni 58 Handicap ccccceceeeeeeees 80 89 107 Kitchen 12 23 41 59 65 Hard of hearing 47 48 59 66 Kitchen sink icon neo eee 58 FI AG STICK oeeo E SA 45 Knitting MACHINES cc cc cccccccceccccccccece 68 Health Condition cccccccceeeeeeeees 90 Hearing 35 44 47 48 66 73 74 L rE OE L shaped knife ees 61 Hearing AIG AE pease 47 75 82 Legislation ane eae 2 30 41 72 Hearing and vision clinics 74 Letter and symbol boards 47 Incontinence advice centres MAS Wide coset te 5 Panos hee est cece 59 62 Orthopaedic CIINICS 1 0 eee 73 74 Lifting Reis oo 44 56 57 59 63 66 72 RESO Un ENCES ae OAS Pilling Oleg e t
124. give indications that make sense all over Europe What is important here is to understand the conceptual bases of assistive technology cost analysis We hope that this chapter has described this base in an understandable way See about the CERTAIN project page108 88 March 1999 EUSTAT User Manual FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY Classification The main objective of a classification in Assistive Technology is to help every one involved in the area users professio nals assistive technology providers researchers manufacturers vendors etc to use the same language so mutual communication and understan ding is promoted between the different actors working in the field This will among other advantages lead to Uniform classification in order to facilitate the search for and selection of information on assistive technology e Uniform terminology which can be used in product information prescription guidelines legal documents catalogues etc e Basis for the production of statistics with different levels of refinement in order to evaluate the levels of use of different devices etc It is also important to stress that an adequate system of classification can be used as a key to information Such adequate system can help any actor involved in the use development and prescription of assistive devices to find the best assistive device which ca
125. h engine which is a program that specifically are used for finding home pages concerned by a topic There are many different search engines all over the world such as http www altavista com http www yahoo com or http www hotbot com where you can search for homepages concerning a specific topic The search engines are functioning in different ways but on most of them you can search by a keyword or by a phrase Many organisations aim to build servers on assistive technology But it is an important and difficult work to collect significant data on the existing devices or services and many projects fail on this point Anyway you can on the Internet find information of organisations in the area of assistive technology municipalities producers and dealers of assistive technology and organisations of disabled people etc Databases A database is a computer based system of collected knowledge which is systematised so that you can search for specific items and find precisely what you are looking for If you enter a database on assistive technology you may e g be asked the following questions in the beginning do you want to search on base of e classification se page 89 producers product name e key words If you answer key words you are asked to write your key word on a special place in the computer screen and e g press the key enter If you have written wheelchair as your key word the data base will pro
126. h them on the operational details Delivery Having taken direct contact with the suppliers Elena directly negotiates the conditions of delivery installation and testing She has technical expertise to interact with suppliers and to evaluate the appropriateness and quality of the devices provided and the adaptations carried out However before beginning payments she also asks for the Advice Centre to inspect the equipment provided and installed correspond to good practice The bed will also be inspected by the physician who prescribed it as required by the National Health Service procedure Follow up Now Elena lives in her flat and Elena has agreed in a job contract with the factory Her daily work consists of designing components and assemblies through the computer aided design software and compiling specifications by means of a word processor and a spreadsheet The product of the work is sent by electronic mail to the factory according to planned deadlines After quality checking it is implemented in the computer aided manufacturing system for constructing the piece of furniture The job involves intensive discussion with other members of the design team and the production line This is organised through e daily exchange of messages through electronic mail with the leader and the other members of the team e video conferencing meetings when needed 42 March 1999 EUSTAT User Manual PEOPLE AND ASSISTIV
127. he future like independent driving of an adapted van but Elena prefers to proceed step by step and return to them in the future Concerning personal assistant Elena is referred to the Municipality Social Services A team assesses the personal assistance needs On the basis of Ele na s proposals and available human and financial resources the Social Services finally negotiates with her on the personal assistance scheme to be applied for Typology of solution The chosen solution worked out in agreement with the Advice Centre consists of four major elements 1 Access to the flat an elevating plat form to be installed on the side wall of the stairs that leads from the building entrance to the flat installed with remote control door opening systems for both doors 40 March 1999 EUSTAT User Manual PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS 2 The flat e Adaptation of the bathroom for wheelchair mobility and transfer to the sanitary equipment such as toilet shower etc Remodelling of the bedroom kitchen and work site with proper furniture which she can easily access and use Air condition and environmental control system an electrically adjustable bed A ceiling fixed hoist with tracks leading from the bedroom to the bathroom in order to reduce falling risks during the most critical transfers in the morning and at night when going to bed The hoist has the aim of relieving
128. he gap between one place to another A turning disc may be helpful if the person can stand for short periods Sliding sheets and cushions may be helpful in moving and rising in a bed and a chair 56 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY Lifting poles are available in many models for beds chairs and bathtubs They are a good help for people with strong hands A wa a Min w D untu A mobile hoist is used for lifting people from one place to another It stands on the floor and has wheels There are several types of hoists so it is important that the disabled person and his family are involved in assessing and selecting the hoist You can have them hydraulic manual operated and electric operated Lifting by a hoist always needs a helper One type of the hoists called standing hoist lift the person while he is standing on his legs which are supported in such a way that the person do not collapse Many people inclusive the helpers feel that this type is more convenient than the traditional type An electric hoist consists of a hoist motor attached to traversing trolley a spreader bar with sling or other attachments which is fixed at the lower end of a spool of tape fitted in the motor box and pull cords or a pendant control box It runs on an overhead track which is either ceiling or wall mounted or on a track fitted to a portable frame gantry It is suitable
129. he old one 2 The same amount 3 Less the new solution requires fewer resources than the new one In the last case we can use the term cost reduction more correctly Coming back to the above example let s imagine you find an expensive assistive device which allows you to wake up and dress independently without any need for help by your husband Let s keep aside here any judgement about which of the two solutions makes your life more comfortable Let s discuss on pure economic grounds It may be true that you spent a lot in technology but it is also true that the 30 monthly hours of you husband s time are made free If your device is going to work well for five years you can evaluate the overall balance between the purchase installation maintenance cost spent in those five years and the 1800 man hours saved 30 hours x 12 months x 5 years Depending on how much you weight those savings e g by considering the correspondent money you would have spent by hiring a professional helper for the same number of hours you may conclude that in the long run you achieved a remarkable cost reduction Which elements to consider as additional social costs Each assistive technology solution involves basically two categories of costs e Technology related costs equipment fitting training maintenance associated services e Assistance related costs associated to the technology provided An assistive technology so
130. hing is possible with assistive technology design for all accessibility changing working methods or using personal help Please do not give up until you are certain that you have got the best obtainable solution for you and your family If you feel that you do not have the strength yourself to make the necessary research then get help from your family friends or other relatives or try to contact another person who uses assistive technology You must in all cases try to find the best advisers in the area and inspire them to work enthusiastic with your Case You are the expert There are many ways to solve problems and there might be many opinions on how you ought to live and manage with your disabilities Even if the advisers in the area of assistive technology supply you with some solutions to your pro blems then do not think that their opini ons count more than yours and that you have to accept a solution if you do not feel it is the right one You are the only person who knows what is right and good for you You are the expert in your own matters then go on asking questions and telling about your problems feelings and dreams The design as a whole the look and the colour of the assistive device are often subject to discussions between users and advisers The user finds the assistive technology as a part of his identity and personality and therefore has difficulty in accepting an assistive device which he finds unat
131. hions and lifts for persons and wheelchairs and many individual adaptations are possible to make in order to get in and out of the car and to transfer you and your wheelchair walking frame etc See Birthe Adaptation of a car page 36 Climbing staircases Some wheelchairs are constructed to be able to climb staircases Another way to climb staircases is to have a so called stairclimber which is combined with the wheelchair and climb the stairs There are models which the user can manage himself and other models which needs an assistant Aids for housekeeping To keep the house or flat in order cooking etc are other essential activities for being independent In the following a number of aids for house keeping activities are described Kitchen arrangement Here are a few and not complete recommendations for arranging the kitchen for wheelchair users It is important to contact the appropriate advisers in order to get the right solutions See Housing and environmental adaptation page 11 Information sites page 73 Professio nals page 76 Design for all page 82 Usability in design page 83 If a wheelchair user is going to work ina kitchen it is necessary that there is a turning space of min 170 X 170 cm Most functions in the kitchen take place at the hob and sink together with the preparation place in between These workplaces must be without lower cupboards so
132. ht prove more difficult to use than a shower if you have a tendency to lose your balance if you have stiff muscles or if you have reduced mobility Hand rails should be mounted on the wall perhaps combined with floor fitted support rail Bath rails to clamp onto the edge of the bathtub might also be useful Figure to the left Television magnifier EUSTAT User Manual March 1999 49 KNOWING ASSISTIVE TECHNOLOGY Bath rails Figure to the right Bath stool fixed on the wall of the cabinet It can be folded when not used Bath seat Figure to the right Adjustable washbasin Bath stool Figure to the right Extended handles Many people find that sitting down or getting up from the bathtub causes difficulties To ease this problem a bath seat perhaps with a supporting back could be a solution Alternatively a board resting on the bath edges or braced firmly against the sides of the bathtub could be a comfortable solution Bathtub swivel seats are also available making the tub more accessible To minimise the risk of slipping non slip strips should be attached to the bottom of the bathtub Bath stools for showering are available with or without arm rails back supports and wheels and in a number of sizes and heights Some models can be fixed on the wall of the cabinet 16 and be folded when not used It is possible also to have padded seats in order to prevent pres sur
133. i R a cen 66 Bed raisers cceccceeeeseeeeeeeeeeeeeeeaes 66 Bed rope ladder 2 00eeeeees 66 Bed table nense i a 66 Bed tape ii aa a ates 66 Bed wedge isorinis 66 Bedlinen e i eee 66 Bedside COMMOAGE 2 cccceeeeeeees 53 Bidet Sea teiist nti a 53 Bikes sees hits ease eee 44 Books 44 46 47 49 66 70 72 90 Bottle openers ceeeeeseeeeeeeeeeeees 61 Bottle tops 2 0 ceeceeeeeeeeeeeeeeeeeeees 61 Braille SySteM ceeeeeeeeeeeeeteeeeeeeeee 47 BrOWSED cccccceccceeeceseeeeeeeeeeenee ees 71 72 Bucket holder cccccseecceeeeeeeeees 63 BUQQIES noie Teinie Ae 56 Button hook arria ai n a 51 Buttons 11 34 45 47 48 51 71 C Call indicator ccecccceeeeseeeeeeeeees 48 Cap removers cccccccccceeeeeseeeeeeeeeeees 61 CAPS EE EERE EE EE 3 110 Cah vani 5 7 8 12 13 14 16 17 27 37 38 55 58 73 90 91 102 106 109 Analysis 0 4 5 8 9 17 24 25 Cards with large figures 000 68 30 39 44 49 86 95 96 102 104 Carving apparatus ceeeeeeeeeee 60 108 111 CCTV SYyStEM 2st ceil ee teoes 46 ANLH Belgium n 109 CD ROM 34 43 73 108 Anti Splash top eceeceeeeeeeeeen 62 CE abelling occ joecass csesctcces ected oats 32 Arm raillS airea reas 50 53 Centres of assessing Assessment 4 8 12 25 29 33 35 driving possibilities
134. identification of career goals Other professionals In the area of assistive technology you will certainly meet some of the following groups of professionals Administrative workers These are the persons you speak to on the telephone who write the letters you receive and maintain databases etc Many of them know much about where to turn with certain questions Dealers and producers of assistive technology These two groups have also often a wide knowledge of the specific assistive devices which they produce and sell Consultants from disabled organi sations The larger organisations of disabled people have now and then occupied their own consultants in the area of assistive technology in order to help their members through the professional jungle These consultants often have an immense knowledge about the legislation of the area and of where to turn when things seem hopeless Researchers in the field of assistive technology You may meet some researchers because they may want to ask you questions register you for their research or to have you testing a new assistive device They have often a profound knowledge on specific areas of assistive technology but this knowledge is not always of practical use to you Any way they might be able to give you some ideas of where to go and where to seek information Educational and counselling professio nals e Educator Vocational evaluator Rehabilitation
135. ily activities as well as you once did sometimes you may only need service such as training recreation changing some daily routines etc So before you ask for an assistive device check if your physical state is still working all right Have a consultation at your doctor and write your problems and questions down and bring them with you to the doctor to be sure to remember everything If the doctor tells you many things which might be difficult to remember then ask him to write down the answers for you Assistive technology which might seem as a help can take some activities from you and make you more weak than your body already is if they are not really necessary Ways to fill the gap between you and your wanted activities Hans is 22 years old and he was paralysed in most of his arms and legs in a car accident He wants to continue his studies as he did before the accident He has received training in sitting and balance and is now able to use an electric wheelchair to get around At first the college had three steps at the entrance however they were levelled so Hans is now able to enter the school Hans cannot write with a pen because of his weak arms and hands but a compu ter is adapted for his needs and use with which he can perform his work at college and at home It costs Hans too much effort to use the toilet by himself although he has trained to manage by himself To save his strength for the communicat
136. in the grip use a potato peeler fitted with suction pads or clamped onto the edge of the worktop Alternatively the table mounted grater and peeler frame is available The potato holder with suction pads holds the potato while being peeled A vegetable brush is also available with suction pads Measuring and weighing If you have visual impairments easily read scales designed with big clearly visible figures are available Another solution could be the use of different sized measuring spoons and cups Openers A wall mounted tin opener with an adjustable platform is a good solution but electric tin openers are also available Jar openers of various types and sizes are available either mounted on the wall clamped onto the edge of the worktop or hold in the hand 60 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY Milk containers are often difficult to open Use openers available in various types or the combi opener Bottle tops are easily removed with either wall mounted bottle openers or cap removers which when pushed over the top effortlessly pulls off the top when lifted Eating When eating place a non slip material under the dishes to keep them from slipping Dishes and egg cups are available with suction pads however vacuum fixed dishes to place on the table are also available To make food easily accessible to spoon or fork us
137. ining house Gardening New activity EUSTAT User Manual May 1998 101 APPENDICES Appendix 3 The Form Analysing the Activity With this form you analyse your activities in order to find the best solutions for you whether it is assistive technology training adapting housing or use of personal helper You fill out a form for each activity mentioned in the form of Activities of my daily life When you have described each activity in the form you have described your needs You do like this 1 In the first column you write the name of the activity 2 Then you describe which problems you have in performing the activities in the next column 3 Next you have to describe under which circumstances you perform this activity Whether it is on the beach in school while doing the laundry Are there special conditions to be aware of like many children nearby cold weather small rooms etc 4 So now you must consider your future situation which might have some influence on your actual choice of assistive technology Take into con sideration that you might change your mind about some of your opinions and choices now so do not close doors by finding solutions which excludes other possibilities unless your are 110 sure of your decisions E g you do not need a car with room for a wheelchair because you manage quite well walking on your legs Later you discover that you would like a wh
138. ion new solutions the heart of the matter Page 10 e Design and what it means to you Pages 82 83 e Adaptations special for you Pages 11 83 e Accessibility in your home and the near surroundings Pages 11 82 83 How your family feels about assistive technology and your situation and what it means to your solutions Page 80 Defining your goals It may be rather difficult from the many forms of analysing the activity to make a satisfying definition and overview of the goals for daily activities and assistive technology But do not get worried because the forms contain all you need it is just to pick it out The way to get hold of it is this e Go through the columns of future situation and note the issues which are mentioned again and again and the issues you find important and then you have found some important characteristics of your solutions Y Hey ov man Oe KEEP YOUR HANDS OFF MY FRUITS e Do the same with the issues written in the columns of characterise your claims for solutions The column which describes the relation with other activities for each activity gives you a general picture of what the problems are and illustrate your personal attitude and ideas of your wanted solutions e The description of the activities and the priorities easily tell you what kind of activities you find most important Every person on his own must do this analysis of the personal
139. ion with his fellow students and the homework he has a personal helper for going to the toilet at the college This case shows 4 different ways to fill the gap between you and your wanted activities 1 You can receive training to perform more than you perhaps are able to do at the moment Hans balance and sitting performance has been trained 2 The environments can be changed so you can manage without further problems The steps of the entrance are levelled 3 You can have adequate assistive technology to perform the activity The computer for homework 4 You can have a personal helper for activities which you cannot manage yourself or activities you want help to perform If you at any time consider the possibilities for solving problems of daily activities you have to go through these four ways of filling the gap and find the best solutions or combination of solutions 23 f ge d gt 2 x A LE SAY oy ay Before you ask for an assistive device check if your physical state is still working all right Assistive technology which might seem as a help can take some activities from you and make you weaker physically There are 4 different ways to fill the gap between you and your wanted activities e You can receive training e The environments can be changed e You can have adequate assistive technology e You can have a personal helper a f EUSTAT User Ma
140. ional abilities that the assistive device has to fulfil in order to be accepted as a useful product Standardisation is usually carried out ina co operation between manufacturers scientists government authorities and sometimes consumer associations In the case of standards for products aimed at disabled and elderly people the participation of users is a point of the utmost importance in order to ensure that new technological products are accessible to all citizens See Terms of sale written guarantee page 27 Design for all page 82 Usability page 83 The new Classification emphasises the role of assistive technology by saying that assistive devices can allow a more adequate partici pation of persons with disabilities in social educational and work activities A standard for an assistive device is a technical specification outlining the requirements for safety security and functional abilities that the assistive device has to fulfil EUSTAT User Manual March 1999 91 FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY In Medical Devices Directive which includes technical aids for disabled persons the devices are classified into one of four risk classes depending upon their intended use A manufacturer can test if his equipment offered to the market has met the claimed standards In this case the equipment is allowed to be mar
141. ised for searching on the WWW called a browser such as Netscape or Internet Explorer You might have other programs to connecting the Internet e g conference programs and chat programs but you will have access to both mail and homepages without these programs When you launch your browser it might look like this Hep lh ogee eee gar Ve gered CONTE g tt 2 G 2 4 ome iia eg mee re ee E r pieni pi Friip si k nd fee jaa eee 2 eS P L lre In the zone labelled location you write the address for the server and the li brary URL address you like to access or you might select an address already recorded from your last visit at the Internet To surf on the NET What does it mean When you connect to an address a homepage will appear There you might see different coloured lines that are underlined buttons like in an elevator or different pictures that you can click on These are all different kinds of links and they will bring up a new homepage on your screen This new homepage might be placed on the same server or it might be a new server in another country that you will be connected to If you want to return to the previous page you can just use the BACK button at the top of your browser For instance the homepage of GIHP Aquitaine is served by a Bordeaux University There is a link for Project EUSTAT which leads to the following short page on the same server E
142. islation Contact your national Ministry of Social Affairs for further information on your social legislation At the social service centre Ms Europe s need is identified defined and described in collaboration between Ms Europe and the adviser ex an occupational therapist A home visit at Ms Europe s premises is also necessary in order for the occupational therapist to define and assess the needs of Ms Europe See Analysis at the technical aid centre page 25 Typology of the solution After having identified and determined the needs of Ms Europe a specification of the functional requirements of the technology is made This means that before selecting a specific product the needs which the technology shall fulfil are analysed and described into functional requirements See Goals page 24 Selection Now the adviser knows the needs and the requirements for an assistive device and she is able to select the appropriate devices In this case she selects two handles to be mounted on the two walls around the bathtub and a seat to be placed in the bathtub in which Ms Europe can sit while taking her bath Specific products are selected which fulfils the requirements of Ms Europe and makes it possible for her to take a bath i e solve Ms Europe s problem See Decisions and solutions page 26 Authorisation for financing Fortunately the handles and the bathtub seat was on the list of ass
143. istive technology which can be given to Ms Europe free of charge See Terms of sale page 27 Funding page 30 See the different ways the funding is raised in People and assistive technology Some stories of success under the section of Financing pages 33 43 Delivery The social service centre orders the devices and a technician mounts the handles and the seat in the bathtub at the premises of Ms Europe See Instruction and training in the use of assistive technology page 12 Management and follow up After 1 month the adviser visits Ms Europe in order to see whether the assistive devices really fulfils the needs of Ms Europe See Follow up on the achieved assistive devices page 27 Funding Either social insurance or taxes finance most of the service delivery systems assistive technology in Europe A minor part of the service delivery systems of assistive technology is funded privately Some assistive devices are however not financed by either public or private funds They have to be financed by the user Some European countries have lists of the assistive technology which are financed by public funds a W ima 7 l Often public funding of assistive technology is described in relevant social legislation so please contact your natio nal Ministry of Social Affairs for further information on your social legislation The funding can be either direct or indire
144. ition then a psychologist can often analyse your situation and recommend specialised training and assistive technology The psychologist also evaluates individual learning and managing potential and assesses need for individual and family counselling In this area you may also meet occupational therapists social workers and educational professionals working close together with psychologists Seeing and hearing Vision and hearing doctors assess visual and hearing perception and the connected disturbances in managing daily activities In this field you will often find psychologists occupational 1 HAVE No IDEA BUT Look HEIS WRITING SOMETHING therapists educational professionals nurses and social workers collaborating with the doctors Medical professionals There are many specialists in the medical field Here are only listed the ones you most often will meet when you try to get assistive technology For each of them their main tasks are mentioned but they may as stated above have elaborated specialised knowledge in the area of assessing assistive technology and some of them are already mentioned in the former chapter Doctor He she checks general health and medical prognosis and determines the appropriate medical or surgical treatments Doctors who work at hospitals or rehabilitation centres are often specialised in specific fields elderly people physical training rheumatism eyes ears sport etc Nurse
145. itions to be aware of like many children nearby cold weather small rooms etc 3 Then you must consider your future situation which might have some influence on your actual choice of assistive technology Take into con sideration that you might change your mind about some of your opinions and choices now so do not close doors by finding solutions which excludes other possibilities unless your are 110 sure of your decisions E g you do not need a car with room for a wheelchair because you manage quite well walking on your legs Later you discover that you would like a wheelchair for shopping and going on trips in the nature and then the car is not suitable any more 4 Now you must characterise in which way you feel your needs can be fulfilled or your problems might be solved in order to find your special wishes for the solutions This part might be difficult to describe precisely but sometimes it helps to list how you do not like the solutions to be After that you might be able to tell which qualities or ways you feel is necessary in order to reach the right solutions for you Here it is important also to discuss with your partner children parents or other near relatives or friends what they think and feel about having assistive technology If they do not feel happy then find out why and have a discussion of mutual aims if you find it important 5 You also have to give the activity a score to tell how impo
146. ity Page 3 out of 6 Activity Problems with the activity Why when where how Describe the circumstances and the place for the activity Inside outside Large room small room Summer winter Often seldom Alone or together with others Etc Future Does your situation change during the next 5 10 years How does this influence the activities Characterise your claims for solutions give perhaps some ideas What do you want in order to manage this activity The wish the dream the feeling when performing the activity What do your family and friends think Importance of the activity 1 Very important to me 2 Not very important 3 Does not matter if can get personal help 4 Does not matter at all Descriptions Going to toilet Cannot sit properly on the toilet because of my stiff hip Cannot rise from the toilet Pain in my knees and hip each time Many times a day also outside home at work at friends etc Perhaps getting worse Must not cause pain and must be safe and clean A seat which allows my stiff hip not to bend A higher toilet Handgrips near the toilet 1 Very important Third column Relation with other activities Write the name of the related activity and shortly describe how the relation is Relation with other activities Almost any time sit down If stress my legs and hip it might get worse all over Counts for all sitting down
147. ivities and the problems managing them are always of vital interest for any person Analysis of daily activities The blank forms activities of daily living and analysing the activity are enclosed as an annex to the manual and they can be copied and adapted the way you find it necessary Pages 100 103 In order to understand and get the idea behind the forms you could profit by either making the first forms altogether or analyse a case like it is done in the manual The case of Ms Hansen page 15 After this the peers themselves fill in the forms of activities of daily living and analysing the activity If the people concerned are not shy and modest it is excellent to fill in the forms in a group not bigger than 4 Here the exchange of knowledge and discussions will bring everybody taking part further in his knowledge about his own way of life daily activities accessibility and the area of assistive technology However it is important to ensure that everybody in the group feel confidant and take part in the work The most difficult but also very important part of the form analysing the activity is to characterise your claims for solutions and perhaps give some ideas Page 18 To get closer to what you feel about the ways you want help and assistive technology it can often be a good idea to write down how you absolutely do not want the solutions to be In this way you can often afterw
148. ivity Would it be possible to find another activity which can give her the same feeling of her body the same challenge Anyway these activities should be found and experienced and not the original sailing activity And the only one who feels and knows this is Ms Hansen Adaptation of assistive technology When choosing an assistive device then be sure that it fits you perfectly and that your goal is obtained in a satisfactory way Any assistive device can be adapted especially for your use and purpose and many assistive devices can be adjusted in various ways Talk to your adviser and supplier about the problems and discuss which solutions might satisfy you If you are going to buy a pair of jeans then you expect them to fit properly to have the right colour and model you prefer Think of your personal assistive device in the same way and do not change your mind too easily You must argue very well for your opinion and statements if the assessing and financing agency or social department has another opinion See Usability in design page 83 And Design for All page 82 Housing and environmental adaptations If you get a new pair of glasses you expect them to reconstruct your sight as well as possible and you choose a frame which matches your personality and the personal environment your home and the immediate environment of your home must fit you too You must find the heart of the matter for you
149. k site and equipment for the professional activity 2 Home adaptations and related appliances 3 Home furniture 4 The adapted bed For the work site and the equipment for professional activity Elena applies successfully to a soft loan scheme offered for the start up of new professio nal activities by the Provident Fund of Engineers and Architects For computer related equipment Elena chooses a leasing scheme which is more convenient for tax deductions and caters for future technology upgrades For home adaptations Elena has to rely on her own resources but is able to negotiate favourable instalment condit ions with the suppliers After the work is completed she will apply to the municipalities for refund enclosing as required by law the invoices and a declaration by an authorised physician If the application is successful she may expect about one third of the expense will be covered then she will avail more money for further investments e g the Car For the home furniture no external funding is available while for the electrical adjustable bed she can obtain a National Health Service medical prescription from the local Health Authority This will entitle reimbursement within a maximum amount which corresponds to 70 of the price of the model chosen by Elena Concerning personal assistance the Municipality approves the application submitted through the Social Services so Elena is entitled to negotiate wit
150. ke part in the society unless you have a spare one Personal helpers In some situations it might be more beneficial for you to have a personal helper instead of an assistive device This counts for situations when you use too much of your own forces on one activity so that you do not have the strength for other activities or in the situations where no assistive technology can help you to manage what you want to do Your helpers can be your family friend or colleges informal helpers You might also use helpers with whom you have a job contract and they get paid either by yourself or by your social service or insurance In some countries paid helpers personal assistance is a matter of public attention whereas in other countries this issue has not even been considered by social services and it is still seen as a matter of privacy If you use personal helpers whether they are your family or paid helpers it is important to give them the right knowledge about your disabilities and give them training in the right and best way to help you Furthermore it is important to establish an effective and rewarding relationship with your helpers and this counts both for informal helpers and personal assistants 28 March 1999 EUSTAT User Manual THE SERVICE DELIVERY SYSTEM The service delivery system In this manual the service delivery system means the national social laws procedures and regulations with respec
151. ked with CE Usually user organisati ons are not directly involved in the process of developing standards or carrying out testing Standardisation bodies International standardisation is mainly carried out within one of the two specialised international agencies for standardisation The International Standardisation Organisation ISO and the International Electromechanical Commission IEC These two are world wide federations of national standard bodies organisations It is the national standard bodies that decide if an Interna tional Standard shall be accepted as a national standard The most important committee in the rehabilitation technology field is the Technical Committee of Technical Systems and Aids for Disabled or Handicapped People At present the programme of work comprises Walking Aids Wheelchairs Serial Interface for Electrical Wheelchair Controllers etc Other technical committees which are working in the area of Assistive Technology field are Prosthetics and Orthotics Optics and Optical Instru ments and Acoustics European level standardisation The European Committee for Standard isation CEN the European Committee for Electro Technical Standardisation CENELEC and the European Telecommunications Standard Institute ETSI form the European standardisat ion system The organisation and work of CEN CENELEC are in broad terms the
152. ll solutions EUSTAT User Manual March 1999 21 Analysing the activity Page 5 out of 6 Activity Problems with the activity Why when where how Describe the circumstances and the place for the activity Inside outside Large room small room Summer winter Often seldom Alone or together with others Etc Future Does your situation change during the next 5 10 years How does this influence the activities Characterise your claims for solutions give perhaps some ideas What do you want in order to manage this activity The wish the dream the feeling when performing the activity What do your family and friends think Importance of the activity 1 Very important to me 2 Not very important 3 Does not matter if can get personal help 4 Does not matter at all Descriptions Dressing undressing Difficulty in putting socks trousers shoes on my right leg At home at hotels at friends at swimming bath Once or twice a day Perhaps getting worse An easy way to do these activities without giving pain 1 Very important Third column Relation with other activities Write the name of the related activity and shortly describe how the relation is Relation with other activities All activities where have to reach the feet toes Counts for all activities Like all other activities 22 March 1999 EUSTAT User Manual Analysing the activit
153. lution is often composed of a mix of technological and human help Both are inseparable from each other and represent in the whole the technology An assistive technology solution is often composed of a mix of technological and human help EUSTAT User Manual March 1999 87 FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY One of the aims of a classification in Assistive Technology is to help every one involved in the area to use the same language so mutual communication and understanding is promoted Technology related costs The equipment cost is the purchase cost including delivery and technical installation The fitting training cost indicates the amount of resources needed for personalising the assistive technology to the user s needs and transferring him the full command of such technology These two are initial costs which mean that they are borne once before any action takes place The maintenance cost as all other costs that follow is a running cost Electricity repairs spare parts etc are resources that need to be spent continuously or at regular intervals to ensure that assistive technology works well for its whole technical duration Some devices may also involve associated services like e g a bulky wheelchair may require to hire a special transport services whenever long distance travels are needed This is also part of th
154. lysing the daily activities in order to find the best solutions to solve problems of activities of daily living In the form of activities of daily living you must e List your daily activities which give you any kind of problem performance e List activities that you would like to do e List the activities you would like to change or end EUSTAT User Manual March 1999 15 Activities of daily living Page 1 out of 1 Main groups of activities Getting around getting in and out of the house Get in and out of bed and changing posi tion in bed Going to the toilet Body care 5 Sexual activities 6 Clothing 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Preparing breakfast lunch and dinner Eating breakfast lunch and dinner Cleaning after breakfast lunch and dinner Communication Using computer Budget making and planing household Watching television and video listening to radio Transport to work or college to leisure to shops etc Shopping Performing your job and education Leisure activities Housecleaning Laundry Care of children Maintaining house Gardening New activity List all specific activities which trouble me cannot perform them ache are too slow tire me can perform them but give an unsatisfying result etc Going upstairs to my bedroom Getting out of bed Cannot sit properly on the toilet
155. lysis at the technical aid centre At the technical aid centre an occu pational therapist named Karen works together with her in order to find the best solutions Karen is an adviser on asses sing training and through assistive technology obtaining wanted goals for personal activities She has knowledge about the functions of the body and of available assistive technology If it is necessary she works together with other specialists such as psychologists speech therapists physiotherapists and social workers S vit n Service delivery i OSET cr The first important thing Karen does in order to see the total activity situation of Ms Hansen is to assess Ms Hansen s mobility how strong she is how well her For each activity you have to consider if your goals can be reached by training changing the surroundings having assistive technology or using personal help Visit the library Find addresses of organisations of disabled people Get informed about fairs Find local groups of disabled people Find somebody who has problems like yours Find web addresses e Etc And visit the nearest centre of assistive technology Assessment of total activity situation Assess mobility how strong you are how well your joints bend how safe and stable are your movements and the gait of yours Then analysis of the activities of daily living EUSTAT User Manual March 1999 25
156. lysis of the forms of daily activities Ms Hansen is able to find the important issues about her wishes for her life with assistive tech nology At first she looks at the columns of future situation and characterise your claims for solutions In these columns she finds what qualities she wants the solutions to fulfil Then she goes through the column of relation with other activities and there she finds a general personal attitude and a trend in the kind of problems she experiences and in that way she finds the following issues which characterise her goals e She wants to have less pain e She wants assistive devices which have good design are functional anonymous and fulfil her expectations of the aim of the assistive device e She would like not to get easily tired in order to have time for personal important activities like walking with her friends etc e She wishes to get around feeling safe e She would like to have a flat without stairs and steps and considering the future she must realise that she might be forced to use a wheelchair because of her weak legs so the flat has to be accessible to a wheelchair e The solutions must take into account that she will get worse in the future The solutions must then if possible have an aspect of prevention and not exclude solutions concerning decreasing mobility for instance e She does not want to appear more handicapped than necessary
157. n This is not the place for a detailed analysis of costing issues which would involve a long dissertation clarification of common terms used by economists and complex financial mathematics In the following two useful points will be shortly clarified so as to provide you of some awareness of how assistive technology costs should be estimated The next section concerns the distinction between cost and expenditure and the following section introduces a checklist of cost items to be considered in the estimation Do we use resources or spend money Imagine that somebody asks you the question What is the monthly cost of the personal assistance that your husband provides you every morning in waking you up and dressing you At a first glance you may answer zero since you actually spend no money for that It is a wrong answer The correct answer would be something like one hour of my husband s time everyday which accounts to some 30 man hours every month Even it is your and your husband s free choice to solve this problem within the family without resorting to external help you are in fact using resources You and your family may be happy to use such resources the 30 hours of your husband s time in this way however this does not mean that you do not bear a cost Conversely it is true that you do not bear any expenditure your wallet is not getting thinner and thinner for this
158. n overcome or minimise the disadvantages of disabled and elderly people Several classifications have been developed with the above mentioned objectives in mind Some of those classifications are ata national level and few at an international level Here we will focus on the ISO Classification which has been widely accepted internationally specially in the case of service providing The ISO Classification The International Standard Organisation ISO has prepared a standard for classification of assistive technology called ISO 9999 Assistive Devices for Disabled Persons In the case of this standard the classification has the intention to be as simple as possible to use due to the diversity in user groups Therefore the classification is based on functional division bearing in mind the user and the use of the assistive device The ISO classification uses the interna tional WHO World Health Organisation official definitions Impairment Any loss or abnormality of psychological physiological or anatomical structure or function Disability Any restriction or lack resulting from an impairment of ability to perform an activity in the manner or within the range considered normal for a human being Handicap A disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfilment of a role that is normal depending on age sex and social and cultural factors fo
159. n anonymous person to use assistive devices might therefore be difficult and a very uneasy step into a new world It might even happen that advisers in the area of assistive technology also have such negative attitudes Impact of assistive technology in the personal life The way a person and his relatives conceive and accept his disability influences of course on the impact assistive technology has on his self esteem self confidence and coping with his activities his family and other social relations Some disabled people strive to get full control of their lives using the possibilities assistive technology gives in full degree others do not try very hard and depend on other people for psychological technical and financial help Introduction of assistive technology in a family may require personal changes of other family members It may also require modifications in the organisation of personal assistance and thus a change in attitudes and habits of personal assistants The family and the personal helpers may support the life style changes required by the introduction of assistive technology or they may reject to them In that way the family might influence on the users independence and freedom There may be cases where assistive technology is well accepted by the individual but not by the family even when the assistive devices are aimed at family relief rather than at the person with disability promise not to look
160. ncerning your life and your daily activities Ask them to let you try many different models and do not compromise your claims too easily Be aware of the fact that they might not present all relevant models for testing because they might have purchase commitment and internal rules in order to restrict the possibility of getting some special models of devices The dealers of assistive technology are professionals too and do not always care adequate for your problems or needs You have to clarify your needs and goals to your self or you might end up with an assistive device which does not cover all your needs Compare similar products and make the dealers explain why they find that their device is the best Ask if the assistive technology is certified according to the law and make sure that the device is on the insurance list otherwise you will have to pay for it yourself Do be very careful with the A good service delivery system is illustrated among other criteria by active user involvement and influence On this page is a list of what to be aware of when working together with the service delivery system to obtain the right assistive device for you The professionals might have purchase commitment and internal rules in order to restrict the possibility of getting some special models of devices The dealers do not always care adequate for your problems or needs EUSTAT User Manual March 1999 31 THE S
161. nd safe Controlling the environment If you are having severe motoric disabilities turning on the radio or televi sion opening the doors and windows drawing the curtains adjusting the bed switching the light on and off are all tasks which are impossible to carry out You will however find that information technology provides a number of solutions to all these tasks with the help of the environmental control which can be either handheld or mounted on your wheelchair There are several methods of activating the control by switch by control panel by sucking blowing using your voice etc x D i i i 7 When the doorbell rings many find it difficult to get to the door in time This problem is solved with the electric door opener which can be connected to the intercom or entry phones The added bonus is the chance to see who is calling before opening the door Aids for recreation To take part in the social life and the cultural activities and having holidays is important for all of us Some of us want to do some kind of sport while others prefer needlework or gardening or are keen collectors Some like arts and visits exhibitions concerts theatres and cinemas Being stiffer in the joints losing the ability to move around or having visual impairments etc should be no obstacle when it comes to pursuing your hobbies or going for holidays In the following are mentioned only some of the possibilities in
162. necessary Assistive disability retume to pone Such adap technology can be very complicated and tations can be very simple like rearran you will need much training to use it ging farine or quite complex and oe properly Ask for instructions and training pensive such as a total remodelling ofa as well as possibility for advice and help bathroom to accommodate a wheelchair if you are uncertain about the use and the or purchasing expensive electronic handling of the device equipment to control the environment See Steve Adaptation of a house page 38 You must have full participation in taking the decisions of the assistive devices and of the changes when your home is going to be adapted to your new life Together with the advisers you must evaluate the changes in the home based on your functional level This includes the evaluation of your strength co ordination endurance balance sensation task Especially assessment of seating for planning proplemsolving ane SAIR work situations and other daily activities judgement Funnene there shouldbe assessment of computerised assistive an gvalualionor exaclly Whal you ale technology for handling activities at work expected to do and in what environment and at home and assessment of personal ihe acivtieS WIILDS performed car adaptation need long time in testing Funbermare your heeds May change training and follow up It can be a long over time as interests and abilities and tough way t
163. ng machines fitted with front control panels The combined washer tumble drier could be a good solution saving you time and space The capacity is less than that of an ordinary tumble drier and you should expect two rounds to one full machine wash The control panel varies from one make to another The programme and tempera ture selector requires either a turn or a push however some knobs are less friendly to operate being too stiff for weak fingers A good solution could be a touch operated machine where a slight touch of a finger activates the functions If you have visual impairments sorting the laundry could prove difficult in particular socks To help this sock locks are available which lock the socks together during washing and drying are available Before buying a tumble drier conside rations such as mentioned in the section about washing machines are of course of similar importance here For ironing it is a good idea to have the ironing board fixed on a wall then it is easier to unfold Furnishings and adaptations to homes and other premises Lack of access to ones home and lack of access inside the home is a basic pro blem for many disabled people But when planning for proper accessibility many obstacles can be easily overcome Choosing the right furniture and furnishing the home so it fulfil the needs of the inhabitants can turn the home into a wonderful place for activities See Hou
164. ng ramps or telescopic ramps are available Rails should be mounted at both sides and at two heights to cater for children and wheelchair users as well as people walking Proper light is essential in the driveway by the foot path and the stairs Sufficient light is needed by the front door to help find the keyhole and the house number and name however the light must be shaded Another possibility is sensor operated security lights which auto matically switch the light on and off according to movements on the premises For a wheelchair user an automatic door opener could prove a necessity since opening the door and manoeuvring the wheelchair simultaneously may prove difficult The door should be wide enough to accommodate wheelchair users It could be necessary to alter the door or the entire opening Sliding doors offer the possibility of a wider door opening They take up less space and are easier to negotiate if you are a wheelchair user or walk with difficulty Getting around inside the house To make your transfer secure inside the house grab rails are very useful There are thousands of models to choose from long short narrow or broad grab different surfaces fastened in different ways specialised for corridors kitchen bath toilet sitting room and specialised for specific diseases If the thresholds cause problems you can for example get thresholds which go into the floor when you drive o
165. nity services 0 73 75 66 67 101 Computer Programmer 06 78 112 March 1999 EUSTAT User Manual APPENDICES Computerised steering 2 55 EquCAalOR vcciscios oh cies ale 79 82 Consultants from Egg CUPS eer 61 disabled organisations 79 Elbow crutches cceeteettteee 54 Contextual Factors 0 90 91 Electric door Opener e cece eee 67 Contrasting colours ceeeeee 59 Electric hoist seeeeeeeeeeeees 57 Control panels ccccceeeeees 48 64 Electric kitchen tools 0 ccceeee 59 Controlling the environment 45 54 67 Electric page turner 5 34 47 Cooking n 35 44 49 59 Electric SC SSOTS i a 68 Cooking basket ccccceeeeeeeeees 59 Electric tin openers ee 60 Cost analysis 5 9 87 88 108 Electrical knives ccccceseeeeeeeeeees 60 Cost of assistive technology 5 85 86 Electrical slicing machines 60 Coverall E atea ena a 52 Electrically operated doors 65 EAn To L EA E TT 60 61 62 Embroidery frame cccceeeeeees 68 G rman S aaisa a R tite 38 67 Empowerment 2 84 110 111 Cushions nieee 54 56 Emulators aeee 45 Cutlery siii paai 61 Engineer ccccccccceeeeeeeeeeeeeeeeees 42 78 CUMING eaei ae aeaiaio
166. not English Your typewriter or your computer may well serve as a compensation for speech in particular the computer offers a wide range of possibilities such as artificial speech word banks phrase banks etc Letter and symbol boards eases the communication if you have a cognitive impairment If you have a tracheostomy and your voice is very low voice amplifiers exist Hearing If you are hard of hearing a range of measures could improve your situation since increasing the volume seldom solves your problem and perhaps only annoys family and neighbours A headset with a built in volume control could prove a good solution when listening to radio and television however not all televisions are fitted with an extra socket for the headset The most common way to improve hearing is the hearing aid This comes in a number of varieties both as a in the ear haring aid and a behind the ear hearing aid A loop amplifier system which transfers the sound via the coil in your hearing aid could also prove a solution when listening to radio or television By using this you avoid the impact of poor acoustic conditions and unnecessary noise from the surroundings Telephoning A wide range of telephones and devices to assist in the use of the telephone are available no matter whether you have visual impairments are hard of hearing need a voice amplifier or you have difficulty in remembering telephone numbers or moving around
167. ns though as to relying 100 on voice control Henrik needed an alternative to the word processor if his voice should fail Consequently a joystick that Henrik could use was searched for A visual keyboard program seemed to be a suitable pro gram But which joystick would be the most effective The answer became clear at the annual Technical Aids fair a small touch sensi tive mouse where the direction and speed of the cursor can be controlled by placing a fingertip on the rubber membrane of the mouse There are two mouse buttons Henrik tried operating the mouse by means of the chin and it worked like a dream The company equipped the mouse with an extra facility for the lock function When it had been mounted on a universal arm the mouse proved to be a smart and very effective solution to his problem Next a speech therapist from the communication centre was brought in to assist Henrik and his helpers in identifying and selecting words phrases etc for the voice control and to help Henrik carry out the recording Selected computer commands common everyday words as well as specialised terminology were chosen Then the advisers heard about a new visual keyboard program that had been presented onto the Danish market and which could be used in Windows This meant that no matter which program was used in Windows e g the construction program of the Technical school the visual keyboard would be accessible Furthermore this
168. nt centres In all European countries employment centres exists If you need information regarding assistive technology at your job it might be a good idea to hear if the local or regional employment centre can help you Eye ear and throat clinics In most local areas eye ear and throat clinics are available They treat sickness in eyes ear and throat and they can perhaps give you advice on existing assistive devices for eye ear and throat problems such as hearing aids glasses etc Or they can tell you where to find the information Libraries Here you can look for books videos and CD ROM s At larger libraries some databases are available where special literature and addresses can be found Ask the librarian for help if you are not familiar with database retrievals Informal resources Companies producing the assistive technology you need One way to get more information on a specific assistive technology area could be to locate the companies producing the assistive technology Community services e Local authorities Medical practitioner Physiotherapeutic consultation Training centres Institutions for mobility impaired persons Employment centres Eye ear and throat clinics Libraries EUSTAT User Manual March 1999 75 INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Informal resources Companies Other users People who might know Professionals are group
169. nt of Speech devices ccccccccceceeeeeeeenes 47 Assistive Technology in Europe 93 Spoon adeeb othnas shang eautieceant stan teeonnd es 60 61 The European Telecommunications Sports 04 38 45 68 73 74 90 Standard Institute cece 92 Spouts EAE E E Suc ciguk TT 62 The International Electromechanical Sprung SC SSOTS ceeeeeereeeeeettees 68 Commission 0ccccceceeeeseese testes 92 StairclimMber cee ceeeeeeeeeeeeeee 58 86 The International Standardisation SLAMS ese eho ee te ea tS SG ae 64 Organisation A ict EAN TAE TEE AE 92 Standard rules of United Nations 84 The Internet 7 25 70 71 72 73 107 Standardisation 5 9 85 91 92 108 Therapists of speech and language wee a4 Standardisation bodies 92 Thermos with a pump ou eee eee 62 Standing hoist ceceeeeeeeeeeeees 57 Thermostat mixer taps 0 0 0 49 Standing mechanism BG ATEK Pen esn ena E 45 Starting the project 4 5 7 14 25 ThresholdS ies 2s thi oeieete ieit 65 78 29 96 99 ARID EE EEA 93 108 Stayt ya n ee ee eee 62 Toilet 13 16 20 24 41 44 52 Steps 0 4 6 7 9 12 13 14 15 53 64 65 70 82 101 24 29 43 65 99 111 Toilet Ghalttscs akceetewe etn f 53 Steps for achieving Toilet Seats oo eee 52 53 assistive technology 6 7 15 99 Touch operated machine 0 0
170. nual May 1998 CHOOSING AND GETTING ASSISTIVE TECHNOLOGY The ways to get assistive technology are explained This makes you able to influence and obtain personal control of the service delivery of assistive technology There are 4 parts in the process of getting assistive technology 1 What is necessary important for you in order to do what you want Needs 2 In which way do you want your solutions to become Goals 3 Finding actual possibilities for solutions Start 4 Trying out and taking decisions among possible solutions Decision Choosing and getting assistive technology This chapter provides you with knowledge about the basic tasks of clarifying needs and wishes for assistive technology In addition the chapter explains the ways to get assistive technology which makes you able to influence and obtain personal control of the service delivery of assistive technology Ms Hansen has been to the hospital because she slipped in the snow in the street and broke her right hip She has gone through surgery and now her hip cannot bend as much as it could previously The doctors say that they have done their best but the hip will never be quite good again Ms Hansen walks insecurely and she cannot sit on an ordinary chair nor drive her car or get to her bedroom on the first floor Furthermore her knees have begun to ache when she walks She needs some assistive devices because her right
171. o go so be prepared and change This must also be taken into make sure you do have the strength and consideration by you and your advisers patience to fulfil all the steps of the There are many aspects to environ process Mehislaccessibilily hey Meldeacoess Often it is the rehabilitation or technical to and through the actual parts of the aids centre and the supplier that are to youRneme such as getting Tand outer give you the instructions and necessary the front door getting to the bathroom training along with possibilities for further and reaching the kitchen cabinets It also contact in case of problems includes using electrical appliances and controls for the environment such as air 12 May 1998 EUSTAT User Manual BE PREPARED FOR THE PROCESS OF GETTING ASSISTIVE TECHNOLOGY Assistive technology or other solutions Mr Andersen has difficulty in managing the 5 steps to enter his house He believes he needs handrails and lower steps He visits the local assistive technology centre to get help While describing his problems to the advisers he realises that he has been ill for a long time and has not quite recovered yet Some training and healthy food will probably solve his problems and he decides to contact his doctor in order to get free training at the physiotherapist After a month of relevant training and daily walking he feels strong again and has no problems passing the stairs When you feel you cannot manage common da
172. oals Together with Mr Europe the adviser of assistive technology at the social service centre analyses his daily activities and especially his seating while he is resting or working The adviser also visits Mr Europe s home and his job to evaluate the arrangement and organisation plan in order to improve his wheelchair seating so his low back pain can be minimised and hopefully disappear Together they define his needs and in which way he wants the solutions to be He wants to go on with all his normal activities including his job and he does not want a heavy wheelchair which is difficult to manage Finding and selecting solutions At the social service centre Mr Europe tries several manual driven by hand power and powered wheelchairs in order to find the most suitable for sitting and easy to handle The advisers have recommended him a small and light powered wheelchair because then he could save his back when going around Eventually he decides to choose a very light and flexible manual wheelchair where he sits well and feels comfortable At the office where he works the furnit ure is rearranged which gives less manoeuvring He feels happy with these solutions and luckily he received funding for the wheelchair How did it go Mr Europe s low back pain is minimised after these changes but he notices that after trips with his family or friends in town or the country side he often gets more pain in his back when h
173. oducts in the assistive technology sector can often be expensive difficult to obtain or may be intended for use by service providers rather than the end user A further factor contributing to products failing to meet user acceptance is the inappropriate choice of products for a particular user s needs in the first place Sometimes products can be rejected for what appear too trivial reasons e g an aid being the wrong colour to appeal to children and it is important to realise that many factors will influence the ultimate Assistive technology products are often poorly designed It is important to realise that many factors will influence the ultimate acceptability of a product and not just its technical performance EUSTAT User Manual March 1999 83 FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY Many political papers stress the importance of disabled and elderly people living an autonomous life Some of the general themes are the impor tance of user empowerment and user involvement in all issues regarding assistive technology and accessibility Service delivery should be organised in such a way as to allow individual users to give feed back acceptability of a product and not just its technical performance Products designed for elderly or disabled people frequently derive from a medical perspective which may be limited in scope It is a common criticism of
174. of your telephone compagny Here you can often get information to start a more precise research This chapter is divided into three parts 1 Tools to get information on assistive technology 2 Sites where information assessment training education counselling and other kind of help necessary to get assistive technology are obtainable 3 Professionals in the area of assistive technology Information tools Here you will find three parts 1 The Internet 2 Databases 3 Books catalogues CD ROM s and videos The Internet This section gives a short explanation of the Internet and its services The Internet or the World Wide Web www is interna tional and everybody can use it if they have the technical equipment and the knowledge of how to use it The net may provide all people with knowledge on almost any subject LAA BAC At the Internet you can search on all matters and issues on assistive technology e g producers of products organisations for disabled people or professionals possibilities for getting education and training or on any other issue or keyword you feel like Perhaps you get lots of information which might be difficult to sort but once you have found the addresses homepages or conferences which are helpful to you then you can always get more and new information so go for it The aim of this chapter is to show the main structure of the Internet and how it works in order to inspire y
175. ogy These are the steps you must go through to get assistive technology se page 14 1 Defining your needs and goals Use the forms Activities of daily living Analysing the activity and Goals from Go for it A Manual for Users of Assistive Technology pages 100 104 2 Starting the project Getting informa tion being assessed Here you start to go through the steps of the Service Delivery System Use Go for it A Manual for Users of Assistive Technology pages 29 32 And use advisory centres advice from other peers and professionals courses and training 3 Decisions and solutions Testing possible assistive devices and finally choose Instruction and training in the chosen assistive devices Use the forms of Validation of Assistive Technology and Terms of Sale Written Guarantee in Go for it A Manual for Users of Assistive Technology pages 105 106 And use advisory centres advice from other peers and professio nals courses and training EUSTAT User Manual March 1999 99 APPENDICES Appendix 2 The form Activities of Daily Living In the following form you must list Your daily activities which give you any kind of problem performance Activities that you would like to do The activities you would like to change or end either because you cannot perform them now or because they give you too many problems pain or stress You do like this
176. oking make sure cooking pans are kept as steady as possible with the help of the pan holder The pan holder is available in various types such as the adjustable holder catering for pans of different heights or the smaller holder clamped onto the hob by magnetic or suction pads To avoid lifting heavy pans use a cooking basket when cooking vegetab les etc Adjustable strainer lids are useful when pouring water from the saucepan using only one hand In general saucepans are easier to use if using only one hand however both saucepans and frying pans are available with two handles If you have visual impairments or are hard of hearing put a noise maker in the pan This is a small metal plate which makes bubbling noises when the liquid boils Kitchen tongs are useful tools for turning and stirring meat in the frying pan They are available with a spring handle which returns to the open posi tion automatically To pour leftover liquid from the frying pan could prove a difficult or even impossible task if you only have the use of one hand Instead use a sucker to suck up the liquid Long barbecue gloves offer a good protection when carrying boiling food Cutting chopping grating and slicing If you only have the use of one hand or cannot grip things special preparation boards are available Cutting boards with spikes hold food such as bread vegetables meat or tableware such as bowls and dishes The
177. ology cccccceeesseeeeeeeeeeseeees 44 Aids for COMMUNICATION eiii a ea NE ETE TE 45 Aids for cognitione e aa el a tae a ea h 49 Aids Tor oeeo RTE E Ee E E EE A ET E T 49 Aids for personal mobility ccc cceeceeeceeeceeceeecaeeeeeceeeeeeeeeeeeeeseeeeeneeeees 54 Aids for housekeeping cee cece ceeeeeeeeeeceeeeeeeeaeeaecaeecaeeaeeeeeeeeeeeeeeeeeeeeeeeees 58 Furnishings and adaptations to homes and other premises 64 AIDS fOr recreation ts 22 cseseszezca vis eecbesaessec a sac tebe deae batts EE E 67 Information resources and personal advice on assistive technology cccsesceeeeeeeeeeeeeeeeeee 70 Information tool Sk e r a e N a a anaa EA 70 Information Sites A oea Na Ea a T a NAA 73 Professional Saen a ene a TE Aa a Ee AON Nania TT 76 For you who want to know more some societal issues of assistive technology 80 Definition of assistive technology ceeceeeceeeceeeceeeeeeeeeeeeeeeeeseeeeeees 80 Impact of assistive technology ceceeseeeceeceeeceeeceeeeeeeeeeeeeeeeeseeeeeees 80 Design TOF allies cicesevedeciescetyeeaeendesengae a E Eaa coeds tendecavernevtee elites 82 Usability in design ccc ceeeeeeceeeecee cece ceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeteeeeeeeteeteeeees 83 Policy in the area of disability and assistive technology 84 The cost of assistive technology ccccccccecceeeeeeeee
178. on The aim of this manual is to provide methodologies in achieving assistive technology and to provide the users all over Europe with a broad and general knowledge in the area of assistive technology There are much material about specific assistive devices and how to achieve assistive technology in different countries and areas of Europe This manual intends to be valid anywhere in Europe and provide the users an overall understanding and approach to assistive technology The manual intends not to become obsolete in the near future Therefore it describes general methods and tools in getting assistive technology and it does not offer a detailed description of all specific models of assistive devices Neither does it provide the reader with knowledge about specific national institutions advisers legislation and literature of assistive technology The target group of this manual is adults young as well as elderly who experience problems in their daily activities and who are able to read and understand the manual Also relatives of disabled people advisers and retailers etc in the field of assistive technology and rehabilitation can benefit of the information given in the manual Assistive technology in the area of training and education is not included in the manual which only focuses on assistive technology for daily activities Lilly Jensen Work package leader Copenhagen 15 March 1999 March 1999 EUSTAT User M
179. ood practices have been identified and described all over Europe The results of the project are to find in a number of reports which are available in all national languages in Europe The groups made 84 March 1999 EUSTAT User Manual FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY conclusions and proposals for each theme Some of the general themes in these conclusions are the importance of user empowerment and user involvement in all issues regarding assistive technology and accessibility The many reports are available in twelve European languages and are found on following website http wal autonomia org The HEART recommendations The HEART Horizontal European Activities in Rehabilitation Technology was a European project with the goal to improve the life situation of persons with disabilities and elderly people by bringing about changes in the field of assistive technology in Europe for example creating a single market facilitating co operation and exchange between the actors in the field and raise the quality and efficiency of products and services In the reports from the HEART project you will find many recommendations on the area of assistive technology Here are a couple of the recommendations from the group which summarised the results of the project Ensure user involvement National and European user organisations should be associated to the development and standardis
180. organisations of disabled people who work for equal opportunities self determination and self respect Telematics Application Programme Disabled and Elderly Sector http www cordis lu Community Research and Development information In this website you will find all EU s Research and Development programmes Homepage http www readap umontreal ca internot home html This homepage is Occupational therapy on the Internet You can find issues about assistive technology e g Virtual Exhibition on assistive technology Homepage Http www pat org Here you find Partnerships in Assistive Technology PAT It says Here you will find resour ces to help you with your computer access aug mentative communication power mobility and envi ronmental control tech nology needs Homepage http www tell us your story com Finding What We Have In Common One Story at a Time A discussion forum which helps people with disabilities share stories about their personal experiences EUSTAT User Manual March 1999 107 APPENDICES Appendix 8 Credit to sources Other EU research projects CERTAIN Cost analysis page 85 CERTAIN cost effective rehabilitation Technology through Appropriate Indicators was a horizontal activity funded by TIDE Technology for the Integration of the Disabled and Elderly which is an EU research program The concepts of cost analysis for assisti
181. ortunately the combination of a supplementary pension as well as a local charitable organisation and financial support of Germaine s children after a long process allows her to get this so desired reading help Delivery The purchase of the adapted needle is done during a mobility session with the instructor On her advices Germaine s husband will purchase the cane sold by mail order from a specialised company The visual aid camera system will be delivered at home and installed by the usual optician who will take care of its maintenance Follow up During the whole process of analysing the situation and choosing regular meetings with the psychologist of the rehabilitation service supported Germaine in accepting the use of these different aids particularly the cane but also managing her visual impairment in her relation with other people Germaine gradually enjoyed reading and sewing again during short and regular training sessions at home She rapidly became very effective in the use of the camera system and contemplated to train herself to write under the camera in order to gradually manage her mail herself Walking skills with the cane with an appropriate width and symmetry were difficult for her to acquire but Germaine has now a walking comfort and security like the one she had earlier At the same time training of orientation listening and the use of the remaining visual capacities is done which in fact was mor
182. ou to try it out and hopefully to get some usable infor mation Internet Structure and services The Internet is a connection between many computers both private computers as yours and big ones owned by companies organisations or different authorities The net is organised like this 70 March 1999 EUSTAT User Manual INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY j m a ri ene mirer baiah l i a ah Each server is a computer connected to the World Wide Web and the links between these computers might be either permanent or temporary A server from your internet supplier manages the connections between the computers and you connect to your internet supplier either trough the phone lines by a modem or trough a permanent line without a modem A server is a computer where service programs run permanently These service programs might include Web service to send homepages to your computer when you ask for it e Mail service to store in a mailbox the messages people send to you Name server to translate addresses of other computers at the net and to send the requires to the right addresses How to access a server After you have turned on your computer you launch a special program either for contacting the WWW or for exchanging mail called a client program to set up the connection This might be a mail program downloading and sending your mail or a program special
183. ove the floor it should be fitted and which make would serve you best with regard to control panel capacity and use Provide a trolley pull out working surface or something similar to simplify the process of filling and emptying the racks Small table mounted dishwashers are available catering for only 4 place settings however the racks are easier to handle A few models of dishwashers operated by finger touch are available Instead of protruding knobs to press or turn all functions are selected with only a slight touch of a finger on a designated area Cleaning The everyday cleaning tasks are easier to carry out if correct work processes are observed good quality tools are 62 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY provided and most important the layout of the utility room is as comfortable as possible The cupboard for the storage of cleaning materials and tools should have provision for shelves hooks etc fitted at a comfortable height and easy to see and reach The cupboard containing the vacuum cleaner should not have a plinth and should be level with the adjoining floor to avoid lifting the vacuum cleaner If the room is carpeted attach sliding studs under the furniture If however the floors are bare attach small felt pads A small trolley or frame walker to carry bucket mop dusters and cleaning materials will save you many a step and much lifting Long handles
184. oviding the correct working position are available People having asthma or people who are allergic to dust should choose a vacuum cleaner with special asthma filters which sucks up to 99 per cent of dust particles Squeeze able mop Figure to the left Dustpan with long handles EUSTAT User Manual March 1999 63 KNOWING ASSISTIVE TECHNOLOGY Figure to the right lroning board fixed on a wall Place the hose in a holder on your belt this makes moving the vacuum cleaner much more comfortable If you find it difficult to pull out the vacuum cleaner plug or plugs in general plug pulling devices with large moulded handles are available To get a good grip on the hose can prove difficult for weak hands or joints If the hose is provided with one or two extra handles a more comfortable grip can be obtained A small lightweight carpet sweeper could prove a good solution if you only want to remove a few crumbs Doing the laundry Before purchasing your washing mac hine consider carefully if the desired functions are available whether you can manage the door opener the control panel detergent container etc Small washing machines are available and convenient if you live on your own or lack of space A specially designed narrow washing machine loaded from the top is convenient if you have difficulty bending down or lack of space however it is slightly more difficult to operate compared with washi
185. portant 3 Does not matter if can get personal help 4 Does not matter at all Third column Relation with other activities Write the name of the related activity and shortly describe how the relation is Relation with other activities EUSTAT User Manual May 1998 103 APPENDICES Appendix 4 Goals Now having filled in the form of Analysing the activity for all the activities listed in the form Activity of daily life you can begin to define your goals objectives In which way do you want your solutions to be like for improving your daily activities Going through the analysis of the forms of daily activities you are able to find the important issues about your wishes for your life with assistive technology First look at the columns of future situation and characterise your claims for solutions In these rows you will find what qualities you want the solutions to fulfil Then run through the column of relation with other activities and there you might find a general personal attitude Trends in the kind of problems you experience or some general ways you prefer for your solutions Then look at the column in the form where you have prioritized your activities and see which kind of the activities you find most important List all your important statements from the forms and make your conclusions for your goals Conclusions on goals In which wa
186. prepared for the process of getting assistive technology icoane tats cewcdasscicdddiicrnuananccucideentens Aai 10 Don t give up get Nel pl ec cee cece ceeceeseeseneeeeeeaeeesaesaeeaeeeaeeeeeeeeeeeeeeeees 10 Youare TNE expert ordnen paeten oare ee a TE E EERE REE ERETO eke 10 Make a goal and go for it o oo ce cece ete e eee e eee ee tee eteeeteeeeeeeeeeeeeeeeees 10 Adaptation of assistive technology eeeeeeseeeceeccnecaeeeeeeeeeeeeeeeeeeees 11 Housing and environmental adaptations 00 cee ceeeeeeeeteseerseeeeteaees 11 Instruction and training in the use of assistive technology 0008 12 Assistive technology or other solutions cece ceeeceeceeeceeeeeeeeeeeeeeeeeeeees 13 Ways to fill the gap between you and your wanted activities 13 Choosing and getting assistive technology 14 Steps to go to get assistive technology ccccceccccceeeeeeeeeeeeeeeteeeeeeees 14 Defining your needs and goals 0 ceeceeeeeeeeeeseereeesceecaeeeeeeaeeeeeeeeeeees 15 Form of Activities of daily living cceecceeeeeeeeeeceeceeeeeeeeeeeeeeeeeeeeeeeees 15 Form of Analysing the activity cc cceeseesseecceceeeceeeeeeeeeeeeeeeeeeeeeeeees 18 Starting the Projet dreri eina Soeecvendeu cecevevsed destyeeeceetaveed a 25 D cisions and Solutions sre eiantosscehl tite ee tami ia eres a 26 Follow up
187. providing or prescribing the technical aids needs to know which technologies are best in what circumstances Also the system that pays for rehabilitation needs to know that the investment is a good one Finally to the industry testing is also important A manufacturer will test that his equipment offered to the market has met such standards In this case the equipment is allowed to be marked with CE Testing helps to assure a stable and predictable market If a company meets a 92 May 1998 EUSTAT User Manual FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY standard or a specification it has reason to believe that its product has a good chance to be accepted in the market Actual testing can be done by the manufacturer but will often be carried out by an independent certified laboratory Testing laboratories in Europe A survey of laboratories involved in testing assistive technology was carried out by the HEART project See page 108 The HEART study found that a formal accreditation system for testing laboratories is being set up and is already operational in a number of countries e g the Nordic countries Switzerland Germany and The Netherlands The European Organisation for Testing and Certification was encouraged to develop European certification systems for laboratories and for mutual recognition agreements of test results The HEART study also found that testing methods a
188. ptations are developed They have the detailed and specialised technical insight in all the more or less complicated assistive devices Technicians as generalist of assistive technology Some of the technicians work as genera list of assistive technology and know how to explain the technological secrets for the non technical professions and the users and they have knowledge of maintaining and repairing the devices They also take care of small accessibility changes in houses like taking thresholds away putting up grips and changing handles These technicians work often at a service centre of assistive technology and have mostly professions of mechanics or engineers Rehabilitation Engineer Evaluates the usefulness of customised devices or provides modification to commercially available equipment The engineer may be specialised in adapting cars electric wheelchairs communications aids lifts and elevators computerised assistive technology etc Computer Programmer Determines the usefulness of existing computer programs and explores the possibility of modifying existing programs or developing new programs Accessibility constructor This technician is often an architect but can also be an engineer They plan greater changes of houses in order to achieve accessibility for disabled per sons and they plan new accessible homes and transport possibilities for disabled persons Truss maker This technician has a speci
189. r daily activities finding what the activity gave you finding the wish the need or the dream of the activity Any assistive device can be adapted especially for your use and pur pose The personal environment your home and the immediate environment of your home must fit you EUSTAT User Manual March 1999 11 BE PREPARED FOR THE PROCESS OF GETTING ASSISTIVE TECHNOLOGY You must have full participation in taking the decisions of the assistive devices and of the changes when your home is going to be adapted The use of new assistive technology also claims instructions and often training with follow up and possibility to get help and advice when Environmental adaptation addresses the conditioning heating and lighting See Usability in design page 83 Design for All page 82 Instruction and training in the use of assistive technology If you buy a new car or washing machine then you get instruction in how to use it and you are always welcome to contact the dealer to ask further questions and to get advice if you have problems with the new device If you get a new machine or software at your work you are both instructed and trained to use it properly The use of new assistive technology also claims instructions and often training necessary needs for changing the immediate with follow up and possibility to get help environment Whena Person WIEN ADEW and advice when
190. r the individual Disabled person a person with one or more impairments one or more disabilities one or more handicaps or a combination of impairment disability and or handicap Assistive technology following the ISO classification The classification consists of three hierarchical levels classes subclasses and divisions Each class subclass or division consists of a code and a name If it is needed there is a definition or explanatory test and a reference to other parts of the classification The classes of the SO classification are ISO 03 Aids for therapy and training Including aids for perceptual training visual training and communication therapy ISO 06 Orthoses and prostheses Including both body powered and externally powered orthoses and prostheses orthopaedic footwear and cosmetic prostheses It excludes endoprostheses which are not part of this standard e ISO 09 Aids for personal care and protection Including aids for WHO s definitions of impairment disability handicap and disabled person are on this page EUSTAT User Manual March 1999 89 FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY The new WHO classification ICIDH 2 has 5 central dimensions Health condition Impairments Activities Participation and Contextual Factors Definitions from the WHO classification 1997 are on this page This knowledge might give you power to
191. re very technical and usually user organisations are not directly involved in the process of developing standards or carrying out testing Surprisingly the survey also showed that even when international standards are available testing laboratories to determine test methods does not necessarily use them Research and development Research is needed into the requirements which elderly people and people with disabilities have in relation to interfaces information representation etc Research is also needed into the development and adaptation of technologies to accommodate their needs Research is needed in the multidisciplinary and cross cultural understanding of ageing and disability Research and development programs The following subjects have been identified as important to be addressed by research and development programmes within the European Community 1 fundamental research in ageing disability and living conditions 2 research and development for the assessment restoration and enhancement of individual functions 3 research and development on living conditions and services 4 research and development on social and environmental accessibility and support 5 Socio economic studies TIDE Telematics Initiative for Disabled and Elderly People is a European research and development program which is dedicated to Assistive Technology exclusively Activities are grouped under two lines 1 Access to Technolog
192. realises that she after all wants a wheelchair for her outdoor trips She and Karen begin the assessing of the right wheelchair See Decisions and solutions page 26 Having assistive technology page 27 Terms of sale written guarantee If you buy your assistive devices yourself then be sure to have written instructions of use cleaning and maintaining and be aware of having the necessary training in the use of the assistive device Get a written sales agreement with e A specific description of the assistive device Description of special adaptations Description of special equipment and accessories e Precise time of delivery e Notes about free repairs during the period of guarantee including maximal duration for these repairs substitution of the assistive device during the time of repair paying of transport during the time of repair e Period of guarantee and period of having spare parts available for a number of years after delivery e Maintenance and service agreements e Sales price with clearly definition of what it covers special adaptations accessories repairs in the period of guarantee e How the payment is executed e Others issues relevant for you All these issues are especially important to have in mind when getting an advanced and or complicated assistive device like wheelchairs car adaptations communication aids etc Ask the technical aid centre to help you define the p
193. recise issues in the sales agreement Having assistive technology The story of Ms Hansen and her achieving assistive technology is created to illustrate the process of getting You must be trained in the use of the relevant assistive technology until you feel secure and happy about the solutions Be sure to have written instructions of use cleaning and maintaining and be aware of having the necessary training in the use of the assistive device Get a written sales agreement Ask the technical aid centre to help you define the precise issues in the sales agreement EUSTAT User Manual March 1999 27 CHOOSING AND GETTING ASSISTIVE TECHNOLOGY The assistive technology offers you new possibilities but at the same time it might give you constraints Having assistive technology often means that you have to maintain and repair it If you use personal helpers it is important to give them the right knowledge about your disabilities and giving them training in the right and best way to help you assistive technology In real life it might not be that easy because it might be difficult to collaborate with your adviser impossible to find the right solution for you or you might have problems to get funding for the assistive technology you want See Get success page 31 Also having achieved the right assistive technology and using it for a while is not always
194. red a high level spinal cord injury due to a road accident She is now quadriplegic with very limited control of upper limbs However during the rehabili tation treatment in a specialised Centre for spinal injured she was able to develop a remarkable level of functional independence in comparison to the severity of the injury and now she drives her powered wheelchair by means of a A control of the environment via the telephone where the possibilities are numerous was chosen because he also wants to activate the computer the percolator and the lamps Steve contacts several firms in order to receive an analysis and he chooses the quality and price which suits him Elena is a 42 year old Italian architect Two years ago she suffered a high level spinal cord injury due to a road accident She is now quadriplegic with very limited control of upper limbs EUSTAT User Manual March 1999 39 PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS She now drives an electronic wheelchair by a chin controlled joystick She decides to apply a technical aid centre to get an overall guidance and a specific assessment The chosen solution had four major elements Access to the flat adaptation of the flat personal and work site set up chin controlled joystick The wheelchair and other basic assistive devices for daily life for instance the incontinence aids were prescribed and provided on the
195. reeeeeeeennnneees 105 Appendix 6 Terms of Sale written guarantee vas ce ceded ohecs sescecs Wetedacsaciles Mobaskveaseadoasts 106 Appendix 7 Addresses and NOMep ages sceehs aescpacd ete ncdix febeea ec ieteice hie atten ee 107 Appendix 8 Credit 10 SOUNCES ainni E A E e E Ae Reveee paces 108 Appendix 9 EUSTAT Project Consortium and public EUSTAT documents 110 Appendix 10 GO FOR IT 6 March 1999 EUSTAT User Manual THE STORY OF MR EUROPE The story of Mr Europe This story of Mr Europe shows ina general way what to do in order to get assistive technology as well as describes what this manual contains Taking the initiative Mr Europe needs a new wheelchair because he has got low back pain and it is slowly getting worse and worse He has used a wheelchair since he as a young man was paralysed in his legs after making a dive into low water At that time he was trained to manage his daily activities from a wheelchair and he got all necessary assistive technology as part of his rehabilitation Also his home and work surroundings were made accessible But now he has taken the initiative to contact his doctor and the doctor finds that Mr Europe s back needs better support in the wheelchair After having studied the various existing wheelchairs from catalogues and seeking information on wheelchairs on the Internet Mr Europe contacts the nearest social service centre Defining needs and g
196. rfacing existing products and services to meet particular requirements The word Assistive Technology is used both for technology based on design for all as well on technology and services specially designed for elderly people and people with disabilities See European associations in the area of design for all page 109 Usability in design A common assumption is that products or services specially designed for the elderly or disabled user are appropriate and usable This however is not always the case Assistive technology products often are poorly designed A number of factors are responsible which generally involve failure to attend to usability issues in the design process These factors include e g designers assuming that they could rely on their own experience rather than systematically assess the real ti i pemer experiences and requirements of users Poor communication between designers and users and inappropriate techniques for eliciting information from them are partly to blame A products overall usability includes inherent good design matching product to task matching product to environment good user interface design matching user capabilities and recognising their limitations ensuring that users are well trained and supported that service and delivery support is adequate and that the products is well matched to the wider social and political environment in which it operates Pr
197. rom them At the same time assistive technology will become more flexible to adjust to individual needs See Design for all page 82 and Usability in design page 83 Finally it is important to stress that accessibility in the environment profound assessing analysis personal adaptations instruction and training and following up on assistive technologies play a huge role when getting an assistive device See Housing and environmental adaptation page 11 Ways to fill the gap between you and your wanted activities page 13 Defining your needs and goals page 15 Adaptation of assistive technology page 11 Instruction and training in the use of assistive technology page 12 Following up on the achieved assistive devices page 27 The assistive technology is described in following groups which have our daily activities as foundation e Aids for communication including aids for writing reading talking hearing telephoning aids for listening to the radio and watching television and a short description on social alarm systems e Aids for cognition including turn on turn off watch illustrative recipes and tape recorded books and newspapers e Aids for personal care including aids for washing bathing and showering aids for dressing and undressing aids for going to the toilet aids for incontinence and aids for sexual activities e Aids for personal mobility including
198. rtant the activity is for you This allows you to use your time and energy for the activities you find most important and you can focus on them when working with the solutions of the problems of the activities of daily living In the column on the right side of the form you note if any of the problems circumstances future situation etc have relation to one or more of your other activities This allows you to find some general trends in your analysis which helps you to define your goals O The second form has also been constructed for this manual so you are welcome to change enlarge or minimise it in a way that suits you best In the appendix of the manual you will find a blank form which you can copy and use for your personal analyses page 103 Ms Hansen has also filled in this form However all the forms of Ms Hansen s activities are not shown here In the form of analysing the activity you must describe problems with activities circumstances for the activity your future situation a characteristic of your wishes priority of the activities relation to other activities EUSTAT User Manual March 1999 17 Analysing the activity Page 1 out of 6 Activity Problems with the activity Why when where how Describe the circumstances and the place for the activity Inside outside Large room small room Summer winter Often seldom Alone or together with others
199. s the inflatable seat or seats made of soft fibre filled materials If it is difficult to wipe one s bottom special tongs for toilet paper are avai lable The paper is fastened and wrapped around the tongs If these measures are inadequate toilets with built in bidet and also an air drier function are available For those who are less mobile a bedside commode could be a good solution These are available in a number of different models catering for bucket or bed pan and fitted with a lid Wheeled commodes or a combination of a commode and a bath seat are also available Incontinence A long range of assistive devices for the various degrees and forms of incontinence exist Diapers and pads are available for both men and women in many different shapes and so are urine and faecal collectors too Figure to the left Toilet chair Special tongs Figures to the left Arm rails EUSTAT User Manual March 1999 53 KNOWING ASSISTIVE TECHNOLOGY There are a great variety of trousers and pads for chairs and beds The assistive devices have different forms material function in order to fit personally There are devices for training too In this area it is very important to get a profound assessment in order to find the best solution which also might be training medicine or operation Contact the relevant sites or professionals see page 73 Sexual activities Assistive devices to train and as
200. s get more and more difficult to perform the basic methods of the achieving assistive technology process are the same for all So if you cannot recognise your problems in one of the case stories in the manual please concentrate on the methods used and the concrete information given which is the main issue You may find that the case stories in this manual are very smooth and without many difficulties compared to real life The intention is to present a simple picture of how to get assistive technology This picture must not get blurred with descriptions of all the difficulties which might occur in the process of getting assistive technology The difficulties are often concentrated about collaboration between you and the advisers and dealers and concentrated about elaborating of personal adaptations of the assistive devices or accessibility and in getting funding and enough information What to find in this manual The manual has 6 main parts 1 The first part contains three chapters 1 Be prepared for the process of getting assistive technology Pages 10 13 2 Choosing and getting assistive technology Pages 14 28 3 The service delivery system Pages 29 32 These chapters provide you with information on the method to describe and analyse your activities in order to get the appropriate assistive technology At the same time it is explained what you have to be aware of and consider in the analysis when
201. safe and not give pain or Stress 18 March 1999 EUSTAT User Manual Analysing the activity Page 2 out of 6 Activity Problems with the activity Why when where how Describe the circumstances and the place for the activity Inside outside Large room small room Summer winter Often seldom Alone or together with others Etc Future Does your situation change during the next 5 10 years How does this influence the activities Characterise your claims for solutions give perhaps some ideas What do you want in order to manage this activity The wish the dream the feeling when performing the activity What do your family and friends think Importance of the activity 1 Very important to me 2 Not very important 3 Does not matter if can get personal help 4 Does not matter at all Descriptions Getting out of bed Pain in my hip each time Twice a day and more if am ill Perhaps getting worse Must not cause pain and must be safe so do not fall Perhaps a higher bed or an adjustable one 1 Very important Third column Relation with other activities Write the name of the related activity and shortly describe how the relation is Relation with other activities Pain Using my legs might in the future get more troublesome and cause pain Not to have pain and not to feel insecure EUSTAT User Manual March 1999 19 Analysing the activ
202. same as in the above mentioned interna tional standardisation bodies ISO IEC The whole procedure for developing an international and European standard from the initiative to the national implementation is a long process taking usually at least two years The European Union Directives developed in the European standardisat ion bodies are very important The Medical Devices Directive is an example of a directive with influence in the field of assistive technology In this Directive which includes technical aids for disabled persons the devices are classified into one of four risk classes depending upon their intended use The products have to pass different procedures and examinations depending on which class they have Some proposals of directives are also very important for area of disability Examples are Proposal of directive for transportation of workers with reduced mobility and Proposal of directive of lifts CE labelling and testing of assistive technology Testing and standardisation are intimately connected Formal testing is the best way to check compliance to standards and directives of the European Union Testing is very important for all the actors involved in assistive technology The disabled person wants e g assurances of safety quality functionality and effectiveness of assistive technology A system of testing furnishes essential information for such assurances The professionals
203. scary and not to drool on the other Alig Introduction of assistive technology in a family may require personal changes of other family members A disabled person who has developed a positive and active attitude may face prejudices It is important that disabled people under stand what the societal expectations are towards them EUSTAT User Manual May 1998 81 FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY The principle of Design for all takes into account a broader average of users when designing mainstream products and services The public opinion of disability is of course also met in the local community A disabled person who has developed a positive and active attitude may face the prejudices His moving about attracts the public interest towards him as a living token of uneasiness weakness and an unlucky life Not everybody feels comfortable suddenly to have a public role In such situations he may feel alone and uncomfortable with the unwanted public role he has to play in the community This may lead to discomfort and not taking active part in the society In communities with negative attitudes of people with disability it may be expected that users of assistive technology never go around alone and members of the community are quite embarrassed to meet them They do not know what to do in such situations and matters of assisting are only
204. sing and environmental adaptation page 11 Steve adaptation of a house page 38 Design for all page 82 Usability page 83 Entering leaving and getting around in the house If you have a mobility impairment it must first be considered how the environ ment can be adapted to make access easier ex doorway widths and thres holds floor coverings passageway width bathrooms and toilets Then ramps stairlifts or floor lifts may be necessary to assist getting around There 64 March 1999 EUSTAT User Manual KNOWING ASSISTIVE TECHNOLOGY are many different models of lifts and hoists See Personal mobility page 54 Entering the house Steps and staircases by the entrance will almost always cause problems if you walk with difficulty or are a wheelchair user A rail or perhaps just a grip is very convenient if you are forced to climb one or two steps If the entrance door is at the same level as the adjoining ground and the doorstep sticks up this problem can be overcome by placing a roll up ramp on the side free of the door Adjustable doorsteps which are pressed flat when the wheelchair passes over the doorstep are available however they need frequent cleaning to ensure they work properly A ramp is a necessity for a wheelchair user if the entrance is not at level with the adjoining ground If a built in ramp is inadequate or cannot be installed porta ble ramps either foldi
205. sist during sexual activities are available in a number of shapes and forms Vibrators and massage devices can assist you in achieving orgasm ejaculation and or erection Also a number of dummies are available e g penis vagina and whole body dummies If you have difficulties in carrying through a sexual intercourse due to functional limitation a number of seats and cushions are available to make the act possible In this area it is also very important to get a profound assessment in order to find the best solution Contact the rele vant sites or professionals see page 70 Aids for personal mobility Mobility is a person s ability to move around within the environment When we talk about assistive devices for mobility we often think of walking aids and wheelchairs These assistive devices are probably the most common devices for moving around and there are hundreds of different models which are to be chosen with great care in order to fit the needs of the person using it However there are many more assistive devices for mobility than walking aids and wheelchairs Support for walking The surroundings streets shop etc vary when it comes to accessibility Choose the streets without too many obstacles such as stairs difference in level heavy difficult doors etc Tell your local policy makers about your problems in order to stress how important getting around is to you See Houseing and environmental
206. sistive technology Introduction The aim of this chapter is to give you a general knowledge about different types of assistive devices in order to give you an overview of what assistive technology is This information gives you a basic possibility to work out ideas for yourself create solutions and to set goals for your own special wishes See about goals pages 15 and 24 The chapter is meant to be illustrative and to give examples It is not meant to be a complete catalogue of assistive technology The market of assistive technology develops fast there are always new technologies which opens new possibilities for people with disabilities and elderly people helping to overcome and solve their functional problems reducing dependence on others and contributing to the integration into their families and society Therefore let not your fantasy stop you get hold of all the information you can get and afterwards set your goals See Informa tion resources and personal advice on assistive technology page 70 Such issues as design and functionality plays nowadays a major role in the development of assistive technology which is mainly due to increased dem ands from the users of assistive technology who now take active part in the society The needs and requirements of disabled and elderly people will to a higher degree be taken into account in the design of main stream products so that also disabled people benefit f
207. sonal factors Disablement The term disablement is used as an umbrella term to cover all the negative dimensions of the ICIDH i e impairment activity limitations and participation restrictions formerly referred to disabilities and handicaps either toget her or separately This new Classification emphasises the role of Assistive technology by saying that assistive devices can allow a more adequate participation of persons with disabilities in social educational and work activities Often such classifications become a part of the theoretical considerations and the basic philosophical frames in the areas they might concern This new classification stress that the personal surroundings the attitude of the community the providing of assistive devices and the accessibility etc have important influence on persons activities and participation in the society Standardisation and quality assurance With the creation of the European Single Market it is important that technical standards are used for all types of products in order to assure the quality of the products across the boarders of the different countries The fact that standard products are available across the Euro pean borders can lead to a much broader choice of assistive technology products Similar to other technical domains a standard for an assistive device is a technical specification outlining the requirements for safety security and funct
208. ssibility and design for all are often found at national and regional level and they can give advice and information on these matters Information advice centres on assistive technology In most countries information advice services on assistive technology are available at regional or local level these are centres where people access data bases and documentation relevant to available assistive technologies discuss with professionals and peers that are competent to provide advice on assistive technology and even try assistive devices if the centre is equipped with an exhibition Information sites are grouped in four e Centres on assistive technology e Centres in the area of disability Community services e Informal resources Centres specialised on assistive technology e National resource centres Accessibility and Design for all Advice centres Communication centres Assessing driving possibility Hearing and vision centres Incontinence advice centres Orthopaedic clinics User organisations of sports EUSTAT User Manual March 1999 73 INFORMATIVE RESOURCES AND PERSONAL ADVICE ON ASSISTIVE TECHNOLOGY Resource centres in the area of disability e User organisations e Rheumatoid clinics e Skin clinics e Hospitals Communication centres for impaired people Many communication centres exist in Europe Here different communication specialists are available to inform
209. sy for Birthe to get up Driving position The seat is suitable to Birthe who can Birthe s reaction time her strength at the steering wheel and a hand operated brake are being tested The tests show that Birthe is able to geta driving licence for a car with specific adaptations The car is delivered with automatic transmission and power steering as standard equipment EUSTAT User Manual March 1999 37 PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS The accelerator and brake was in one grip for operation of the accelera tor with a push downward and the brake with a push forward adapted for operation by the right arm stump When Birthe s car was ready she had driving lessons and passed the driving test Steve is 31 years old and following a progressive illness he is getting around in a wheelchair He wants to buy a new house possess a good driving position The prostheses cannot reach the pedal thus a shielding is unnecessary Operation The car is delivered with automatic transmission and power steering as standard equipment A special grip in mounted on the steering wheel for operation by the left hand and a special produced aggregate for operation the accelerator and brake pedals with right arm stump Birthe needs a support grip in order to operate the gear lever Two switches is mounted on the steering wheel in order to operate the horn The left switch has
210. t to the provision of assistive technology including related services such as infor mation and training The service delivery system can be defined as the complexity of processes that act as an intermediary between the needs of an individual with a disability or impairment and existing resources and assistive technology This definition comes from the HEART project Page 108 This means that a service delivery system includes a long range of proces ses of supporting the rehabilitation of the user These processes can be the actual delivery of assistive technology training housing adaptation evaluation on needs etc Steps in a typical service delivery system Each country in Europe has a unique and often very complex service delivery system for assistive technology In most European countries it is the assistive technology and the connection in which the assistive technology is used that determine the way through the service delivery system The HEART project page 108 describes the way through the service delivery system in 7 steps 1 Initiative 2 Assessment 3 Typology of the solution 4 Selection 5 Authorisation for financing 6 Delivery 7 Management and follow up The story of Ms Europe shows the steps of the service delivery process The story of Ms Europe Initiative Ms Europe is in need of support to get into and out of the bathtub She cannot get in or out of the bathtub by herself and she
211. te is thus placed in front of her very near to her In consideration of safety during an emergency braking and the like would another design however be better for instance the aggregate placed between the seats Birthe is able to operate the switches while driving if they are placed where she can reach them with her short fingers On the basis of the tests it is decided that Birthe is able to get a driving licence for a car with specific adaptations The PTU s special designed test cars do not possess the required equipment in order to be used for Birthe s driving lessons without changes Therefore Birthe has to take driving lessons in her own car equipped as a learner car Typology of the solution and selection Birthe needs a car which can be adapted as described in the text Getting in and out of the car must be fairly easy and she must be able to sit properly She tests four car models where Birthe and her advisers find a suited make of car and where the following objects have to be changed Getting in and out of the car When getting in and out of the car it is difficult to place her right leg beneath the steering wheel It would be better if the seat could move backwards to the backseat so that the entire opening could be used Birthe cannot operate the slide bar of the driver s seat therefore a long and smooth running slide bar must be mounted instead The height of the seat is relative high which makes it ea
212. th The benefit of the electric control and a bed which is adjustable in height as well as in parts is a large degree of independence A hand held control to clamp onto the bed is all it takes to adjust the bed Lying in bed you can rise to a sitting in position and you will benefit from the adjustment of the height when getting out of bed When you are moving from the bed to the wheelchair the height of the bed should measure just below the height of the seat and vice versa If however you are able to stand but not walk a transfer turntable is a help The turntable is best used when a helper is present If you use a stick clamp the stick grip onto the edge of the bed The mattress A wide range of mattresses caters for all kinds of needs A few shops allow you to test a mattress at home for a short period To minimise the risk of pressure sores special mattresses which allow the pressure to spread more evenly are available in the shape of air or water mattresses special soft and thick foam mattresses or fibre mattresses Before placing a water mattress in the bed frame be sure the frame is built for the extra weight Alternatively a water bed frame could be chosen If you are incontinent protect the mattress with a protective waterproof lining sheet or fitted waterproof mattress cover Anumber of protective linings and covers are fitted with an underlying absorbent layer making you feel dry a
213. the personal assistants 3 Personal assistance on the basis of the assessment Elena negotiates with the Social Services the personalised personal assistant scheme to be applied for 4 Job work site set up and proper computer hardware and software for the professional activity Selection The selection of the equipment is based on a number of criteria depending of what Elena feels most important within reasonable price when looking at what the market offers Very expensive installations like the elevating platform the ceiling mounted hoist and the bathroom furniture are chosen after seeing the proposals from more firms not just in terms of their investment prices but also looking at maintenance cost reliability of the goods and of the firms guarantee etc The legislation in Italy allows applying the municipality for partial refund of expenses borne for house adaptation for accessibility but such budget is fixed and limited every year Therefore Elena has to be prepared to bear the whole cost if the application is unsuccessful Concerning the environmental control equipment Elena chooses a wheelchair mounted environmental control that communicates via infrared with satellite units disseminated throughout the home each devoted to a specific task opening closing the doors switching on off the lights the fan coils and other domestic appliance This device can also solve many other problems like door opening
214. the questions mentioned in Decisions and solutions page 20 in Terms of sale written guarantee page 27 and the part Having assistive technology Page 27 Discuss these issues and questions profoundly in order to realise what it means to you and what impact these issues might have on your daily life See Impact of assistive technology page 80 Make a list of the factors or circumstances you want to include when you decide your assistive device and do remember to be well prepared See You are the expert page 10 Get success page 31 You can use the checklist for Validation of assistive technology enclosed as an appendix to the manual Page 105 Copy it and change it in the way you feel For you who want to know more Some theoretical aspects of assistive technology When you communicate with the profes sionals in the area of assistive technology it might be a good idea to know about some basic issues in the area of assistive technology because this knowledge might give you power to discuss equally This knowledge might give you power to discuss equally and qualified with the professionals about your goals and solutions EUSTAT User Manual May 1998 97 THE NEXT CHALLENGE FROM ENDUSER TO PEER COUNSELLOR and qualified with the professionals about your goals and solutions The chapter For you who want to know more Some societal issues of assistive
215. tivities 16 54 101 T Shower handset seers 50s Tablet splitter 0 0 cece 62 Showering ccccceeceeeeeeeeees 44 49 50 Talking 35 36 44 45 47 48 SIVA Italy 3 71 108 109 TOO Tandem 57 Sleeping nnnc 65 Tap tumer escent Ato etceetete tone 50 Slicing whol anaaee A E iacwka dines 59 60 Tape recorder cccccececcccececeeceeee 47 49 Sliding GOOIS seit 65 Tape recorded DOOKS ccc ccccecceeee 44 49 Sliding sheets ceeeeeetteeeee 56 Technical professionals 76 78 Sliding StUdS cccceeeeeeeeeeeeeeeeeeeees 63 Telephone holder c ccecceeeeeeeeeeees 48 Social COStS weds cients r i 87 Telephoning cccccceeeeeee 44 47 49 Social worker 25 29 33 34 36 Television magnifier 0 0 0cce 49 75 76 77 78 Terms of Sale 4 6 7 9 27 28 30 SOCK PUller ce eeeeeeeccecececeeeeeeeeeeees 52 32 92 97 99 106 Solutions onanan 4 5 7 10 11 Testing 0 0 7 9 12 26 28 31 42 13 14 15 17 18 19 20 21 22 23 79 85 92 93 94 99 108 24 25 26 27 28 32 40 44 53 58 Testing laboratories in Europe 93 66 67 74 86 87 90 94 95 96 Testing of assistive technology 92 97 99 102 103 104 Text input and or output 0 0 48 Sowing roller cccceeeeeeeeeeeeeeeeee 69 The Association of Advanceme
216. to be raised so Birthe can reach and operate it with the fingers on her left hand The switches for the indicator light and the windscreen wiper is built into the headrest or to be operated by her left hand The switch for the rear window has to be moved from right hand operation to left hand opera tion Timer setting car heater To defrost the windows during winter a timer setting car heater is recommen dable Financing and delivery The PTU sends an application with a conclusion to Birthe s local council which grants her a car with the following equipment 1 Learner car equipment is used while possessing a driving licence 2 Long smooth running slide bars beneath the driver s seat with the grip placed for left hand operation 3 A special grip on the steering wheel for operation with left hand perhaps a padded ring shaped C grip 4 The accelerator and brake in one grip for operation of the accelerator with a push downward and the brake with a push forward adapted for operation by the right arm stump The hand grip is shaped as an open cup A collisionproof device is built into the aggregate which has to be extended because of the length of the arm stump in order to get close to her body 5 A support grip for operation of the gear lever designed so that Birthe easily can reach it 6 A switch for the horn on the left side onthe steering wheel is raised so that Birthe can reach it with the fingers
217. to get the informa tion and try to get it Discuss the results of this exercise and list the problems in getting information and list what you further want to know Make a list of good ways to get information and a list of what has to be improved how this can be done and by whom e How is the service delivery system in your country Chapters The Service delivery system Funding page 29 and People and assistive technology Some stories of success page 33 Exercises here could be to discuss the mentioned chapters and cases and find good and bad ways of service delivery and then finally describe the national system and ways of funding e Which professionals in the area of assistive technology do have to consult Chapter Information resources and personal advice on assistive technology page 70 Make discussions of what the different professionals can offer you and how to contact them Make a list of relevant professionals in order to reach your goals and find good hints for contacting and working together with them See You are the expert page 10 and Get success page 31 And at last What is important to know before you start the process of getting assistive technology Page 10 Decisions and solutions When the above exercises are perfor med it is time for decisions and solutions where the assistive technology is evaluated and tested by you It is very important to consider
218. ton or a hem The use of her telephone does not present any problem as soon as Germaine realises that number 5 has a raised mark and that if memorising the position of all numbers her index finger can move easily from one key to another Germaine did not mind using a cane for walking about outside On the contrary she claims to get one so that people can realise her visual problems The mobility instructor mentioned that the cane could also help her to detect obstacles and help her keeping the balance Training is necessary in order to move autonomously and safe with a precise technique combined with the use of hearing reflection memory etc Selection Following the occupational therapist advices a demonstration with the dealer of opticial assistive devices is organised at Germaine s home for the camera system Germaine is very fond of the Germaine is 70 years old and visually impaired Her optician advises her to see an occupational therapist at the social rehabilitation centre Enlarging of the picture by an electronic magnifying glass enables her to read her magazines and improves her speed and comfort in reading A camera system ona portable arm was good and could be installed ona TV set she already had EUSTAT User Manual March 1999 35 PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS She will be able to read her mail magazines watch photographs again and also she can see
219. tractive or just plain Therefore it is important to discuss these problems profoundly in order to find the right solutions Do not be overwhelmed by the advisers many wise and reasonable arguments Do not compromise your feelings and opinions if you do not understand or feel doubtful about the advices Go on until you find the solutions which are the right for you during the actual circumstances because as mentioned before it is your life your activities your home and your way of living which it all is about You are the real expert Make a goal and go for it Consider what is important for you in selecting assistive technology Here follows three different concepts for choosing an assistive device These concepts have been developed by the Swedish Centre CERTEC See page 108 10 March 1999 EUSTAT User Manual BE PREPARED FOR THE PROCESS OF GETTING ASSISTIVE TECHNOLOGY Doing it in the same way If it is important for you from a social perspective to handle a situation in the way a non disabled person would do then this may be the best solution for you Ms Hansen has broken her right hip and after the operation at the hospital she does not walk very well But she does not want to have a wheelchair for long walking distances with her friends she wants to walk like other people So she would prefer to have a walking stick with a little rest seat where she now and then can rest her legs and back She
220. tunity to make a special program for the user of the chair or to change the program for inside or outside driving Powered wheelchairs such as scooters and buggies are only meant for out door use These wheelchairs allow the user to move independent outdoor but because they are generally too large to use indoors the user will often need to be able to walk a little so as to be able to enter the premises they are visiting Indoor outdoor powered chairs and scooters can have seat raising mechanisms This allows the user to be raised several inches whilst remaining in the sitting position which assists for examples in reaching the top drawer of a filling cabinet A standing mechanism which lifts the user from the seated to the upright position can be fitted to both self propel led and powered wheelchairs The mechanism allows people to stand supported for work or social purposes and also have medical advantages in relieving pressure For wheelchairs you can get special cushions of many models and materials e g air and gel for preventing pressure sores or for persons with incontinence so ask your adviser to try them out before you decide which one is best for you It is possible too to get a little cushion which can be strapped on to your bottom and then you are free to get out of the wheelchair and sit in a car or in the theatre etc Transfer turning and lifting activities Transfer board can be used to bridge t
221. u can claim them changed in order to be accessible for disabled persons If they are not changed in an acceptable way you can lawsuit the responsible persons firms In this way The Americans with Disabilities Act has strongly contributed to the fact that USA is now one of the most accessible countries in the world The cost of assistive technology How much does assistive technology cost At a first glance it seems a trivial question which answer is easily found by looking at commercial catalogues of assistive devices with related pricelists But when using AT for daily life for carrying out a job or attending education ADA If you find that some services are not accessible then you can claim them changed in order to be accessible for disabled persons Apparently a very expensive solution in terms of initial cost can give rise toa tremendous cost reduction in the long run EUSTAT User Manual March 1999 85 FOR YOU WHO WANT TO KNOW MORE SOME SOCIETAL ISSUES OF ASSISTIVE TECHNOLOGY When we say cost of assistive technology we want to indicate the flow of resources generated by the use of technology including all services and support involved We speak of social cost when we consider the sum of all resources used by all actors taking part in an individual assistive technology programme If we want to know the economic consequences of the choice of assistive devices we are interest
222. ulties he would devote himself more to his favourite 38 March 1999 EUSTAT User Manual PEOPLE AND ASSISTIVE TECHNOLOGY SOME STORIES OF SUCCESS tai Wa A sport the Ping pong He therefore decides to achieve these systems for his new house Assessment Steve very enthusiastic is ready to contact the firm directly However Antoine lets him learn his own experience he did not know the market at all and had confidence in the dealer He bought some useless and unsatisfactory devices and even the electric system he has now is not completely satisfactory for him There are some other techniques which are much more efficient He recommends Steve to go to an assistive technology service where he receive advice and find what suits him best Typology of the situation Steve gets in touch with the centre and explains his situation his difficulties his desires and his dreams He also explains his financial limits and that he must not be the only one to be able to use his AT It is not easy for him to become aware of all the details his disability and the possible evolution the architecture of the house his actual and future family his desiderata his budget the financial means but he discusses it with the advisers Selection On the basis of a checklist the solution seems to be a control of the environment via the telephone where the possibilities are numerous and because he needs more th
223. ve technology The field of Assistive Technology should be regarded both from a pure technological point of view and also from a broader holistic as a whole in connection with many other issues approach where human and social cultural perspectives are included Human attitudes believs and ways of living play an important role in the acceptance and use of assistive technology See Impact of assistive technology page 80 Make a goal and go for it page 10 The European project HEART defines assistive technology this way Any product instrument strategy service and practice used by people with disabilities and older people specially produced or generally available to prevent compensate relieve or neutralise the impairment disability or handicap and improve the individuals autonomy and quality of life This definition says that the concept of assistive technology contains not only the concrete assistive devices but also the strategies e g political local or personal intentions rules services e g the service delivery system and practices e g the methods the professionals use in assessing and giving information Developing assessing and training of assistive technology with this broad holistic approach is therefore a very important key to empower the users See HEART pages 85 and 108 Impact of assistive technology The evolution of assistive technology which is availabl
224. ve technology accessibility design for all and disability AAATE Association for the Advancement of Assistive Technology in Europe C o Danish Centre Gregersensvej DK 2630 Taastrup Tel 45 43 99 33 22 Fax 45 43 52 70 72 ANEC European Asso ciation for the Coordina tion of consumer repre sentation in standardiza tion 36 Avenue de Tervveren B 1040 Brussels Tel 32 2 735 31 10 or 32 2 743 24 70 Fax 32 2 736 35 52 e mail anec skynet be Dan Design for Ageing Network Design Age Royal College of Art Kensington Core UK SW7 2EU London Tel 44 171 590 42 42 Fax 171 590 45 00 EAPH European Associa tion for People with Handicap Philadelphia Care Foundation PO Boks 505 8070 AM Nunspeet The Netherlands Tel 31577 411800 Fax 31 577 411836 EEID European Institute for Design and Disability Special Needs Research Unit University of Northumbria Coach Lane Campus Newcasle Upon Tyne UK NE7 7TW Tel 44 91 22 7 4211 Fax 44 91 266 4061 Eurolink Age Place du Luxembourg 1 B 1050 Brussels Tel 322 512 99 46 Fax 322 512 66 73 email Eurolink ace org uk http www eurolinkage org euro European Disability Forum EDF Secretariat Square Ambiorix 32 Box 2 A B 1000 Brussels Tel 32 2 282 4606 Fax 32 2 282 4609 e mail policy edf arc be www edf unicall be Institute on independent living http www independentliving org The Institute serves self help
225. ve technology which are used in the manual were developed in CERTAIN consortium 1996 Certain Consortium included CMT Linkoping Sweden project leader TNO Delft The Netherlands REHAB NOR Tomter Norway IRV Hoensbroek The Netherlands and SIVA Milano Italy Contact CMT Linkoping University S 58183 Linkoping Sweden www siva it research certain DAILY Photos in the chapter Knowing assistive technology pages 44 69 DAILY is a CD ROM that supplies infor mation about assistive devices It is build up in a home environment so in every room in the house you can look for information The purpose is to make it easier to live every day life with the help of relatively simple often small devices In the CD ROM the assistive devices are shown and also the use of some of them in pictures and sound The end users of DAILY are older people with minor motor impairments but also professionals who work with older people can benefit from the information Four partners have developed the CD ROM Hadar from Sweden SIVA from Italy CRPG from Portugal and Danish Centre Denmark Projectleader It has partly been financed by The European Commission www hmi dk HEART Pages 29 31 80 85 93 108 The HEART Horizontal European Activities in Rehabilitation Technology Study was a joint effort by a consortium of 21 institutions organisations and companies in 12 European countries to study the assistive technology market for peopl
226. ver them or you can get small ramps adapted to your thresholds Electrically operated doors which are operated by foot or hand switch pressure mat or by movement sensor are available for people with poor strength in the functions of the hands The house can be supplied with a complete system to open and lock switch on and off doors windows light radio computer etc Getting in and out of bed sleeping If using a mobile hoist remember to leave sufficient space on both sides of the bed You will need 200 cm on one side of the bed 85 on the other for the helper Grab rails EUSTAT User Manual March 1999 65 KNOWING ASSISTIVE TECHNOLOGY Bed table with adjustable overbed top Figure to the right A pillow raiser A solid bed rail and a wallmounted hand rail Two figures to the right Height adjustable bed Abed table accommodating telephone alarm clock and books is a good solu tion Bed tables with adjustable overbed tops are available A range of bookstands which rest on the bed or your stomach is available Alarm clocks with large clearly visible figures and chunky clearly visible hands are available Loudly ringing alarm clocks are available for people who are hard of hearing or clocks connected to light or vibrators to put under the pillow are also available The bed If you find it difficult to rise from lying flat to a sitting position or to turn around a lifting pole
227. wheelchair with a chin joystick so the possibility of incorporating the computer control in the joystick was explored This solution was possible because the joystick had sufficient available capacity However Henrik had experienced a few problems with his powered wheel chair and did not want the computer linked to the wheelchair Henrik trained to be a joiner at the Technical School in Copenhagen Now he would like to return to the school in order to attend a course in construction techniques The Technical School told Henrik that the course involved working with PCs and a special construction program The school was also briefed on the special circumstances concerning Henrik and his need for special aids The next step involved once more to evaluate Henrik s operating options his head head movements his mouth including blow and suck and his voice Typology of the solution and selection The communication centre s technician was contacted Henrik had heard about voice control automatic speech recognition of computers but not in promising terms The technician however was optimistic He had just received a new type of voice control from the United States Henrik an elite gymnast was injured during trampoline practice and sustained quadriplegia He needed writing aid to compensate for the lack of function in his arms and hands Henrik has a powered wheelchair with a chin joystick so the possibility o
228. y Page 6 out of 6 Activity Problems with the activity Why when where how Describe the circumstances and the place for the activity Inside outside Large room small room Summer winter Often seldom Alone or together with others Etc Future Does your situation change during the next 5 10 years How does this influence the activities Characterise your claims for solutions give perhaps some ideas What do you want in order to manage this activity The wish the dream the feeling when performing the activity What do your family and friends think Importance of the activity 1 Very important to me 2 Not very important 3 Does not matter if can get personal help 4 Does not matter at all Descriptions Preparing breakfast lunch and dinner It causes pain to stand for a long time and it is difficult for me to bring things to the table because of the walking stick At home in the kitchen 2 3 times a day It might get more difficult and I might get more pain An easy way to do these activities without having pain A chair suitable for my hip with wheels to use in the kitchen A tray on wheels which can push 3 Does not matter if can get personal help Third column Relation with other activities Write the name of the related activity and shortly describe how the relation is Relation with other activities Cleaning after the meals and house cleaning
229. y either to find a better solution or to change the conditions The occupational therapist visits Ms Hansen at home and together they go through all the rooms in the house the entrance the car and the parking space and while discussing the problems and solutions in details See Housing and environmental adaptations page 11 Eventually Ms Hansen and Karen together found the solutions which Ms Hansen preferred although not everything was absolutely perfect but better design and usability were not to be found See Usability in design page 83 And Design for all page 82 The assistive devices were brought to Ms Hansen s home and placed where it was most convenient Ms Hansen is trained in the use of the relevant assistive technology and she feels secure and happy about the solutions See Instruc tion and training in the use of assistive technology page 12 Follow up on the achieved assistive devices Ms Hansen and Karen have made an appointment three months later in order to assess the solutions and check everything is functioning or eventually to solve new problems Furthermore Ms Hansen can contact Karen any time she needs help or advice about her activities of daily living Within a month Ms Hansen realises that a couple of the assistive devices does not fit her well and she contacts Karen to discuss these problems and to find better solutions After two months Ms Hansen also
230. y and services comprising three sub areas 2 Activities concerning compensation for functional disability and enhancement of function this with two sub areas See TIDE page 107 There are several other research and development programmes in Europe and there might be national research and development programmes in all Euro pean nations The local library and centres of assistive technology can help to identify these programmes Research The Association of Advancement of Assistive Technology in Europe AAATE has many institutions and researchers in the area of assistive technology as members Each second year AAATE arranges a conference where scientific papers product developments and new methodologies are presented See AAATE page 107 TIDE Telematics Initiative for Disabled and Elderly People The Association of Advancement of Assistive Technology in Europe AAATE EUSTAT User Manual May 1998 93 THE NEXT CHALLENGE FROM ENDUSER TO PEER COUNSELLOR This chapter gives you some hints for bringing your knowledge on to other persons Your knowledge must be given at the right time in the right connection and in the right amount to let the other person work in his own way to solve the problems The next challenge from end user to peer counsellor If you have some experiences in assistive technology it would be a pity that you keep them just for yourself when others could
231. y do you want your solutions to be like 104 March 1999 EUSTAT User Manual APPENDICES Appendix 5 Validation of Assistive Technology When trying assistive technology it is important to be very thorough and consider following questions Validation of Assistive Technology Does it solve your problem Does it fulfil your quality claims Does it have a good design and is the usability high Do you like it and are you pleased with it How is the usability for your helper Can you manage the cleaning yourself If not who can then make the cleaning Can you manage the maintenance yourself If not who can then make the maintenance Can you handle the repairs yourself If not who can then make the repairs Do you have the necessary instructions and training possibilities Can you easily get help and advice if you have problems with the assistive technology If the assistive device brake down can you get a substitute at once What is the attitude of your family and personal helpers to this specific assistive device If the answers to some of these questions are no or problematic in some ways it is important to discuss the problem with your adviser in assistive technology either to find a better solution or to change the conditions EUSTAT User Manual March 1999 105 APPENDICES Appendix 6 Terms of Sale written Guarantee If you buy your assistive devices yourself then b

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