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Effects of an Assistive Technology Intervention on Older Adults with Disabilities and Their Informal Caregivers: An Exploratory Randomized Controlled Trial

Mortenson, W. Ben PhD, MSc, BScOT; Demers, Louise PhD, MSc, BScOT; Fuhrer, Marcus J. PhD; Jutai, Jeffrey W. PhD, CPsych; Lenker, James PhD, MSc, BSc, BSc; DeRuyter, Frank PhD, MA, BA

American Journal of Physical Medicine & Rehabilitation: April 2013 - Volume 92 - Issue 4 - p 297–306
doi: 10.1097/PHM.0b013e31827d65bf
Original Research Articles
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Objective The aim of this study was to demonstrate experimentally that an assistive technology (AT) intervention improves older AT users’ activity performance and satisfaction with activity performance and decreases their caregivers’ sense of burden.

Design This study was a delayed intervention, randomized control trial. Baseline data were collected on 44 community-dwelling AT user-caregiver dyads in Vancouver, British Columbia, and Montreal, Quebec. The primary outcome measures for AT users were the satisfaction and accomplishment scales from the Assessment of Life Habits. The primary outcome measure for caregivers was the Caregiver Assistive Technology Outcome Measure, which assessed burden associated with dyad-identified problematic activities.

Results After the intervention, assistance users in the immediate intervention group reported significantly increased satisfaction with activity performance (P < 0.001) and improved accomplishment scores (P = 0.014). Informal caregivers in the immediate intervention group experienced significantly decreased burden with the dyad-identified problematic activity (P = 0.013). Participants in the delayed intervention group experienced similar benefits after the intervention. Improvements for both groups were mostly maintained 4 mos after the conclusion of the intervention.

Conclusions This is the first experimental study to demonstrate that the provision of AT decreases caregiver burden. If confirmed and extended by subsequent research, the findings have significant policy and practice implications and may enable health care providers to advocate for improved access to AT provision and the related follow-up services.

From the Centre de recherche de l’institut universitaire de gériatrie de Montréal, Montreal, PQ, Canada (WBM, LD); Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada (WBM); École de réadaptation, Université de Montréal, Montréal, PQ, Canada (LD); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland (MJF); Interdisciplinary School of Health Sciences, University of Ottawa and Bruyére Research Institute, Ottawa, ON, Canada (JWJ); University at Buffalo, Department of Rehabilitation Science, New York (JL); and Duke University, Department of Surgery/Speech Pathology and Audiology, Durham, North Carolina (FDR).

All correspondence and requests for reprints should be addressed to: Louise Demers, PhD, School of Rehabilitation, University of Montreal, C.P. 6128, Succursale Centre-Ville, Montreal, PQ, Canada H3C 3J7.

Supported by the National Institute on Disability and Rehabilitation Research througha grant to the Consortium on AssistiveTechnology Outcomes Research (http://www.outcomes.org/, grant H133A060062) and by Canadian Institutes of Health Research (CIHR) (grant 232262). Personal financial support for Dr Mortenson was provided by a CIHR postdoctoral fellowship in the area of Aging and Mobility from the Institute of Aging. Support was also provided to Dr Demers by the Fonds de recherche en santé du Québec. Portions of the findings from this study were presented at three conferences: (1) Demers L, Mortenson W, Plante M, Raymond M-H & CATOR. Impacts des aides techniques auprès des usagers et de leurs proches-aidants: Résultats préliminaires. Congrès International Francophone de Gériatrie et Gérontologie, Nice, France, October 19–21, 2010; (2) Mortenson WB, Demers L, Roy L, Lenker J, Jutai J, Fuhrer M, DeRuyter F. Efficacy of a user-caregiver assistive technology intervention: Preliminary results. Canadian Association of Occupational Therapists National Conference, May 26–29, 2010; and (3) Mortenson WB, Demers L, Jutai J, Fuhrer MJ, Lenker J, DeRuyter F. How assistive technology use by older individuals with disabilities impacts their informal caregivers. International Federation on Ageing. 11th Global Conference on Ageing. Prague, Czech Republic, May 28–June 1, 2012. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 Lippincott Williams & Wilkins, Inc.