Assistive Technology to Enhance Activities of Daily Living

As discussed earlier, activities of daily living include eating, grooming, dressing, and maintenance of one’s environment. These tasks are essential for all people and often taken for granted by people without disabilities. For people with disabilities the ability to independently perform these activities provides an important sense of empowerment and self-worth. To be independent to the maximum extent possible, people must be able to care for their own needs in each of these areas.

For people with physical disabilities, many of these activities have become either impossible or extremely difficult and time-consuming to perform independently. To make these activities possible, or cut down on the time spent performing tasks, AT can often be employed. Most AT devices used to help people with physical disabilities perform activities of daily living are used to adapt the reach necessary to do the task, to adapt devices for grasping or manipulation, to make two-handed activities into one-handed activities, and to increase the pressure exerted by one's hands (Cook & Hussey, 1995). Examples of AT devices that help accomplish tasks through these adaptations include:

• Wide-handled or angled-handled cooking and eating utensils to provide easier grip
• Anti-tip cups and plates to prevent movement and spilling
• Suction-cupped plates to prevent movement
• Dishes with built up sides for easier scooping
• One-handed can openers
• Adapted button hooks
• Zipper and sock pulls
• Velcro shoes
• Grip poles or researchers for grasping items out of typical reach
• Shower-bars
• Handheld shower heads
• Shower chairs
• Long and wide-handled combs, brushes, and toothbrushes
• Long-handled dustpans and brooms to minimize bending

People with visual disabilities can often have difficulties with similar activities of daily living. However, the difficulty is often in seeing necessary measurements, time, or the difference between objects. AT devices are also available to help individuals with visual disabilities perform activities of daily living, including:

• Large print and talking cooking clocks
• Color-coded measuring devices
• Speaking liquid level indicators
• High contrast cutting boards
• Braille and talking scales
• Braille tape to label food
• Bar code readers to indicate the contents of packaged foods
• High contrasts rugs, bathmats, towels

Many of these devices, although they seem simple, are extremely useful in helping people with various physical or visual disabilities complete activities of daily living necessary to be considered independent. It is simple to create many of these items as well. For example, if someone is having difficulty grabbing a brush because of its small diameter, the diameter could be increased using some clay. Occupational therapists (OT) work almost exclusively with people on increasing their ability to perform activities of daily living. This experience makes OTs excellent sources for ideas for simple technology or ways to adapt devices to aid in activities of daily living.

Assistive Technology to Enhance Mobility

When discussing enhancing mobility for independent living, thoughts immediately turn to people with physical abilities that need AT discussed in an earlier module such as canes, walkers, scooters, manual wheelchairs or power wheelchairs to get around. These types of devices are essential for aiding in the mobility of individuals with physical disabilities effecting lower extremity movement or fatigue.

When discussing mobility enhancements for independent living, an often overlooked population is individuals with visual impairments. People with this type of impairment may not have any physical difficulty moving, however they may have difficulties navigating and orienting themselves. There are devices to accommodate this functional limitation. Long white canes are used to feel the path in front of the user to determine upcoming obstacles allowing the user to adjust their path appropriately. Guide dogs are trained to lead their users around obstacles while also alerting them of upcoming hazards such as traffic at cross streets. Finally, GPS-based talking electronic travel aids have been developed to help people with visual impairments navigate while traveling. These devices locate the user via GPS, allow the user to enter a destination and then reads directions to the user such as "turn left here" or "destination 100 feet ahead". Unfortunately, however, at this point, in time these devices have not provided significant upgrades over the long, white cane or the guide dog, so they are rarely used. Another device, must often used to help with orientation are tactile maps. These maps identify key areas such as elevators or restrooms through raised symbols.  

Whereas the devices discussed are important mobility enhancements, AT-based strategies play an important role in enhancing mobility for people with various disabilities. As discussed in Module 2 there are many pieces of legislation, such as the Rehabilitation Act of 1973 and the ADA, that stipulate the provision of total access for people with disabilities to public transportation systems, buildings, and all other public and private entities. Disability related legislation has worked to eliminate architectural barriers, thus allowing people with disabilities effecting mobility to live more independently. This has encouraged inclusion through the establishment of least restrictive environments through Universal Design, the designing of environments to be used by as many people as possible regardless of ability. Universal design elements that encourage independent living for people with mobility impairments include:

• Cutaway curbs to allow people in wheelchairs to cross the street easier
• Elevators
• Ramped entry ways
• Wider doorways
• Automatic door openers
• Accessible restroom stalls
• Lower sinks
• Lower drinking fountains
• Lifts on public transportation vehicles
• Braille labels on important rooms
• Braille labels in elevators
• Braille and talking alternatives on ATMs
• Talking/Beeping crosswalk signals

Each of these design elements has been incorporated into society in a manner that does not affect people without disabilities. In fact, many of these design elements can be helpful for people pushing strollers, riding bikes, or carrying shopping bags. Ultimately, people without disabilities do not notice most of these design elements, but they are essential in helping people with mobility impairments live independently.