Assistive Technology, Senior Safety And Aging-in-Place Hidden Risks

Our senior population will rely more and more on mobility aids to Age-in-Place. After an injury or surgery and during rehabilitation assistive devices will play a role in recovery. Some if not many bypass FDA regulations in a gray area as assistive technology (AT) devices. At first glance it seems like it's no big deal because everyone assumes they are harmless. Many in healthcare consider assistive aids harmless with no idea what healthcare issues or secondary issues they create. It's time to take a closer look at the hidden and overlooked patient safety and user issues.
The, need for assistive aids and home modification have grown dramatically in recent years and will continue to grow. Freedman, Martin, and Schoeni (2004): state that the number of commercially available AT products has grown from 6,000 in 1992 to over 20,000 in 2002. The rapid shift in enabling people to live at home and in their communities has created a need for more assistive technology. The question is at what cost to safety and how effective are they.

Attention has been on cheap cost without consideration for effectiveness which is another word for safety issues when it comes to mobility. Another area of concern is a lack of basic labeling or a clear intended use of the product. A bigger issue is marketing verses intended use. Often the marketing materials show a much broader use than the user instructions that's if there are any user instructions. You can buy a storage container that has more information than most assistive devices. The difference between a storage container and an assistive aid is that the user will depend on the assistive aid as a means of fall and injury prevention.

One of the main mobility issues for seniors is getting in and out of bed. Some of the most commonly used assistive aids recommended are often not medical devices. They likely should be due to the intended user and use. Too many companies want the senior medical market without the regulations that go with it.

The real patient and user safety issue comes into play when all the products are seen as consumer products. The safety issues are not disclosed and adverse events like injuries and death are not reported partially due to this gray area. Fall prevention programs have relied on many of these assistive aids without knowing about the injury risks. For example the most commonly used slide under the mattress which use the box spring and mattress for support. Does anyone know what happens to the sleep surface when you put something under the mattress?

We measured the degrees in which 4 products changed the sleep surface. From head to foot and side-to-side it was 1 to 3+ degrees different. In short you end up sleeping on an uneven bed with plywood or metal bars somewhere under your hip and shoulders. If, you have any type of chronic condition such as arthritis, osteoporosis or back problems you would likely be on your way to a worsening of those conditions and not even know it. The question is does your healthcare provider know it. Hitting the vertical rails getting in and out of bed can create inflammation in the thigh or hip area increasing your risk of bursitis. Has anyone thought of this, probably not!

Looking at the safety and effectiveness of assistive aids is part of prevention and patient safety. We need to pay more attention to secondary and safety issues that go unreported giving everyone a false sense of security.