Monday, 8 December 2008

Assistive technology as a psychological marker of change

Whilst teaching on a recent course I think I surprised the attendees by talking about the psychosocial impact of electronic assistive technology. It always interests me to see how people often get so into the tech factor they struggle to reconnect to the holistic implications of a high tech medium.

Anyway and interesting discussion ensued about how we can often have the false impression that providing a patient with a bit of kit will be well received as its offers a "solution" to a problem. Sadly however the issue of a device can also be a clear a visible marker of an ability lost or never to be gained and may therefore be received with a distinct feeling of sadness, even anger.

With this in mind I talked with the group about making referrals and provision at appropriate stages not just of functional ability, but also of psychological readiness. The importance of choosing a bit of kit or access method which allows (for those with progressive conditions) for a degree of deterioration is not just pragmatic for cost/resource reasons but also to mask those changes where possible.

When the patient has a deteriorating condition there is a clear argument for demonstrating/providing devices before someone actually needs them. This could be justified to allow the patient some mental preparation for what is too come, to allow a period of learning whilst the patient doesn't solely rely on a device and so on. This approach however can also be detrimental - the patient may not wish to engage with, or contemplate a difficult future, and there may be little motivation to use said "kit" when other more "normal" ways of performing a task still be viable In those situations the contrasting approach may be more appropriate, patients may be more willing to engage with the device when it represents a renewal of ability lost.

The whole notion of the significance and timing of the introduction of AT interests me greatly. It relates so well to the occupational therapy approach of looking holistically at a patients needs and reminds us that, exciting though technology can be, it is only a means to a functinonal end.

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