Alleviating Disability and Unmet Need: Differential dimensions addressed by assistive technology and personal care

Abstract

Purpose. To examine differences in reports of residual disability and unmet need by type of care arrangement (assistive technology and/or personal care) amongst disabled adults. Method. This study compares three specific dimensions of residual difficulty (pain, fatigue, and time intensity) and unmet need for hands-on care across combinations of assistive technology and personal care. Analyses are conducted on samples of between 3,493 to 7,051 persons with limitations in bathing, transferring, walking, and getting outside from the U.S. 1994-95 National Health Interview Survey Phase 2 Disability Supplements. Results. Even accounting for differences in underlying disability, equipment use confers no additional benefit in the three dimensions of residual difficulty analysed here. Equipment users equally or more often report that tasks are tiring or time consuming, or painful even when they use assistance. Though this would appear to indicate unmet needs for care, fewer equipment users report a desire for hands on personal care. Conclusions. We find that disability alleviation by technology is no better on specific dimensions of difficulty, but technology users report less unmet need for personal care. Designing appropriate and cost-effective home care for disabled adults depends upon an understanding of the ways in which technology users may differ from others and the circumstances in which technology can be most effective.