Activities controlled

Activities that can be supported by using an EADL include: (1) environmental regulation by controlling temperature (heater, air conditioner, fan, humidifier), lighting (lamps, curtains/blinds), and pressure relief (bed positions); (2) information acquisition by controlling audio/video equipment, page turners, and note-taking devices; (3) safety/security by controlling doors, door locks, monitoring the premises, and summoning emergency assistance; and (4) communication by controlling telephones, attendant calls, and intercoms.

Persons who have incurred damage to the central nervous system frequently have difficulty regulating body temperature, requiring careful adjustment of the temperature to avoid medical complications and to manage comfort. Furthermore, the perceived comfort of that person may be very different from that of a caregiver or family member. Humidity control is necessary for persons with respiratory problems associated with severe disability. A person unable to independently move is unable to change positions while in bed. The ability to control bed positioning can help avoid skin breakdown and pressure sores. The control of lights is important for aiding safety, maintaining sleep patterns, providing comfort, and enhancing vision.

Acquiring information through TV, radio, page turners, and so forth is important for personal enjoyment, stimulation, and quality of life. However, it is also necessary for gaining pertinent information about the weather, traffic, important happenings and for keeping apprised of community, state, national, and world events.

With regard to security, the ability to know about and control who can gain access to the home, and the ability to independently leave the dwelling may not be possible for someone with severe motor impairments. An EADL can assist in monitoring the home premises, controlling the locks, and opening doors.

The ability to communicate is essential for everyday activities such as coordinating attendant care, scheduling medical services, managing work, school, and family schedules and for requesting assistance. Communication, like information acquisition, is a key component to quality of life and avoiding isolation.

Benefits of electronic aids for daily living

Using an EADL is not a convenience for someone with a severe disability; it is a necessity for him or her to perform many functions. The empowerment provided by such devices allows the independent performance of both urgent and repetitive tasks. Many studies have provided support for the positive psychological and functional impact of EADLs for individuals with disabilities. Ripat provides a good summary table and overview of these findings. Ripat summarizes that the impact of EADLs is generally positive, and identifies independence, control, self worth, adaptability, competence, increased environmental interaction by facilitating communication, recreation, and security as important considerations for consumers. Stickel and colleagues reported that consumers are generally satisfied with their EADLs, and that this satisfaction remained constant over time. Palmer and Seale suggested that “users often initially see the utility in the equipment, but over time, that tool can transcend from utility into a higher level of psychological meaning for that individual.” These investigators also noted that the positive feelings were generally associated with psychological and social benefits. In contrast, those who did not have EADLs expressed frustration and hopelessness, and felt restricted in terms of participating in daily activities.

The areas that have been reported to be have highest functional benefit to the user of an EADL are home security, telephone, television, and attendant call. Wolf and Roa, in a qualitative study, found “the most used functions were the control of entertainment devices, TV, stereo, VCR.” This finding is understandable because the study was measuring the frequency that the EADL produced each type of command, and operating electronic devices requires multiple activations.

The person using an EADL is not the only one to derive benefits from the device. The caregivers’ responsibilities are also alleviated. Harmer and Bakheit highlighted that a caregiver provides personal assistance and companionship as well as completion of many daily routine tasks such as placing phone calls, operating lights, and adjusting the television. Likewise, Platts and Fraser noted that freeing caregivers from mundane tasks allows them to carry out other responsibilities. Making the routine tasks less burdensome will assist in obtaining the needed care that a device cannot provide. Platts and Fraser added that lessening of rote tasks will also improve the morale of the EADL user. Reducing the work load required by the family members and caregivers has also been reported to help improve the family and caregiver relationships with the EADL user. Although the studies mentioned here all have relatively small sample sizes, the consistency of reported benefits seems to have merit.

Benefits of electronic aids for daily living

Using an EADL is not a convenience for someone with a severe disability; it is a necessity for him or her to perform many functions. The empowerment provided by such devices allows the independent performance of both urgent and repetitive tasks. Many studies have provided support for the positive psychological and functional impact of EADLs for individuals with disabilities. Ripat provides a good summary table and overview of these findings. Ripat summarizes that the impact of EADLs is generally positive, and identifies independence, control, self worth, adaptability, competence, increased environmental interaction by facilitating communication, recreation, and security as important considerations for consumers. Stickel and colleagues reported that consumers are generally satisfied with their EADLs, and that this satisfaction remained constant over time. Palmer and Seale suggested that “users often initially see the utility in the equipment, but over time, that tool can transcend from utility into a higher level of psychological meaning for that individual.” These investigators also noted that the positive feelings were generally associated with psychological and social benefits. In contrast, those who did not have EADLs expressed frustration and hopelessness, and felt restricted in terms of participating in daily activities.

The areas that have been reported to be have highest functional benefit to the user of an EADL are home security, telephone, television, and attendant call. Wolf and Roa, in a qualitative study, found “the most used functions were the control of entertainment devices, TV, stereo, VCR.” This finding is understandable because the study was measuring the frequency that the EADL produced each type of command, and operating electronic devices requires multiple activations.

The person using an EADL is not the only one to derive benefits from the device. The caregivers’ responsibilities are also alleviated. Harmer and Bakheit highlighted that a caregiver provides personal assistance and companionship as well as completion of many daily routine tasks such as placing phone calls, operating lights, and adjusting the television. Likewise, Platts and Fraser noted that freeing caregivers from mundane tasks allows them to carry out other responsibilities. Making the routine tasks less burdensome will assist in obtaining the needed care that a device cannot provide. Platts and Fraser added that lessening of rote tasks will also improve the morale of the EADL user. Reducing the work load required by the family members and caregivers has also been reported to help improve the family and caregiver relationships with the EADL user. Although the studies mentioned here all have relatively small sample sizes, the consistency of reported benefits seems to have merit.

Accessing electronic aids to daily living

The user may control the EADL through several different methods, including (1) switch—single or dual, (2) touch screen, (3) voice recognition, or (4) integrated with other controls such as alternate computer access, wheelchair controls, or augmentative communication devices. Using integrated controls to operate an EADL is helpful and often necessary when a person has a limited number of switch/control sites available.

Control methods of electronic aids for daily living

EADLs can control devices through (1) direct connection, (2) infrared (IR) transmission, and (3) power line carrier (X-10). Other control protocols have been used in home automation, but these methods have not been extensively used with specialized EADLs. Each control method has benefits and limitations.

Direct connection implies that the device is wired to the EADL. Such connections may include telephone lines, intercom systems, bed control, nurse call, external speakers, IR extenders, and external relays. Directly connecting an external device is beneficial for reducing the time lag for activation, increasing the reliability of automation and controlling devices that are not suited for IR or X-10. The main disadvantage is that the EADL is tethered to the device it controls.

IR offers control of many different functions in the same way as a TV/VCR/DVD remote control. IR transmission requires “line of sight.” As a result, the controlling signal cannot operate a device located in another room or even in the same room if the controller cannot “see” the device. If IR control is required and the device is located in a different room, then an IR extension cable can be used to deliver the signal to the remote area. Another alternative to controlling IR devices that are not in the line of sight is to change the IR signal into a radiofrequency (RF) signal. This change allows the control signal to pass through walls and extend in all directions. An RF receiver then captures the control signal, translates it back into an IR signal, and delivers it to the device.

The power line control method has historically been accomplished through X-10. X-10 is an industry standard for communication among devices used for home automation. X-10 uses household wiring (power line) to carry short-wave RF signals to the devices to be controlled. An advantage of this type of control is that in many cases the home electrical service does not need to be modified, and no additional wires are required. Furthermore, many types of control modules are available, and the technology is relatively inexpensive. The main disadvantage of using X-10 to control devices is the less than perfect reliability. Although this type of control can dim and brighten lights, it is essentially limited to turning devices on and off.

Other control protocols are available for the home automation market, including (1) Insteon, (2) ZigBee, and (3) Z-Wave. Insteon uses both RF and power line transmission, making it more reliable than X-10. Insteon also advertises that it is compatible with X-10 devices. Both ZigBee and Z-wave use RF transmission; they are not compatible with X-10 devices. Special control units and receivers are required for each of these methods of control, and they are more expensive than X-10. There has been some preliminary work by Bessel and colleagues to design a universal control module using a standard personal digital assistant and ZigBee.

EADL using these types of controls are currently not available. Nonetheless, these control methods may be appropriate for persons who are able to use the standard control interfaces.

Classification of electronic aids to daily living

Due to the diversity in the range of consumers’ functional abilities, access methods, and transmission types, EADLs do not have standardized classifications. Steggles and Leslie proposed a possible classification by output ability, specifically one output, two outputs, or multi outputs. Other classification systems offer a combination of functional use and output ability. Information provided for EADLs often is presented by function, access method, specific devices they control, or simply by manufacturer’s specifications.