Common Telecommunications Technology for Promoting Safety, Independence, and Social Interaction for Older People with Disabilities

Personal emergency response systems and other useful, not-so-advanced technology. Advanced telecommunications technology like the Internet offers exciting immediate and future applications for older people with disabilities. Yet the overwhelming majority of frail elderly people still rely primarily on their telephone for telecommunications. There are many phone features available, and add-on assistive products, that can assist older people with various types of impairments. This paper takes a look at some of these special phone features, including personal emergency response systems. The telephone has been available to us for a relatively short time-about 100 years-and today is an essential component of almost every business and home. For older people with disabilities, many of whom live alone and infrequently leave their home, the phone provides a device for social contacts. For elders who have difficulty getting to places outside their home, the phone can be used for banking and shopping. The phone can also be used to call for help, in the event of a fall, an illness, or some other problem such as an unwanted intrusion. A recent article from the University at Buffalo's Rehabilitation Engineering Research Center on Aging (Mann et al., 1996) suggests that a significant proportion, about Io percent, of frail elders have problems with the use of the phone they own. The types of problems they are having most typically relate directly to their impairments. People with vision impairment have difficulty reading the numbers and letters on the phone. Those who have difficulty ambulating and getting up or down from a seated position often have difficulty getting up to answer the phone before the calling party hangs up. People with fine motor impairment from conditions like arthritis have difficulty with small buttons, rotary dials, and holding the receiver. People with hearing impairment may have difficulty hearing the phone ring or hearing the person at the other end of the line. People with cognitive impairment may have difficulty remembering important numbers. For each of these impairments, and related problems, there are potential interventions, many of which rely on products readily available. FEATURES TO ADDRESS IMPAIRMENTS A recently published book, Communications Technologies for the Elderly (Lubinski and Higginbotham, 1997) describes a number of telephone features to address specific impairments faced by older people. Many of these features are commonly found in any home-an answering machine, for example, to help a person with mobility problems who has trouble getting to the phone. Other solutions are not so common, but can be obtained. Examples are a voiceactivated phone with a speaker feature that can be answered from across the room, or a cordless phone. Vision impairment in the elderly can of course be addressed with the usual large numbers, letters, symbols, and buttons with good color contrast between the background and the symbols. More high-tech solutions include cordless phones with pager buttons on base units that make it easy to find the headset and also devices that can be added to a home phone so that it "speaks" the number dialed, making it possible for the user to detect mistakes made while dialing. People with hand impairment can use phones with voice activation. People with hearing impairment have available many features including add-on devices that provide amplification for the receiver, available in portable models for travel and when amplification is required on several phones, and telecommunication devices for the deaf that include a keypad for typing out messages and a display for reading messages from the person on the other end of the line. Phone features to address memory impairment include picture telephones that display a picture of the person or place to be called (for example, the fire department) next to the memory button. PERSONAL EMERGENCY RESPONSE SYSTEMS Personal emergency response systems (PERS) (also referred to as medical emergency response systems) use telephone lines to signal for help in an emergency situation. …