Assistive Devices

Assistive devices are used to compensate for (i.e., function in spite of) physical limitations. They can provide differing levels and types of mechanical assistance, and they fit into two broad categories: mobility aids and self-care aids. Mobility aids are devices external to the body that provide support during locomotion. They include single-point canes (used for balance and minor support) and wheelchairs or electronic mobility (providing total support). Self-care aids are devices external to the body that enhance the performance of self-care activities. These devices range from can openers, used by people with and without disability, to bath benches, used only in the face of disability. Self-care aids can be quite sophisticated and limitation specific; for example, environmental control units for individuals with deficient immune systems and electronic speech synthesizers for those lacking the ability to phonate.

Orthoses and prosthetics are often identified as assistive devices. An orthosis is a mechanical support that fits to the limb itself, supporting a joint or limb segment affected by muscular or structural weakness or injury. Braces and splints are static orthoses, providing support only. Dynamic orthoses add hinges and springs to allow for movement. Often an attachment is added to the orthosis to allow the performance of special tasks; for example, page turners or pencil holders on wrist or hand splints.

Prosthetics replace missing body parts. They include simple cosmetic additions that make disfigurement less noticeable (e.g., breast prostheses, prosthetic eyes) as well as prosthetics that functionally replace missing limbs. Prosthetic technology is advancing rapidly, now allowing replacement limbs to be controlled by the patient's own nerves and muscles.

The goal for each assistive device will vary by patient situation. For best results, the right device needs to be selected, fitted well, and maintained in good condition. The most common reasons for dissatisfaction with a device are inadequate or improper original information, improper choice of device, and improper fit. Much unsatisfactory equipment is obtained by the patient without professional counsel or prescription. Broken, poorly fitted, or poorly maintained equipment obtained from yard sales, online sources, or community or family members can produce harm rather than improve function. Many physicians are trained to prescribe or recommend assistive devices, as are physical or occupational therapists and specialists in prosthetics. Third-party payers usually require a professional prescription before they pay for an assistive device.

After receiving a new device (especially a mobility aid or prosthetic), training from a licensed therapist ensures safe and efficient use. A device (especially a prosthetic) may be used for the rest of the patient's life. Ongoing monitoring for fit and repair are particularly important. Often, as rehabilitation (or limitation) progresses, a new device or another fit will be necessary to continue maximum functional support.

As older adults are living longer, maintaining independence has become a common goal. Assistive devices can provide cost-effective alternatives to institutional care. Most older adults would rather use an assistive device for self-care and mobility than need to rely on the assistance of other persons.