The FCA online caregiver survey (Appendix C) found that many caregivers are purchasing AT/HM and find it useful. However, findings also suggested a need to raise awareness of available AT/HM, to address caregivers' concerns about costs, and to offer caregiver training on AT/HM and techniques to minimize physical strain. The Internet, physicians' offices, and AAAs were the top places where caregivers go for information on AT/HM.
The site visits and discussions revealed many tips and resources that can help family caregivers reduce their risk of physical strain, assess their homes, and select, access, and pay for AT/HM. We also identified a number of innovative strategies and resources that the NFCSP network can use to assist family caregivers with AT/HM.
Suggestions for a Dissemination Strategy
In discussions with experts and stakeholders, consensus emerged that accelerating the use of AT/HM to reduce physical strain among family caregivers will require a comprehensive dissemination strategy that includes:
Developing multiple informational resources (e.g., videos, brochures, training courses on AT/HM and preventing physical strain).
Disseminating the information through multiple channels (e.g., online, physicians' offices, community organizations, the media).
Reaching multiple target audiences (e.g., family caregivers, CMs and SWs who work with caregivers, physicians, builders, contractors).
A suggested next step was to convene a national meeting of a wider group of stakeholders involved in AT/HM for older adults and their caregivers in order to develop and carry out a dissemination plan. Panel participants noted that this could provide opportunity for the AoA Aging Network to establish new partnerships.
Suggestions for Policy
In addition, panel participants agreed that overcoming barriers to family caregiver use of AT/HM will also require changes to several aspects of health, long-term care, and housing policy.
Challenges to accessing AT/HM will need to be addressed within programs that offer some AT/HM services (e.g., Medicare, Medicaid, HUD assistance programs). Experts and stakeholders recommended expanding coverage to include a comprehensive array of AT/HM, to respond to individual needs for support to retain independence and live at home. In addition, these programs need to be better aligned in support of common goals.
Another frequently mentioned recommendation was to expand coverage in public programs for OT and PT services. Occupational therapists can provide in-depth assessment of a person's home and suggest specific solutions that could help the person maximize function and retain independence.
Another issue raised by several panel participants is the need to modify housing and zoning laws to support aging in place and multi-generational living and to enact policies encouraging universal design in new construction.
Suggestions for Future Research
The discussions indicated two broad areas where additional research is needed:
To develop and expand AT/HM efforts, additional research will be needed to identify effective approaches and evaluate their impacts on reducing caregiver strain, increasing independence, and saving costs. These research questions could be addressed through a potential demonstration project.
Also needed is additional research is to develop and test new AT/HM products that are designed to meet the needs of family caregivers and older adults living at home. Panel participants discussed that one of the barriers to using AT/HM is that many products are designed for use in institutions, rather than in the home.
The above suggestions experts and stakeholders are supported by the research literature. Implementing these actions to encourage the use of AT/HM to reduce caregiver physical strain would also support recent federal efforts to promote community living, evidence-based health care, and cost savings.