2. First
thoughts
• Brian’s issues all seem to relate primarily to the
symptoms of his underlying medical conditions.
• Although he has identified specific areas where these symptoms
cause him difficulty, it is likely that there will be other situations
(both inside and outside the home) where the same symptoms
will cause similar problems.
• Therefore, our focus will be to try to remediate or compensate for
these symptoms – in a manner, wherever possible, that can be
transferred to other environments.

3. Assisting hearing at home and in public places

4. Listening
devices
• It is likely that Brian will already have a hearing aid -
either supplied by the NHS, or privately purchased.
• Research has found, however, that most people
found it more helpful to wear two hearing aids at the
same time (see Kochkin & Kuk, 2000).

5. Listening
devices
• Hearing aid technology has progressed significantly,
and modern versions have been described as "high-
tech computers" (Hear-it AISBL).
• In addition, Brian may find a "personal listener"
helpful (see Action on Hearing Loss for further
information).

6. Boos2ng
the
poten2al
of
listening
devices
• Induction loop or infra-red systems can be
installed within the home or car to filter
out background noise - perhaps making it
possible for Brian to listen to his music or
TV at a lower volume (
Action on Hearing Loss 2011).
• These systems are designed to operate in
a single room. However, an induction-loop
or infra-red microphone may be used to
transmit the sound of the door or phone
ringing, as well as to help Brian to hear
the voice of a caller.
• They are often also used in public
buildings such as cinemas (
Action on Hearing Loss 2011).

7. Boos2ng
the
poten2al
of
listening
devices
• A wireless multi-alerting
system, however, can be used
with a pager or portable
receiver to hear sounds
throughout the home (
Action on Hearing Loss, 2012).
• Some examples of products
can be found here.

8. At home and when shopping

9. Enhancing
vision
in
the
home
Brian may wish to look at ways of
preventing further degeneration of his
eyesight.
One way of doing this may be by
ensuring he has
adequate lighting in the home.
He may want to consider some
relatively simple changes to lighting
that will make a huge difference to his
vision around the home.
Click here for an informative
slideshow on “Housing Design,
Lighting and Visual Impairment” from
the Thomas Pocklington Trust.

10. Enhancing
vision
directly?
• Standard (magnifying) lenses are
relatively ineffective for AMD.
Therefore, a number of alternative
strategies have been developed,
including:
• Surgical implants (e.g. an
intra-ocular lens for visually
impaired people
• Systems of Sight prismatic
glasses (which look very similar
to normal glasses).
• A video magnifier such as the
Vuzix SightMate can be used to
optimise residual peripheral
vision.

11. Shopping
• If Brian is now finding his weekly shopping trips difficult, a
simple answer may be to order items online.
• Many of the devices previously mentioned for enhancing
vision directly could be used alongside a computer; or a
PC could be adapted.
• The RNIB now provides
website audits to help improve
accessibility for visually-impaired
users.
• See also details of the stores that
the RNIB recognises as improving
accessibility for the partially sighted.

12. Shopping
• However, it is recommended that people with
congestive heart failure continue to exercise as much
as possible.
• Therefore, although Crosier (2009) found several
barriers to shopping for blind or partially-sighted
people, it may be best to encourage Brian to continue
shopping in the ‘traditional’ way.

13. Naviga2on
to
and
from
the
shops
Smartphone Apps
• Brian may find using
mobile-phone software
helpful for navigation.

14. Naviga2on
to
and
from
the
shops
Smartphone Apps
• Brian may find using
mobile-phone software
helpful for navigation.
• They could help him
pinpoint his location
should he become lost,
and give him step by
step directions either
home or to a shop.
(e.g. GoogleMaps for Windows phone)

15. Naviga2on
to
and
from
the
shops
Smartphone Apps
• Brian may find using
mobile-phone software
helpful for navigation.
• They could also help
with finding the right
shops & facilities near
to him. (e.g. AroundMe app for Smart phones)

16. Naviga2on
to
and
from
the
shops
GPS Hardware
• The Trekker Breeze uses GPS
within specialist hardware for
blind or partially-sighted people.
• Some automobile satellite
navigation devices (e.g. The
Garmin Nuvi series) are small
enough to be hand held, can be
voice activated and provide
visual and vocal directions.

17. Naviga2on
to
and
from
the
shops
Obstacles
• Traditionally, visually-impaired
people may have been
recommended a white cane to
assist them in detecting
obstacles.
• Now, however, there are a
series of electronic obstacle-
detectors that Brian may find to
be more user-friendly.
• See Ball (2004) for some
examples – ranging from add-
ons to canes, to ‘sonic imaging’
devices.
• Click the images below for two
other interesting methods of
detecting obstacles:

18. In
the
supermarket
• Again, there are plenty of
Smartphone apps which
can assist with shopping
tasks:

19. In
the
supermarket
• Again, there are plenty of
Smartphone apps which
can assist with shopping
tasks:
• TapTapSee uses a phone
camera to recognise objects
and then ‘says’ what it is
(Named App of the Month
by RNIB in March, 2013).

20. In
the
supermarket
• Again, there are plenty of
Smartphone apps which
can assist with shopping
tasks:
• TapTapSee uses a phone
camera to recognise objects
and then ‘says’ what it is
(Named App of the Month
by RNIB in March, 2013).
• ScanLife Barcode & QR
Scanner recognises label
codes and automatically
finds product information.

21. In
the
supermarket
• Shop Sense combines a
hand-held device with a
re-design of the shopping
experience.
Click picture for more details

22. In
the
supermarket
• Shop Sense combines a
hand-held device with a
re-design of the shopping
experience.
• The MediaCart combines
in-store navigational
technology with a barcode
reader and voice-
recognition technology, to
integrate all aspects of
shopping. Click picture for more details

24. Strategies
to
help
Brian
deal
with
his
memory
problems
• One or more of the following strategies could be
adopted by Brian:
• Automatic pill-dispensers.
• More generic memory devices.
• Technology to help Brian exercise his memory
retention.

25. Automa2c
pill-­‐dispensers
• Boots the Chemist have
agreed that they will fill
the
Pivotell pill-dispenser for
users, so that the initial
organisation process is
no longer required.

26. Generic
memory-­‐aids
• A large number of
mainstream devices are
available to provide
reminders of important
events and information,
including PDA and mobile-
phone technology.
• A smartphone app example
could be a medication
reminder (e.g. PillManager).

27. Generic
memory-­‐aids
• Alternatively, products such
as the Pivotell Mem-X can
be used to record messages
which will give audible
reminders of key tasks
during the day.
• Although Brian’s current
difficulties are not sufficient
to suggest a diagnosis of
dementia, he may still find
devices such as the
MANA Calendar to be
helpful.

28. Using
technology
to
exercise
memory
reten2on
• Although there is some
disagreement in this regard,
most studies suggest that
cognitively stimulating
activities are of benefit in
enhancing or maintaining
memory (see also:
McDaniel & Vick, 2010;
Hardy et al, 2011).
• One promising application of
this concept is the development
of life-logging technology such
as the Sensecam.

30. Home
monitoring
and
exercise
• Telecare such as
Docobo's
Doc@Home system
allows daily monitoring
of Brian's health status -
reducing the need for
repeated visits to or
from healthcare
providers.

31. Home
monitoring
and
exercise
• Home exercise programmes
have been found to be
beneficial for heart-failure, but
some factors may prevent this,
whilst some patients may be
worried about over-exercising
(Jolly et al, 2007).
• The Philips Motiva system may
therefore be useful, as it
provides education and
feedback in addition to
monitoring.
• The CARME study gives
evidence that Motiva has a
number of benefits for this
patient group.

32. More
about
exercise...
• Gentle exercise is recommended for
people with heart failure, such as
walking and Tai Chi (Yeh et al, 2009).
• Therefore Brian should be encouraged
to engage in gentle exercise; but
motivation can be difficult.
• One solution may be to utilise
pedometer (e.g. FitBit) and step
counter (e.g. Pacer; Walk4Life)
technology, some of which can ink to
websites and phone apps to plan
routes, log progress, create goals etc.

33. More
about
exercise...
• Another answer to this may be to use
mainstream computer gaming
technology for real-time feedback:
• The new motion-sensing Kinect
system has a game called
Your Shape, which is an exercise
package that includes Tai Chi.
• The Nintendo Wii has the fitness
oriented Wii Fit add-on, which is
designed to help improve fitness,
balance and muscle tone.
• However, the movement involved in
many of the Wii games can prove
popular and intuitive for someone like
Brian to use, and can help improve
fitness without feeling like exercise.

35. Low
mood
&
loneliness
• Technology could be most useful in assisting Brian to decrease his sense of
loneliness.
• He could use social networking sites such as Facebook to keep in contact with
friends
• He could join forums (e.g. perhaps one for bereaved spouses such as Widow.co.uk).
• He could use Skype or FaceTime to keep in contact with others.
• There are a variety of websites and apps that may help him to manage his
mood
• MoodGYM is an online CBT based self help programme aimed at reducing feelings
of depression and anxiety.
• A tool like Lifepsychol (evaluated by HDTI, Coventry University) could be used to
monitor his mood over time.
• Five ways to Wellbeing is an app which looks at coaching the user to improving
overall mental wellbeing.
• Moodscope tracks mood but also provides a facility to share scores with friends/
family enabling them to offer help to the user without needing to be asked.

37. Some
points
to
think
about
...
• As you can see, there is plenty of technology available to assist with each
aspect of Brian’s health issues.
• However, we need to remember to look at Brian’s issues holistically, bearing in
mind that what may work for him in one respect may be counteracted in
another respect.
• For example;
• There are a variety of mobile phone apps which can assist Brian with monitoring and
managing his own health, BUT what if his deteriorating eyesight means that he
cannot see the screen?
• There several physical devices (e.g. spectacles, hearing aids etc) that may help
Brian interact with his environment effectively, BUT what if his memory problems
means that he forgets to pick them up and wear them?
• There is no right or wrong answer here – just a reminder that when considering
which ATs might be useful for a person, it is important to consider ALL aspects
of their health, abilities and circumstances.