title: Examination of new environmental control applications.
abstract: The aim of this study was to examine the application of new Environmental Control Systems (ECSs) in the homes of users and caregivers. The research questions were: (1) Can new ECS applications improve the activities of daily living (ADL) of people with significant functional limitations who require personal assistance? (2) Can new ECS applications replace home services and lessen caregiver burden? To answer these questions, user satisfaction regarding ECS applications, impact on ADL, technical performance, and caregiver burden were examined. This collaborative investigation involving a local community health care center, a telephone monitoring service, an industrial partner, and a university research team used a case study approach. Five users with moderate cognitive problems or significant functional limitations who required personal assistance were chosen, along with their caregivers, for a 3-month in-home trial to test new ECS alternatives. The ECS in the study featured remote control functions (e.g., door lock release, outside intercom), specific verbal reminders (e.g., reminders to turn off stove elements), and automatic functions (e.g., night-lights in the bathroom and hallway). Information was collected in the users' homes with three standardized questionnaires and a company-designed questionnaire. The overall technical performance of the ECS was found to be in most cases moderately efficient. Participant satisfaction revealed that ECS alternatives needed improvement with respect to the service aspects such as follow-up services and repair/servicing. Caregiver burden was lessened for psychological aspects but not for physical tasks. Users seemed to have a positive perception of the impact of the ECS on many of their ADL. We learned six lessons from this 15-month case study, namely: (1) the use of remote control by people with moderate cognitive impairments was difficult; (2) verbal reminders were greatly appreciated; (3) the automatic ECS applications needed more adjustment; (4) reactions varied depending on the participant's perspective; (5) other assessment tools might have been better suited to mild cognitive problems; and (6) removal of a beneficial product at the conclusion of the evaluation phase raised ethical considerations.
authors.affiliation: Dept of Rehabilitation, Faculty of Medicine, Université Laval, Sainte-Foy, Québec, Canada.
authors.forename: Claude
authors.initials: C
authors.lastname: Vincent
authors.forename: Gilbert
authors.initials: G
authors.lastname: Drouin
authors.forename: François
authors.initials: F
authors.lastname: Routhier
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004780:Environment, Controlled; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011792:Quebec