Demonstrating a Model Approach to
Independent Living Center-Based Assistive Technology Services

By Margaret A. Nosek, PhD; Thomas Krouskop, PhD

The ILRU Research and Training Center on Independent Living at The Institute for Rehabilitation and Research and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030

Sponsor: National Institute on Disability and Rehabilitation Research, Washington, DC 20202

Purpose

This project is designed to establish, operate, and evaluate the effectiveness of an independent living center-based assistive technology service. The main objectives of this service is to provide appropriate, timely, and affordable repair of assistive equipment and devices; teach preventive maintenance practices to increase the longevity of assistive equipment and devices; refer consumers whose equipment is irreparable to appropriate service providers or vendors who can assist them in obtaining new equipment; and counsel consumers about sources of sponsorship for equipment repair or the acquisition of new equipment. In addition to wheelchairs, assistive technology includes telecommunication devices for hearing-impaired persons, computerized communication boards for persons with aphasia, environmental control systems for persons with movement restriction, and microprocessor controls on wheelchairs.

Progress

Surveys have been completed to identify gaps between consumer need and technology services available in the Houston areas. The Houston Center for Independent Living (HCIL) interviewed 30 consumers from various parts of the city and 22 vendors of equipment and equipment repair services. ILRU staff surveyed independent living centers (ILCs) who responded affirmatively to the equipment services questions in the 1988 ILRU national survey of ILCs.

Based on the results of these surveys, a wheelchair maintenance clinic is held monthly at TIRR as a demonstration model service. A system is now in place where HCIL advertises the clinic, schedules appointments, maintains a database on equipment repair services and resources, does intake when consumers arrive at the clinic, offers counseling and referral services while they wait, and documents maintenance services received. TIRR rehabilitation engineers recruit volunteer workers, supervise and instruct volunteers during the clinic, and perform some of the more complicated maintenance services. ILRU research staff supervise the clinics and conduct evaluation activities.

The first clinic, held at TIRR in January 1992, is now operating at capacity, serving 25 to 30 consumers every month. The first satellite clinic, in the Clear Lake area, was implemented in February 1993 and now provides services for 4 to 8 people monthly.

Results

The experience of ILCs nationwide shows equipment repair services are difficult and cost-ineffective to offer, generally operating at a deficit. The foremost problem identified from the survey of consumers was the unavailability of preventative services and the costly nature of repair services offered through commercial vendors. Transportation problems further complicate efforts to obtain repairs; few vendors offer pick up/delivery or in-home services. The result is that consumers postpone seeking repairs until equipment problems reach crisis proportions. By that time repairs are very costly and consumers are often without their equipment and immobile for long periods of time.

Follow-up satisfaction surveys of consumers who used the wheelchair maintenance clinic showed exceptionally positive responses to the helpfulness of volunteers, quality of services, relatively short waiting time, and extent to which they learned something new about their equipment. Of the respondents, 97 percent felt the preventive maintenance clinic was a worthwhile program. These clinics have saved consumers hundreds of dollars in unnecessary repairs. Before the clinic began operations, only 25 percent of respondents did preventive maintenance on their wheelchairs.

Future Plans

We plan to continue the wheelchair clinics at the present locations because evaluations indicate they have been highly successful. The service schedule for clinics will be evaluated to ensure that it is accessible to the largest number of consumers. New ways will be explored for marketing the program to the community. Information will be sent to community vendors on how they can be more responsive to consumer needs and desires. Periodic follow-up telephone calls will be made to randomly selected consumers to determine consumer satisfaction with the program and responsiveness of the program to overall consumer needs.

Recent Publications from this Research

Demonstrating a model approach to independent living center-based mobility technology services. Nosek MA, Krouskop TA. Assist Technol 1995:7(l):48-54.

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