Stay Independent With These Assistive Technologies

Adaptive Equipment and Durable Medical Equipment

Amy Kwan, PT, is a physical therapist based in New York City who specializes in providing care to patients with a variety of orthopedic and neurological conditions.

Elaine Hinzey is a registered dietitian, writer, and fact-checker with nearly two decades of experience in educating clients and other healthcare professionals.

If you or a loved one suffer an injury that leads to either short-term or long-term difficulty in performing daily tasks, the use of assistive equipment and technology may help you return to independence.

The world of technology to help with everyday tasks is vast and varied. There are many options and industry lingo to sift through; so much so that consultation with a professional, such as a rehabilitation therapist, is often merited.

It's important to learn the different categories of assistive technology and, hopefully, set a starting point in finding and understand the technology that might work best for you or your loved one.

Though durable medical equipment, adaptive equipment, and assistive technology are at times used interchangeably, it is generally accepted that assistive technology is the broadest category of devices to assist people in participating in everyday life. Assistive technology is an item or product that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities, such as speech readers or reachers.

Durable medical equipment is equipment that is used in the home by a person with an injury or illness, such as a wheelchair or a shower chair. Adaptive equipment and durable medical equipment are a type of medical supply, which can also be categorized as self-care supplies. These categories are important to understand because they may impact whether the device is covered by insurance.

The phrase "technology" is somewhat misleading as some types of assistive technology are very simple tools, such as a magnifying glass. These are known as low-tech assistive technology. High-tech assistive technology can be as complex as a power wheelchair operated through puffs of air.

Assistive technology refers to any equipment or technology that enhances life participation for people with disabilities or injuries.

A standard definition of assistive technology is used in several pieces of legislation including Section 508: "Any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities."

What sets assistive technology apart from its subcategories is that it does not need to be specifically designed for people with disabilities. It can also benefit the general public.

For example, it is handy for anyone to be able to disarm their smoke detector via a phone app. For a person with limited mobility who is not able to access a ladder, this technology is the difference between being able to perform the task independently and needing to find someone to help.

Other examples of assistive technology at this broadest level include:

Assistive technology in this broadest sense is closely associated with universal design, which is the aspiration of making things accessible to as many people as possible. Universal design can eliminate the need for special technologies and accommodations for people with impairments.

Adaptive equipment is designed specifically for people with long- or short-term disabilities.

The most common types of adaptive equipment are related to activities of daily living (ADLs). These are essential tasks people must perform to sustain a quality of life.

This categorization is important because hospitals and medical facilities ascertain that individuals have a method for safely performing ADLs before discharging. It is in this context that many people are introduced to adaptive equipment.

The examples below are not exhaustive but do represent some of the most common types of adaptive equipment.

Adaptive equipment for dressing:

Adaptive equipment for bathing:

Adaptive equipment for toileting:

Adaptive equipment for eating:

Adaptive equipment for basic mobility:

Mobility can range from walking to driving to the grocery store. Often times, a physical therapist will recommend and provide instruction on basic mobility devices.

Instrumental activities of daily living (IADLs) are activities that enhance daily life beyond basic survival. These are often the second tier tasks that are addressed once discharged from an acute setting.

These pieces of adaptive equipment are more likely to be introduced in an outpatient setting, skilled nursing facility, through home health, or investigated by an individual or family member.

This list is nowhere close to exhaustive as IADLs is a broader category than ADLs. These are simply some examples from a few of the categories, intended to give you a glimpse into the scope of adaptive equipment.

Driving and community mobility:

Communication management:

Cognition:

Leisure:

Safety:

Durable medical equipment includes adaptive equipment items that are most likely to be covered by your insurance.

When the below criteria are met, these items are covered by Medicare Part B. Medicaid programs and other insurance options can also cover durable medical equipment.

In order to be covered by Medicare, a prescription must be written by your healthcare provider. Your rehabilitation therapist's documentation may be critical in justifying this claim to Medicare.

According to the Social Security website, durable medical equipment is defined by the following qualities:

Examples include:

Assistive technology can be introduced in all stages of a healthcare journey, from the hospital to an online support group.

Many people will first be introduced to assistive technology, especially adaptive equipment, through collaboration with a medical professional, such as an occupational, speech, or physical therapist. All three disciplines have training in assistive technology.

These therapists often have the goal of facilitating physical healing for a patient's return to independence. There are circumstances, however, when devices are needed for a period while physical healing progresses (for example, the use of a walker in the first weeks following a hip surgery) or in the case of a more permanent condition adaptive equipment may become a part of daily life (for example, the use of a wheelchair).

Some therapists do go on to become Assistive Technology Professionals (ATPs). This is a special certification that requires 1000 hours of work experience and extra training. Your rehab facility may connect you with one of these professionals for more complex cases. Within this certification, some specialize specifically in seating. These professionals are called seating and mobility specialists (SMS).

While a therapist may recommend certain kinds of equipment and a healthcare provider may order it—it is often up the client to actually purchase the equipment.

The hospital or facility may have some devices on hand for you. In many cases, it will be in the best interest of your pocketbook to shop around and explore all avenues for finding the right aid.

Many times, hospitals and facilities will have particular medical supply vendors they work with and can recommend. This can be particularly helpful when medical supply companies have ATPs on staff. Local vendors can also help you understand Medicare and Medicaid services in your state and other local resources.

Some communities have borrowing closets for commonly used medical supplies. This is particularly beneficial when you need a piece of equipment for a short time. Begin by asking your therapist if they are aware of this service.

Some medical supply companies and other entities offer rental programs for expensive medical supplies (for example, wheelchairs). Again, ask your local rehab department or vendor about options available in your area.

If you or your loved one has a particular diagnosis, there may be assistance through related organizations, either national or local. For example, see this page on the National Multiple Sclerosis Society.

Almost every state has an assistive technology program. The National Assistive Technology Act Technical Assistance and Training (AT3) Center has a helpful directory of resources in each state.

If you or a loved one has a disability, you may benefit from more complex and specialized equipment than has made the above list of common items. There are exciting resources out there to help individuals with disabilities make their environment more accessible. DIYAbility out of NY is a great resource to check out.

Disability Awareness. Assistive tech and DME.

Section508.gov. Glossary.

University of Washington. What is universal design?

AgeSmart Community Resources. Adaptive equipment. Updated July 17, 2015.

Senior Planning Services. ADL/IADL checklist.

Medicare.gov. Durable medical equipment (DME) coverage.

Social Security. HI 00610.200 definition of durable medical equipment.

Rehabilitation Engineering and Assistive Technology Society of North America. Get certified.

AT3 Center. Program directory - find your state program.

DIYAbility. Make your world.

By Sarah Lyon, OTR/L Sarah Lyon, OTR/L, is a board-certified occupational therapist and founder of OT Potential.