The cost of dependence of people with limited mobility.

Why should one care about their independence? 

Let’s look at statistics. Almost 30% of U.S. households have at least one person with a disability and the most vulnerable population is older people. According to Harvard research, there is a 40% chance of having a disability after 65 years old. Mobility limitations are a major reason for losing independence. Specifically, more than 11 million people in the States cannot get out of bed without assistance.  They cannot perform basic activities of daily living on their own and are forced to rely on the assistance of family or professional caretakers. 

The dependence of people with disabilities causes a big burden on family and professional caregivers. According to a 2020 AARP report, 53 million Americans are unpaid caregivers. Research made by MIT AgeLab shows that caregivers spend an average of 30.8 hours per week on direct care tasks. Not surprisingly, 69% of working caregivers report having to rearrange their work schedule, decrease their hours, or take an unpaid leave in order to meet their caregiving responsibilities. Caregiver absenteeism costs the U.S. economy an estimated $25.2 billion in lost productivity.

The problem tends to get worse because of the rapid increase in the elderly population globally. It is estimated that 7 out of 10 Americans aged 65+ will eventually need long-term care services. Therefore, by 2030, the demand for home health care is anticipated to grow with more than 1 million new home care jobs needing to be filled.

Who is interested in solving these problems? 

Clearly, many parties can benefit from providing disabled individuals with more independence, including people with disabilities themselves, family caregivers and their employers, professional caretakers, and government agencies. For most parties, increased independence for people with disabilities can provide economic benefits and time savings.

However, the largest meaning independence has for people with disabilities themselves. I know that from my personal experience. My grandfather was paralyzed after a stroke, and he always strived to regain his mobility and independence. It was embarrassing and painful for him to ask for someone’s assistance every time he needed to do simple tasks that previously were so easy to do for him.

Our research made for my startup ReviMo confirmed that it is a very common problem.  We interviewed dozens of people with disabilities and their caregivers. The vast majority of people with mobility impairments declared that they want to regain or save their independence. It gives them the freedom to make their life choices and creates a sense of normal living. People want to independently move around their homes, eat, get dressed, and go to the toilet and bathroom with dignity. 

It is supported by statistics. 77 percent of adults 50 and older want to remain in their homes for the long term — a number that has been consistent for more than a decade.  Why this serious and widespread problem has not been solved yet with all the advancements in engineering, robotics, and AI?!

What solutions are currently available? * 

Human assistance is by far the most common way for people with disabilities to fulfill activities of daily living. Family or professional caretakers assist impaired individuals with dressing, cooking, eating, toileting, bathing, and other tasks. Caretakers can live with a disabled individual permanently or visit them several times per day. To help a disabled person to move from bed to a wheelchair or commode chair caregivers often lift them manually with a risk to get injured themselves. In fact, Certified Nursing Assistants – people typically involved in patient transfer - are highly susceptible to work-related injuries. They have been found to have the highest incidence of work-related injuries and illnesses compared to other occupations, including those in the construction and manufacturing industry. 

What is the reason? The alternative to “heavy lifting” of people with disabilities is using mobility assistive devices such Hoyer lifts or Sit-to-stand devices. They can help to diminish the physical difficulty of transfer, but there is an issue associated with that. To use the device, a caretaker should make a long set of actions that can take up to 20 minutes per transfer.  Although it makes transfer easier, caregivers still need to manually reposition a patient on a bed or help them to sit, which can damage their backs.

What do they do? As we mentioned, there is a shortage of caregivers, and they are highly overworked. Because of the constant lack of time, they are forced to cut corners and manually lift a person, even if it is recommended to use an assistive device for transfer. As a result, they often get injured and take days off exacerbating the shortage in care staff.

What about people living at home? Although the above-mentioned problems are common among private care workers and family caregivers as well, there are additional issues. Most existing mobility devices are designed for use in a hospital or long-term care facility setting. They are reliable and simple but large, heavy, and require special training to use. Many people just cannot fit such devices in their houses and are forced to rely solely on a caregiver’s physical strength. 

So, what about the independence? As you can see, people who cannot stand up or move from a bed to a wheelchair on their own can currently rely only on human assistance and just dream about more independence. The only reliable option for them is asking for assistance, enduring embarrassment, and feeling “not normal”. Some people probably will never be able to replace the human touch of a carer, but why can’t they get the level of independence that allows them to feel more normal?!

Fortunately, startups and tech companies are starting to actively address this growing demand. They are creating voice-controlled digital assistants (like Siri, Alexa, and Cortana) that can be used to control lights, televisions, and home appliances. There are companies like Labrador creating assistive robots that help to transfer food and other things to a disabled person. There are enormous amounts of apps that can be used to remind people living alone to take their medication or when their next doctor’s appointment is, etc. Startups like Sedmed, Smart Hygiene create smart assistive devices that can simplify the toileting process for people with mobility problems.

At ReviMo we have a vision of the product ecosystem that will allow people with severe mobility impairments to fulfill all major activities of daily living independently. Our first device will help people with mobility difficulties to solve the most difficult task – get out of bed without assistance, and then we will create an ecosystem of solutions helping them to bring their independence to maximum. People with a disability should not be excluded. Technology can and must be used to regain their normal lives. 

Please comment on your experience with mobility issues. What other solutions to improve independence do you know?

*In this post, we focus specifically on people with serious mobility impairments who are forced to use assistive devices for everyday living. Although other types of physical or mental disabilities are very important as well, we do not cover them here.

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