There is an increasing body of evidence that has documented the persistent decline of functional deficits in traumatic brain injury (TBI) survivors as they age. 1 In consequence of this decreased function, there is an increasing reliance on the support systems that increase the burden on aging caregivers, health care providers and community support programs. This has occurred within the context of a Canadian society that is further being shaped by an increased presence and integration of technology within the home and community. However, we still have limited knowledge about how smart homes and monitoring technologies can be used to optimize the functioning and participation of individuals aging with TBI, and reduce caregiver burden. This symposium will discuss current evidence examining long-term needs of individuals with TBI, and present a working framework depicting an e-health strategy and strategic technological initiatives addressing these needs.
The first talk of this symposium will present a summary of priority needs of individuals aging with TBI based on the findings of a World Café conducted with experts in TBI, people having sustained a TBI, caregivers and representatives from community associations. Results of a recently completed scoping review and an accompanying stakeholder consultation will then highlight important aspects of subjective and objective caregiver burden in need of being addressed in individuals more than two years post-injury.2
The second presentation will introduce a framework depicting an e-health strategy designed to address the long-terms needs of individuals living with the effects of TBI and their aging caregivers. The framework depicts various technological innovations (e.g., monitoring devices, smart homes), and aspects of the user-technology interaction, that influence desired outcomes. The technology has been developed through iterative cycles of knowledge synthesis and ongoing consultation of caregivers and individuals living with severe TBI.
The third presentation will illustrate how a smart home technology called the COgnitive assistant for coOKing (COOK) was developed to optimize the security and long-term rehabilitation of individuals with severe TBI. 3 Data will be presented on 3 individuals with severe TBI using this technology in an alternative living residence to prepare meals. The findings demonstrate that COOK technology facilitated the transfer from a long-term care residence to a supervised apartment with cooking privileges. A mobile app developed to facilitate caregiver supervision will complete this presentation.
The symposium will conclude with a discussion of how the social and political context influences uptake of emerging technologies for the long-term support of individuals having sustained a severe TBI. A discussant will describe the Canadian funding for assistive technology, as well as international trends towards universal access, and pose key questions to illuminate areas for further study.