Whether we realize it or not, nearly everyone utilizes some sort of “assistive technology” on a daily basis. This can range from eyeglasses and pill cases to hearing aids and prosthetic limbs. However, with such a broad range of products categorized under one large umbrella, can we really say all assistive technology has been created equal? Unfortunately for the nearly 2 million people living with limb loss in the United States, the answer is no.
Access to assistive technology
While some of these devices are easily accessible in drug stores and pharmacies, others like prosthetic limbs, are much more difficult to obtain. This is a fact that thousands of individuals with limb loss have had to learn the hard way. In a study completed by The National Institute of Health in 2017, only 27-56% of individuals with upper-limb loss and 49-95% of those with lower-limb loss consistently utilized a prosthetic device. While it is known that some people prefer not to use a device, this still leaves thousands of people who may benefit from a prosthesis without one.
For many, it can be simplified down to a lack of access to available resources. Understanding where to start in obtaining this type of customized, advanced assistive technology can be extremely overwhelming. Depending on an individual’s location they may have to travel far to find a certified prosthetist or orthotist who is capable of properly fitting and fabricating. As there are ongoing challenges with accessibility of public transportation in many rural areas, this may be impossible for some. For those who do have access to a prosthetist, factors such as poor patient education, poor fit, and inconsistent follow-up care can hinder long-term use.
A unique challenge for this population is that correct use of a multi-joint prosthetic limb can require weeks of device-specific therapy. If location, transportation, and/or time constraints are an issue, this training will often be incomplete. To compare to the pill cases mentioned above, imagine if a pharmacist locked someone’s prescription pills in one and didn’t educate them on how to open it. That would be similar to sending someone home with a prosthesis before first teaching them how to use it. Eventually, anyone would stop using the pill case, and stop wearing the prosthesis, and toss them both to the side.
Read more: Examining the Past, Present, and Future of Assistive Technology.
Financial burden
In addition to access and use, the financial burden of acquiring a prosthesis can be an early limiting factor. According to Amputee Coalition, the nation’s leading organization on limb loss, most devices are only partially covered by insurance. A prosthesis can range from $5,000 to $50,000 each and are recommended to be replaced every 3-5 years. The lifelong costs can be mind-blowing. Amputee Coalition recognizes the process of insurance reimbursement is not smooth sailing either. On their Prosthetic FAQ page, they offer the following advice for those seeking a prosthesis:
Be prepared to make several phone calls, provide documentation, and be your own advocate with your insurance company.
For those individuals who are unable to understand their healthcare documents, or lack the ability to advocate for themselves, this can be a difficult barrier to overcome. At the end of the day, those who simply don’t have the time to spend hours calling insurance companies, attend fittings, complete training, and then commit to lifelong maintenance, may choose to just bypass a prosthesis altogether.
Assistance available
Luckily for those who do wish to utilize every piece of technology available to them, there are several advocacy groups and agencies available to the public to help throughout this process. A thorough reference created by the Assistive Technology Industry Association provides local, state, and federal organizations which are working to increase access to essential assistive technologies. This reference also provides opportunities for financial support, information on insurance policies as well as fundraising ideas. Resources such as this provide a step in the right direction for bringing more accessibility to this unique population. However, until anyone with limb loss or limb difference can obtain customized devices as easily as they can obtain a custom pair of bifocals, the world of “assistive technology” has not yet reached equality.
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