COMMUNITY DESCRIPTION 

 

This program area covers the northwestern corner of North Carolina.  Virginia forms its northern border, while Tennessee bounds it on the west.  The region is northeast of Asheville and roughly 90 miles west of Winston-Salem.  The district is one of the most mountainous and rural (92 percent of the population) in the state.  Rough­ly 13 percent (35,600) of its population is elderly, and one in four lives at or below the poverty level.  According to demographic statistics, 19 percent live alone,  just under 12 percent are mobility impaired, and four and one-half percent need personal care services. 

 

BACKGROUND HISTORY 

 

The ABILITY Program loans low-tech assis­tive equipment to older adults to increase or maintain their independence.  It also promotes collaboration among agencies that serve older adults in the region by acquiring and maintaining inventories of commonly used equipment.  New and used assistive items are loaned to an individual until he/she no longer needs them.  Through sharing stored equipment, the Program benefits a greater number of older adults.

 

State and federally funded programs such as Medicare and the Community Alternatives Program for Disabled Adults provide only limited assistance with assistive technology equipment.  Eligibility is limited to those with very low incomes and, even then, the programs usually pay only a portion of the equipment cost.  Seniors who live on low to moderate incomes often face high medical bills and are unable to afford needed personal equipment.

 

The term “assistive equipment” (or assistive technology), includes any device that maintains or improves the ability of someone to function more “normally.”  Typical items include walkers,  phone amplifiers,  quad-canes,  bath benches,  elevated toilet seats,  bathtub or shower grab bars,  large-handled utensils (spoons, forks, knives), etc. These devices can provide older or disabled adults with the tools they need to maintain personal independence--an important  aspect of their emotional well-being.

 

PROJECT INITIATIVE

 

Low-tech equipment or appliances assist impaired and disabled seniors in performing activities of daily living, such as bathing, toileting, cooking, cleaning, and climb­ing stairs.  The shortage of nearby medical and pharmaceutical facilities in the ABILITY service area creates additional burdens on those needing such equipment. This program has satisfied some of this demand and helped seniors stay in their homes and avoid serious injury that could result in hospitalization.

 

To qualify, an individual must be:  1) at least 60 years of age, 2) a resident of one of the seven area counties, and  3) in need of low-tech assistive equipment.

 

The goals of the ABILITY Program are twofold.  The first is to distribute low-tech assistive equipment to older (age 60+) disabled adults to maintain or enhance their independence.   The second is to educate the community on the availability of such equipment.  The targeted group is notified that a single referral organization for such equipment has been established in each county.  Individuals may contact this agency to see whether they qualify.  The community learns of the program via presentations, demonstrations and workshops throughout the seven-county region.

 

During the initial phase of the program, an advisory committee was formed.  This group played a strong and influential role in the development stage.  The committee was charged with:  1) establishing policies and procedures for equipment referrals and distribution, 2) monitoring program activities, 3) making recommendations for improving the program, and 4) outreach and needs identification in each of the counties served.  The regional committee met monthly while the program was beginning, and quarterly thereafter.  The coordinator was responsible for keeping the advisory committee informed of any pertinent activities affecting the program.

 

Any senior service provider in the region may refer an older adult.  All referrals are sent first to the county coordinating agency.  The coordinating agency conducts a needs assessment.  If the applicant qualifies, the referral is forwarded to the program coordinator.  The coordinator then orders the equipment and pays the vendor.  Equipment is shipped directly to the county coordinating agency which then delivers the equipment and trains the client in its operation.

 

Evaluations are performed to ascertain the extent to which the loaned equipment has maintained or improved clients’ abilities to perform activities of daily living.  Recommendations for modifications to the ABILITY Program are made by the Advisory Committee and Area Agency on Aging staff.

 

When clients no longer need the loaned equipment, it is returned to the county coordinating agency to be stored in their “closet” until it is needed again.  Establishing and maintaining these “loan closets” ensures that the benefits of the ABILITY Program will continue beyond the grant period.

 

FUNDING

 

The ABILITY Program was funded as a two-year grant of $110,000 by the Kate B. Reynolds Charitable Trust of Winston-Salem.  It is administered through the Area Agency on Aging, which is within the organizational structure of Region D Council of Governments.  The funds were distributed equally to each county and used primarily to purchase new assistive equipment.  Some funding was retained by the regional organization to cover administrative costs.  This grant expires on December 31, 1997.

 

CHALLENGES

 

Undoubtedly, the greatest challenge has been to inform older adults of the availability of assistive devices that could make their lives better.  Another has been overcoming the simple pride that prevents some from accepting services.  Many who need assistive equipment have done without for a long time or found an alternative device to “do-the-job.”  Some just feel more comfortable doing things the old way, rather than making a change.  Breaking down these barriers has been difficult.

 

As of 1997, the program had finished the grant period and served over 400 clients.  The most commonly ordered items were kitchen accessories, hand held shower sprays, tub safety rails, transfer benches, raised toilet seats and adjustable bath chairs. These are all fairly common in urban environments; however, they are somewhat foreign in rural areas.  They are used by seniors who have chronic problems rather than critical illnesses.  The principal medical conditions have been arthritis, orthopedic problems, and vision impairment.  Naturally, many older people have more than one impairing condition.

           

Women were the greatest users by a ratio of 5.6:1.  The average client age is 78, with an age range of 61 to 96.

 

Use rate by county for the most part reflected the county population.  However, the rate for one county was higher because their local office had a VISTA volunteer to screen, deliver equipment, and train recipients.  Those counties with smaller coordinating agencies sometimes found it hard to add this program to their responsibilities.

Based on conversations with the program coordinator, it is believed this program can be easily duplicated.  A minimal amount of money is actually needed since items are used and re-used.  Most of the devices are inexpensive if they prolong a senior’s independence in their own home.  Many people on fixed incomes probably could not afford them; however they are excited to get the use of these items free.

 

CURRENT STATUS 

 

In 1997, the Ability II Program began.  The purpose of this program is to continue and expand the assistive technology programs started by the first Ability Program.  The program will provide financing for initiatives that promote and provide access to assistive technologies at home, in the work place, and in the community.