Computers: not just for e-mail anymore! You might be surprised at what computer systems and Internet access can do for residents—and which ones can benefit

Nursing Homes, July, 2004 by Jack York

Statistics continue to show that older adults are the fastest-growing audience to take advantage of the Internet. Those statistics usually take into account healthy, independent older adults who are physically and cognitively able to deal with the complexities of computers, but the elders most in need of staying in touch, staying connected, and staying mentally active are the millions who live in a variety of nursing homes and assisted living communities throughout the country.

Some people say NH residents are "too old" or "too disabled" to use computers, but through my work with It's Never 2 Late, I've seen remarkable examples that shatter this myth. I've gotten to know a 103-year-old woman who independently sends and receives e-mail and another who is 110 years old and blind who sends audio e-mails with assistance. Contrary to what many believe, even those residents with Alzheimer's disease and other cognitive impairments can benefit from using computers. Although e-mail is obviously beneficial in decreasing or eliminating the isolation that plagues residents of long-term care facilities, and although it is often the driving force behind a facility's deciding to get its residents "wired," it is only one of many ways a computer system can be used to add richness to residents' lives.

This article shows how long-term care residents, including those with physical and cognitive limitations, can have engaging and stimulating computer experiences with the use of the adaptive devices and equipment. It also highlights some of the many resident activities for which computers and the Internet can be used and explains ways in which computers are being successfully used as therapy tools.

Tools That Simplify Access

Special keyboards and mouse devices, visual magnification software, touch-screen monitors, and portable computer systems are just a few of the tools that can help residents take advantage of the health and connectivity benefits of the Internet. The following are examples of devices and equipment available on today's market.

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Adaptive keyboards, such as those available from IntelliTools[R], Inc., have large, well-spaced keys in high-contrast colors, making them easier to use than standard keyboards for people with visual impairment or arthritic hands. The keys are flush on a flat surface, rather than raised as on a standard keyboard. The accompanying IntelliKeys[R] software enables plastic overlays to be placed over the keyboard to provide additional adaptation. For example, one overlay arranges keys in alphabetical order rather than in the usual QWERTY arrangement--a useful feature for people who rely on the "hunt and peck" method because they never learned to type by touch. Although our company has had excellent results with IntelliTools, there are dozens of other adaptive keyboard manufacturers. Web sites such as www.rehabtools.com show a variety of available options.

Trackballs, available from many computer equipment manufacturers, are alternatives to the standard computer mouse. Instead of having to move a mouse around a mousepad, users of trackballs simply roll a ball that sits in a stationary device to move the cursor. Some users find this device easier to maneuver than a mouse. Our primary adaptive mouse supplier is a company called Infogrip, Inc., which offers the Ergo-Track-ball by Comfort[TM], among others. The adaptive-tools Web site mentioned above provides additional options.

Various types of visual magnification software are available to help individuals with sight issues, but our results have been mixed. We have found that the software is an excellent tool for individuals with computer experience who have impaired vision, but for first-time users, the added complexity of the software can create frustration. For them, we have had greater success with simply attaching a flat-screen monitor to an arm (built by Kensington) that can position the monitor close to an individual's eyes.

The software we do recommend, where appropriate, is BigShot Screen Magnifier[R] (a fairly inexpensive and easy-to-use program without a lot of features) and ZoomText (a very sophisticated program with a multitude of features, but fairly expensive).

Adaptations are also available through the Windows[R] operating system. There is an "accessibility options" icon within the Windows[R] control panel that lists a variety of changes one can make to font sizes, colors, etc. These options are easy to use and free.

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A touch-screen monitor, as the name implies, enables a user to choose from options displayed on the monitor by touching the screen instead of typing or clicking the mouse. Monitors can be purchased with touch-screen capability already built in, or overlays are available that will convert a standard monitor into a touch screen. The overlays are much cheaper than a touch-screen monitor out of the box, but quality can be an issue. Touch-screen monitors are useful for residents who are visually or cognitively impaired or those who, for whatever reason, cannot use a keyboard. Some touch-screen monitors support a combination of touch-screen, keyboard, and mouse/trackball inputting.