Page 267 - Encyclopedia of Nursing Research

234 n HOMe cAre TecHNOlOGIeS

quality of life for patients and that families
HoMe Care teCHnologies overwhelmingly want these devises and
H informatics in their home (Smith, 1999, 2007).
A common requirement for placing com-
The Office of Technology Assessment, in plex technological equipment in the home
a 1987 memorandum to the U.S. congress, is that a competent and willing caregiver is
described a technology-dependent person as available to manage the equipment before
one who needs both an ongoing nursing care treatment (such as home parenteral nutrition
and a medical device to compensate for loss therapy). Technology caregiving resembles
of a vital body function, to sustain life, and to a miniature, urgent care center where fam-
avert death or further disability. Home care ilies provide complex, direct patient care,
technologies include mechanical ventilation; maintain equipment and supply invento-
apnea detection monitoring; oxygen assist; ries, obtain needed home services, negotiate
continuous positive airway pressure; nutri- for reimbursement, and manage caregiver
tion or hydration via central venous infusion; problems of fatigue (czaja & Schulz, 2006;
hemodialysis and peritoneal dialysis; spinal Day, Demiris, Oliver, courtney, & Hensel,
infusion for pain; vascular infusions for 2007). With both medical devise and infor-
chemotherapy, insulin, or antibiotics; auto- matics home care technologies, a family can
matic internal cardiac defibrillation; and left- provide the patient with daily nursing care,
ventrical heart assist devises (Smith, 2009). makes complex decisions about treatments,
Both technology devices and information and learns skills in managing machines
technology systems (Internet, cell phones, or and informatic connections (Matthew, 2006,
telehealth) are involved in home care tech- Morgan, 2004).
nologies. Information technology is used Nursing research has contributed to
to provide guides for assisting families in study of home care technologies findings in
managing home care technology treatments several areas (Smith, 2009). Smith (1995) has
and in supporting health care practitioners’ a series of studies on families, caregivers,
and patients’ visual and audio communica- and patients dependent on technology for
tions (piamjarakul & Smith, 2007; yadrich & lifelong survival (Smith et al., 2002). The eth-
Smith, 2008). Modern informatics technology ical issues in technological home care were
can achieve the goal of “establishing access to summarized and research questions posed
information about home technology care and in a Hastings center report (Arras, 1994,
overcome the discontinuity between inpa- Arthur, pang, & Wong, 2001). Family mem-
tient and home care setting.” bers reported being ill-prepared for technol-
The latest area of home technology ogy caregiving (Smith, 2008), and little has
development is assistance by robots, which been done to support caregivers with their
can remind patients about treatment sched- long-term daily technology care (Smith, 2007;
ules, medications, and even assist in walking Smith, Mintz, & caplan, 1996).
(czaja & Schulz, 2006; pollack et al., 2002). In research with home care technolo-
addition, there are now “smart” homes for gies should be systems oriented on a vari-
frail elders (pollack et al., 2010). Smart homes ety of levels: machine reliability and safety,
are wired with sensors to detect motion and compensated physiological systems, family
thus monitor safety of activities in the home, caregiving, community support, health care
such as overuse of stoves and alert emergency providers, and third-party payers’ reim-
services (Matthews, 2006; rialle, Duchene, bursement (Noel, Vogel, erdos, cornwall,
Noury, Bajolle, & Dermongeot, 2002). & levin, 2004). The most extensive research
Studies verify that various home care has been at the machine or device level,
technologies lead to added length and including manufacturers’ studies of the