Until recent times, people with high-level spinal-cord injury or disorder (SCI/D) and limited mobility may have been very dependent on family members or caregivers to perform a variety of basic daily functions. They may not have been able to do simple things like operating television controls, answering telephone calls, having computer and Internet access, selecting music, or controlling room temperature or lighting. The same may have been true of those being treated in an SCI/D Acute Care or Long Term Care unit where they likely depended on staff and visitors to assist them.
This extreme change in life condition for a person with SCI/D can lead to lower self-esteem and a sense of helplessness. This is often due to depending on others for many activities they effortlessly once did and that most people take for granted.
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Assistance with Daily Living
The environmental control unit (ECU) was invented to help people with limited mobility control basic daily functions with touch, voice, eye, or other body movements. An ECU is a small electronic device with wireless and infrared capabilities and multiple ports that allows users to connect with many electronic devices such as DVD players, televisions, appliances, computers, lighting, and much more.
Over the last few decades, the ECU changed as technology evolved. In 1983, Michael Rourke invented the first voice-activated ECU for his mother, who had multiple sclerosis (MS). Today, ECU technology has developed to allow individuals in their private residences, hospital rooms, or long-term-care settings to experience a greater sense of independence and self-esteem. The new technology allows for much greater control over the environment without the constant need for a family member, caregiver, or hospital staff to attend to them.
The latest technology allows people to operate the ECU and its functions through touch screen, voice, eye, head, tactile, and Sip N' Puff methods. Sip N' Puff technology allows an individual with tetraplegia to control the ECU by placing a plastic tube in his/her mouth. Commands are based upon the quantity of air blown or inhaled into the tube; this has worked well for many people.
Product Examples
One company offers an ECU product that received EDA approval (for medical devices) and says it is the only company with such approval in the marketplace. The firm custom builds its ECUs to meet users' unique requirements. This ECU can control a computer, Internet access, VCR, DVD, CD player, television, phone, and stereo tuner. In addition to these common functions, the unit can connect to a satellite dish, open and close doors and windows, adjust the thermostat, turn lamps on and off, and even [urn book pages. The technology can connect up to (54 appliances and 64 lights in a house with one ECU and can be switch activated, voice activated, or accessed via remote control, and has a voice-controlled mouse/keyboard option.
Another company has developed technology mat allows users to control functions with eye movement, otherwise referred to as "eye gaze." This ECU can remotely control doors, lights, blinds, television, music, nurse call, and even the humidifier. In the hospital setting, the individual can use this technology to control the use of the public elevator by allowing remote operation of the elevator call button in the corridor and the control buttons within the elevator cab. Additionally, the ECU is able to control many functions within patients' rooms.
The Memphis VA Medical Center SCI/D unit staff is proposing to order state-of-the-art ECUs for all its beds. In addition to the typical functions previously mentioned, this system offers upgraded software features such as screen games, book-reading software, and "phrase talker " for verbally challenged patients so they can communicate their needs to staff and family. These ECUs come with built-in Wi-Fi, Bluetooth, a large memory, high-resolution multi-angle touch screen, high-output speakers, and a long battery life.
Designers of new residential projects or renovations, as well as SCI/D hospital and long-term-care facilities, should provide the infrastructure, specify appliances, and select electronic devices compatible with the ECUs available in the marketplace. Appropriate family members, caregivers, or hospital staff should be trained in the operation of the ECUs in the event problems occur with the devices.
Veterans with SCI/D may have the option of obtaining an ECU at little or no cost through the Department of Veterans Affairs (VA). For people who don't qualify for VA financial assistance, other programs may be available and vary from state to state.
Do Your Homework!
Before purchasing an ECU, ask these questions:
Does the manufacturer specialize in ECUs?
Does the unit have flexibility in the types of control and activation?
Is it a stand-alone or computer-based system (a computer-based system could crash)?
Is the ECU flexible enough to be modified and tailored to individual needs?
Does it have remote capabilities?
Is the hierarchy of commands simple and user-friendly?
Are all the functions built-in or does it require many plug-ins?
Does the ECU control the computer and not the opposite (the mouse and keyboard should be operated separate from the PC)?
Is the ECU easy to install?
Is there battery back-up in the event of a power outage?
Does the manufacturer offer excellent service and support?
Technological advances in ECUs have been extraordinary during the last few decades. This should continue well into the future as new technologies become available, leading to even greater independence for individuals with SCI/D.
It is advisable to research several different manufacturers of ECUs before selecting one to make sure the companies provide the functionality, support, and service you require. And, as with all new technology, the price should become more affordable over time.
Contact: PVA Architecture, 800-424-8200.
Resources
Note: PVA has not tested and does not endorse the following products or manufacturers:
* Quartet Technology, Inc.
www.qtiusa.com / 978-957-4328
* PEAC PC
www.peacpc.com / 805-504-9740
* EZCOMM Assistive Technology Solutions
www.atsaac.com / 800-457-2318
MARK GOELLER, AIA, PVA ARCHITECTURE
