Clinical Question

Is smart-home technology effective for persons with disabilities who live at home?

Evidence-Based Answer

There is not enough evidence at this time to support or refute incorporating smart-home technologies into care of persons with disabilities.

Practice Pointers

Persons with disabilities or who are frail often need caregivers to help with daily activities. Approximately 13 percent of persons in the current workforce have elder care responsibilities,¹ and many more are responsible for younger family members who are chronically ill or disabled. American businesses may lose as much as $34 billion each year because their employees need to care for loved ones who are disabled and 50 years or older.² Additionally, family caregivers who experience stress and strain have higher mortality rates than persons who are not caregivers.³

Various smart-home technologies have been developed to allow persons to be more independent and to support caregivers. Electronic assistive technology includes devices that allow a person with a disability to have more control over his or her environment. Interventions in this Cochrane review included social alarms (an alarm used to summon help if a person has a problem); electronic assistive devices (e.g., keyboards, joysticks, touchscreens); telecare social alert platforms (sensors in the house that monitor if the person is standing, falling, or walking outside); environmental control systems (remote control of electronic devices in the environment⁴); automated home environments (remote controls for home technology, such as lights and phones); and ubiquitous homes (hundreds of computerized sensors that are designed to be “everywhere” and adjust the environment, such as light level and room temperature⁵).

The authors searched for studies that compared the use of a smart-home with no intervention, a single nontechnology intervention (e.g., care staff), and a multifaceted nontechnology intervention (e.g., house without technology). Outcome measures included quality of life, prevention of admission to institutions, health care workload, economic outcomes, service and device satisfaction, and health care attitudes or satisfaction. The authors did not find any articles that met their inclusion criteria.

More research needs to be done before these technologies can be recommended, especially for situations in which patients rely on the technology for their safety. Caregivers can seek other forms of support, such as respite, paid help, and affiliation with organizations (e.g., National Family Caregivers Association [http://www.nfcacares.org]).