Understanding adherence to assistive devices among older adults: a conceptual review

Abstract

Purpose: The aim of this study was to identify and examine how existing literature has conceptualized adherence to assistive devices (ADs) among older adults.

Methods: English articles were searched in MEDLINE, PubMed, and CINAHL (January 1990 to October 2017) for the key words “acceptance”, “adherence”, “assistive devices”, “compliance”, “concept,” and relevant synonyms. Bibliographies of selected articles were also examined. Articles were analyzed if the following conditions were met conjointly: (1) attempted to define or conceptualize adherence to some degree; (2) were concerned with any AD for older adults; (3) were concerned with adults aged 65 years or older.

Results: Sixteen of the 484 articles were included. Adherence to ADs among older adults seemed to be conceptualized under three core themes: psychological, contextual, and functional factors; each with their own unique considerations related to adherence that are analyzed in this study.

Conclusion: This review identified a large gap in knowledge about adherence to ADs. Adherence is multi-factorial and highly specific to the individual’s circumstances and their relationship with their health care practitioner. Further empirical research should focus on how the three core themes of adherence interact with and influence each other.

Implications for rehabilitation

• Health care professionals who assess for, and recommend ADs should foster a shared decision-making relationship with their clients

• This review identifies some of the key themes that practitioners should consider when developing and implementing AD regimens with older adults

• Conceptualizing AD adherence among older adults will help improve monitoring of and quality of care for AD users

Keywords:

• Assistive device
• adherence
• outcome
• rehabilitation
• model

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was funded in part by the Canadian Institutes of Health Research (CIHR, Ottawa, ON, Canada), grant no NRF-111147. Principal investigators were : L. Demers, F. Deruyter, J. W. Jutai, W. B. Mortenson, and A. Sixsmith.