Beatrice Yazbek, 81, of Halifax has cared for her husband who has Parkinson's disease for almost four years. It is has been rewarding, but the lifting, bending and pulling has been strenuous on her back. Now, four of the couple's adult children who live in town take turns sleeping at their parents' condominium to help their father lift his legs in and out of bed.
Carolyn Sutherland, a busy Ottawa professional in her 50s, makes time to take a 90-year-old family friend to appointments and out for excursions. She enjoys their time together but is concerned that she doesn't know the best way to transfer her friend from the chair to the walker, and in and out of the car, in a way that protects her own back.
More than eight million Canadians are caring for family members or friends. One of the biggest risks they face is injuring their backs while helping loved ones with activities such as chair and bed transfers, dressing, toileting and bathing.
"We're putting an increasing burden on people to provide care in the home yet we really haven't given them the right tools or training to do their jobs," says Dr. Tilak Dutta, a scientist at Toronto Rehab and an investigator with the AGE-WELL Network of Centres of Excellence, Canada's Technology and Aging Network.
Dr. Dutta, in partnership with Saint Elizabeth Health Care, has developed PostureCoach. This light-weight, wearable device provides caregivers with real-time feedback through a vibration or an audio signal when they are in a posture that puts them at high risk for back injury.
PostureCoach measures the angle between two sensors – one positioned for the upper back and the other for the lower back. It is designed to encourage the wearer to keep their lower back straight, and to bend from the hips instead of flexing the spine.
"It is often impossible to avoid bending in an unsafe posture," says Dr. Dutta. "We know that back injuries are the result of cumulative damage from being in dangerous postures for extended periods of time.
"If you can reduce that cumulative effect or load, you will reduce the chances of experiencing pain or a serious injury."
Wearing PostureCoach, even for a short period of time, would give caregivers an insight into their own behaviours when they are doing caregiving tasks. The device is for anyone who provides care for another person – whether they are a family caregiver or health professional, such as personal support worker (PSW). PSWs often provide care to people in their homes.
Modelled after coach-athlete relationship
PSWs, 92 per cent of whom are female, are the highest injured female workforce in Ontario. Family caregivers are considered at higher risk for injury since they lack training in how to safely perform tasks.
Caregiving in the home is especially challenging due to confined spaces and stairs. Home-based caregivers usually work alone with little assistive equipment.
PostureCoach is modelled after the coach-athlete relationship where a coach's continual feedback over time enhances an athlete's performance. By providing the caregiver with instant alerts when they are in risky postures, researchers hope caregivers will learn to avoid or minimize these positions.
Decreases time spent in high-risk postures
"Behavioural changes take repetitive feedback and the opportunity to continually practice the activity," explains Dr. Dutta.
A pilot study, funded in part by Saint Elizabeth Health Care, showed that new health professionals and people with no caregiving experience or training showed a decrease in the amount of time spent in high-risk or extreme postures when using PostureCoach during a set of caregiving tasks.
Experienced and well-trained health professionals benefited the least from PostureCoach.
Amanda Longfield, occupational therapist and program development leader in the Adult Occupational Therapy Program at Saint Elizabeth, was part of the pilot project team. She also helped to evaluate the initial PostureCoach prototype.
Her key message to the design team: "Caregivers in the field are very busy so this can't be something extra in their day. It has to be simple – easy to put on, easy to wear and easy to use to get that immediate feedback."
With $25,000 in funding from AGE-WELL, PostureCoach was redesigned after the pilot and 10 samples of the new version are being manufactured. Researchers have applied for government funding to use the new prototypes in a larger-scale test involving 100 PSWs in the community.
"The funding from AGE-WELL has been extremely important," says Dr. Dutta. "It is so difficult to get funding to build prototypes. AGE-WELL has given us a very unique opportunity."
"I think PostureCoach has a lot of potential," adds Longfield, "and it's really exciting to see it moving forward."
