Choosing assistive technology is rarely as simple as matching a product to a diagnosis.
Two people with similar health conditions may have completely different routines, priorities, home environments and attitudes towards technology. A device that works well for one person may feel impractical, uncomfortable or unnecessary to another.
This is why a successful recommendation begins with questions—not products.
Before discussing features, models or funding, Occupational Therapists need to understand what the client wants to do, what is getting in the way and how a potential solution would fit into everyday life.
The following questions can help guide a more person-centred assistive technology assessment.
1. What Does the Client Want to Keep Doing?
The first conversation should focus on the person’s goals, not the equipment.
Ask:
- Which activities are most important to you?
- Is there anything you have stopped doing or now avoid?
- What would you like to manage more independently?
- What would help you feel safer or more confident?
- Which daily routines do you not want to change?
A client may not be particularly interested in “reducing falls risk” as an abstract goal. They may, however, care deeply about continuing to walk the dog, visit friends, work in the garden or live in their own home.
Connecting the recommendation to a meaningful activity gives the technology a clear purpose.
Without this connection, even a clinically appropriate device may feel like something being imposed on the person.
2. What Is Actually Happening During the Activity?
A general description of the problem may not reveal what is causing the difficulty.
Whenever possible, observe the client completing the activity in the environment where it normally occurs.
Consider:
- What happens immediately before the difficulty?
- At which point does the task become unsafe or frustrating?
- Is the problem consistent or does it vary?
- Does fatigue affect performance?
- Are distractions, noise or poor lighting involved?
- Is the person already using a workaround?
- Does the difficulty occur at a particular time of day?
For example, a client may report having trouble getting to the bathroom. The underlying issue might involve poor lighting, urgency, dizziness when standing, unsuitable footwear, a narrow walking path or difficulty remembering where a mobility aid was left.
The most appropriate response will depend on the actual cause.
3. What Is the Client Already Doing Successfully?
Assessments can easily become focused on limitations.
However, understanding the client’s strengths is equally important.
Ask:
- What parts of the activity can you still complete comfortably?
- Have you found any strategies that make it easier?
- What equipment are you already using?
- Which routines are working well?
- What technology do you already feel confident using?
A person who regularly uses a smartphone may be comfortable with an application-based solution. Someone who has never used a touchscreen may prefer a device with one clearly marked button.
Existing skills, habits and problem-solving strategies can guide the recommendation and reduce the amount of change required.
The aim is to support the client’s abilities—not replace them unnecessarily.
4. What Does the Client Think the Technology Represents?
Assistive technology carries different meanings for different people.
A personal alarm may represent reassurance to one client and declining independence to another. A mobility aid may feel empowering to someone who wants to remain active but embarrassing to someone who worries about appearing frail.
Ask:
- How do you feel about using this type of technology?
- Have you used something similar before?
- Is there anything about it that concerns you?
- How would you feel wearing or using it around other people?
- What would make it feel more acceptable?
These questions can reveal emotional barriers that a standard functional assessment may miss.
A client who says, “I don’t need that,” may be expressing fear, uncertainty or concern about what the device symbolises.
Our article on why clients resist assistive technology explores these factors in greater detail.
5. Does the Technology Match the Client’s Abilities?
The device must be accessible to the person who will use it.
Consider the client’s:
Vision
Can they see the screen, labels, buttons and indicator lights? Can the text size and contrast be adjusted?
Hearing
Can they hear alerts, instructions or spoken responses? Are vibration or visual alerts available?
Dexterity
Can they hold the device, press its buttons and connect the charger? Would arthritis, weakness, tremors or reduced sensation affect use?
Cognition
Can they remember the required steps? Does the device rely on changing menus, passwords or unfamiliar symbols?
Communication
Can the person understand the instructions and communicate effectively through the device?
Mobility
Can they reach, carry or wear the technology where it is needed?
A long list of features has little value when the client cannot comfortably complete the device’s main function.
6. Will It Fit Into the Client’s Daily Routine?
A device may work well during an assessment but fail once it enters the person’s everyday life.
Ask:
- When will the device be used?
- Where will it be kept?
- Does it need to be worn throughout the day?
- When and where will it be charged?
- How will the client remember to use it?
- What happens when they shower, sleep or leave the house?
- Does the technology interrupt an established routine?
The easier a device is to incorporate into existing habits, the more likely it is to be used consistently.
For example, a wearable emergency device may be beneficial only if the client is comfortable wearing it and has a realistic charging routine. A medication reminder may not help if it sounds in a room the person rarely uses.
Technology should adapt to everyday life wherever possible.
7. Where Must the Technology Work?
The environment can affect performance just as much as the device itself.
Assess:
- The layout of the home
- Lighting and background noise
- Mobile or internet coverage
- Access to power points
- Bathroom and outdoor use
- Distance between rooms
- Building materials that may affect connectivity
- Places the client regularly visits
- Whether the technology must work away from home
A home-based alarm may not provide coverage in the garden or community. A mobile device may depend on network availability. A voice-controlled system may struggle in a noisy household or when the client has changes in speech.
Before recommending connected technology, confirm where it needs to function and whether the necessary infrastructure is reliable.
8. What Is the Simplest Option That Can Meet the Need?
Advanced features can be helpful, but they also introduce more opportunities for confusion or failure.
Ask:
- Which features directly support the client’s goal?
- Which features are optional?
- Would a simpler device achieve the same outcome?
- Does the client want remote monitoring or data sharing?
- Will added functions create more work for the client or family?
- Can unnecessary features be disabled?
The best solution is not always the device with the most capabilities.
A simple tool that is used every day may be more effective than a highly advanced system that the client finds intimidating.
The right level of technology should be determined by the person’s needs and preferences—not by what happens to be newest.
9. Who Will Help With Setup and Ongoing Support?
Assistive technology often requires support beyond the initial recommendation.
Ask:
- Who will install or configure the device?
- Who will provide training?
- Is there someone available to help with updates or troubleshooting?
- Who will replace batteries or check charging?
- What happens if the device stops working?
- Is customer or technical support available?
- Are instructions accessible and easy to understand?
Family members may be willing to help, but their availability should not be assumed. They may live elsewhere, work full-time or feel uncomfortable managing the technology.
Providers and clinicians should also be clear about who is responsible for installation, testing, maintenance and follow-up.
Without an agreed support plan, minor technical problems can quickly lead to device abandonment.
10. What Could Prevent the Client From Using It?
Instead of asking only why the technology might work, consider why it might fail.
Potential barriers include:
- Discomfort
- Stigma or embarrassment
- Complicated controls
- Fear of false alarms
- Poor battery life
- Difficult charging
- Unreliable coverage
- Ongoing costs
- Subscription requirements
- Lack of family support
- Concerns about privacy
- Changes in cognition or health
- Unclear instructions
Ask the client directly:
“What do you think could make you stop using this?”
Their answer may identify a problem that can be addressed before the equipment is purchased.
11. Has the Client Had a Meaningful Choice?
Person-centred care requires more than presenting one preferred product.
Ask:
- Has the client been given understandable information?
- Have suitable alternatives been discussed?
- Does the client understand the benefits and limitations?
- Have cost and ongoing fees been explained?
- Has the client had enough time to decide?
- Are family members influencing the decision?
- Does the client feel comfortable saying no?
Older people receiving funded aged-care services have rights related to independence, autonomy and freedom of choice. The Australian Government’s Statement of Rights emphasises the importance of enabling older people to make their own decisions and maintain control over their care.
The client’s preferences should remain central, even when family members or professionals have concerns.
12. Can the Client Trial the Technology?
A trial allows the client to experience the device in real situations before making a longer-term commitment.
During the trial, assess whether the person can:
- Complete the primary function
- Understand alerts and instructions
- Wear or carry the device comfortably
- Charge or maintain it
- Use it in different parts of the home
- Recover from common mistakes
- Remember to include it in their routine
- Explain when and why they would use it
Agree on what success will look like.
This might include:
- Wearing the device for most of the day
- Completing a call without assistance
- Responding correctly to a reminder
- Feeling more confident during a particular activity
- Reducing the amount of help required
- Experiencing fewer practical difficulties
A trial should test whether the technology improves the client’s daily life—not simply whether the device technically works.
13. What Happens if the Technology Fails?
Assistive technology can reduce risk, but no device is perfect.
Ask:
- What happens during a power outage?
- What if the battery is flat?
- What if mobile or internet coverage is unavailable?
- What if the client is not wearing or carrying the device?
- What if an alert is not detected?
- Is there another way to call for help?
- Who will notice if the device stops working?
For safety or emergency technology, explain limitations clearly and create a backup plan.
The client and family should understand that technology supports a broader safety strategy. It does not replace appropriate medical care, environmental changes, human contact or emergency planning.
14. When Will the Recommendation Be Reviewed?
A recommendation should not end when the device is delivered.
Ask:
- When will the first follow-up take place?
- Who will confirm that the technology is working?
- How will concerns be reported?
- What changes would trigger an earlier review?
- Is the client still using the device as intended?
- Has it improved the activity it was selected to support?
Follow-up may reveal that the client needs more practice, a different wearing option, clearer instructions or a change to the setup.
It may also show that the technology is not the right fit.
This should not automatically be treated as non-compliance. It is information that can be used to improve the recommendation.
Move From Product Selection to Person-Centred Problem-Solving
The World Health Organization notes that assistive technology includes both physical and digital products that support functioning and independence.
However, access to a device does not guarantee that it will be useful.
Successful recommendations depend on how well the technology fits the client’s goals, abilities, environment, routine and preferences.
Before asking, “Which product should I recommend?” it may be more useful to ask:
- What matters most to this person?
- What is happening during the activity?
- What strengths can we build on?
- What barriers could affect use?
- How will we know whether the solution is working?
These questions shift the assessment away from selecting equipment and towards understanding the person.
Because the success of assistive technology is not measured by whether it was recommended, funded or delivered.
It is measured by whether the client can—and chooses to—use it in the life they want to continue living.
Frequently Asked Questions
What should an assistive technology assessment include?
It should consider the client’s goals, abilities, routines, environment, preferences, existing strategies, available support and the practical demands of the technology. It should also include trialling, training and follow-up where appropriate.
Why do clients stop using assistive technology?
Common reasons include discomfort, complexity, stigma, poor fit with daily routines, lack of training, charging difficulties, unreliable performance and a feeling that the device was chosen without their involvement.
How long should an assistive technology trial last?
The appropriate length depends on the device and the activity being assessed. The trial should be long enough for the client to use the technology during normal routines and identify practical barriers that may not appear during a demonstration.
When should assistive technology be reviewed?
Review it after installation and training, when the client’s health or living situation changes, when the technology is no longer being used consistently or when it no longer supports the intended goal.