Assistive technology assessments can easily become product comparisons.
How long does the battery last? Is the device waterproof? Does it have automatic detection, voice control or location tracking? Can family members access it remotely?
These questions matter, but they do not tell an occupational therapist whether the client will actually use the product.
A device may perform perfectly in a demonstration and still fail in daily life because it does not fit the person’s habits. It may need to be charged at the wrong time, stored in the wrong place or activated through a sequence that is too difficult during a stressful moment.
Product features explain what technology can do. Daily routines reveal whether those features will be available, acceptable and useful when the client needs them.
Assistive Technology Works Within a Routine
The World Health Organization describes assistive technology as both assistive products and the systems and services connected with their use.
That distinction is important. A product rarely works on its own.
For example, a medication reminder depends on someone:
- Setting the correct schedule
- Refilling the medication
- Hearing or seeing the alert
- Understanding what the alert means
- Taking the correct dose
- Responding appropriately when a dose is missed
A personal alarm depends on someone:
- Remembering to wear or carry it
- Keeping it charged
- Being able to activate it
- Understanding what will happen after activation
- Having an appropriate person or service available to respond
The product is only one part of the system. The routine determines whether the system works.
Features Answer “Can It?” Routines Answer “Will It?”
A feature list usually answers technical questions. A routine-based assessment asks how those features will function in the client’s real life.
| Product Question | Routine-Based Question |
|---|---|
| How long does the battery last? | When and where will it be charged, and who will notice if it is not? |
| Is it wearable? | Will the client put it on every morning and keep wearing it during the activities that matter? |
| Does it have voice control? | Can the system recognise the client’s voice in their usual environment? |
| Is it portable? | Will it be carried, or left in a drawer when the person goes out? |
| Does it send automatic alerts? | Who receives the alert, and what will they do next? |
| Does it have a touchscreen? | Can the client see and operate it when tired, in pain or without their glasses? |
| Can it provide reminders? | Does the reminder occur at the point in the routine when action is possible? |
| Is it waterproof? | Will the client actually take it into the bathroom or remove it before showering? |
| Does it have location tracking? | Has the client agreed to the tracking, and who is responsible for monitoring it? |
A product may pass every technical test and still be a poor match for the person’s routine.
Begin With a Typical Day
Before discussing equipment, ask the client to describe an ordinary day.
Start with:
- What time do you usually wake up?
- What is the first thing you do?
- When do you take medication?
- Where do you prepare and eat meals?
- Which rooms do you use most?
- When do you leave the house?
- Which activities do you complete alone?
- When is another person usually present?
- What happens in the evening?
- What do you do before going to bed?
- Which part of the day feels most difficult?
The purpose is not to collect a timetable for its own sake. It is to identify where an assistive product would need to enter the routine.
If there is no natural place for the product, the client will have to create a completely new habit around it. That may be possible, but it requires more training, prompting and follow-up.
Ask About Difficult Days Too
A “typical day” may reflect the client at their best.
Ask what changes when the person:
- Has slept poorly
- Is in pain
- Feels dizzy or fatigued
- Has an appointment
- Leaves the house early
- Has no family member present
- Is unwell
- Experiences confusion or anxiety
- Has reduced mobile or internet coverage
- Follows a different weekend routine
A device that works only when the person is rested and following a perfect schedule may not address the situation in which support is most needed.
This is particularly important for clients with variable conditions. The assessment should consider not only whether the person can operate the technology but whether they can operate it reliably across the range of circumstances they normally experience.
Observe the Task in Context
People do not always describe routines in the same way they perform them.
A client may say, “I take my medication with breakfast,” but observation may reveal that breakfast happens at different times, tablets are stored in another room and morning doses are sometimes delayed while the client answers the phone or cares for a pet.
Whenever possible, observe the actual task.
Look for:
- The order in which actions occur
- Objects the person uses as cues
- Interruptions
- Points where errors or hesitation occur
- The amount of physical effort required
- Environmental noise and lighting
- Whether the person wears their glasses or hearing aids
- Where equipment is stored
- How family members or carers participate
- Workarounds the person has already developed
Workarounds can be particularly informative. They may show that the client has found an effective low-technology solution, or that the existing task has become unsafe or unnecessarily difficult.
Identify Existing Habit Anchors
New behaviours are often easier to establish when attached to something the person already does consistently.
Possible habit anchors include:
- Making morning tea or coffee
- Brushing teeth
- Eating breakfast
- Watching a particular programme
- Feeding a pet
- Locking the door
- Charging a mobile phone
- Placing keys in the same location
- Preparing for bed
A new medication reminder might be placed where breakfast is prepared. A wearable safety device might be stored beside the watch the client already puts on each morning. A charging routine might be attached to an evening television programme.
Ask:
- “What do you do every day without needing to think about it?”
- “Where do you naturally pause during the day?”
- “What object do you always take with you?”
- “What routine could remind you to use this?”
The goal is not to force technology into the person’s life. It is to find the least disruptive point where it can support an existing pattern.
Look for Routine Friction
Routine friction is anything that makes a product harder to use repeatedly.
Examples include:
- A charger located in an inaccessible room
- Small buttons that require glasses the client does not wear at home
- A wearable device that must be removed to change clothes
- An alert that sounds during a noisy part of the day
- A complicated password
- Frequent software updates
- A product stored out of sight
- A monitoring system that depends on a family member who works irregular hours
- Equipment that blocks another household member’s access
- A device that must be transferred between several walking aids
- Instructions that are kept away from where the task occurs
One small inconvenience may not seem important during an assessment. Repeated every day, it can become the reason the product is abandoned.
The best product is often the one that creates the fewest additional steps.
Understand Who Does What
Assistive technology frequently depends on more than one person.
Create a clear responsibility map:
- Who puts the product on or sets it up?
- Who charges it?
- Who cleans it?
- Who replaces batteries or supplies?
- Who responds to alerts?
- Who updates contact details?
- Who arranges repairs?
- Who checks that it is working?
- Who provides help if the usual support person is unavailable?
Do not assume that a spouse, adult child or carer can take responsibility. Ask whether they are willing, available and confident in the role.
A family member who lives nearby may still be unable to respond during work. A carer who visits in the morning may not be responsible for evening charging. A client may not want a particular relative to receive location information.
If responsibility is unclear, the product’s support system is incomplete.
Check Whether the Product Fits the Client’s Identity
Routines are not only practical. They reflect identity, culture and personal preference.
A client may reject a product because it:
- Looks medical
- Draws attention in public
- Interferes with clothing
- Conflicts with religious or cultural practices
- Makes the person feel monitored
- Changes how a familiar activity is performed
- Represents a level of dependence they do not identify with
- Was selected mainly to reassure the family
Ask how the product makes the person feel.
A technically ideal product that conflicts with the client’s identity may be used during the trial and then quietly set aside.
Assess the Real Emergency Routine
Safety technology deserves particular attention because it is often judged by features rather than the complete response process.
For a personal alarm or emergency communication system, assess:
- Where the client spends time
- Whether they wear or carry the device in those locations
- Whether it works indoors, outdoors or away from home
- Whether the client can activate it from the floor
- What happens after activation
- Whether two-way communication is possible
- Who receives the alert
- How quickly the responder can realistically act
- What happens if the first contact does not answer
- Whether the device depends on power or network coverage
- What backup plan exists
- Whether the client understands the limitations
Automatic fall detection may add reassurance, but no device can guarantee that every fall will be recognised. Manual activation and a clear response plan remain important.
The assessment should follow the entire sequence—from the incident to the arrival of appropriate help—not stop at the moment an alert is transmitted.
Trial the Technology Within the Routine
A product demonstration shows how a device works under controlled conditions. A meaningful trial shows whether it works in the client’s life.
During the trial, ask the client to use the product:
- At the usual time of day
- In the intended room or community location
- With their normal clothing and footwear
- During the actual task
- With the people usually present
- Under less-than-perfect conditions where safe to do so
Observe:
- Whether the client remembers the product
- How long setup takes
- Whether they need prompting
- Whether the product interrupts another activity
- Whether they create a workaround
- What happens when something goes wrong
- How support people respond
- Whether use becomes easier over several days
The WHO’s assistive product service approach includes selection, fitting, teaching the person how to use the product and follow-up. These stages are reflected in its Learning on TAP resources.
A trial should test the whole routine, not only the product.
Teach the Routine, Not Just the Controls
Product training often focuses on buttons, menus and settings. Clients also need to practise when, where and why they will use the technology.
Instead of only teaching, “Press this button to send an alert,” practise:
- Where the device will be kept overnight
- When it will be put on in the morning
- How the client will know it needs charging
- What they should say after an alert is answered
- What to do if the device does not respond
- How to cancel an accidental activation
Use teach-back:
- “Show me what you will do when you get up tomorrow.”
- “Where will you charge it this evening?”
- “What will happen after you press this button?”
- “What will you do if the usual contact does not answer?”
Place simple instructions where the relevant action occurs. Charging instructions belong beside the charger. Emergency steps should be available where the client is most likely to need them.
Measure Participation, Not Just Product Use
Frequent use does not automatically mean that the technology is improving the client’s life.
Ask whether the product has helped the person:
- Complete a meaningful task
- Feel safer without becoming more restricted
- Use less physical or mental effort
- Reduce reliance on another person
- Resume an activity
- Leave the house more confidently
- Make fewer errors
- Participate in family or community life
- Remain in control of decisions
A device may be used every day yet add frustration without improving participation. Another product may be used only occasionally but provide essential support when a specific situation occurs.
Outcome measurement should return to the original occupational goal.
Reassess When the Routine Changes
Daily routines are not fixed.
Review the technology following:
- Hospital discharge
- A fall or near fall
- A new diagnosis
- Changes in medication
- A change in vision, hearing or cognition
- The loss or addition of a caregiver
- Moving to a new home
- A change in work or family schedule
- New internet or mobile service
- A decline or improvement in mobility
A product that worked well six months ago may no longer fit the person’s abilities or circumstances.
Follow-up should ask not only, “Is the product still working?” but also, “Does it still fit the way the person lives?”
Examples of Routine-Based Assessment
Medication Reminder
Feature-focused approach: Choose the reminder with the loudest alarm and the most scheduling options.
Routine-focused approach: Identify where medication is stored, when meals occur, whether the client hears alarms, who refills the organiser and what happens when the client leaves home.
Shower Equipment
Feature-focused approach: Select equipment based on measurements and weight capacity.
Routine-focused approach: Observe how the client enters the bathroom, removes clothing, controls the water, transfers, washes, dries and leaves the area. Check where towels and toiletries are placed.
Personal Alarm
Feature-focused approach: Compare battery life, location tracking and automatic detection.
Routine-focused approach: Determine whether the client will wear it, where charging fits into the day, who will receive alerts and how help will reach the client.
Video Calling Device
Feature-focused approach: Choose the largest screen with the best camera.
Routine-focused approach: Consider who initiates calls, whether the client remembers passwords, where they normally sit, the level of background noise and who will provide technical support.
A Routine-Based Assistive Technology Checklist
Understand the Day
- The client has described a typical day.
- Difficult days and changing routines have been discussed.
- The meaningful activity and desired outcome are clear.
- The task has been observed where possible.
Identify the Fit
- The product fits an existing habit or cue.
- Additional steps have been kept to a minimum.
- The client can use it under realistic conditions.
- The product fits the physical and social environment.
- Privacy and personal preferences have been considered.
Map Responsibilities
- Charging and cleaning responsibilities are clear.
- Alert or monitoring responsibilities are agreed upon.
- Maintenance and repair arrangements are realistic.
- Backup support is available.
- Family and carers understand their roles.
Test and Review
- The product has been trialled in the real routine.
- Training includes when and how it will be used.
- The client can demonstrate the complete sequence.
- Follow-up has been scheduled.
- Outcomes will be measured against participation and independence.
Frequently Asked Questions
Are product features unimportant?
No. Safety, reliability, accessibility and technical performance remain essential. However, features should be evaluated according to the client’s goals and routines rather than treated as benefits in isolation.
What if the client does not have a consistent routine?
Map the variations. Identify which parts of the day remain predictable and whether the product can accommodate changing schedules. A highly variable routine may require simpler technology or more flexible support.
Should family routines be included in the assessment?
Yes, when family members or carers are involved and the client agrees. Their availability and responsibilities may determine whether charging, monitoring, maintenance or emergency response is realistic.
What if a trial is not available?
Use the closest possible simulation, seek demonstrations, review return policies and gather information from comparable users. Document the limits of the assessment and arrange early follow-up after delivery.
How soon should follow-up occur?
The timing depends on the product and level of risk. Early contact may be needed for safety-critical or complex technology, followed by another review once the routine has had time to develop.
Final Thoughts
Assistive technology succeeds or fails in the ordinary moments of the day.
It succeeds when a client remembers to put it on, can reach it when needed, knows what to do and has someone available to provide the next part of the support.
It fails when those practical details are left to chance.
Occupational therapists can move beyond product-led recommendations by mapping routines, observing real tasks and testing technology where life actually happens.
The most important question is not simply, “What features does this product have?”
It is, “How will this product become part of this person’s day?”
This article provides general professional information. Occupational therapists should apply their clinical judgement, professional scope, relevant product standards, funding requirements and local regulations when assessing or recommending assistive technology.