The Process Facilitator
The role of the Process
Facilitator (PF) is crucial in ascertaining the specific needs
of people with disabilities and impairments. This paper considers
the role of the PF in relation to one of the case studies from
the CUSTODIAN project. The case study is a female, in her sixties,
who has suffered a lengthy undiscovered viral infection which
affected the brain leaving her wheelchair bound, unable to communicate
effectively, ataxic and physically contracted. Through previous
meetings it had been determined that her mental faculties where
not hindered by the lengthy illness, and in many ways this had
added to the distress that she experiences arising from her present
condition.
The case study was released
after the New Year (2000) and now lives with her husband in a
bungalow near the centre of Dundee. Her husband moved in to the
new accommodation due to the condition of his wife and has not
had a chance to redecorate the premises. The case study is aware
that she is a ‘case study’ for the project and is happy
that she is able to obtain the technology, which could make her
life happier and more independent. As a consequence of the predicament
of the case study, the role of the PF is central in determining
the appropriate technology to meet her needs as well as translating
the technology into user friendly language.Moreover, the PF in
cases such as this must act as an advocate for the case study
and mediate with the stakeholders of her behalf. The Engineer
utilised an ‘evolutionary’, ‘hit or miss’
approach to matching devices with need, wherein through interaction
with the client and supporting staff, a determination of the
minimum devices was developed. From this the Client (the case
study and her husband) could determine for themselves what they
considered was appropriate. Having decided for themselves on
the devices, depending on finances, and whether the product was
manufacturer specific, the engineer would, in the future, return
to the house to install the devices.Accordingly, an unspoken
open-ended offer existed where the engineer would keep returning
to the house (possibly forever) until the client was satisfied
that they had all the required devices or the financial ceiling
had been attained. Through discussions with the client, the engineer
constantly pointed to the endless things that Smart Home technology
could do for the clients, whilst avoiding specific such as what
should be done. At no point did he question the client concerning
their condition or make any attempt to gather data regarding
what difficulties the client might be experiencing.
Consequently the client
were left initially in a state of shock, being completely flummoxed
as to defining their technological requirements. The engineer
left a videocassette with them, which was a PR video, outlining
how to build Smart homes for rich people.He did explain that
a lot of what was on the video was inappropriate to the clients’
needs, possibly, but at no point tried to suggest appropriate
configurations of devices that might have been relevant. Two
observations and considerations are important to state: Firstly,
the engineer never asked the case study herself what she wanted,
or for that matter even engaged in eye contact with her. Almost
all interactions where between him and the husband. Consequently,
it is likely that the husband will appropriate the decisions
of the appropriate devices to be installed to the house.Secondly,
the husband was determined by care professionals to be an individual
who was over-anxious and over attentive. The husband clearly
demonstrated symptomatic actions, which were not beneficial for
the rehabilitation of his wife, such as preventing her from using
the given remote control devices because he could change the
TV channel for her. A number of critical issues emanate from
the observations of the afternoon, as follow:- the ‘hit
and miss’ approach of the engineer could mean that appropriate
devices might not be installed. ·There is a clear logistical
problem with this type of ‘evolutionary’ design, in
that the engineer is required to return on a regular basis adding
one or two devices at a time, could mean that the process is
never ending or that when the client finally hits on an important
device it is too late. ·There appears to be little clear
evaluation of the value of the devices, within the remit of the
engineer.His task just appears to be to install them when required.
There is little doubt it might not be as simple as this in reality
and should devices be used that are later determined to be inappropriate
there is a strong possibility he might return and remove them.
·Although the client is two people (the case study and
her husband), it is important that the view of the person with
disabilities is considered equally to the person without. Effectively,
if her wishes are not sought and her needs not catered for the
under half the solution has been achieved. ·One of the
reasons why this case study was chosen initially was due to the
life circumstances that presented themselves. The over-attentive
husband needs not to be tied up from the burden of responsibility,
of caring for his wife, for short periods of time, respite is
essential.For this reason the system is required to be installed
to allow him to feel confident to allow her to do her ‘own
thing’. Moreover, the case study needs to become more independent
of her husband. Her empowerment was central to the decision to
use her in the study. Through the ‘hit or miss’ approach
of the engineer, it is unclear how she is to be empowered by
the system. It appears that the engineer is considering more
the containment aspects that can be perceived as being related
to her disability. ·The role of the PF is central in mediating
between the care sector and the engineering sector to eliminate
many of the above deficiencies. The PF is able to design a system
of appropriate devices that meet the needs of the client and
resource constraints.Through the use of a PF there are a number
of serious advantages which should be highlighted:
ØThe PF can mediate
in cases such as the case study above, to determine the real
needs of the user
ØThe necessity
of repeat visits by the engineer is minimised two visits (prior
to installation and installation itself).
ØThrough the use
of CUSTODIAN, the PF should be able to match the technological
solution to the user needs, in an appropriate, resource-driven
approach.
ØThrough the use
of CUSTODIAN, devices, which are essential and relevant to the
client, are unlikely to be overlooked, and devices can be prioritised
to reflect economic circumstances.
ØThe PF can undertake
checks and evaluations of the expediency of the devices both
pre and post installation, and mediate with the care sector and
engineer to obtain the optimum design configuration for the client.
ØThe PF save money
all-round.Saving the purchaser of the equipment money and time
by defining the best solution and costing it appropriately; and
saving the installation company money by relieving them of the
necessity for repeated home visits to the client and the time
taken to design an appropriate system.
ØThe PF is also the insurance policy, not totally infallible
agreed, but through utilising the PF to undertake the design
specifications, all parties are likely to be consulted on a number
of occasions and any difficulties can be resolved prior to installation
of the equipment.
ØThe PF releases
valuable time from the purchasers and installers, whilst allowing
the views of all stakeholders to be reflected.
ØFinally, the PF acts as a mediator between the opposing
factions/stakeholders.
It is apparent that any
authority deciding to implement a number of Smart Home schemes
for adults with disabilities, that there will be a number of
differing factions/stakeholders involved in the decision making
process.As a non-partisan individual the PF has the ability to
liaise with each stake holder and mediate through potential problems
to enable the development to continue: i.e. become a non-specific
product champion.
© 2000, G.Dewsbury, RGU, CUSTODIAN, TIDE DE4004
Smart
Thinking: Socio-Medical and Assistive technological Research
for Today
The
Independent Health Research Consultancy
