We're back after a break, and it feels great! Especially when we get to talk to someone who loves AT as much as North Dakota Assistive's Jeannie Krull.
"I think one of my biggest goals, until I can't do this anymore, is for everybody to know about this," she said. "Everybody in the planet needs to know about assistive technology before they need it. "
In this wide-ranging discussion she talks about:
Welcome to accessible times the UA TP podcast. We talk about the technology that helps people be independent and how it changes lives. I'm JoLynne Lyon. Well, we're back after a break, and it feels great. We'll be speaking with Jeannie Krull, program director for North Dakota Assistive. She'll fill us in on how to provide services in rural areas, and on some favorite assistive technology for seniors. So if you need some ideas, you might want to keep a notepad handy. So tell me who you are and what you do. I am Jeanie Krull, and I'm the program director, Director for North Dakota Assistive. I've been here since the year 2000. And prior to that, I was a speech pathologist in private practice. Can you tell me just a little bit about your program, W e started out with a different name. And, and we started out in state government. But in 2005, we moved out of state government and we're under and that another nonprofit. And then in 2009, we became our own nonprofit. And we still are. So right now we have nine different contracts, including the Assistive Technology Act program. And so part of that large part of that really helps us serve seniors. So I want to ask you specifically, you know, the topic that I've felt has been neglected so far is technology for seniors or aids for daily living. So if you could talk to me not just about those things, but about satisfying those needs when you're in such a rural area. I think that's one thing that we have in common. Yeah, well, we have two centers in Fargo and Bismarck, and they're both simulated homes, and we get a lot of people just coming in because the two major places to hospital are in Fargo in Bismarck. So we have a lot of rural individuals coming into these towns anyways, and then we're a stop. And then we do go out and visit but we tried to piggyback those visits, so we get a call from you know, 200 miles away, we're going to make that trip worth our while. So we'll go see that person put then we're going to make sure we're presenting visiting whoever the aging person is in the voc rehab for you know, and really stack those visits, and to make the most of them. And, and then video conferencing is huge. And then many times if this if it's possible, we will video first so we bring the right equipment. And then in some cases we don't end up having to go because especially if there's a therapist or somebody that's partially in the know, and it might be all they need is that zoom and with seniors, you know, it's not usually not always the therapist involved. So so many times we do go there and and help them out. And then sometimes it's like our Fargo and Bismarck locations are kind of destinations in North Dakota. So it's like, you know, I was coming to visit my daughter anyways, I'll come you no doubt. I am curious with the video conferencing as well. This is a topic that it's just really interested me because I have a personal connection to it. In our family we've just been doing a lot including with my mother who's in her 80s and she's, she's adapted really well to it. Are you seeing seniors use video conferencing? Or are they still hesitant on that? I'm definitely seeing them using it, including my own parents, like I think this year really, really pushed people like this is, if you want to attend, this is it? The only way you're gonna get it. So we're I don't know if I could have pushed them to do it. I mean, I think they did. Our son was over in Albania. And so that was the only reason the only way for them to communicate with him when he was in the Peace Corps. And so they did a little bit but it was always like, "How do you do this thing?" you know, and then so they perfected their techniques, let's put it this way over because of COVID they're seeing that it's another alternative it's a way to maybe meet with loved ones who are far away. In addition to I want to see their face, you know, not just hear their voice. I want to make sure that they're really feeling the way they're feeling. And also I think it's a great way to we've certainly been using and promoting the use of like the lamp Amazon's you know Alexa feature, the drop-in calling. Yeah, yeah. And that's just really a lifesaver for people and just being able to drop in on a relative to make sure they're okay. Plus the surrounding smart home. You know, okay, mom opened the fridge today. She's She's open at 'em, you know, she's turned on the radio. Okay. She's doing good. You know. can you know bit how you would know that? Like, how that technology works? Yeah. Well, it's so inexpensive, you know, pretty familiar with the Amazon Alexa products. And then there's a lot of smart home things like motion detectors, simple things like that, door alarms. And you can put those on simply basically put it on a fridge door, put it on a cupboard door that you know has the pills that that your mom has to take and different things just simple things like that put it in the doorway to go to the restroom. And you can see how many times she's had to go in like UTI Hmm. And you know, it depends on you know, an agreement between you and her how invasive you know, you want to be, but all of this stuff is so I mean for under 200, $300, maybe even less, you you've got a home monitoring system, as the adult child, you can look on your phone, and you can get notifications every time the motion detectors set off or the door is opened. It's it's really, really nice and gives you a bit peace of mind. But you might also be on the unplug it because Alexa is listening, which is what my mom did. So you have to be in the same mindset. I can't, I can't diss it too much. You know, it is kind of weird when you just talk about something and then you see it on Facebook, or you know, it starts following you around your technology. And it is kind of weird, it takes some getting used to so yeah, when I told her that her phone is listening to her just as much as Alexa is, and so she didn't like that. But she won't give up her smartphone, though. And she does love her smartphone. So it's it's Yeah, I mean, you have to take the good with the bad, but I think the bad is it for for her is just going to a nursing home. So I mean, in that that is you know, or more restrictive environment having to leave the farm. And that is not what she wants to do. So this, this can be definitely a smart home devices and other you know, aids for daily living, like you were, you know, or thinking of, you know, just lifelines in general, and, you know, Medicaid lock medication dispensers all, you know, devices like that, obviously the ones for grab bars, and you know, safety like that are all ways to stay in the home, and you know, bathroom mods. All of those things can extend this day, you know, let you and it's just I would want that, and I'm using it now. I mean, not the last two. But I mean, we have, you know, I think there's a whole generation and I'm one year removed from the baby boomers generation, but it's, it's, I think we're going to be growing up in this smart home world. And, you know, by the time we get in there, kind of hopefully, we're already, you know, weaponized ourselves against, you know, having to go in a more restrictive environment we've saved proved ourselves, we're used to the technology, and maybe we'll just need a little more. But who knows? I mean, iPad wasn't developed until 2010. I mean, that's always the seemed, so bizarre to me. I don't know. Alexa 2014. Who knows what's going to be available? To help us stay in the community? You know, we have some apple technology, smart apartment. Is it a good alternative? Like is it as developed as some of these other? I believe it's more private, but is it as effective. And the privacy part I don't know how much more private it is from the others. But we had a Christopher and Dana Reeve Grant 2018 2019. And we with that grant, we was smart home for people with paralysis. But what it allowed us to do is try all of the voice assistants at the time, which was Cortana, Apple, Google and Alexa. And at least those were the four main ones that we did well Cortana was Cortana is like the Microsoft one. Is that a smart speaker? Or is it just your computer? It's a smart speaker. And I think it's obsolete now. And yeah, they should be unless they've been proved. It was not accessible. If you didn't, weren't able to speak to it. It didn't work. And so it was a great speaker though, for music, it was beautiful. And that's kind of, and it was compatible with about two things. So that was out. But you know, we needed to try it and see, you know, and we hadn't heard of it, you know, before we really started to dive in. And then and then there was the top three. And really, it came with him, you know, how many devices are these things compatible with? And really, Apple was compatible with the least and it was debatable, sometimes it was easy to set up, sometimes it wasn't. And since then, Google and Alexa kind of tied for first in our mind. And so it really depends on the person and what they want. And if they want Apple we'll set up Apple but but we have the most experience with Google and Alexa. And and there's certainly some things with the the shopping piece with Alexa. But having had Alexa since 2014, I'm not, I don't get advertisements. Really anything. I mean, I have a show right here. And I don't get that on my, on my show. It didn't, you know, it allows you to do shopping on it, but I turned it off. So I mean, I don't want to accidentally order 10 mils of butter. You know, I'm joking, my friend did that. That was with their fingers, too. That was before you can turn that part off. So if you have an echo show that on all of them. I mean, so you just turned it off in the settings as far as being able to automatically order, you know, something just by saying it. And so and but you know, she'll ask you do you want to join amazon music or things like that, and every once in a while when you request a song that isn't there. But if you put a lock on that, or better yet, don't put a credit card on your parents account. And you can easily do that. Nobody's going to ask. You can? I thought that they really wanted a credit card. So that's cool that you know, I am almost positive, you don't have to, because we have a lot of Yeah, because our one that we have in our home first center doesn't have a credit card attached to it. So yeah. And it doesn't have to be prime either. So that's, that's the other piece. So you can set up an account for your parents, and you can also attach relatives to your account as well. Like I've done that with my kids, you know, when they weren't kids when they were kids. I mean so yeah. Yeah. Interesting stuff. So another thing that I wanted to just touch on was the psychology of getting people to to adopt assistive technology and whether it's high or low tech, I think there's a certain amount of resistance, you know, even if they very clearly need a cane or a walker, you know, there's going to be some resistance to that. What is the best way that you found to help people get to the point where they they will adopt it? I think our assistive technology acts in general really help with that as far as being able to have the loan libraries may be able to try, but did you have to get them in the door first, right? And do we get to that point and and like I said earlier, we do have a lot of usually males but sometimes women as well, you know over the age of 65 so I would say 70 and they're brought there you know not willingly usually by their older children and and there's a lot of arm crossing and why am I here and and I don't have a hearing problem. You just need to speak more clearly. And I get it. I mean if that were me, I'm not sure I would want to go either. And, and then we'll put on like a duet or a personal listening system, such as a wedge or a pocket talker on their ears. If it is a hearing problem, let's say and, and I would say 95% of cases maybe even higher. It's like holy crap, you just holy buckets. You champion that but that's how it's just amazing to them how much that changes and they don't want to give it up. Can I take this one home? And so many times and then they're carrying it around and they're like, everything changes. And it is so fun to see. And they realize how much they were missing. I've had people come in there that had no intention, they were just getting a tour of our center and try that out and they're like, I think I need one of these I'm hearing you so much better. And I think especially with hearing I mean vision we certainly see that with a vision but the the aha moment comes the most of the time was most of the time with hearing and that makes sense because you know, with hearing you you that's when you see when you lose hearing you see so much retreat from society from individuals, not so much when they lose their vision, but more with hearing. Just being able to try it, I think is certainly one way and then when we bring when we go out to the senior centers, for example, and we bring the technology with us of course, and that is probably the thing that's the most eye opening for people again, is the like the pocket talker and you can tell when it stops moving, that person has a hearing loss and they aren't giving it up, you pass that thing around and there's squeals and you know because everybody's you know really back with it but then all of a sudden it stops at one person and it never goes any farther and it's because that person is like the first time they've come to a meeting at a senior center and they can hear it and and then afterwards it's like they're passing it around and I'll try to sign up to get one of your senior safety program it's it's become the in thing you know, they want to hear as good as a friend now. And so I think there's just a lot I think the way that we've been doing things certainly helps but they need to see work for them and I think our centers help with that too. We have we've had a center at least once since 2002 for people to come and see the technology but it was always equipment on shelves and in 2013 we built our first house and it's it's a you know 1100 square feet with you know Bathroom Bedroom kitchen, dining room living room all filled with assistive technology and now also smart home technology, and when they walk into that all of a sudden they get and then they see how the technology can be easily fit right into their lives when they see it in a environment. And with that kitchen or with that home I think we're one step closer to people knowing about it before they need it and they really do need to know about it before yeah once they're in that crisis situation, the first thought you know when they're in the hospital and they've overdosed on their meds or for whatever you know broke their hip, it's you know, nursing home nursing home nursing home it's the other end is not explored. And because just you just want them safe and you don't want to buy a whole bunch of new stuff and so I think we're really on a campaign to teach people before they before they need it maybe even before that hearing loss you know and definitely before the the going into the nursing home and for the need arises so I don't know if I answered your question you Did you Did I appreciate it. And another thing I just wanted to touch on was high tech versus low tech I... The first question that I really want to address is will seniors use a higher tech piece of equipment? I think it depends on the need I mean the way we approach it is need based always, and we also try to get them to use a tech there they already own, and then the least tech you know but there's sometimes they need a smartphone and but then let's make that smartphone the easiest, as easy as possible then. If it does end up being a smartphone let's and it's a Samsung for instance, let's put it in easy mode. Or if really all they can do is use a smartphone app or maybe maybe it's an iPhone you know, then we eliminate all the apps you know put them on screen, all the ones that have to be on there, put them on a screen far far away. You know, and all it's on there is the phone. And and there's you know, ways to also just lock them into that phone app too. And, you know, and put pictures with those apps to make them super easy. I guess I'm we're always you know, easy based on the needs really and then less is more but sometimes, you know, I think Smart Home stuff is high tech, but really, it's not that hard to, you know, it's like, oh, my parents won't build this understand Smart Home stuff, well, they don't have to set it up, they just have to be there and then have some support, because it doesn't always work, you know, in a thunderstorm happens, and you know, something goes offline, and somebody does need to go in and set it up again. So you do need that support, but it doesn't necessarily have to be the one using it that needs it. So we also, you know, we look at all the levels of support, and what what is their support system, before we recommend, as well, and because it has to be maintained. And then the training that always is, you know, I remember my mom, and my dad getting smartphones, probably, gosh, seven or eight years ago, I mean, they're in their 80s now, but even even then, when they were younger, he came home with two giant Galaxy Note threes. And he's, you know, he's bought a new Mac, he loves tech. And she was like, give me back my flip phone. But the minute she found value in it, like she could creep on the grandkids on Facebook. Then that was her that phone became her best friend. And she learned how to use it. So that finding the value in in whatever it is that you get. So true. Like I remember I had my first smartphone. And I remember my parents were driving across southern Wyoming, which is very barren. there's just not a lot and realize that they needed to find a place to pull over. And I made a reservation for them on my smartphone. And after that they had to have one. So yeah, it definitely, I think seeing the value of it is such a huge part of it. Yeah. And I mean in getting to know it. I mean, my dad thought it was the best thing since sliced bread. He realized he was being charged to watch those videos when he wasn't on Wi Fi. Yeah, that was a greatphone bill. So it's, you know, still learning curve with some of this stuff, but but it's it's there. I would say they're great users. They've had three different phones since then, you know, and they have a better phone than I do right now. So but not everybody is that way. So I mean, we have some individuals who, no, no, she's just never gonna touch it. And it's like, Okay, well, what will she work with, and then we go from there. And one thing is like, especially if they can't afford it, vision is a great thing. Like they maybe she would benefit really greatly from a handheld digital magnifier, because the whole handheld ones, lighted magnifiers the real low tech ones just aren't enough anymore. And of course, you know, when you go get when you increase the magnification, the lens gets smaller and smaller and smaller. And most people don't realize that unless they're in this field. And they're like, I don't want it smaller, I want to see the whole sheet, well, then you're only going to get two times, you know, maybe three, it's not going to be that great. So once they hear that they're like, okay, I don't want an iPad, I want that digital magnifier that cost 700 to $1,000 because I want the big screen. And then that's too much, potentially. So then, you know, we're telling families, you know, do you have an old iPhone laying around, or even an old Android or Samsung phone, because those have technologies where you can lock the person into an app, and you can just lock them into that magnifying app, and then you've got a handheld magnifier. And so it's worth a try. Try it out first and see if that's enough. And then and then maybe we look at buying a handheld magnifier. But so there's just a lot of lot of things that we think of and it's so individualistic and based on so many things, environment, support, technology. And need, need being number one. I also wanted to touch on low tech technology stuff that's maybe not nearly as expensive. Do you have a favorite? Oh gosh, probably one of my favorite ones. And I've known about it probably for 18 years is a device that actually isn't even, didn't start out being a part of the senior safety world. It started out in the shop. And it's a little lock plug and you put it on a toaster for example. Like when somebody has Alzheimers and you don't want them necessarily getting into their toaster and other appliances right? But you also don't want to take them away because that will really cause some anxiety and frustration that there somebody took their stuff and I would for me too but you can put this little lock plug it's it's a looks just like a plug extender and so you take the plug in from the toaster for example plug it into this little piece of plastic and then lock it with the key so that person can't plug that into the wall and it came from technology like you would have in shop class so the kids can't plug in the drill or whatever without the teacher being there and or just shops in general and and we've been using it ever since and it's just great. I love that thing and it's just it's so eye opening for people and then it starts that just builds on other things for you know for especially for people with dementia and that's probably one of my favorite to to discuss with individuals and then probably our on our senior safety program that we have the two top ones are besides grab bars are probably our freedom alert which is a no monthly fee life alert type system that works with a landline and I don't know how familiar you are with that but it I have not heard of that one. I've heard of all kinds of them but yeah, yeah no that's a really great one and you called the landline into it and you can still have your phone and you don't need two lines and it works with the cordless phone technology so the piece that goes on the person either on a wristband around their neck can be up to 300 feet away and so could possibly be in the backyard really depends on the house and the interference and things like that because it's just like your cordless phones the old cordless phones, you know, you used to get interference with the microwaves you know and different things like that so it's the same kind of thing. But you can set it to be to do three different things to consider to just do 911, to call your four friends and 911, or just your four friends. Okay, and I gets you started and then we'll call the first friend and if that friend doesn't answer goes to the next and the next and the next and then 911 and it knows so you're wondering well How does it know you know when it gets to voicemail or something well it asks you if you're a real person to push a number so if it doesn't get that that push then it'll go on to the next person. So we really do recommend that if you think that person needs Lifeline they should be getting Lifeline but there's some people that don't want don't have and don't want to spend 40 to $50 a month and so this this is a great alternative and they get it free through our program, and then it doesn't cost them anything else after that because it's not calling a service, and but they will make sure they understand that though. But yeah that's probably one of the one of the best ones of course now with the you know the landlines going away it's tough and there are no monthly fee free devices I mean they all require a a some kind of a fee, or to have a smartphone or something like that with the exception of there there are some devices out there that have a they can just call 911. You know how your phone if you when you get a new phone your old phone can still you take the SIM card out and it can still call 911? Well these little devices are kind of like that the danger with those though is it doesn't it calls whatever 911 picks up it doesn't they don't they can't locate you so that if you can't speak it's not going to do you any good. No not at all, and I wouldn't recommend them but some people are doing that when they're out and about and it's like well when you're out in the boat and you're still conscious that's going to work. So the best thing is to have a phone number attached to it phone number that has your name up so there's an there's certainly ones that are cellular you know we've got smartwatches that have like Apple and Galaxy Samsung Galaxy have SOS features built into them and you can actually have SIM cards in your in the watches so that's nice and do they have fall detection on them? The the apple one does and I know we got that I tried to get it to work by dropping to the ground several times. And it didn't work for me but probably knew I was faking it but I've heard that It works and so I guess I wasn't ready to injure myself. Set up a crash pad or something actually landing on the couch because they apparently my couch is just too soft. It's not working. So you know, it's like, No, I'm not gonna fall to the floor. Um, but uh, yeah, I think it's definitely an especially to call my one one, I definitely know that one. That part works. I'm setting up for a client and accidentally called and, sorry, but yeah, it works. Awesome. I think one of my biggest goals until I can't do this anymore is you know, to, for just, for everybody to know about this, everybody in the planet needs to know about assistive technology before they need it. And because they're going to know about need to use it for themselves, or they're going to know somebody who needs to use it. And it's, it's, it's so different than any other profession. And and, and we you know, it's all includes everybody, all ages. And and it's a big tough.... You know, I was gonna say it's really tough when you're in the information business of trying to get people information that they're just not looking for, you know, they don't look for it until they needed. So it's Yeah, and then they can't find it. Yeah. So it's a matter of selling it to them before they need it. And that's Yeah, I think Yeah, and it's fun. I know it does, and I want it to be as simple someday as needing medical medication and you know, getting a prescription from a doctor that they just know about it. That simple. And it's it's everybody gets who needs a wheelchair, you know, at least whether they can get enough financially, they at least know they need, you know, my legs don't work, there's a wheelchair out there. And maybe they know about glasses and hearing aids. But beyond that, yeah, we have a lot of work to do, I think to make it mainstream. Well, thanks for being interviewed. Hopefully this will help. You've been listening to Accessible Times the UATP podcast. This production is brought to you by the Utah Assistive Technology Program, part of the Institute for Disability Research, Policy & Practice at Utah State University.