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Telecare & independent living at home
Telecare is a very topical buzzword, but in fact the basic concept has been with us for many years. Put simply, telecare involves using technology to monitor a person's well-being, and summon help if required.
Many local authorities and private companies offer simple telecare services in the form of an alarm system connected to the telephone, with a special button to press if you need help. More than 1.5 million people in the UK already have access to this type of service, which is called by various names, such as community alarm, careline, lifeline, social alarm, etc.
As technology progresses, the possibilities of telecare increase. At
the same time, the government is encouraging measures which enable people
to live independently in their own homes, rather than going into residential
care, and these factors have resulted in various new developments in this
area.
Click the links below to go straight to more information on:
What are the services available?
How is a person's need assessed?
Can Direct Payments be used for telecare?
What is the Preventative Technology Grant?
Some service and equipment suppliers. Clicking on a highlighted name will open the supplier's page in a new browser window:
Aid-Call Healthcare Communications
Cirrus Communication Systems
Easygates
Easylink UK
Helping Hands Homecare
Just Checking
LifeMax
PivoTell
Supra UK
Vivatec
What are the services available?
Telecare services can be as simple as a telephone-based community alarm, which responds to emergencies and makes regular telephone contact to check on well-being.
According to need, telecare can also include the provision of monitors and detectors. These could be triggered when, for example, a person falls or has a seizure; or when gas or smoke are detected, so that appropriate help can be provided. Monitors can also detect such problems as intruders or bogus callers, and summon help. Technology can also help to prevent problems: for example, a spoken reminder to turn off the cooker can help prevent a kitchen fire; or a bed sensor could turn on the light when it detects a person getting out of bed in the night, thus helping to prevent a fall.
A service that is often referred to as "lifestyle monitoring" can be incorporated. Tailored to suit individual circumstances, the system relies on a series of movement sensors in strategic locations around the home which build a log of the user's movements as they go about their daily routine. Carers can then quickly identify any changes in habitual behaviour which may be indicators of deteriorating health or increasing mental confusion.
A
client's medication regime can be monitored remotely: for example, the
PivoTell automatic pill dispenser has an integrated interface that enables
it to link with the call centre-based services, as part of a telecare
package.
A further development of telecare is telehealth or telemedicine, where the user's vital signs (such as blood pressure, pulse, blood sugar levels) can be monitored remotely, often with their collaboration. This development is important in terms of earlier hospital discharges; better management of long-term medical conditions without the need for hospitalisation; earlier warning of problems with a change of medication, for example.
How is a person's need assessed?
Anybody who needs support to live in their home is entitled to a care assessment by their local authority. If they have a carer, their needs are also entitled to be assessed. The assessment will generally be carried out by a suitably qualified person, such as an occupational therapist or a social worker.
A care assessment involves finding out what a person can and cannot do for themselves and whether their home provides a suitable environment for them. If there is a carer involved, their need for support in their care duties as well as their need for a break from them, will also be assessed.
Support may be recommended in the form of visits from carers to help with particular tasks and/or it may involve making adaptations to the home so that it is more suitable to the needs of the occupant(s). Telecare services have a clear role to play in supporting independent living, and should routinely be considered by local authorities as part of the care package that can help an individual to remain safely and confidently in their own home.
In fact, the lifestyle monitoring aspect of telecare can be a useful part of the assessment process itself, by establishing patterns of behaviour over a period of time, and thus identifying areas where support is required. This is particularly helpful in the case of individuals with conditions such as Alzheimer's, who may not be able to give an accurate account of their needs.
What is extra care housing?
Extra care housing is a way of living independently, but with extra support on site. Individuals live in their own appartment, equipped with the sort of assistive technology that makes life easier for them, and with access to home and health care staff, and various communal facilities, that may include library, laundry, cafeteria or restaurant, shared lounges, hairdressing, a shop, etc.
There is more support available in extra care housing than in traditional warden-assisted schemes, so it makes independent living a realistic choice for people who might otherwise move into residential care.
People choosing extra care housing have a wide variety of needs. They may have a physical or sensory impairment that limits their mobility or ability to manage daily tasks. They may have learning difficulties or moderate dementia, making them more prone to forgetfulness and accidents. It may be social isolation that prompts the move into a more communal environment.
In all these situations, the appropriate telecare package can improve services to the individual, making them more reliable, and often more economic.
Can Direct Payments be used for telecare?
Anybody over the age of 16 who has been assessed as needing support services, either as a client or a carer (see above, How is a person's need assessed?) is entitled to receive the money from their Local Authority to pay for the services themselves.
Direct Payments can be used to pay for all the support services that are assessed as being necessary, or just part of them. As part of the care package, telecare services can be bought using Direct Payments.
Find out more about Direct Payments in general.
What is the Preventative Technology Grant?
The government has announced that £80 million in grant funding will be available for two years from April 2006, to enable local authorities and their partners to increase the number of people who can benefit from telecare, by at least 160,000 nationally.
By investing in telecare services, the government aims to reduce the need for residential/nursing care; reduce the burden placed on family carers; and provide more choice and independence for services users, including those with long term health conditions, and those with terminal illnesses who wish to die at home. It is anticipated that increased use of telecare services should save money and other resources by reducing acute hospital admissions; reducing the number of falls and other accidents in the home; enabling patients to be safely discharged from hospital to their own home.
The grant will be shared amongst all local authorities in England that have responsibility for social services, with £30 million available in 2006/7 and £50 million in 2007/8. The local authorities are expected to work with partners in housing, health, voluntary and independent sectors, service users and carers.
In order to access the money, which is not ring-fenced, Local Authorities should have plans in place before the April 2006 commencement date.
Further resources
The Department of Health's Care Services Improvement Partnership has produced Factsheets which can be downloaded in pdf format. Available from the Integrating Community Equipment Services website (the site will open in a new window. You can then click on the titles you wish to download).
Building Telecare in England is the Department of Health's vision for implementing telecare services.
Getting Started with Telecare is an
ICES (National Integrating Community Equipment Services) report on three
pilot telecare projects, which includes a lot of helpful material. The
pilots involve three different goals in three different areas:
Medway - Supporting people at home/reducing hospital admissions
Eastbourne - Hospital discharge support
Isle of Wight - Fall prevention
Training workshops can help Local Authority personnel and project partners familiarise themselves with the equipment and services available, and how to benefit from the Preventative Technology Grant.
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