Is telecare ‘care’?

Can the use of telecare systems tip the balance in allowing vulnerable people to live independently or are they merely a useful adjunct to existing modes of care? David Potter reports

With the number of people aged over 65 expected to rise from 9.3 million to 16.8 million over the next 50 years, services are constantly on the look out for innovative ways of supporting this ever-expanding part of the population.

Many of this group will favour living in their own homes over going into residential care and given the potential cost savings this could bring, alongside increased client satisfaction rates, it is not surprising that the government sees telecare as a vital part of social care.

The use of telecare has come a long way since the days of an oversized alert button on a bedside telephone. Traditional equipment such as community alarm systems are still used but they have been joined by more sophisticated devices such as motion sensors, used with people who have a history of falling, and systems to remind a user to take their medication.

The advantages of using telecare are clear. Sensors are linked directly to a 24/7 monitoring centre, where key information on the needs of the user is held allowing remote staff to make fast, well-informed judgements on the appropriate response to incidents.

Pam Mills is the project officer for Durham County Council’s People at Home and in Touch scheme and has been running small-scale pilot telecare projects in the area since 1998. The council has been trying to integrate the schemes into mainstream services since 2004, but have been restricted by a lack of funding.

It has 150 people benefiting from telecare schemes across the area and with the aid of a £349,000 preventive technology grant (see Telecare in England), Mills expects this to rise to about 750 over the next two years.

“It’s about making the best use of scarce resources and directing them to where they are most effective,” she says.

“We’ve proved that people can be kept out of residential care, by using telecare, but it isn’t a tangible saving so it can be difficult to cost out.”
 
Mills points out that the benefits of telecare are more than just financial. “It gives the user choice,” she says. “We had a woman who traditionally needed a sleep-in carer.

She now uses a bed sensor [where if a user gets out of bed at an unusual time and does not return within a set timescale an alarm is sent to the monitoring centre] and much prefers that than having a stranger sleeping in her house. She got what she wanted and it has saved us the cost of a carer.”

Two years ago Kent Council piloted telecare schemes in three of its 12 districts, investing £2.25m in the process. It has 427 live installations and expects a further 260 applications to be passed during the next six months.

Clare Skidmore, the telecare project manager at Kent, says the independence that telecare can give people is invaluable.

“We commissioned a recent survey of [telecare] users and 93 per cent of people said that they now feel more independent and safe at home. Several of those people said that they were thinking about moving house before the technology was installed.”

Kent has secured £72m from the government for its Better Homes Active Lives project. The money will be used to build a range of supported accommodation in 10 of its districts. Each building will house independent flats, equipped with round-the-clock telecare and telehealth monitoring.

Kevin Lynes, the cabinet member for adult services at Kent County Council, says the scheme will help relieve the burden on resources and offer a better quality of life for users.

“We are investing in preventive work so fewer people come to us with complex needs. It’s about investing to save, but it’s also about independent living for the user. An older person would go into one of these flats, but use the telecare and telehealth systems to allow for an independent life.”

But for some, telecare needs to be closely monitored. Help the Aged housing policy officer Joe Oldman says that telecare does offer clear benefits but that its use should be under constant review: “Telecare should not be seen as a replacement for carers but rather something that complements existing services and offers the client greater control and independence. We must not see it as a panacea for all of the problems that older people face in accessing care and support and it should never be
used as a substitute for human contact.”

Telecare in England
In July 2004, the government announced its plans to invest £80m in telecare services through the preventative technology grant, with the first phase of investment being made available in April 2006.

According to Department of Health research1 an estimated 90 per cent of older people want to live in their own home. About 500,000 older people, however, live in care homes.

It believes that as many as 35 per cent of those people could be supported to live at home or in extra care housing schemes through the use of telecare. Its approach is three-fold:

● To provide initial investment.
● To co-ordinate demand to ensure industry grows strong as fast as possible.
● To educate and build knowledge and awareness among those who will be commissioning telecare services and those who will benefit from them.

1 Building Telecare in England, Department of Health, July 2005