Empowerment, Risk

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Empowerment, Risk Choice Changing the
CultureCSIP National ConferenceLondon 26
September 2006

• How Assistive Technology Can Really Support
  Empowerment Independence
• Dyllis Faife
• Service Development Officer for Assistive
  Technology Prevention Services
• Norfolk Adult Social Services
• CSIP Regional Fellow in Assistive Technology

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Aims of Presentation

• Raise awareness of the existence of assistive
  technology, what it is and how it works
• Illustrate how assistive technology can empower
  people
• Illustrate how assistive technology can enable
  individuals staff to take more risks
• Illustrate how assistive technology can offer
  people more choice
• Discuss the benefits for family carers and paid
  staff and the changed mind set required

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The Preventative Technology Grant2006 - 2008

• 80 million over 2 years
• Announcement of the PTG by Liam Byrne (then
  Member for Care Services)
• The purpose of the Preventative Technology Grant
  is to initiate a profound
• transformation in the design and delivery of
  health and social care services
• and prevention strategies to enhance and
  maintain the well being, self esteem,
• independence and autonomy of individuals by
  using electronic technologies to
• support them to live safely and securely at
  home.

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Our Choice, Our Care, Our Say A new direction
for community services

• Assistive technology/telecare supports the
  aspirations of the White Paper.
• People should have
• A good quality of life
• Independence
• More choice
• Greater control over their lives (including
  Direct Payments and Individualised Budgets)
• Support to maintain mental health and emotional
  well-being
• Flexible and personalised services
• Services responsive to individualised needs
• Access to early preventative support/services
• Support of health promotion activities
• Information prescription needs to include
  assistive technology
• Access to joint health and social care teams for
  people with Long Term Conditions
• Quality standards of care
• Well trained staff

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Long Term Conditions

• 17.5 million adults in the UK live with a chronic
  disease
• 80 of GP admissions to acute hospital care are
  related to these adults
• Patients with a chronic condition or
  complications use over 60 of hospital beds
• Telecare/telehealth can offer enhanced management
  of these conditions and assist with
  self-management
• Role of Community Matrons and telecare/telehealth

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Why Telecare/Telehealth?

• Ageing population
• Increased frailty of some older people
• An increasing number of older people with severe
  mental impairment
• Workforce shortage
• Hospital bed capacity issues
• Shift from secondary care to primary care and
  community services
• Increased support reassurance to carers
• Increased dignity in residential care
• Focus on falls prevention and reduction
• Long term care conditions
• Increased expectations
• The technological revolution
• New ways of working/new skills

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What Is Assistive Technology/Telecare/Telehealth?

• In simple terms, telecare includes detectors or
  monitors often linked to community alarm
• systems that send an alert to a control centre,
  where the appropriate response can then
• be determined.
• ALERT MONITOR RESPONSE
• ALERT REVIEW DATA INTERVENTION
• Detectors can also be installed within the
  service users home so that the alert goes
• direct to the carer living within the property or
  to a carer living using other technology.
• Range of stand alone items
• Telehealth remote vital signs monitoring, such
  as blood pressure, temperature, pulse
• and rate of respiration, oxygen saturation and
  glucose monitoring - data transmitted to a
• response centre or clinicians computer
• ASSESSMENT SKILLS ESSENTIAL

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Telecare Equipment Being Provided by (Norfolk)
Social Services (1)

• Bogus caller button
• Super smoke detector - can be linked to vibrating
  pillow/flashing strobe light
• Carbon monoxide detector
• Gas detector with automatic shut off valve
• Flood detector
• Temperature extremes detector
• Fall detector
• Bed leaving/chair leaving pressure mat
• Bed leaving pressure mat linked to lighting
• Door exit sensor device
• PIR movement detectors
• Epilepsy sensor
• Prompting service
• Consider use in residential care in the
  community

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Telecare Equipment Being Provided by (Norfolk)
Social Services (2)

• Stand alone items
• Medication carousel
• Pressure mat linked to doorbell device/pager
  (carer support)
• Memo minder
• Locator device/Keytracker
• Electronic calendars
• Large wall clock/calendar with date time
• Voice announciator
• Monitor
• Consider use in residential care the community

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How to Spread the Word

• Use of Smart Home demonstration properties
• Specialist dedicated roles
• Awareness raising training
• National Vocational Qualifications National
  Occupational Standards
• THINK TECHNOLOGY, THINK SIMPLY, THINK CREATIVELY
• Research the Internet
• DIY shops

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Who Can Benefit ?

• People with Long Term Conditions (self care)
• Older people with a wide range of needs (in
  control)
• Older and younger people with dementia
• Working age adults with physical disabilities
• People with learning disabilities
• Adults with mental health needs (well-being
  monitoring)
• Children with disabilities
• Carer and parents

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Case Study Examples (1)

• Mr A - with severe Parkinsons disease,
  supported by family carer wife
• - concerns about leaving the property falling
  downstairs
• - use of pressure mat with carer alert
• Mrs B - 95 years old, lived in residential care
  for 14 months
• - history of impaired mobility falls
• - returned home with bed occupancy sensor
  linked to automatic light
• Mrs C - 85 years old, some memory loss as a
  result of stroke
• - supported by family carer daughter
• - left bathroom taps on flooding his flat
  damaging flat below
• - provided flood detector, linked to community
  alarm centre
• - use of text phone/hand clapping

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Case Study Examples (2)

• Mrs D - 80 years old, lives alone (son lives
  away)
• - memory loss limited mobility
• - concerns about fire risk
• - installed radio linked smoke detector
• Mrs E - elderly lady, difficulties with self
  medication not eating well
• - provision of medication carousel
• - assisted with medication compliance as
  mealtime reminder
• - no home care required
• Mrs F - elderly lady, lives in sheltered housing
• - had dementia
• - she is at risk of leaving the property
  getting lost
• - installed door exit sensors

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Case Study Examples (3)

• Mr G - elderly gentleman has dementia, lives
  with wife
• - frequently gets out of bed at night to look
  out of the window to check if it is day or
  night
• - prone to falls
• - provided pressure mat with portable doorbell
  facility electronic
• calendar
• Mrs H - a lady with dementia
• - son-in-law works at home, upstairs in
  4-storey house
• - concerns about mother-in-law leaving property
  getting lost
• - provided video monitor
• Mrs I - lady with dementia, supported by family
  carer husband
• - becomes distressed when cant remember where
  husband is
• - provided Memominder

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Telecare/Telehealth classifications

• Safety security monitoring - stay at home
• - feel safe
• Personal monitoring - confident of a timely
  response
• - respect and dignity
• Stand alone prompting - be independent
• - choice
• Vital signs monitoring - expert patient
• - in control
• Well-being monitoring - tailored to individual
• - focus on quality of life and prevention
• Social inclusion - actively engaged
• - be part of the wider community

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White Paper Consultation Long Term Conditions -
Comments

• People wanted services based around their needs
  which help them
• take control of their health, support their
  well-being, and enable
• them to lead an independent and fulfilling life.
• Solid evidence that care is less effective if
  people feel they are not
• in control.
• Future Healthcare Network Care Services
  Improvement
• Partnership report for NHS Confederation
  Conference June 2006
• The future will see patients and doctors coming
  together by phone,
• email, text message, digital TV and the Web.
• Telehealth products will become as common as TV
  set-top boxes.