Healthcare, social welfare and housing policy agendas, while emphasising the importance of supporting the independent living of older people at home, have generally failed to take account of the actual or potential role played by social alarms and telecare. This book draws on research and practice throughout the developed world. It documents the emergence of these important technologies and considers their potential in the contexts of healthcare, social welfare and housing
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This paper examines, by reference to a telecare service evaluation in the Republic of Ireland, the role and potential of bed epilepsy sensors. It points to benefits for both users and carers that arise from the sensors both enabling speedy responses in the event of a seizure, and in their providing reassurance and a better quality of life for both parties.
The growth of telecare is providing an infrastructure that will underpin services at home for an increasing number of people with support needs in the UK. The growth is prompted, in part, by grant funding from central government and the devolved administrations. It also relates to imperatives that (a) respond to people's choices; (b) promote better health and well‐being; and (c) seek savings in public money. Increasing proportions of telecare service users have critical or substantial needs (according to the Fair Access to Care Services criteria operated by social services authorities). There is the concomitant requirement that such services must be provided in accordance with good practice. This paper explores some of the issues around that good practice and the way that the Telecare Services Association Code of Practice is changing to ensure that progress is made towards good practice goals.
In the 1980s few studies adopted a positive attitude to ageing and elderly people. First published in 1986, reissued with a new preface, this book helped to redress this imbalance by focusing on the theme of independence, examined particularly from the perspective of housing and social policies relating to elderly people.
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Purpose – The purpose of this paper is to consider the use of surveillance technologies in care homes and the way in which they can help protect older people. It signals an ethical way forward for their use that de-fuses the heightened rhetoric associated with concerns about the abuse. Totally, seven principles are put forward by which the use of surveillance technologies can be supported.
Design/methodology/approach – The paper recognises the significance of technological developments and the key part that they now play in helping people live more independently. Surveillance technologies have a part in this within care homes, but there are important ethical considerations – notably around the way in which concerns for privacy are balanced with those about people's safety and autonomy.
Findings – The paper points to an approach that can guide the use of surveillance technologies within care homes. The seven principles put forward will be built on through further work in 2015 including care home residents, family carers, formal care providers and others. In setting out these principles the paper mediates between the positions of those who argue the merits of such technologies and those who point to some of them, notably cameras, as undermining people's privacy and the nature of the "care relationship".
Originality/value – The subject matter of the paper is important because of the attention being given to problems of abuse in care settings; and the freedom by which anyone can access technologies that can be used for surveillance. The paper is timely and carries substantial originality.
The rapid evolution of the social alarm network in the UK during the 1980s is one of the greatest success stories of the local authority housing departments which championed their growth. Yet, during the past decade, when 'care in the community' became a reality and the number of older people living alone in society increased significantly, the number of connections has often grown slowly and investment in new technology has been relatively low. This article describes the features of new generations of 'telecare' using systems with increasing potential.
Background This paper discusses findings from a study of English Local Authority (LA) Adult Social Care Departments (ASCDs) that explored how managers use telecare. A decade earlier, a large clinical trial, the 'Whole System Demonstrator' project (WSD), funded by the Department of Health (DH) investigated telecare's effectiveness in promoting and maintaining independence among users. It found no evidence that telecare improved outcomes. Despite these conclusions, the DH did not change its policy or guidance, and LAs did not appear to scale back investment in telecare.
Aims and objectives The present study explores how English ASCDs responded to WSD findings and why investment continued despite evidence from the WSD.
Methods Data were obtained from an online survey sent to all telecare lead managers in England. The survey achieved a final response rate of 75%.
Findings The survey asked questions focused on awareness and use of research in general, and specifically knowledge about the findings of the WSD. Most respondents were highly critical of the WSD methods, and its findings.
Discussion Critical examination of telecare manager views found widespread inaccurate information about the trial methodology and findings, as well as the wider political and policy context that shaped it.
Conclusions The WSD could not explain why telecare did not deliver better outcomes. A more nuanced understanding of the circumstances in which it might achieve good outcomes has received little consideration. LA difficulties in using evidence in telecare commissioning potentially leaves the sector at risk of market capture and supplier induced demand.
Summary This article explores the role of telecare assessment, review and staff training in meeting the needs of older people living at home. Using original empirical data obtained from an online survey of English local authorities it reveals considerable variation in assessment and review practice and in training given to social work and other staff who assess and review, which may impact on outcomes for telecare users. The study findings are situated within an English policy context and earlier findings from a large, government funded randomised controlled trial. This trial concluded that telecare did not lead to better outcomes for users. Findings Our survey findings suggest that it may be the way in which telecare is used, rather than telecare itself that shapes outcomes for people who use it, and that 'sub-optimal' outcomes from telecare may be linked to how telecare is adopted, adapted and used; and that this is influenced by staff training, telecare availability and a failure to regard telecare as a complex intervention. Application The findings may help to reconcile evidence which suggests that telecare does not deliver better outcomes and local authority responses to this which either discount or contest its value. The article suggests that to use telecare to achieve optimal outcomes for older people, social workers, care managers and other professionals involved in assessing for telecare will need to be given enhanced training opportunities, and their employers will need to perceive telecare as a complex intervention rather than simply a 'plug and play' solution.