Wednesday, 10 September 2008

Person-centred telecare assessments

What is meant by person-centred? In the UK this term is bandied around as an excuse or a rationale for many things including telecare. Telecare is person-centred! I am amazed at the number of people who talk about their person centred telecare approach and then immediately focus on the telecare technology.

So how should a person centred assessment be conducted? It is funny as there are no current guidelines from the health or social care authorities. The new TSA guidelines concern themselves with assessment but it is a very generic model that is used and the notion of person-centredness is often lost in the translation.

Person-centredness in assessment is about finding out about the whole person, and what their needs are. It is about discussing and allowing a forum for the person's concerns to be aired and for the assessor to best meet those needs by the available options - referrals to other services, adaptions or telecare. So telecare is only one of a range of options.

Telecare assessments should be face to face, as often when people talk about what telecare a person might need, they are not in possession of the full facts. For example, on a home visit, whilst looking around the house with the person it might become clear that the initial options would be unsuitable due to the layout or activity patterns of the person.

Often during an assessment a problem that had previously been highlighted might actually become downgraded as other issues come to light and require more urgent addressing.

This means that assessments over the phone, computer based or via some assessment form will have a limited effect, it might capture some parts of an issue but other more pressing ones will be lost in the process.

Often telecare might sound like a really good option when you speak to a person but when you visit the person's needs are so great that other options need to be explored first.

A possible guideline for an assessment to be person-centred is to not think about telecare. Listen to the needs and consider how best to meet them. If telecare is the best method, then use it, but if other methods are better use them.

What is clear is that person-centred assessments are not conducted by asking a person "are you worried about falls?" "do you ever forget to turn the taps off?" All these questions attempt to pigeon hole the person into predefined telecare categories based on the limited equipment available. A good assessor will always think out of the box and not be telecare-centric. They will be person-centred.
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