The Recipe for Assessments – More on falls

I was watching Masterchef the other night. This is a TV food competition where people who think they can cook are put through their paces. In the first round competitors are given a set of ingredients and told to make something to impress the judges. Low and behold, everyone makes a stab at producing some culinary fare suitable for royalty. The only difference is that some participants actually succeed in making truly great food whilst others produce what can only be fit for farm animal fodder.

So what does this have to do with assessing for telecare?

Well there is a straight analogy, which relates to standardisation processes.

When an assessor undertakes a visit to a person who could benefit from telecare, they are like the competitors in the Masterchef competition. No matter who visits or how the assessment is conducted they all start with the same ingredients: the person, their family, friends; the house structure etc...

What they make of these ingredients will depend on their skills as an assessor as well as their ability to understand the ingredients and put them together in new and innovative ways. In the UK Masterchef programme the judges coo over the people who use ingredients in new ways to make exciting new tastes and put things together to make innovative new combinations that work. Telecare assessments are the same. The Dependability Telecare Assessment (DTA) tool helps develop this element of diversity and innovation in design whilst ensuring a level of dependability.

So let us illustrate this somewhat. Let us take a person who has had a number of falls. We could give them a fall detector, I hear a number of people thinking, and yes, we could, but I would suggest that there are a number of steps we need to go through before we reach our outcome.

Where does the person fall? Is during a transfer from bed to chair or commode? Has the person fallen on the stairs?

When does the person fall? Is it predominantly day or night? Is it whilst doing a particular task? Is the person unsteady getting in or out of the bath?

Are the falls because of something else, such as the need to go to the toilet? Medication?

What does the person do when they have a fall? How did they summon help?

If a person is falling, can they press a pendant button? If they are no cognitive or dexterity issues then a standard pendant is all that might be required. This rules out the use of a fall detector.

If a person is falling at night, perhaps a bed occupancy sensor might be useful. Also a simple sensor light (a light that is switched on by movement in the dark) could be used for illuminating the way and showing up any objects that they might fall over.

Does the person live with someone else? Does the person have a carer at night? If they do then simple standalone alternatives are a possibility.

I could carry on putting questions up and answering each with a suggestion, but the point should be made, that there are a number of possible solutions for any issue. There is no set answer, no set recipe.

In the assessment, I would not expect the assessor to directly ask “have you fallen at night?” rather to determine the answer through a series of detailed questions within a conversational style. This is the mark of a good assessment and anything less would mean the person would not go through to the next round in Masterchef.

We need to encourage diversity and innovation in telecare assessment as well as embrace new service providers if they can demonstrate their equipment is more appropriate. The difficulty is that telecare is growing at such a rate and new technologies are being developed so fast that it can be hard to keep up to date. It is also the case that to actually determine whether a piece of telecare equipment is actually robust and useful is a very skilled process. I certainly agree with and support the idea of trialling anything new, but there is no point in doing this when the product does not meet the DTA criteria in the first place. Here again I refer you back to the DTA as a means of helping you decide whether something is worth investing time and money into.

Most importantly, The Masterchef lesson is that sometimes too many ingredients can ruin a perfectly good dish; similarly not being adventurous enough can also make a potentially great dish mediocre.

When we assess, we must go beyond the tick box approaches to really understand what the needs of a person truly are as well as their aspirations, which might be simply being independent again following a hospital admission. We need to embrace the idea that technology is not always the answer but sometimes, a little technology can make the difference between a person being dependent on help from others and actually helping themselves.

... Now I am hungry....