Taking Telecare to a new level

With the beginning of a new year, after considerable thought I have decided to take telecare activities to the next level. Having spent three years as a Telecare Coordinator for a London Borough and obtained excellent CQC reports for the service whilst in charge, and having worked as an academic for over ten years working in the field of telecare, assistive technology, smart homes, telehealth, ambient technologies, ubiquitous technologies, eHealth, mHealth, mobile technologies in addittion to my other interests in architecture and building design, health in general and of course people with long term conditions and disabled people, I now feel that the time is right for something new.

The Whole Systems Demonstrators (WSD) by the UK’s Dpeartment of Health (DH) has recently reported on its headline findings which clearly indicate a positive use of technology can save lives and save resources. There is little doubt that these findings will be scrutinised fully once the full reports are available, and at this point the headlines might not reveal the whole picture, but they are very encouraging.

We can now be confident that technology can save lives and resources, but we also need to ensure that the technology meets the needs and expectations of the people requiring it. It is important that as a result of using technology the person is not expected to become a machine, operating in unreasonable and predictive manners.

If you have a long term condition, your life is punctuated by regular events, such as taking medication, medical appointments, all the way through to the more chronic who might require assistance in all activities of daily living. What I consider unacceptable, is that technology designed to assist becomes the problem. This could be through making assumptions about people’s lifestyles and expecting unreasonable interactions such as checking-in every hour, or pressing a button regularly to stop an alert. This could also be through false alerts or just the technology not meeting operational expectations.

We are in a era which is really exciting. Technology is evolving faster than ever before and we should be able to harness this technology to enhance people’s live by removing barriers of distance, by producing virtual communities, and bringing virtual services through the cloud to people anywhere in the world.

My current concern is that although some electronic devices benefit from the advances in modern technologies, (eg mobile phones, tablets etc) other more mundane technologies, such as pendant alarm based systems or wandering sensors are failing to think beyond the standard.

We are entering a new year, 2012, and we have the chance to begin to create the world we want. A world where distance is not an issue, where access to products and services is far easier through modern technology. My hope for this new year is that we can get together and design products that will last, which have relevance and meaning to those we design for. This year could and should be the year of personalisation and innovation.

We need to stop waiting for tomorrow to create what is needed to today. We need to act now!

We need to change the way we think about products.

We need to change the way we think about services and service provision.

We need to change the way we think about technology and we need to change the way we think about people.

We need to step away from the tick box solution.

Let’s make Person-Centred Design truly person-centred!

It is with these messages in mind that I have started a new business called gdewsbury which is a Freelance Specialist Technology Writing Service and Consultancy (gdewsbury.com) with which I wish to work with the cutting edge businesses to assist in the build and design or truly exeptional products and help small or new businesses become great through expert input.

This is the year to take telecare to a new level.

Wondering about wandering

Wondering about wandering

It is a while ago (2008) that I proposed the enablement/containment models as part of the Dependability Telecare Assessment tool (DTA) (http://www.smartthinking.ukideas.com/telecare.html and http://thetelecareblog.blogspot.com/2008/09/enablement-and-containment-models.html) in which I proposed that technology should enable people not contain them. So, 4 years on, I now turn my attention to those who have supposedly been enabled.

In the UK, there are a range of safeguarding structures in place to enable and ensure that a person has basic human rights and the ability to live an unfettered life. Locking the door on a demented family member was the option of a bygone age whereas today people are faced with the difficulty of ensuring the safety of a person who does not have capacity.

From a telecare perspective, there is a range of devices that are on the market that provide one or more of these four features:
1) to alert someone in the house of a person wandering
2) to alert a call centre when someone wanders
3) GPS based bespoke devices that can map where a wandering person is (as long as it is charged and with the person)
4) mobile phone based GPS/GSM systems that provide mapping and voice communication.

So, I am wondering, which is used today and which actually work effectively?

I recall, when I was working in a London Borough, that alerts to a family member in a house were the most effective, followed closely by the alerts to a call centre. But what is being used now and are they really effective?

I recall the problem with GPS tracking devices was that they required regular or daily charging and from what I can see this is still the case. Is their use limited to people who have family close by who are prepared to charge the devices? Additionally, you have to have the foresight to put it into a coat pocket or handbag so the person has it with them when they decide to wander. However, most people highlighted in assessment I did in London, were wandering at night partially clothed.

This means that through the safeguarding and enabling initiatives that have happened people who wander, be they older, younger or middle aged are left with few realistic alternatives. So how does this play out in the real world?


Enabling Who? - The real questions
Are friends and families put under more stress and strain to covertly contain their loved ones by locking them in and not telling anyone about it?

Are friends and families put under more stress and strain by providing their own 24-hour watch of the loved one?

Are families reliant on the telecare alert directly to them so they can drop everything and go looking for the missing person.

Has the responsibility for locating missing people been delegated to emergency organisations such as the ambulance or police services?

Has the responsibility fallen on social services to provide more care and assistance to the people who wander without friends or families?

I wonder, are the wanderers left to wander, and only after they have wandered several times with potentially dangerous consequences, are they then forced into a more contained environment where they cannot wander?

In the news, there is talk of tagging people with GPS type devices or ensuring that it is difficult for people to leave a property without actually stopping them. Both have drawbacks, the former being that this might not be consensual or hard to get agreement from families, and the latter might appear the best solution until the house is on fire and the occupant cannot get out.

I wonder is there another solution?

I wonder what is happening in the real world?

Is enablement the new containment?

Is telecare colluding in this containment in any way?