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?
Thursday, 15 December 2011
Sunday, 27 November 2011
Choosing a telecare mobile phone
The telephone is a simple device that has been with us for many years in various forms. In recent years it has undergone some considerable revolutions allowing hands-free communication, number identification and a range of other features to enhance the experience. For older people, big button phones appeared which were ideal for the visually impaired and phones with loop settings aided the hearing impaired.
The mobile phone is a new development for many. Although most people have a mobile phone, their potential is often not realised. Just as Microsoft Office can do amazing things most people use it for typing things and generally use only a fraction of what it can do.
It seemed to be a good idea to think about phones. Phones make and an ideal gift for parents who are less than tech savvy. The mobile phone has changed so much and continues to evolve with new models three to four times a year. As Steve Jobs understood, the traditional computer is less likely to be developed as handheld mobile devices are likely to proliferate the market. This could happen if the experience of the person using the mobile is equal to their expectations.
I have a confession, I love mobile phones and am passionate about the variety available and which is the best. When it came to my upgrade, I spent months working through exactly the specifications that I needed from my new phone before making the decision.
The mobile market is interesting as it currently has four main operating systems: Windows mobile, Apple IOS, Android (from Google) and Blackberry which are available on the mass market.There are other operating systems out there but these are the big four.
Each operating system has its own usability issues and positive and negative features. The phone manufacturer can also add the the features as can your phone operator by limiting some functions and expanding others, so already you can see that the choice of phone is very difficult.
The mobile phone makes a potentially excellent telecare device. The difficulty is matching the phone to the person. There are a range of simple display phones available. There are also phones with clear well defined keys to enable dialling. There are large displays phones which enable people with visual difficulties to see what they are dialling or writing and loop phones for the hearing impaired, but are these telecare phones? There are a number of mobiles that provide dedicated digits or an extra button which can be dedicated to sending a call through to a pre-specified recipient. These can be useful as long as the person using the phone has the capacity to operate it when required and will operate it.
Mobile phones have a range of other things that might be worth considering. Applications, or apps that can be downloaded from the operating system provider and can be very useful for making a phone into a medical device or reminder system, ideal for people with medical conditions or memory problems. Each operating system has its own apps and it is worth considering the apps available before buying a phone, similarly the ease of downloading them and the reliability are key things to think about. Viruses and malware are problems with smart phones where you can download apps to and the operating systems way that they deal with malware and viruses is also something to consider prior to purchase.
Location, location, location... Many phones have simple location devices built in and most smart phones have a range of locating software built in to the phone which can be used to locate a lost older person and provide a map home (if maps are built in and preprogrammed). Having maps and location properties on a mobile is only the beginning as the actual software that comes with the maps might be too difficult for the user to use so actually playing with the location software is very important in the decision process.
Gyroscopes and accelerometers can be built into phones which can be set to alert a friend or family when someone falls. These are a great idea and well worth exploring but always test the functionality of them before purchase. Do they trigger false alerts? Do they not work when someone actually falls? These conditions can easily be replicated in a shop. It is also important to consider the alert call that could be produced and who is to respond. There is no point in living a long way away and being the first call number, ideally a neighbour or a call centre would be be better, as speed of getting to the person who has fallen is most important, but read the blog entry on fall detectors before considering purchasing this on a phone.
The downside to location services and fall detection is the additional battery usage. As phones have become smarter, more applications run undetected, in the background, constantly working things out, such as where the phone is and at what angle is. All this background data analysis consumes battery life and timely changing of a mobile phone is a critical feature for modern smartphones. Although the battery life that the manufacturers provides are accurate, they are before any applications are downloaded and location and other services are activated. If you want a phone with ‘bells and whistles’ you pay with battery life, so expect to charge the phone daily. This can be a difficulty for some people so the capacity to do this is essential.
Sound quality, network coverage and ability to use the phone are actually the most important aspects to consider in a phone when purchasing it for someone else. A good phone should enable a the person to make calls easily, be able to hear the person they call and have a call go through from where they live without needing to go outside.
Finally, don't forget about the cost of calls and network coverage, the smarter the phone and the more things it does the more likely it will use more bandwidth even if no calls are made as there will be a lot of things sending and receiving data on the phone so ensure the package is one that enables the person to use the phone as they would like.
In sum, a mobile phone is potentially a very good telecare device providing the ability to alert others when a difficulty arises, but just because a phone sounds good does not mean it will be the correct phone for the person. Hopefully, issues already addressed in this blog will help in the decision process and this entry has highlighted the main things to think about.
The mobile phone is a new development for many. Although most people have a mobile phone, their potential is often not realised. Just as Microsoft Office can do amazing things most people use it for typing things and generally use only a fraction of what it can do.
It seemed to be a good idea to think about phones. Phones make and an ideal gift for parents who are less than tech savvy. The mobile phone has changed so much and continues to evolve with new models three to four times a year. As Steve Jobs understood, the traditional computer is less likely to be developed as handheld mobile devices are likely to proliferate the market. This could happen if the experience of the person using the mobile is equal to their expectations.
I have a confession, I love mobile phones and am passionate about the variety available and which is the best. When it came to my upgrade, I spent months working through exactly the specifications that I needed from my new phone before making the decision.
The mobile market is interesting as it currently has four main operating systems: Windows mobile, Apple IOS, Android (from Google) and Blackberry which are available on the mass market.There are other operating systems out there but these are the big four.
Each operating system has its own usability issues and positive and negative features. The phone manufacturer can also add the the features as can your phone operator by limiting some functions and expanding others, so already you can see that the choice of phone is very difficult.
The mobile phone makes a potentially excellent telecare device. The difficulty is matching the phone to the person. There are a range of simple display phones available. There are also phones with clear well defined keys to enable dialling. There are large displays phones which enable people with visual difficulties to see what they are dialling or writing and loop phones for the hearing impaired, but are these telecare phones? There are a number of mobiles that provide dedicated digits or an extra button which can be dedicated to sending a call through to a pre-specified recipient. These can be useful as long as the person using the phone has the capacity to operate it when required and will operate it.
Mobile phones have a range of other things that might be worth considering. Applications, or apps that can be downloaded from the operating system provider and can be very useful for making a phone into a medical device or reminder system, ideal for people with medical conditions or memory problems. Each operating system has its own apps and it is worth considering the apps available before buying a phone, similarly the ease of downloading them and the reliability are key things to think about. Viruses and malware are problems with smart phones where you can download apps to and the operating systems way that they deal with malware and viruses is also something to consider prior to purchase.
Location, location, location... Many phones have simple location devices built in and most smart phones have a range of locating software built in to the phone which can be used to locate a lost older person and provide a map home (if maps are built in and preprogrammed). Having maps and location properties on a mobile is only the beginning as the actual software that comes with the maps might be too difficult for the user to use so actually playing with the location software is very important in the decision process.
Gyroscopes and accelerometers can be built into phones which can be set to alert a friend or family when someone falls. These are a great idea and well worth exploring but always test the functionality of them before purchase. Do they trigger false alerts? Do they not work when someone actually falls? These conditions can easily be replicated in a shop. It is also important to consider the alert call that could be produced and who is to respond. There is no point in living a long way away and being the first call number, ideally a neighbour or a call centre would be be better, as speed of getting to the person who has fallen is most important, but read the blog entry on fall detectors before considering purchasing this on a phone.
The downside to location services and fall detection is the additional battery usage. As phones have become smarter, more applications run undetected, in the background, constantly working things out, such as where the phone is and at what angle is. All this background data analysis consumes battery life and timely changing of a mobile phone is a critical feature for modern smartphones. Although the battery life that the manufacturers provides are accurate, they are before any applications are downloaded and location and other services are activated. If you want a phone with ‘bells and whistles’ you pay with battery life, so expect to charge the phone daily. This can be a difficulty for some people so the capacity to do this is essential.
Sound quality, network coverage and ability to use the phone are actually the most important aspects to consider in a phone when purchasing it for someone else. A good phone should enable a the person to make calls easily, be able to hear the person they call and have a call go through from where they live without needing to go outside.
Finally, don't forget about the cost of calls and network coverage, the smarter the phone and the more things it does the more likely it will use more bandwidth even if no calls are made as there will be a lot of things sending and receiving data on the phone so ensure the package is one that enables the person to use the phone as they would like.
In sum, a mobile phone is potentially a very good telecare device providing the ability to alert others when a difficulty arises, but just because a phone sounds good does not mean it will be the correct phone for the person. Hopefully, issues already addressed in this blog will help in the decision process and this entry has highlighted the main things to think about.
Sunday, 6 November 2011
Telecare Efficiencies
One of the main reasons for the use and uptake of telecare is the potential efficiencies it brings. Efficiencies is a euphemism for cuts or savings not the alternative meaning of improving something. This does not mean that by making cuts something could not be improved, simply, this is not the main agenda.
This blog is testament to how efficiencies can be made whilst ensuring the quality of service and care are not reduced.
Telecare can save money, there is considerable evidence to back this up, but it can also waste money. Wastage is most clear when a predetermined set of telecare devices are used as a standard response to a specific condition. This can often mean redundant and disabling devices. Person specific telecare should ensure mean no redundant devices, thereby saving unwanted devices and their potential running costs.
The personalisation of telecare should enable efficiencies through enabling people and promoting healthier behaviours. For example, a woman who had fallen badly several times and been lying on her floor for many hours before being discovered by her daughter. As a result of this fall she sat in a chair all day too scared to move in case she fell again. The provision of a simple telecare pendant meant she no longer felt she had to remain seated. Moving around was now permitted as she could call for assistance in the event of a fall. This is constitutes efficiency and true enablement. Efficiency as all that was required was a pendant alarm. Enablement was through the woman not spending her remaining years sat in a chair. For this woman telecare meant independence. Clearly the hidden savings are in other health related spending as a result of sitting all day and not moving. Over the forthcoming years that could be a seriously large amount of money for this one person.
The most effective efficiencies are derived through assessing people correctly for telecare and ensuring that team that provides the telecare works well. This means the processes and protocols are in a coherent workable form. It also follows that they need to be easy to implement and follow just as audit trails are required to be evidenceable at any time.
The telecare service provision is most likely to be riddled with policies and procedures that either do not exist or outdated and this directly causes inefficiencies. Inefficiencies equate to throwing away money and poor customer service. These inefficiencies can be riddled throughout the whole service including response services and the sales teams.
This blog is testament to how efficiencies can be made whilst ensuring the quality of service and care are not reduced.
Telecare can save money, there is considerable evidence to back this up, but it can also waste money. Wastage is most clear when a predetermined set of telecare devices are used as a standard response to a specific condition. This can often mean redundant and disabling devices. Person specific telecare should ensure mean no redundant devices, thereby saving unwanted devices and their potential running costs.
The personalisation of telecare should enable efficiencies through enabling people and promoting healthier behaviours. For example, a woman who had fallen badly several times and been lying on her floor for many hours before being discovered by her daughter. As a result of this fall she sat in a chair all day too scared to move in case she fell again. The provision of a simple telecare pendant meant she no longer felt she had to remain seated. Moving around was now permitted as she could call for assistance in the event of a fall. This is constitutes efficiency and true enablement. Efficiency as all that was required was a pendant alarm. Enablement was through the woman not spending her remaining years sat in a chair. For this woman telecare meant independence. Clearly the hidden savings are in other health related spending as a result of sitting all day and not moving. Over the forthcoming years that could be a seriously large amount of money for this one person.
The most effective efficiencies are derived through assessing people correctly for telecare and ensuring that team that provides the telecare works well. This means the processes and protocols are in a coherent workable form. It also follows that they need to be easy to implement and follow just as audit trails are required to be evidenceable at any time.
The telecare service provision is most likely to be riddled with policies and procedures that either do not exist or outdated and this directly causes inefficiencies. Inefficiencies equate to throwing away money and poor customer service. These inefficiencies can be riddled throughout the whole service including response services and the sales teams.
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