TELECARE

1. TELECARE Assessing and referring for Telecare in Highland

2. Aims of the session By the end of today you will be able to: • Understand what Telecare is and how it fits in with other types of care provision • Choose Telecare packages to meet your service users’ needs • Request a Telecare package

3. What will be covered • Definition of Telecare • What we already have • What can be added: the wireless sensors • Applications of Telecare • Case studies • Referral pathway

4. Telecare - what is it? The remote and continual monitoring of a person’s safety and well-being, with the provision of assistance when a need is detected.

5. Telecare - what is it? • Unobtrusive technology that manages risk and: • Enables choice • Supports independence • Delivers person centred care • Supports carers (formal and informal) • Provides reassurance • Facilitates new methods of care delivery

6. Why use Telecare? Independent living introduces and encourages risk taking…. ….the principle of Telecare is based on the recognition and continual management of those risks in order to reduce them to acceptable levels.

7. Risks to Independence • Anxiety and fear • Inability to cope • Cannot perform one or more activities of daily living • Instability when standing or walking • History of falls • Purposeful walking (or wandering) • Decline in senses – hearing and/or eyesight • Accidents within the home – e.g. pan fires, floods, etc. • Illness • Confusion

8. It’s not the technology!

9. Why use Telecare now? • 9.3m people over 65 to rise to 16.8 over next 50 years • 35% of people now living in care homes could live at home with the right support (DoH) • Estimated 90% of people want to live in their own homes

10. Highland Telecare Service – key objectives • Maintain service users independence at home for as long as possible • Improve safety within the home for vulnerable people • Improve quality of life for service users and carers • Reduce delays in discharge from hospital • Reduce length of stay in hospital • Reduce length of average stay in care homes • Reduce amount of direct care provision for significant number of service users • Enhance staff skills and roles – in assessment and installations

11. Balance - the importance of human contact • Balance between use of technology and continuation of human contact • Must take care not to allow the technologies to control or isolate people

12. ‘ ‘Thanks to the smarter home, a home help is required only once a year, to change the batteries’

13. Current Status - Nationally • UK • Several telecare pilots now rolled out • Variety: extended CAS, sheltered housing, intermediate care, ‘virtual care village’ • Particularly successful in rural areas • Scotland - West Lothian is only fully fledged service, but is leader in Europe

14. Current Status - Highland • Upgraded existing Community Alarm Service (Helpcall) equipment to Basic Telecare Service – 2500 service users – during 2007 • Upgrade programme in progress for Council sheltered housing alarms systems to telecare compliant systems – 590 tenants • Introduction of Enhanced Telecare Service – using range of environmental sensors and monitors within the home – now got 85 packages

15. Basic Telecare Service Smoke detector Plus these…if required Lifeline unit and personal trigger Temperature Extremes Sensor

16. Telecare Alarm Call Process Lifeline Base Unit CallMonitoring Centre Response Network Sensors or devices

17. Referring for a Basic Telecare Service • Complete SSA • Complete SSA Request for Basic Telecare Service Form • Send to local Care at Home Co-ordinator

18. When is the Basic Telecare Service not enough? Data from a telephone survey of 200 basic telecare users : “Where is your community alarm pendant at this moment?” Where? Percentage In a drawer 22% Round a door handle/peg 9% By my bed 31% Not sure 6% Somewhere else 11% Round my neck 22%

19. Why is the Basic Service not always appropriate? To operate the basic telecare equipment, service users need to: • wear their personal trigger • understand how it works • be conscious during an emergency to activate pendant • choose to use it • take it with them to bed at night!

20. Enhanced Telecare Service • Wireless sensors around home are programmed to sense specific events e.g. epileptic seizure, fall, inactivity; • Sensors send a radio signal to the Lifeline base unit • Lifeline calls for help • Many sensors can be programmed to individual requirements

21. Epilepsy sensor Carbon monoxide Smoke detector Personal trigger Gas sensor Lifeline unit Movement sensor Flood sensor Body-worn fall detector Bed occupancy sensor Temperature Extremes sensor

22. Falls Management - 24 Hour Fall Detection • Body worn fall detector or inactivity monitor - daytime • Overnight - bed occupancy sensor

23. Night time fall - bed occupancy Night time fall - bed occupancy Bed Sensor Lifeline Alarm Unit Monitoring Centre carer Day time fall - inactivity detection or - body-worn fall detector

24. Bed and chair monitors You need to specify: • What hours are to be monitored • How long an interval before the alarm is activated

25. At risk out of the home • A PIR movement sensor is used alongside a magnetic door contact • Door contact senses when door has been opened • PIR senses whether any movement follows inside the door (i.e. whether the person has come back in) • If no movement follows, alarm is raised

26. Property Exit Sensor You need to specify: • Which door(s) • What hours are to be monitored • How long before the alarm is raised • Any known behaviour patterns eg does the person always head to their friend’s house?

27. Fire, flood and gas • Smoke • High Temperature • Low Temperature • Flood/leaks from taps or pipes • Carbon Monoxide • Natural gas • Gas shut-off available

28. Carer Support • Lifeline can be programmed directly to a carer’s phone BUT remember call centre is available 24/7 • Stand-alone equipment assistive technology (i.e. equipment which is not linked to telecare base unit) is available via the Community Occupational Therapy Service - this can be cheaper and can be easier to manage for live-in carer

29. Security • Bogus caller button • PIR sensor used with Away button on Lifeline • For both person must be able to understand how it works

30. Timed Reminders • Carer Message • secure • timed Lifeline 4000

31. Just Checking The Just Checking system monitors a person in their home, and provides a chart of activity via the internet. Care professionals can use it for assessment and planning care packages for people with dementia or memory loss.

32. Lifestyle Assessment • Uses same movement sensors (PIRs) as for telecare alarms • Can have monitors on kettle, microwave, fridge, water-usage, cupboards, etc • Keeps a log of when the sensors detect activity • Information put into graph format for analysis by carers / professionals, etc

33. Case Studies

34. Case Study 1 - Jayne Risks Identified: •  forgetting the cooker is on • walking about

35. Case Study 1 - Jayne Telecare solution identified: • temperature extreme sensor • door exit sensor

36. Case Study 2 - Bernard Risks Identified: • falls • fire • flood • lack of nutrition

37. Case Study 2 - Bernard Telecare solution identified: • fall detector • bed occupancy sensor • smoke detector • temperature extreme sensor • flood detector • PIR’s

38. Referring for Enhanced Telecare • Same SSA referral pathway as Basic Telecare Service request • Assessor (that’s you!) assesses need and decides which telecare equipment is required • Send Request for Enhanced Telecare referral form to Maurice Nicholson, Ach An Eas, Island Bank Road, Inverness or by email to maurice.nicholson@highland.gsx.gov.uk, with password protection

39. What happens next? Maurice will: • Phone you to go through the referral and discuss the equipment suitability • Acquire equipment from stock or special order • Liaise with RCC re service user information and response • Arrange with Tunstall, DLO or Handyperson Scheme to install, programme and test equipment. • Installer will explain demonstrate and explain equipment to carer and service user.

40. What happens next? • Maurice will advise you (as assessor) when the installation is to take place and ask you to be present for part of installation visit • You should regularly review the package to ensure that it meets the needs of your service user and their carer

41. Support available to assessors • Ring Maurice Nicholson on 01463 710890 or 07979787924 to discuss a service user’s needs if you’re not sure what sensors are most suitable. • Joint assessments visits can be arranged, if you require a helping hand • Tunstall Telecare Helpline – 0845 026 1255

42. Our challenge to you! Consider the use of Enhanced Telecare sensors, as part of a care package, for at least one new assessment / review in the next month!