TELEHEALTH AND TELECARE FOR OLDER PEOPLE

Matching Older People’s Needs

The world population is ageing. In the UK the percentage of older people (over 65) was 24.4% in 2000 and is predicted to rise to 39.2% by 2050. It is beneficial for older people to maintain an independent life in their own homes – often called assisted living - and technology for home care has been enthusiastically promoted as part of the solution for looking after older people.

Scottish Government policy has been particularly supportive of technologies for home-based care. In fact, Scotland has a high degree of expertise in this area thanks to the work of organisations such as NHS24, the Scottish Centre for Telehealth and Telecare, and the Joint Improvement Team which provides organisational support to social and health care partnerships across Scotland.

Home based care has two key technologically based components - Telecare and Telehealth. Telecare refers to remote support of social care at home and this includes monitoring for undesirable situations such as a fall or night wandering. Telecare also supports services for the less able, such as curtain openers or door entry phones. Effective telecare brings considerable benefits for end users, but also for families who are reassured that the condition and safety of their family member is being monitored. Care professionals can also benefit from better availability of care information about the people they are looking after. There are also economic advantages because telecare operates at a significantly lower cost than looking after someone in a care home.

Telehealth is similar but focuses on home-based health. This includes remote consultation and diagnosis, as well as monitoring health parameters like blood pressure and heart rate. The benefits include fewer unplanned hospital admissions as well as cost savings from enhanced self-care.

The Match Project

The Match project (Mobilising Advanced Technologies for Care at Home) has been running since November 2005. Match has nine research partners, seven care partners and six commercial partners – mostly based in Scotland. The founder academic participants are the Universities of Dundee, Edinburgh, Glasgow and Stirling, which is the lead university. Match is financially supported by the Scottish Funding Council and by these Universities.

Match has worked to create a centre of excellence in technologies for home care. Collaborative research has been undertaken in the areas of care technology requirements, home care systems, lifestyle monitoring, multimodal interfaces and speech communication. A challenging feature of home care is that there are many stakeholders: end users, their families, care professionals, support technicians, policy makers, etc. so Match has been working with different stakeholders to identify the requirements for home care technologies and how to overcome barriers to their uptake.

Home Care Technologies

A home care system is simply a computer-based system that supports delivery of care. Match has developed a flexible and advanced system that supports many kinds of devices. These include the equipment used in telecare and telehealth, as well as devices useful for monitoring and managing the home. For example, the system can observe how rooms are used, and can check appliance usage and environmental conditions.

Lifestyle monitoring using this system takes raw data and establishes high-level patterns for how a resident makes use of their home. The Match approach allows norms, trends and anomalies to be investigated, including how the ‘busyness’ (overall activity) of residents changes in the home. It might, for example, reveal that a resident is sleeping poorly, has become less active, or is making less use of parts of the home. The analysis of this information could help to inform the dialogue of care between residents and carers regarding changes that might be happening in the lives of residents.

Multimodal interfaces support various senses as an alternative to traditional ways of using computers and this presents a sophisticated menu of options for patient or resident interaction. Match has now developed new techniques for interacting with the home care system using audio (e.g. chimes), gesture (e.g. pointing at an object), touch (e.g. using a touch pad) and smell (e.g. encouraging meal preparation by emitting an appetising aroma).

Speech communication complements this range of interactivity by easing communication through listening and talking. Match has developed advanced speech synthesis which allow spoken reminders, and also speech recognition to support spoken enquiries. A dialogue system allows natural ‘conversations’ with the home care system on well-defined topics such as booking an appointment.

The Future

The work of Match has positioned Scottish research on an international stage and the Match work will be the basis of future products and services that could have a global impact. An important gain of this co-operative working has been to create a tightly-knit Scottish community of expertise on research, development and delivery of technology-based services for home care which should yield further domestic benefits to complement international potential.

 

Ken Turner leads the Match project. He is a Professor of Computing Science at the University of Stirling, where he leads the Care Technologies research cluster (www.cs.stir.ac.uk/research/groups/caret.html).

By Ken Turner, Professor of Computing Science, University of Stirling

Issue 2: March 2012

• A Health Constitutional Conundrum on Medicines?
• Care and Health Editorial
• What do Patients Think?
• A Demand Led Approach to Services for Older People
• Anticipating the Ills of Ageing
• The Christie Report and Care - Time to Stand and Deliver?

OTHER ARTICLES IN THIS ISSUE

• Editorial
• The Role of the Scottish Budget in Stimulating Investment
• In My View...
• The Evolving Public Sector Response to Budget Challenges
• Welfare Reform - Lone Parents Caught in the Cross-Fire
• A Tale of Two City Strategies
• A Digital Soapbox
• Searching for Scotland's 'Green Gold' - A Reader Writes