Telecare call centre work and ageing in place

© 2016, The Author(s).We report findings from a study of call centre staff working to deliver a telecare service designed to enable older people to ‘age in place’. We show the steps they routinely take to produce a care system on behalf of their clients and their families that is both workable within the constraints of available resources and fit-for-purpose. In doing so, we have seen how call centre staff share with one another their experiences and solutions to problems, carry out liaison work with networks of lay carers, and generally act as the ‘glue’ providing the all-important link between otherwise fragmented services. We conclude with some thoughts on the significant technical and organizational challenges if the ‘ageing in place’ vision is to be realized in a practical, secure, dependable and cost-effective way

Outcomes for Older Telecare Recipients: The Importance of Assessments

The article explores both telecare in relation to its composition of assistive technologies, including sensors; and associated services that use such technologies as a means by which, often vulnerable, people can obtain help through their activation - with signals being routed to monitoring centres. The context is one where there are changes to such technologies and ongoing growth in the use of telecare services - despite there being no indicated benefits from a major study (the Whole System Demonstrators). The 'curious' investment in such technologies and services by Adult Social Care Departments in England is investigated through an interview survey that elicited over 100 valid responses. Iy gave particular attention to the assessment process by which effective targeting (to those who would be most likely to benefit) would, it had been assumed, have taken place. Key outcomes point to needed improvements to social care practice - including the need to balance a narrow focus on risk (determined in a largely top-down way) with other telecare offerings that could more proactively address (e.g. loneliness) and involve the user more proactively in relation to technology and service options. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Summary This article explores the role of telecare assessment, review and staff training in meeting the needs of older people living at home. Using original empirical data obtained from an online survey of English local authorities it reveals considerable variation in assessment and review practice and in training given to social work and other staff who assess and review, which may impact on outcomes for telecare users. The study findings are situated within an English policy context and earlier findings from a large, government funded randomised controlled trial. This trial concluded that telecare did not lead to better outcomes for users. Findings Our survey findings suggest that it may be the way in which telecare is used, rather than telecare itself that shapes outcomes for people who use it, and that ‘sub-optimal’ outcomes from telecare may be linked to how telecare is adopted, adapted and used; and that this is influenced by staff training, telecare availability and a failure to regard telecare as a complex intervention. Application The findings may help to reconcile evidence which suggests that telecare does not deliver better outcomes and local authority responses to this which either discount or contest its value. The article suggests that to use telecare to achieve optimal outcomes for older people, social workers, care managers and other professionals involved in assessing for telecare will need to be given enhanced training opportunities, and their employers will need to perceive telecare as a complex intervention rather than simply a ‘plug and play’ solution

`Everyone is a winner, help is just a push of a button away. . . ' : the Telecare Plus service in Malta

This paper reports on a research study on the role of assistive technologies in later life. Re- search questions included what is the impact of assistive technologies on the quality of life of older service-users, and to what extent does assistive technology lead to an improved quality of life for subscribers and in- formal carers? The chosen method of enquiry was a case-study of the Telecare Plus service in Malta. A total of 26 semi-structured interviews were held with a convenience sample of 26 people aged 60-plus about their use and experience of this particular telecare system. The Telecare Plus service was found to contribute positively to subscribers' levels of emotional and physical wellbeing, interpersonal relations and personal develop- ment, as well as towards the quality of life of informal carers. However, research also highlighted a range of challenges that stood in the way of increased adoption rates of the Telecare Plus service by older people. The fact that the fi eld of assistive technologies in Malta lacks effi cient and clear business models constitutes another barrier towards the take up of such services.peer-reviewe

If telecare is the answer, what was the question? Storyline, tensions and the unintended consequences of technology-supported care

This document is the Accepted Manuscript version. The final, definitive version of this paper has been published in Critical Social Policy, March 2018, published by SAGE Publishing. Content in the UH Research Archive is made available for personal research, educational, and non-commercial purposes only. Unless otherwise stated, all content is protected by copyright, and in the absence of an open license, permissions for further re-use should be sought from the publisher, the author, or other copyright holder.Telecare—services employing technology to monitor people’s movement, medication and home environment at a distance—has emerged as a key component of global social care and health policies. The relationship between policies about telecare and the experiences and aspirations of service users has been under-interrogated. This paper draws on findings from an organisational case study involving people living with complex conditions using various telecare devices and employs Hajer’s (1995) concept of argumentative discourse analysis to identify two key storylines arguing that telecare improves people’s quality of life and promotes independence. While these storylines point to seemingly logical and incontestable objectives, uncritical policy and practice fails to recognise and prioritise the aspirations of service users, leading to unintended consequences that can deepen people’s isolation and minimise organisational benefits.Peer reviewedFinal Accepted Versio

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

Use of personal call alarms among community-dwelling older people.

Having a fall and then lying on the floor for an hour or more is known as a ‘long lie’, which are associated with serious injury and an elevated risk of admission to hospital, long-term care, and death. Personal call alarms are designed to prevent long lies, although little is known about their use. Using cross-sectional data from the English Longitudinal Study on Ageing, this study investigated the proportion of self-reported users of personal call alarms among 3091 community-dwelling adults aged 65+ who reported difficulties of mobility or activities of daily living. The characteristics of users were then explored through logistic regressions comparing those living alone with those living with others. One hundred and eighty people self-reported using a personal call alarm (6%). Multivariate regression found the following to significantly predict personal call alarm use among both those living alone and with others: greater difficulty with activities / instrumental activities of daily living, older age, and for those living with others only: lower score on the quality of life subscale for control. Personal call alarm use may be markedly lower than the 30 per cent annual incidence of falls among community-dwelling older people. Better understanding is needed of the reasons for low usage, even amongst those at highest falls risk for whom such alarms are most likely to be beneficial

What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare

Telehealth and telecare research has been dominated by efficacy trials. The field lacks a sophisticated theorisation of [a] what matters to older people with assisted living needs; [b] how illness affects people's capacity to use technologies; and [c] the materiality of assistive technologies. We sought to develop a phenomenologically and socio-materially informed theoretical model of assistive technology use. Forty people aged 60–98 (recruited via NHS, social care and third sector) were visited at home several times in 2011–13. Using ethnographic methods, we built a detailed picture of participants' lives, illness experiences and use (or non-use) of technologies. Data were analysed phenomenologically, drawing on the work of Heidegger, and contextualised using a structuration approach with reference to Bourdieu's notions of habitus and field. We found that participants' needs were diverse and unique. Each had multiple, mutually reinforcing impairments (e.g. tremor and visual loss and stiff hands) that were steadily worsening, culturally framed and bound up with the prospect of decline and death. They managed these conditions subjectively and experientially, appropriating or adapting technologies so as to enhance their capacity to sense and act on their world. Installed assistive technologies met few participants' needs; some devices had been abandoned and a few deliberately disabled. Successful technology arrangements were often characterised by ‘bricolage’ (pragmatic customisation, combining new with legacy devices) by the participant or someone who knew and cared about them. With few exceptions, the current generation of so-called ‘assisted living technologies’ does not assist people to live with illness. To overcome this irony, technology providers need to move beyond the goal of representing technology users informationally (e.g. as biometric data) to providing flexible components from which individuals and their carers can ‘think with things’ to improve the situated, lived experience of multi-morbidity. A radical revision of assistive technology design policy may be needed

It is always on your mind: Experiences and perceptions of falling of older people and their carers and the potential of a mobile falls detection device

Copyright © 2013 Veronika Williams et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background. Falls and fear of falling present a major risk to older people as both can affect their quality of life and independence. Mobile assistive technologies (AT) fall detection devices may maximise the potential for older people to live independently for as long as possible within their own homes by facilitating early detection of falls. Aims. To explore the experiences and perceptions of older people and their carers as to the potential of a mobile falls detection AT device. Methods. Nine focus groups with 47 participants including both older people with a range of health conditions and their carers. Interviews were audio recorded, transcribed verbatim, and thematically analysed. Results. Four key themes were identified relating to participants’ experiences and perceptions of falling and the potential impact of a mobile falls detector: cause of falling, falling as everyday vulnerability, the environmental context of falling, and regaining confidence and independence by having a mobile falls detector. Conclusion. The perceived benefits of a mobile falls detector may differ between older people and their carers. The experience of falling has to be taken into account when designing mobile assistive technology devices as these may influence perceptions of such devices and how older people utilise them.European Commissio