Surveillance technologies in care homes: Seven principles for their use

Purpose – The purpose of this paper is to consider the use of surveillance technologies in care homes and the way in which they can help protect older people. It signals an ethical way forward for their use that de-fuses the heightened rhetoric associated with concerns about the abuse. Totally, seven principles are put forward by which the use of surveillance technologies can be supported. Design/methodology/approach – The paper recognises the significance of technological developments and the key part that they now play in helping people live more independently. Surveillance technologies have a part in this within care homes, but there are important ethical considerations – notably around the way in which concerns for privacy are balanced with those about people’s safety and autonomy. Findings – The paper points to an approach that can guide the use of surveillance technologies within care homes. The seven principles put forward will be built on through further work in 2015 including care home residents, family carers, formal care providers and others. In setting out these principles the paper mediates between the positions of those who argue the merits of such technologies and those who point to some of them, notably cameras, as undermining people’s privacy and the nature of the “care relationship”. Originality/value – The subject matter of the paper is important because of the attention being given to problems of abuse in care settings; and the freedom by which anyone can access technologies that can be used for surveillance. The paper is timely and carries substantial originality

Assistive lighting for people with sight loss

This paper affirms the importance of lighting as a technology in the context of people with sight loss. Its importance lies in the ability of appropriate lighting interventions to support independent living and to reduce the likelihood of falls and accidents. The concept of “assistive lighting” is introduced with a set of tenets by which the merits of different lighting interventions can be considered. The tenets are derived from research on lighting and sight loss, including a thorough review of the literature; and consultation in the period from 2008 to 2010 with over 80 rehabilitation workers and occupational therapists in the United Kingdom. They affirm the need for lighting to be appropriate, sufficient, even, adjustable, sustainable and energy efficient, simple and adaptable. Examples of different lighting interventions are provided and these are considered in relation to the tenets. One of the key outcomes of the research was publication of a guide to good practice on lighting interventions for people with sight loss. Implications for Rehabilitation -Assistive lighting has important implications for rehabilitation in relation to people with sight loss. -Simple lighting interventions carry the potential for improving the independence and quality of life of people with sight loss and can reduce the risk of accidents. -The tenets by which options for lighting interventions can be considered can assist rehabilitation officers and occupational therapists in their work. -Lighting can be considered as a factor of increasing importance within the broader context of universal design

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

Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States

Background: On the 12th March 2020, the World Health Organization (WHO) announced the COVID-19 virus outbreak as a pandemic. On that date there were 134,576 reported cases and 4,981 deaths worldwide. By 26th March, just two weeks later, reported cases had increased fourfold to 531,865 and deaths fivefold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19. Objectives: This paper examines the extent to which Australia, the United Kingdom (UK) and the United States (US) during the two weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail and/or be self-isolating; and give support or facilitate the treatment of people who are or maybe infected. Methods: The paper reports, for the two-week period or immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels); together with publications of or guidance issued by professional, trade and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyse information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component. Results: The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences centre on the nature of their health services; the extent of attention given to older people (and the circumstances that can relate to them); the different geographies (notably concerned with rurality) and the changes to funding frameworks that impact on these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use. Conclusion: The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and healthcare providers