Implementing telecare for older people the w lothian experience


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Implementing telecare for older people the w lothian experience

  1. 1. Implementing telecare for older people: the West Lothian experience Alison Bowes University of Stirling, Scotland Slide 1
  2. 2. Thanks to: The Health Foundation The Nuffield Foundation Big Lottery Fund Gill McColgan, Sherry MacIntosh, Ghizala Avan, Mike Wilson West Lothian Council Research participants Slide 2
  3. 3. Changing policy for older people• Recent changes involve – Focus on independence – The whole person – Individual responsibility• Service users as active agents – Empowered – With rights Slide 3
  4. 4. The contribution of telecare/telemedicine• Can it – Increase independence – Deliver more effective and efficient services – Control expenditure?• Or does it – Replace human contact – Increase isolation – Raise risk levels – Present insuperable ethical obstacles? Slide 4
  5. 5. A citizenship approach• Focusing on older people as active agents (citizens), I aim to explore the impact of a radical telecare innovation in West Lothian, Scotland, in terms of older people’s own citizenship goals. Slide 5
  6. 6. Citizenship goals for older people (Craig 2004)• independence• social participation• identity Slide 6
  7. 7. West Lothian, Scotland Slide 7
  8. 8. Telecare in West Lothian• everyone aged 60 and over (10,000 households – 3,200 as at May 2007)• baseline for support for older people: – a home alert console, linking sensors to a Call Centre – two passive infrared (PIR) detectors – two flood detectors – one heat extreme sensor (hot and cold) – one smoke detector and (optional) – other devices to suit the individual• augmented if support needs develop• Call Centre has response protocols for each client• challenging stigma through mainstreaming Slide 8
  9. 9. The research evaluation• views and experiences of key stakeholders over time – older people in the different settings (at home and in housing with care developments) – unpaid (informal/family) carers – staff at all levels• comparator study in another area• file study• study of costs Slide 9
  10. 10. Independence• Maintaining one’s own independence• Avoiding care• Freedom of routine• Supporting capacity Slide 10
  11. 11. Limits of independence• Requires appropriate model of care• Requires limit to risk aversion• Wider issues of safety and security apply Slide 11
  12. 12. Participation• Maintained community and social networks• For unpaid carers, improved interaction and peace of mind• In housing with care, open doors and new community Slide 12
  13. 13. Limits to participation• Less human contact?• Narrowing networks• Disabling environments• Threats to status Slide 13
  14. 14. Identity• Belonging, supported by independence and participation• Local connection• Mainstreaming strategy reduces ‘spoiled’ identities Slide 14
  15. 15. Limits on identity• Negativity about services reflects perceptions of failure• Exclusion in e.g. public spaces• Stereotyping of older people – ageist attitudes and behaviours Slide 15
  16. 16. Conclusion• Support for citizenship goals through telecare• Limits come from wider social and policy context• Other excluded groups? – identify the possibilities and limitations Slide 16