16. USE OF ASSISTIVE TECHNOLOGY
The purpose of this chapter is to set out action to extend the use of telecare and to ensure that carers have access to information and training on the use of equipment.
16.1 Telecare is the remote or enhanced delivery of care services to people in their own home or a community setting by means of telecommunications and computerised services. The term usually refers to sensors and alerts which provide automatic and remote monitoring of care emergencies and lifestyle changes, to trigger human responses or shut down equipment to prevent hazards. All 32 local partnerships in Scotland have developed telecare services.
16.2 A very broad range of technologies to support health and care needs has been developed. The term 'telehealthcare' is now being used to describe the wider package of services.
Joyce has dementia and lives with her husband in Edinburgh. Joyce tends to walk about during the night. Recently Joyce was admitted to hospital, unlikely to return home due to her health situation and lack of management of her night walking. However, Joyce was provided with a telecare solution, including a property exit sensor and a pager system. Should Joyce try to leave the house during the night, the property exit sensor automatically raises a call to her husband's pager and gradually turns on the bedside light. This allows Joyce's husband to get to the front door or street to assist his wife to return home. It also helps him to get a better sleep knowing he will be alerted if needed.
16.3 In an independent review of the Telecare Programme in 2008, 28 74% of carers reported reduced stress and 93% of those being cared for felt safer at home. More recent research 29 further reinforces these findings, and identifies that carers can benefit significantly from using telecare services.
16.4 Carers have said:
"When you have a vulnerable person to care for in your house, it feels like you're on duty 24/7. So it was wonderful, it allowed me to relax, gave me chill out time. I wasn't on alert throughout the night."
"I can sleep easier and work easier knowing that a call-out will happen if something is wrong."
16.5 The appropriate and targeted use of telecare can help carers by: providing affordable access to support and assistance round the clock; supporting individual, personalised services; achieving fewer days in hospital and care homes and less Accident and Emergency admissions; reducing stress and providing peace of mind; enabling a good night's sleep; helping some carers to combine work and care; providing some with an opportunity for a life outside of caring; and providing early intervention.
16.6 The Scottish Government will work with partners, including local authorities, to ensure that telecare fully benefits carers in Scotland, enables more people to live independently and improves the quality of life for carers.
ACTION POINT 16.1
In 2010-11 the Scottish Government, with local authority and other partners, will raise awareness of telecare amongst carers nationally and locally and will ensure that carers have better access to appropriate information on services.
ACTION POINT 16.2
The Scottish Government, with Carers Scotland, will ensure that carers' training is included as part of a national approach to telecare education and training, with a specific workstream developed to address this over 2010-12.
ACTION POINT 16.3
In 2010-12, the Scottish Government will ensure that telecare is included in the practical guide to undertaking carers' assessments and will promote its further integration within Single Assessment and Care Management/Review protocols and processes.
ACTION POINT 16.4
By 2015, the Scottish Government will further maximise the impact of its telecare investment to ensure that the benefits and applications of the new technology for carers continues and develops.
ACTION POINT 16.5
In 2010-2015 the Scottish Government will further explore the innovative use of new technologies in support of carers living in remote and rural areas, and identify mechanisms which may be more accessible to young carers.
Equipment and Adaptations
16.7 Equipment and adaptations can play an important part in supporting the role of carers. Having the right equipment or adaptations in the home will allow the cared-for person to remain at home for longer. It will also reduce the pressure on, and risks to, the carer and it can help prevent hospital admissions.
16.8 Research 30 has shown that many carers and other family members are putting their health at risk, or suffering actual short or long-term injury, through lifting or carrying their children or other relatives, because of the lack of suitable facilities.
"His mother had back problems and had to have an emergency operation after lifting him onto the toilet one day. She has seen X-rays of her spine which have convinced her that she cannot risk further damage by trying to help him in these areas."
16.9 It is clear that the provision of equipment and adaptations can provide physical relief, particularly with regard to back strain. There are also financial and economic implications, as a damaged back can cost the state in medical treatment and lost employment.
16.10 The issue of compatibility of equipment is often raised by carers, including parent carers, young people and practitioners. Parents in particular feel that manufacturers should work together to ensure equipment is compatible.
16.11 Any unnecessary delay in the provision of equipment and adaptations can cause frustration and put carers and the people they care for at risk.
16.12 It is essential therefore that assessments are carried out as early as possible and that the views and experience of the carer are taken into account. The assessment should take into account how needs will change over time, especially when providing adaptations. Where delays are unavoidable, carers and the people they care for need to be kept informed, advised of the reasons for any delay and given a realistic timescale for delivery of equipment or completion of the adaptation.
16.13 It is also vital that carers receive adequate training on the use of the equipment provided. The Handle with Care Report 31 published in 2008 by Scotland's Commissioner for Children and Young People highlighted this as a major issue.
16.14 The report stated that the vast majority of the parents and carers had received no moving and handling training. One carer stated:
"We never get offered moving and handling training. Our hoist was put in at home but no training was offered regarding the hoists and slings. They didn't even guide us to where we could get training."
ACTION POINT 16.6
In 2011-15 the Scottish Government, with local authorities, Health Boards and other partners, will raise awareness of equipment and adaptations amongst carers and ensure that carers have better access to appropriate information and training on equipment.