Telecare for an ageing population?

One of the challenges of population ageing is the need for health and social care related to an increased prevalence of (often multiple) long-term conditions and associated functional disability. To meet these needs, the health and social care sectors need to find new ways of delivering quality care with improved outcomes and reduced costs. In other business sectors such as retailing and banking, the challenges of increasing efficiency and improving productivity are being met with spectacular success through the use of new and emerging technologies (though some down sides are also evident). Great importance is becoming attached to the evaluation of the use of information and communications technologies to facilitate the provision of health and/ or social care in new and potentially more cost-effective ways. The concepts of 'telehealth' and 'telecare' are entering the lexicon. Telehealth includes remote patient monitoring in which sensors and electronic questionnaires are used to monitor vital health signs and symptoms remotely (usually in the person's home) and transmit data to an appropriately trained person who can make decisions about potential interventions, without the patient needing to attend a clinic. The effect of telehealth interventions may, therefore, be expected to be seen in supporting patients to manage their own conditions in their own home and in reduced dependence on traditional primary or secondary care outpatient services, elective and non-elective hospital admissions [1]. Telecare, on the other hand, generally refers to the use of personal and environmental sensors in the home [1] with the aim of enabling people to remain safe and maintaining independence, avoiding institutionalisation and reducing isolation [2, 3]. Basic telecare, in the form of the pendant alarm and similar devices, has been around for several decades and is thought to be used by over a million people in the UK [4]. Newer additions to telecare include such things as falls, epilepsy and enuresis sensors, security monitoring and environmental monitors such as temperature, carbon monoxide and smoke detectors. These technologies enhance the physical and practical home environment in similar ways to other, low technology, low level social interventions such as support for cleaning and shopping, home maintenance etc. The effect of telecare monitoring may therefore be expected to be seen in the maintenance (or enhancement) of the quality of life and wellbeing, independence in the home and participation and engagement in society. It is therefore hoped that the use of these technologies will influence the …