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Using Technology to support people with dementia and their carers in Portsmouth

Rosanne Brown MSc DipCOTWessex HIEC workshop

4th October 2012

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Session planDefinitions & principlesDevelopment of Telecare service Response serviceTraining for staffPublic awareness raisingKey lessons learned ResourcesObtaining AT for your clients

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Assistive Technology (AT)

Assistive technology = A generic term for any device or equipment which enables someone to undertake an activity of daily living with greater safety and/or independence.

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Stand alone……………………TelecareWhat’s the difference?

Stand aloneused directly by the person or carer (not linked to alarm monitoring centre)

Stand alone examples• Recorded message memo minders• Plug that releases the water in a bath before it overflows if tap left running

Telecare automatically sends a signal to A N Other (may be an on-site carer or to an alarm monitoring centre) to call for assistance

Telecare examples• Fall detector raises alert even if user unconscious• Door exit monitors that raise alert if person leaves building at inappropriate times

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Principles of AT in person-centred assessment & care planning

Should be considered following holistic assessment of the needs and wishes of the individual concerned

Should be used to enable and support people to live more independently

Should be considered alongside ethical issuesShould be considered alongside the use of other

services, not as a replacement for human contact and care

It may not be the answer for everyone

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Is technology appropriate in the situation?

What are the alternatives to technology?AT is not a ‘quick fix’ K.I.S.S.Start with low-tech, least intrusive, most cost

effective

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Practical considerations in service provision

Booking appointment for installation Family available for assessment & installMonitoring - issues for call centreResponse servicesTraining of user / carersEvaluation of installationRegular review

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Portsmouth early ‘specials’Medication managementResidential Rehab unit installs – Care SensorUrgent installations – no phone - Mobile cell routerAssessment with QuietCareWandering solutions Door exit monitor Lions Emergency Message in a Bottle & Photo Responders GPS trialsASC Funding Panels

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Current serviceApprox 70% of total referrals are for dementia.Telecare and stand-alone equipment now in use for

assessment purposes and to support users and carers in the community.

Risks being managed: wandering, medication compliance, falls, epilepsy,

extreme temperatures, gas, smoke, flood, inactivity, bogus callers, domestic violence

Impact on carers

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Cost of Telecare in PortsmouthNo installation chargeTelecare (Monitoring) charge = £5.40 per weekSensors can be added at no extra costTelecare Plus (Monitoring + Night Responder service)

= £7.50 per weekNo charge for Key SafeDisability-related expense – care packageNo charge for stand-alone equipment if identified

need during community care assessment

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Portsmouth Telecare Responders• From April 2009, PCC has provided a night time (9pm to 6am) response service for Telecare users whose key holders cannot be contacted, or who do not have their own night responder.• Staff with personal care skills, trained in risk assessment, first aid, moving & handling, use of Mangar Elk (lifting cushion)• Feedback to NHS & social care, to close information loop on, e.g. fallers, people who wander• Requirement remains for joint-funded, integrated (NHS & PCC) 24/7 responder service

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Training for staffTelecare – a tool in everybody’s toolbox‘Telecare Experience’ - fortnightly training

programme for health, housing and social care staff, & voluntary sector

Enhanced training workshop on AT in dementia

Currently no on-going training programme

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Support for staffUntil February 2012 - Telecare Co-ordinator and Telecare Development

Worker available to answer queries, provide advice and information to staff considering making referrals

Joint assessment visits with staff, to help determine appropriate recommendations and increase staff confidence and competence

Currently no dedicated staff for this task

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Public Awareness-raising

For carers of people newly-diagnosed with dementia Talks to church groups, clubs for older people e.g.

U3A, day centres, established carers’ groupsStaff of major local employersDisplays and presentations at community events, e.g.

Carers WeekCurrently no dedicated staff for this task

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Key Lessons LearnedEffective use of AT requires…..Informed, skilled and personalised outcomes-focussed

assessment of needs and riskResolution of ethical dilemmas around capacity, informed

consent and choice (for each individual in each situation)Training and education for the service user, carers, personal

care and support staff in how the equipment can be used or misused, and how it should be tested and maintained

Regular review of its effectivenessRobust, integrated 24/7 response servicesJointly-commissioned and funded AT service based in JES

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Assistive Technology in Dementia website

www.atdementia.org.uk Interactive self-help area - Identify topic of interest,

answer yes/no questions to narrow down likely problem, receive suggestions for products, suppliers

Product directory, based on 4 major subject headings – Prompts/reminders, Leisure, Safety, Communication

www.alvolution.co.uk – product search & comparison site

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Displays of AT for dementiaAssistive Technology Library at: Acorn Therapy Unit,

Moorgreen Hospital, Botley Road, Southampton SO30 3JB. Tel: 023 8047 5111

Joint Equipment Service, Josian Centre, Southampton. Tel: 023 8071 0359

AZTEC Centre, Croydon - Comprehensive display of Telecare & Free-standing AT for purchase. 28 Boulogne Road, Croydon CR0 2QT. Tel: 020 8664 8860. brian.longman@btinternet.com

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Referrals for TelecareIndividual can self-referCarer can referProfessional can referIn PortsmouthInfo for professionals at :

http://www.portsmouth.gov.uk/living/19498.htmlFreephone: 0800 731 2228Write to: Portsmouth City Council, Telecare, Freepost NAT17741,

Portsmouth PO1 2BREmail: telecare@portsmouthcc.gov.ukIn SouthamptonRichard de Normanville Guy, Tel: 023 8083 4916 Email: richard.deNormanvilleGuy@southampton.gov.uk

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Obtaining free-standing AT for dementia

In PortsmouthLimited supply from Telecare service PCCPersonal budgetJoint equipment serviceHigh street gadgets vs. ‘disability’ products

In SouthamptonJoint equipment service

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Useful referenceswww.atdementia.org.ukwww.alvolution.co.uk www.telecarelin.org.ukwww.chubbcommunitycare.co.ukwww.tunstallgroup.com/home.aspxwww.quietcare.co.ukwww.pivotell.co.ukwww.telecareaware.comwww.dementia.stir.ac.ukwww.scie.org.uk/publications/dementia/in

dex.asp