Taking up Assistive Technologies

The Guardian printed an article earlier in the week about a poor take up nationally of telecare. Telecare (assistive technology)  is the system of various automatic alerts that are often used in local authorities for the care of older people.

The most familiar might be an ‘remote alarm call’ system – perhaps a pendant worn around the neck or wrist with a big red button to be pressed in case of a fall. At which point (at least with the systems I’ve worked with) a disembodied voice echoes from a small box-like device asking if any assistance is required. If there is no response or a call for help (because sometimes the button is pressed accidently or sat upon by visiting social workers.. yes, I’ve done that more than once) people will attend (they have keys) and respond appropriately.

image red at Flickr

But the world of ‘Telecare’ has expanded exponentially – or at least, I thought it had.

We have fall monitors which can test the pressure on ‘usual’ chairs or beds and alert the appropriate team if there isn’t anyone on that particular chair/bed for a programmed period of time (and it can be set so that the bed monitor is only active between certain hours and the same with the chair monitors).

We have gas detection monitors, C02 monitors, smoke detectors and heat monitors and flood detectors which all report back to a central office in case the person in question is not able to alert anyone.

There are, as I have actually been directly involved in recently, have ‘door monitors’ that can detect if someone ‘wanders’ out of a front door at night.

And probably lots of other types of equipment that I haven’t even begun to explore.

I was surprised at the poor take up because as the article notes, a lot of money has been thrown at the project – it’s certainly been very evident in our local authority. Perhaps the poor take up is related to seeing it as a ‘replacement’ service for home care workers. I’ve never considered that but more of an additional service – a kind of safety net.

Again, in my own Borough, the funding provided by central government has been used to provide the service as free on demand so we are able to offer these services to users at no current cost (although we have to explain that this may change in the future as the funding runs out). Perhaps that is why we have been more successful in rolling out the services than some.

And I have not personally known anyone considering reducing face-to-face care as a result of Telecare being implemented. Sometimes it is a more of a case of peace of mind for the carer who might not live in the same house, as much as needed for the user. I have certainly used that line as persuading factor, you know, ‘get the gas detector for your daughter’s sake, not because you wouldn’t know exactly what to do if you smelt gas during the night’.

So why the low take up, the Guardian presents a concerning but unsurprising conclusion.

In 2006, the government made £80m available in grants for English councils to pilot telecare and other forms of assistive technology…But there is uncertainty about how much of the £80m, which was not ring-fenced, was spent on telecare, as opposed to other uses

Of course the main worry has been that these new technologies will lead to a decrease in care visits but I haven’t seen it used in that way yet, and I hope it never will after all, the needs that are met are very different.

I am actually rather glad that I work in one of the authorities that seems to want to take this forward though as I’ve seen a lot of direct benefits  – in fact, someone I work with currently managed to leave the gas on and this was alerted through exactly this system. It might have been a lot longer if there had been no electronic trigger.

I can’t see it being anything other than an integral part of the packages that are delivered increasingly in the future. Technology does not have to be our enemy and it does not have to replace people.

Away Day and Old Acquaintances

As I was wandering around the office, stretching my legs, I fell upon a conversation between one of the social workers who works in a different locality team and her manager about the possibility of a whole team ‘team building away day’.

Of course this was too good an opportunity to miss. My view of an away day will always be a trip to a theme park or the zoo but unfortunately that wasn’t quite what was being proposed – it was more of a ‘sitting in a room and discussing’ type of team-building that was being proposed.

I thought paintballing sounded quite fun – we could split on a geographical basis or in our own type of geeky way, discussed a possible football match between ‘social model’ v ‘medical model’ with the doctors and nurses against the social workers and psychologists (as one of our clinical psychologists piped up at this point that she was very good at football!).

Of course this led to a discussion of which team would ‘claim’ the occupational therapists.. (I think we would because they are quite athletic and the social workers – if my colleagues will forgive me – are probably the least.. erm.. athletic.. to put it kindly).

Of course outside of my imagination, what is likely to happen is that the away day will consist of us all sitting in one of the Trust or Council offices discussing team dynamics and trying not to raise the issues that really need to be discussed.

image szlea at Flickr

Through various convoluted means that would be way too complicated to explain, today, I am going to an event at which my first practice teacher from my first placement as a social work student will be present. I qualified in 2000 and my first placement was in a local authority older adults community care team in 1998/9.

It was the first experience that I had in a statutory setting and I had a wonderfully kind and supportive practice teacher. I remember I was the first student she took as she was completing the practice teaching course as I was studying.

She was exceptionally thorough and has consistently been an inspiration to me of ‘how I would like to be at some point’. My second placement was a little less happy but fortunately, I had the experiences of the first placement to inspire me and carry me through. Through my own laziness really, we never kept in touch – although we said we would in that way you do when things come to an end – that and the fact that I left the country pretty soon after I qualified.

I saw her name though, on the distribution list for the invitations to the event. I wonder if she noticed mine. She’s probably had lots of students with and around her since so I’ll be one among many. I am not at all sure what I’ll say or even if she’ll recognise me after 10 years.

If ever though, there was a point for reflection of where I’ve come in these last ten years, it will be today..

Music to my ears

Here’s a pleasant story from the BBC.  Music affects positively both physical and mental health.  I don’t suppose this will surprise anyone who thinks about it too much as I know it is certainly the case for me (well, as far as mood is concerned anyway – I never really considered the effect on physical health!).

Particularly the research from Pavia University near Milan tested the volunteers’ responses to classical music.

Every musical crescendo – a gradual volume increase – “aroused” the body and led to narrowing of blood vessels under the skin, increased blood pressure and heart rate and increased respiratory rates.

Conversely, the decrescendos – gradual volume decreases – caused relaxation, which slowed heart rate and lowered blood pressure.

image Euromagic at Flickr

It might be time to readjust some of the playlists on my Ipod. I wonder if the same is the case for more contemporary music – not that a strong dose of Puccini and Beethoven is anything other than positive.

Scienceblog publishes a few more of the details about the study which is printed in Circulation : Journal of  the American Heart Association and summarises the conclusions as follows.

  • Every crescendo led to increased narrowing of blood vessels under the skin, increased blood pressure and heart rate and increased respiration amplitude. In each music track the extent of the effect was proportional to the change in music profile.

  • During the silent pause, changes decreased, with blood vessels under the skin dilating and marked reductions in heart rate and blood pressure. Unlike with music, silence reduced heart rate and other variables, indicating relaxation.
  • Music phrases around 10 seconds long, like those used in “Va Pensiero” and “Libiam Nei Lieti Calici,” synchronized inherent cardiovascular rhythm, thus modulating cardiovascular control.

Music, as the article explains, has already been shown to reduce stress, boost athletic performance and increase resistance to pain and is and can be used through different therapeutic means.

As for me, I don’t doubt it for a moment. I wonder if Singstar ABBA will ever be used as a therapeutic tool.. I know it makes me feel better!

Paying for long term care

Just a quick post which I hope will be of use to some. I listen to the Moneybox and Moneybox Live podcasts and yesterday, I heard the edition from Wednesday of Moneybox Live which was about funding long term care.

There were a few discussions (it has the format of a phone-in) about differing issues and certainly clarified some points for me and can be downloaded here.

Incidentally, although it is often not in the slightest bit related to my work, it is a well-constructed and more-interesting-that-it-sounds podcast that I’d recommend more generally.