Suchergebnisse

Purpose
– The purpose of this paper is to identify opportunities where technology interventions could help manage the risks associated with fire and explosions in homes of people who are older or who are vulnerable through other causes such as mental health problems or a history of substance abuse.


Design/methodology/approach
– The approach focused on reviewing the latest available statistics in order to identify the major causes and rooms in which fire accidents occurred.


Findings
– The authors found that the number of incidents and fatalities continues to decrease as a result of preventive measures such as a greater use of smoke detectors, but that there remained issues with cooking safety. New products for limiting damage and managing risks are available which could have a positive impact.


Research limitations/implications
– The paper concludes that the challenges are making both professionals and the public aware of the available technologies and of introducing them following appropriate assessment of needs and risks.


Practical implications
– Greater resources need to be offered for training of the public and of health and safety professionals. Further funding may be needed to implement the introduction of new technology.


Originality/value
– This is the most up-to-date review of fire control measures employing assistive technology and telecare for domestic properties and will be of value to community health teams, adults care organisations, housing associations and other public bodies.

Successful telecare services require technical and operational stability and should meet users' needs. In this study our aim was to explore the telecare services commonly used by Taiwanese aged 60 and over (mean age of participants = 65 ± 4.5 years) and how both user satisfaction
and trust of the families directly influence continued use intention. A survey was conducted with 120 people living in the community in Eastern Taiwan, 60 of whom were elderly people who had received telecare over a 2-year period, and 60 of the telecare users' family members. The findings
revealed that among this group of older adult users telecare continued use intention was significantly associated with their level of satisfaction (p < .01) and their family members' trust (p < .01) of these services. These results should assist medical institutions in
understanding the experiences of older adults using telecare and in providing future services that better comply with clients' requirements.

PurposeThe purpose of this paper is to ascertain the views of people with intellectual disabilities (PWID) and people with dementia (PWD) on the ethical issues around assistive technology and telecare (AT&T).Design/methodology/approachTwo focus groups were convened twice to discuss and validate the topic areas/results of a Delphi study on the ethical issues around telecare. The focus groups comprised five PWID and five PWD, respectively.FindingsParticipants' ratings indicated that they felt there were important ethical issues around seven areas related to AT&T: motivation for telecare, risk, assessment and review, consent, privacy, social isolation and equipment installation.Research limitations/implicationsThis is an exploratory study with relatively few participants so the results cannot be generalised.Originality/valuePeople receiving AT&T have strong opinions on the related ethical issues and it is important that these views are heard. This study provides that opportunity.

Background
This paper discusses findings from a study of English Local Authority (LA) Adult Social Care Departments (ASCDs) that explored how managers use telecare. A decade earlier, a large clinical trial, the 'Whole System Demonstrator' project (WSD), funded by the Department of Health (DH) investigated telecare's effectiveness in promoting and maintaining independence among users. It found no evidence that telecare improved outcomes. Despite these conclusions, the DH did not change its policy or guidance, and LAs did not appear to scale back investment in telecare.


Aims and objectives
The present study explores how English ASCDs responded to WSD findings and why investment continued despite evidence from the WSD.


Methods
Data were obtained from an online survey sent to all telecare lead managers in England. The survey achieved a final response rate of 75%.


Findings
The survey asked questions focused on awareness and use of research in general, and specifically knowledge about the findings of the WSD. Most respondents were highly critical of the WSD methods, and its findings.


Discussion
Critical examination of telecare manager views found widespread inaccurate information about the trial methodology and findings, as well as the wider political and policy context that shaped it.


Conclusions
The WSD could not explain why telecare did not deliver better outcomes. A more nuanced understanding of the circumstances in which it might achieve good outcomes has received little consideration. LA difficulties in using evidence in telecare commissioning potentially leaves the sector at risk of market capture and supplier induced demand.

Many telecare services will in the future rely on service users to subsidise their existence through a charging policy. This will reduce the level of uptake, and hence the economic efficiency, unless services are shown to offer value for money. As part of a wide audit and evaluation of telecare provision in Gwynedd, service users were asked both about the value of the service to them and to their families. The responses showed that the service was perceived to be valuable to the vast majority of services users, but even more so to their families. Most thought that telecare played a valuable role in helping them to maintain their independence. When asked about the financial value of the service, more than half felt that it was worth £4.50 per week or more without a dedicated response team. The majority would not wish to pay extra for a response team.

Telehealth and telecare have been heralded as major mechanisms by which frail elderly people can continue to live at home but numerous pilot studies have not led to the adoption of these technologies as mainstream contributors to the health and social care of people in the community. This paper reviews why dissemination has proved difficult and concludes that one problem is that these technologies require considerable organisational changes if they are to be effective: successful implementation is not just a technical design issue but is a sociotechnical design challenge. The paper reviews the plans of 25 health communities in England to introduce integrated health and social care for the elderly. It concludes that these plans when implemented will produce organisational environments conducive to the mainstream deployment of telehealth and telecare. However, the plans focus on different kinds of integrated care and each makes different demands on telehealth and telecare. Progress on getting mainstream benefits from telehealth and telecare will therefore depend on building a number of different sociotechnical systems geared to different forms of integrated care and incorporating different forms of telehealth and telecare.

This paper examines, by reference to a telecare service evaluation in the Republic of Ireland, the role and potential of bed epilepsy sensors. It points to benefits for both users and carers that arise from the sensors both enabling speedy responses in the event of a seizure, and in their providing reassurance and a better quality of life for both parties.

Telecare is advocated as a means of effectively and economically delivering health and social care services in people's homes, using technology that can monitor activities and safety, provide virtual home visiting, activate reminder systems, increase home security and convey information. Significant planned investment by central government will be rewarded if telecare results in fewer older people requiring institutional care, and more remaining independent in their own homes longer than would otherwise be the case. This paper, which reports on focus group work with older people, carers and professional stakeholders, considers key issues rarely addressed in provider-led studies. Emerging social policy implications centre on the potential impact of telecare on service users' autonomy and privacy and, controversially, as a replacement for human support. We argue that the development of relevant policy and practice in respect of telecare has to pay close and careful attention to concerns held by all stakeholders, particularly in regard to individual choice, surveillance, risk-taking and quality of service.

This paper looks at some case studies from the TATE [Through Assistive Technology to Employment] Project. Funded through the second round of the Equal Community Programme (ESF) the TATE Project has looked at how assistive technology and telecare can be implemented to enhance the quality of life for adults with learning disabilities. Using a series of case studies, the paper illustrates some of the advantages of both innovative and traditional assistive technology and telecare to the service user, formal and family carers.

This paper describes the TATE [Through Assistive Technology to Employment] Project. TATE is a European Social Fund Equal project that developed electronic assistive technology (EAT) to enhance the independence and employability of adults with learning disabilities. This paper describes the model developed by the TATE Project for the implementation of EAT into organisations for adults with learning disabilities. The TATE Project has resulted in positive benefits to the lives of people with learning disabilities through the use of EAT and there has subsequently been much interest generated in further promoting the use of EAT within the UK and the EU.