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ASSISTIVE TECHNOLOGY:
What difference does it make?

West Lothian Council and its partners have successfully mainstreamed the use of assistive technology as a housing support mechanism in its Home Safety Service in order to assist people to continue living in their own homes. The technology is used in conjunction with new models of support and care. Evaluations to date show improved quality of life for service users who gain increased independence and confidence living at home.

Core Home Safety

Imagine your parents are both over 80, your father frail and hard of hearing, and your mother has dementia. She leaves the cooker on and the taps running, and constantly gets up during the night and wanders. Your father never hears her getting up and lately she has begun to leave the house. You and your partner, the carers, are extremely worried. Your GP recommends a nursing home, but you know your parents want to stay at home. Your mother's social worker suggests you try the Home Safety Service.

A core home-safety package is installed in their home. A lifeline unit, two flood detectors, two passive infrared detectors, one extreme-heat detector, one smoke detector and one pendant are connected to a care centre that is staffed 24/7. As all the equipment is wireless, it can be installed very quickly. Staff know if one of the sensors is activated and contact service users via the lifeline. For added safety a bed monitor is installed under your mother' mattress and set between 10.00pm and 7.00am. If she gets out of bed and does not return within a set time, this equipment will alert you via your mobile phone. You can then ring your parents' house to alert your father or talk your mother back to bed.

Fiction? No. This is a true story. The Home Safety Service changes lives. It also provides a cost-effective solution for the local authority and the NHS, because the cost of the equipment rentalised over five years together with the staffing costs to support the scheme work out at around £7 per week - the equivalent of about half an hour of alternative care.

Integration of Technology

Although the service initially focused on older people, the West Lothian Council quickly realised that it would also benefit other vulnerable client groups such as people experiencing domestic violence, mental health problems, learning difficulties, physical disabilities or illness such as epilepsy. In West Lothian, around 2,000 older people and other vulnerable service users benefit from the Home Safety scheme. Most only have the core home safety package, funded through Supporting People grant. Around 10% have additional technology that includes devices that detect falls, wandering or epileptic seizure, medication reminders, and bed and chair occupancy monitors. The service model does not replace personal contact with technology. It integrates telecare technology with healthcare and social care systems and reshapes models of care to meet the needs of service users. West Lothian Council's experience has been that technology, as part of a service package, increases independence.

Benefits

Project outcomes have had a significant impact including improvements in quality of life for service users and their carers, more effective use of healthcare and social work resources and cost savings to the public purse. Four years ago there were over 70 delayed-discharge patients in West Lothian; today there are around 20. Average length of stay in a nursing home has dropped from around three years in 2000 to around 16.4 months in 2004. The proportion of people over the age of 65 blocking beds in West Lothian is 1.4 per 1,000, compared with a Scottish average of 2.74 and a Lothian average of over four. Added to this, the mean duration of length-of-stay by someone blocking a hospital bed is 30 days, compared with a Scottish average of 112 days.

The local consultant geriatrician estimated that 3,000 hospital-bed days were saved in the first year of operation either by early discharge or by avoiding admissions to hospital because of the care team's rapid response and use of the technologies as part of a model of care. Clearly this programme provides a significant cost benefit at a time when, through demographic changes, demand for care is increasing.

Proposed Changes to Charges

The council's current policy is to offer the core housing support package to everyone over the age of 60 living alone or with a partner, for a charge of £4.87 per week, means-tested via the Supporting People Charging Policy. The aim is to have over 3,000 households benefiting from the service within the next 12 months. Does assistive technology work? Judge for yourself.