Telehealth & Telecare Learning Network John Honeyman, Telecare Training and Marketing Adviser, Fife Council Marie Gilchrist, Community Psychiatric Nurse, NHS GGC Doreen Watson, Telecare Consultant, Joint Improvement Team Sandra Shafii, AHP Consultant in Dementia, NHS Lanarkshire Nessa Barry, SCTT

A discussion about the current uses of telehealth and telecare to support individuals with dementia in their homes and communities and the necessary supportive structures.

Telehealth & Telecare Learning Network Health, housing, social care, academia, policy, research, user and carer organisations Supports knowledge transfer, good practice Feb-November 2012 monthly webcasts – access anytime 1 Network Event (May), 1 Conference – 1st November 2012 Conscious effort to bring together different perspectives from telehealth and telecare to discuss the monthly topic www.knowledge.scot.nhs.uk/telehealthcare www.video3uk.com/sctt

National Mental Health Programme Dr Stella Clark Clinical Lead for Mental Health NHS 24 Cathy Dorrian Service Development Manager Scottish Centre for Telehealth & Telecare

Efficiency and Productivity Report Mental Health Pathway Efficiency and Productivity Report

How technology might be used .” Environmental monitoring in the home or care home e.g. Medication reminders Fall detectors Mobile technology to support independence and activity e.g. GPS Video conferencing to improve access to services e.g. memory clinics and other out patient services and ongoing support. Web-based information and training resources for family and carers.   The National Telecare Programme supported the development of a series of practice guides looking at telecare and dementia, falls, learning disability, mental health, physical disability and sensory impairment. The workbooks cover topics such as assessment, principles, rights and ethics, and a suggested training programme 6

Have a look www.sct.scot.nhs.uk www.nhs24.com and www.nhsinform.co.uk www.jitscotland.org.uk/action-areas/telecare-in-scotland/ www.carersscotland.org dementia.stir.ac.uk/ www.telescot.org/copd.html www.patientvoices.org.uk/telehealth.htm www.patientvoices.org.uk/sth.htm

GPS technology: Safer walking & risk enablement John Honeyman Fife Council & SE Scotland GPS Forum John

What is ‘safer walking’? Enable a person affected by dementia to retain some independence and mobility Alert when a person affected by dementia leaves a ‘safe area’ Facilitate emergency location John

Jack’s story

John

Types of location products Mobile phone with GPS capability Non-secure watch based devices Watch based device with secure fixings Devices that can be carried by the person John

Potential service users Dementia Learning disability Vulnerable adults Adult protection Domestic abuse Travel training Acquired brain injury Donna

Limitations of the technology Compliance Battery life & charging Needs sight of satellites Needs mobile phone signal Time delay in reporting current location Tall buildings can block satellites Donna

Assessment Person-centred and carer’s assessment What do you want to achieve? Actual v perceived risk Other interventions considered? Managing expectations Consent, ethics and legal issues Care management/planning, response & review Technical glitches Alison

Monitoring, response & review Monitoring – local, third-party, carer Response – appropriate infrastructure Carer Police Response service Emergency plan Review Alison

Service delivery options Provide device free after assessment Assist family to ‘try before you buy’ What are your plans? Donna

Thank you

Extra Care Housing Experience Telecare and Dementia Extra Care Housing Experience Marie Gilchrist CPN Greater Glasgow & Clyde NHS

Telecare & Dementia Definition; “extra care offers housing with full legal rights associated with being a tenant, or homeowner, in combination with 24 hour on-site care that can be delivered flexibly according to a person’s changing needs”. Evans, S., Vallelly, S., (2007) Social well-being in extra care housing. The Joseph Rowntree Foundation.

Telecare & Dementia Changing needs; knowledge & skills of staff robust education program – pro-active risk assessment regular review with healthcare team autonomy for individual and family

Telecare & Dementia Process development; risk assessment – response pathway door contacts – linked to Tunstall Telephone System (warden call system) response pathway held in tenant file Buddi-System – GPS tracking alert system response pathway reviewed and updated

Telecare & Dementia Advantages Disadvantages time delay real-time tracking boundaries non-intrusive equipment inclusive reduces anxiety immediate response from services reduce risk of injury/accident Disadvantages time delay sensitive difficult to reset

Telecare & Dementia Impact on safety; reduce risk plan care positive risk taking maintain independence remain at home longer essential part of treatment plan within ALL complexes future discussions with healthcare staff, care homes and individuals

Telecare Training – NHS Lanarkshire Dementia Demonstrator Partnership with NHS Lanarkshire, North and South Lanarkshire Councils, Tynetec, Supra UK and Joint Improvement Team Kitting out OT Department with assistive technology and telecare equipment Developing a one day training session with Dementia Champions (equipment, pathways and response to telecare) Planning on-going buzz sessions to raise awareness in clinical teams Support clinical decision making and discharge planning

Is Telecare Cost Effective for People with Dementia? Sandra Shafii AHP Dementia Consultant NHS Lanarkshire

What evidence have we found? “Safe at Home” study in Northamptonshire “Opening Doors for Older People” West Lothian study Looking at Renfrewshire data just now There are other case studies but………. Generally there is a failure to capture all relevant costs no control group study duration too short to observe benefits difficulty in generalising from small-scale studies with their own unique local aspects to other areas.

So the issue is? A conservative estimate of NHS and social care to manage the 40,195 (GP Register 2010/11) people diagnosed with dementia is £1.02 billion (£25,305 per patient) Numbers of people with dementia set to double over next 25 years We need to be businesslike in how we are going to manage resources whilst also improving the health and social care system Appears to be a consensus that providing AT and telecare early in the dementia journey can reduce demand for care home places and hospital beds. We need to be able to articulate the evidence for effectiveness of care, improvement in health AND cost….. SO Could a key barrier to wider adoption of telecare to support people with dementia be a lack of robust evidence for its cost effectiveness? What problems would we face if we include cost effectiveness measures as an integral part of any project evaluation?

Telehealth and Telecare Learning Network Webcasts – last week of each month between February – November 2012. Lots of exciting 5 minute snapshot presentations from the May 30th Learning Network event are available. To view go to our portal site www.knowledge.scot.nhs.uk/telehealthcare.aspx July webcast – date to be confirmed November 1st SCTT annual conference. Venue: Heriot Watt University, Edinburgh.

Telehealth and Telecare Learning Network To find out more go to our portal site: www.knowledge.scot.nhs.uk/telehealthcare.aspx & use your Athens password to join the community. By doing this you will receive updates and information about the Learning Network and other events and resources as they become available. You can contact us with ideas for the Network events: Nessa.Barry@nhs.net donna@antaraconsulting.co.uk