1. 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

2. 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.

3. 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

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

5. Efficiency and Productivity Report
Mental Health Pathway
Efficiency and Productivity Report

6. 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

7. Have a look www.sct.scot.nhs.uk www.nhs24.com and www.nhsinform.co.uk
dementia.stir.ac.uk/

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

9. 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

10. Jack’s story

11. John

12. 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

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

14. 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

15. 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

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

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

18. Thank you

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

20. 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.

21. 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

22. 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

23. 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

24. 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

25. 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

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

27. 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.

28. 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?

29. 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
July webcast – date to be confirmed
November 1st SCTT annual conference. Venue: Heriot Watt University, Edinburgh.

30. Telehealth and Telecare Learning Network
To find out more go to our portal site:
& 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: