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GeniUS! Challenge #2 - Aiding vulnerable people

How can we intelligently use non-intrusive tools and methods to aid older and vulnerable people in their homes?

Summary

Challenge #2 was launched on February 1st, 2012. Background information on this challenge was provided by Question Champion Heather Barden, who is a Service Manager for CYC’s Home Care Services and leads on the Telecare services. It was important to give a context to this challenge to allow contributors to understand the problems that need to be countered. Information was provided on the physical, emotional and social problems faced the elderly and vulnerable, including a moving video on a local pensioner, Frank. Details were also provided on the telecare service already provided by CYC to improve people’s lives.

What happened

The Innovation team, in their discussions, found it difficult to decide upon on which solution may provide the greatest benefit to the City’s vulnerable & elderly. With this in mind, the team decided to define an ‘alternative’ idea to those directly submitted on the web platform but which would encompass as much of what was suggested as possible.

The aim was to set up a ‘prototype’ test space (a showflat) in the City which would provide a space to demonstrate smarter assisted living capabilities to all interested parties and to provide a ‘demo’ space for those technological solutions proposed on the platform and to ultimately tackle social isolation among elderly and vulnerable people.

The Challenge team of Innovate York, the council’s telecare team and an external expert successfully made the show flat happen between February and March 2013. A location for this facility was found at Alex Lyon House, Tang Hall, York, using a Ground Floor Flat with suitable access for the elderly and vulnerable. Residents of the sheltered housing scheme were consulted and use of this space was tailored to suit their requirements. Elderly residents and their family members were able to see the equipment in a real life environment and try it out for themselves with help and advice from the Council’s Warden Call staff.

As a result of this challenge, the Council’s Home Care Services team is now working with Independent technology professionals to develop and pilot a completely new type of ‘fall detection device’ – the first of its kind in the UK and with the potential to help older people to remain in their homes for longer.

 

Original Question and Conversation

How can we intelligently use non-intrusive tools and methods to aid older and vulnerable people in their homes?
 
With an ever increasing ageing population, the issue of care for the elderly and vulnerable becomes more prevalent not just at a local level but also nationally. The problems faced by this group of people, such as social isolation, quality of care, cost of care and quality of life are problems that all of us will one day face.

Please watch the video about Frank.

One of the biggest hurdles we currently face is communicating what we already have available to those who may be able to make use of it.

Raising awareness that technology can enhance elderly and vulnerable peoples lives in addition to traditional care packages is important. In some instances technology may prevent the need for formal care for some years as it can provide peace of mind that, even though risk cannot be avoided someone will be alerted and know if there is a problem.

Informing relatives as well as those affected as to how technology could enhance the life of a vulnerable or isolated person is also an important challenge. It is a fact that older people will listen and take more heed of the voice of a grandchild more than any other family member. How could we use that to help support and prompt people who may have short term memory issues?

One area of technology that perhaps is being under-utilised is the use of the internet and mobile phone technology to help with the social isolation aspect of vulnerability.

What is out there to help connect families who are geographically apart?

How can older people be encouraged to use technology? How can it be made simpler? How can they access it more easily? 

It would be nice to be able to provide technology to bring remote families closer together to allow geographical boundaries to be brought down by technological communication that is easy to use and that could perhaps be lead at one end and just received at the other end.

All of these challenges are important and relevant to improving the quality of life and care of those older and vulnerable people within our society.

Existing Solutions

The City of York Council Telecare service is now well established with over 1300 customers currently benefitting from some sort of telecare sensor. Lots more information on this service can be found at: http://www.york.gov.uk/health/Services_for_older_people/telecare/.

We routinely now offer some home safety devices to Warden Call customers (smoke detectors, carbon monoxide detectors and bogus caller buttons). Other customers have more complex packages of technology installed in their homes to facilitate and support traditional care packages. 

Care Managers, Occupational Therapists and GPs regularly refer in to the service to provide equipment as part of a commissioned care package or to provide additional support to prevent the need for a move to residential care. We are about to start a project with a local pharmacy to be able to dispense medication into telecare devices which will alert the customer to when they are required to take their medication. 

The Council have worked with Safer at York to follow up any Bogus Caller alerts to ensure the safety of our most vulnerable customers and has invested money in order to provide equipment free of charge to as many customers who require it.
 
Resources

Funding for equipment is already available. City of York Council have already agreed to spend £250k every year for the next 4 years to be able to provide this type of equipment in the knowledge that it will help reduce risks in some cases and reduce the need for care in other cases. 

Although much as this funding is already earmarked for specific use, it is possible that funding could be provided for a small pilot if the right technology was available to help support our desire to reduce social isolation. Or if anyone could suggest a way to promote the service that exists in such a way as to encourage family members and carers to request more information or to give us complicated scenarios to work through so as to enhance the service we already provide. 

City of York Council are committed to continue to provide a quality telecare service to the citizens of York – what we are looking for in this Challenge are new ideas as to how we provide the service, how we can be more effective at telling people about the service and how we can maximise technology to help bring people closer together.

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Replies

  • I propose a mobile "tea and talking" van aimed at older people who are isolated or find it difficult to move very far from their homes.

    Based on the idea of the mobile playbuses that ply deprived parts of London; the buses equipped with ICT equipment that seek to engage young people in school holidays; the bus that a PCT in the capital uses for training its health staff at its various sites; and, of course, drawing on traditional mobile libraries.

    I see the bus as visiting for half a day a month to offering hot drinks (espcially in winter and cold ones, of course in summer - hydration/warming) and the chance to socialise or play games, with contemporaries.

     On a second half day a month, the sessions could have a theme: ICT; eye health; nutrition; fear of the future; benefits; podiatry; exercise opportunities locally; financial advice; literacy,"show and tell"; a singalong... These themed sessions would be scheduled in advanced, and communicated to service users, so they had a chance to think about what they want to know, learn about...

    It would be colourful and welcoming. There would be an accessible toilet; a niche kitchen; comfy chairs...

    The staff would be alert for issues that might otherwise not be picked up on... sight, hearing, memory problems, insufficient clothing in cold months... They might also be able to help with ad hoc things such as reading mail; understanding official letters.

    Such a bus would be accessible for a range of users who would otherwise be isolated due to mobility or other issues ie the same vehicle could be redeployed across other groups.

    • Challenge 2 Goes LIVE!

      York gets first independent living telecare show flat

      Today the City of York Council is opening York’s first Independent Living Telecare show flat, giving older people the chance to try out the latest technology that could help them to continue to live safely and independently in their own homes

      The show flat, which is located at Alex Lyon House sheltered housing scheme in Tang Hall, has been created as a result of the council’s award-winning innovation project GeniUS!

      Last year, the online GeniUS! initiative asked for people to come forward with ideas on how the city can help its older and vulnerable residents live in their own homes for longer with more confidence and security.

      One of those suggestions was for somewhere that older people and their carers could visit to try out the latest approved telecare technology on the market in a real life home environment with expert advice on hand so they can see what will work best for them and their needs.

      Councillor Tracey Simpson-Laing, Cabinet member for Health, Housing and Adult Social Services said: “The new flat is a great innovation and a wonderful way to help older or more vulnerable people and their carers test out the best solutions for them to carry on living in their own homes with confidence and security.

      “There are so many different telecare products on the market and being able to see how the best of these work in a real home situation and have all their relative benefits explained simply and clearly by welfare professionals will enable customers to make the right decisions for their personal situation and help give them and their carers peace of mind. Anyone can make an appointment, so there’s no waiting for referrals by their GP or care workers or agencies.”

      The show flat at Alex Lyon House includes a range of very simple to use IT equipment and intelligent Telecare sensors and equipment. 

      Telecare helps to manage risk and support independence by means of unobtrusive wireless sensors placed around the home which detect possible problems such as smoke, gas, flood, extremes of temperature, movement or lack of movement or a person falling.

      The sensors automatically raise a local, audible alarm, as well as alerting a carer, key holder or a monitoring centre.  Devices on show include panic buttons, floor, bed and chair occupancy sensors, personal alarm pendants, watches and medication dispensers which alert carers to missed doses.

      In addition to the Telecare equipment, the council has worked alongside technology and network specialist Ray Hallam to install enhanced remote monitoring capability that further helps individualise services to particular needs.  This includes a touchscreen controller that the customer and carer can use to operate all devices including lights, sensors and alarms.

      The show flat will be open for viewings by appointment from the 22 January until the end of March at the following times:

      Tuesdays – between 10am-12pm

      Wednesdays – between 1pm-3pm

      Customers will be shown around by a member of the council’s Warden Call Telecare Team who will be able to fully demonstrate each item of equipment and explain the associated benefits. To arrange a viewing please customers simply need to call the council on 01904 551550 to arrange an appointment time.

      The show flat at Alex Lyon House is being opened as a pilot for three months at the end of which a full review will be conducted to assess the benefits and decide where and how the scheme should be offered in the future.

      City of York Council would like to thank the following businesses for donating carpets and furniture to furnish the flat:

      • The Community Furniture Store - The Raylor Centre, James Street, York, YO10 3DW
      • Calverts Carpets and Flooring – 15 The Stonebow, York, YO1 7NY
      • Rodgers of York - Monks Cross, York, YO32 9JR
  • I wonder if there is an opportunity to work with schools?

    Some kind of programme where youngsters are encouraged to interact with older people and learn from their wealth of life experience and at the same time bring the elderly back into the community to reduce their isolation.

    • I've given this a bit more thought and think that it would be great if the elderly could attend in person to get real live interaction, but the programme should also support a way for those who are not physically able to also take part.

      Some kind of 2-way video communications technology like Skype or similar, would need to be installed in the home. It may be that there are specialised technical solutions which are being rolled out anyway that would allow this, but if not it would be relatively easy to install simple pc and webcam technology. In addition, the whole programme could be organised via a web interface.

      If the cost of the computer equipment is prohibitive then this may be something that could be developed for the new Raspberry PI £15 computer that hooks up to a TV screen.

      Initially at least there would need to be support to show the participants how to use things, but that support could be reduced once they get the hang of it. 

      • Sounds sensible. I have been asking around and, to be perfectly honest, am quite surprised at some of the responses I get. Last night I was explaining the idea to my elderly mother and she surprised me with her reactions particularly when I mentioned cameras. I explained how they could be used, but also stated that this is approaching Big Brother. She told me that she wouldn't object as she quite liked the idea of the family being able to see her.

        She seemed most interested in something that checks whether she has locked the house at night and said that this is something that many of the elderly people she knows have in common: security. Many nights she will get up at least once (often twice) to check that the doors are all locked as she feels vulnerable in the quiet hours (recently widowed). In fact her main concern was physical security at night.

        I think that many elderly folk feel vulnerable in their beds at night and also quite alone, perhaps Skype could be useful here. Yep, I would just go with a cheap webcam solution here, I've had some good results with £10-£20 USB jobs in such roles.

        Skype (etc) has a lot to offer here, especially considering its price tag (free). When it comes to remote viewing / testing, do not overlook the fact that these automation systems are usually designed to be operable from a distance (i.e. over the Internet), so not only would less mobile people be able to view the devices, they would be able to remotely control them and fully test them.

        Raspberry PI are still not released (or at least last I checked) and may prove difficult to buy in any numbers for the foreseeable future. If they become available in bulk quantities, then they would be my system of choice - it would be great to support their project. I do wonder about the processing power though and their reliability would have to be tested, but I will be getting one the moment they are released and will see how far they can be pushed.

        Nano-ITX units have been available for quite a few years now and Gumstix are already fairly proven in industry (as is the FIT2PC), so the concept of a truly micro computer is not new. R-PI's main claim to novelty is price and emphasis on graphical performance.

        Whatever the case, you're right in stating that people should be able to see the tech in action and have the choice of selecting any module that they would find useful - anything less and we are moving closer to paternalism.

  • I think a big factor Im reading into this is that it is saying how can we get vulnerable people to do what we want them to do- eg to use computers. Many elderly people do not want to use computers.  Its important not to parent elderly people in a way that is unintentionally condescending. The best way to communicate what is on offer and reach vulnerable adults is via the gp services at their local doctors. All those who are struggling will call at their doctors regularly and as the situation deteriorates this will increase. Therefore I think the best idea is to have a leaflet that the doctor can give patients that says what help is avaliable. Even someone very isolated will still communicate with their doctor

    • You are right in many ways however although using the GP woul work for some it may not work for others as each GP practice is very different to the next one and some are much better than others. If you have a good practice they will know and have information about many local schemes etc and be looking to provide as much information for thier patients as they can. However if your practice is not that good you may miss out.

      As one way of contacting people its a great idea but it should be part of a number of options made available. Technology has been a great focus of this challenge as it is a massively growing part of our country's culture but it will only work if recipients are willing. For some it will be lifesaving and for others it will add nothing to their lives however we have to explore this as it can often help us support more traditional methods of communicating and promoting independence in a cost effective way and sadly we have tomake those considerations.

      • Fair point, but I think it would be difficult to find a one-size-fits-all solution, there will always be a variety of alternative approaches necessary to reach the target users (mediums of radio, leaflets, etc). Word of mouth is not to be underestimated either.

        You're right that one cannot morally foist anything on an unwilling person or it runs the risk of doing more harm than good.

        I doubt any technology will ever come anything close to replacing physical visits as we humans tend to be social creatures who value human contact above most (if not all) other things, but I do believe firmly in giving options where these are available.

        Did some digging around and found this: a pretty decent example of the first stages of a standard X10 setup:

        http://www.youtube.com/watch?v=f1Tz7-Pv0iU

        This could easily be controlled via a portable tablet PC, or remote as the guy does here.

        I've been involved in some decent and very reliable X10 setups and designed well they work well.

      • I think elderly people do not want to be guinea pigs for hair brained schemes. Nowadays we are constantly changing things, updating, revamping. Elderly people need consistancy because they are not at a point in their lives where they can keep relearning new systems and methods that keep changing. If you are physically weak and trying to accomplish a goal the last thing you need is someone with a clipboard saying "shall we put the goalposts here or over there?"
        When your memory isnt what it used to be you need consisency and reliability and a good quality of service. These are the most important things rather than innovation.

        Sorry if this appears a bit dramatic but I socialise with age 70+ people on a daily basis and they just want life to be simple and not taxing. They dont want to be pressurised to do new things. Im into brainy stuff but my astrology is earthsign so Im always gonna get my goat horns on and headbutt ideas with a dose of down to earth common sense  :P HUGS

        • I think you're massively overgeneralising about what "old people" want. I know many elderly people and they are as diverse in their wants and needs than any other age group. As I have said above, I know a lady in her late 70s who went from a standing start to an MSc in Computer Science in one year without breaking a sweat (for health reasons she missed the first 6 weeks of her course and caught that lot up in a couple of days). A young person would have struggled with this. I have installed a Linux-based long distance WIFI link for an elderly gent (again, late 70s) in rural Scotland and he's never offline now and just last week donated a laptop to a nun in her 80s which she is over the moon with.

          Since moving into my current home, I have put up a village-wide WLAN that shares my internet connection with my neighbours, most of whom are well retired (60s and 70s) as well as donating various PCs to them - they use these for anything from downloading knitting patterns to graphic design / photo editing.

          These "guinea pigs" are all very happy with their setups.

          Nobody is talking about forcing anything on anybody, but to think that elderly folk are adverse to technology is a mistake - TVs, cars, electrical appliances, mobility scooters, etc were all "new fangled gadgets" at some point and yet they are present in the homes of young and old alike.

          To take your example of the "physically weak", would you prefer that they had to struggle on in their current state, while only young people are permitted to enjoy the benefits of modern technology, or would you think that they may perhaps like a choice? A person may be physically weak, but this does not make them stupid.

          When someone's memory is failing, modern technology can literally be a lifesaver.

          These ideas are not about forcing anything on vulnerable people, it's about offering them options to enhance their lives.

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This website is for anyone and everyone to share ideas on how we can tackle the challenges that York and its inhabitants face. We want to encourage and develop new and imaginative ways for the city to meet some of its key challenges.

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