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ILC WA & Perth Home Care Telecare Project: Building capacity to support the sector to implement Telecare technologies Lauren Farrell and Lynsey Monk Independent Living Centre of Western Australia Perth, Western Australia Abstract There are many opportunities available to implement assistive technologies that fall into the category of Telecare, yet WA service providers have recognised and expressed a lack of understanding and uptake of these options. Equally, there are few opportunities currently where services are being planned that give consideration to assistive technologies, including Telecare technologies, as a clear option that can impact directly on the way care hours and service delivery is structured. A collaborative project undertaken by The Independent Living Centre of WA and Perth Home Care involved the assessment, implementation, monitoring and review of Telecare technologies for a number of individuals in different supported community living arrangements. The project aimed to increase the Independent Living Centre of WA’s capacity to support the sector to uptake and incorporate Telecare technologies into client care packages, to develop current knowledge of the options available to participants in the project, to facilitate the co-ordination and assessment for the installation of Telecare technologies, to evaluate and provide evidence for the social and economic benefits of the use of Telecare and to define options and pathways for future uptake and consumer support. Key words Telecare, assistive technology, implementation, trial, collaborative working 1. Introduction The Independent Living Centre (ILC) and Perth Home Care Services (PHCS) undertook a joint project to enable both services to implement and trial the use of Telecare Technology. This involved trialling related assistive technology (AT) with a number of individuals with a disability living in the community and receiving services through PHCS. The ILC has experience providing one to one consultation and problem solving AT solutions for individuals and holds forums and training to support understanding in the sector of the potential use of AT. This work across the aged care and disability sector allows us to have an overview of the level of uptake of Telecare and AT. Due to the recent increases in available products in this area and the relatively low uptake in WA there is a lack of practical working knowledge of the installation and implications of the devices once they are set up. There are few opportunities available where individual supports and services are being planned to ensure that assistive technologies, including Telecare technologies, are a clear option that can have a positive impact directly on the way services are designed. The purpose of this paper is to demonstrate how a collaborative approach between two leading organisations enables greater inclusion and independence for clients of PHCS through trialling the use of Telecare technologies. 2. Body of Paper 2.1 Outline: The aim of the project is to increase the uptake and practical knowledge of ILC staff, PHCS staff and associates as to the benefits of Telecare options and how these will optimise individual outcomes and efficient service delivery. 2.2 Objectives: The following objectives were developed to guide the project and support the outcomes of client satisfaction and technology uptake: Increase access to Telecare products and services for PHCS supported people Develop a working knowledge and practical expertise of the Telecare process; including product selection and installation, through experiential learning ILC and PHCS staff will have an increased understanding of the training and support requirements for Telecare options to achieve successful outcomes for supported people Build objective conclusions about the impact that Telecare has on planning, design and implementation of supports for people with Individualised funding The evaluation of the project will inform policy and procedure development for PHCS and ILC in relation to Telecare technologies and client service provision The disability sector will have greater evidence of the use of Telecare and assistive technologies. 2.3 Definition of Telecare: Telecare technologies are mostly used to provide remote support and assistance to a client in their home. They consist often of user operated emergency call systems, inactivity monitors, flood and gas detectors, door / chair / bed exit monitors and other items that enable a person to manage their environment safely and independently. It was decided that environmental controls e.g. adapted switches to open front doors and adapted controllers for air conditioning units did not fit the remit of the project and were not considered for funding. However, the therapists did provide clients with support to explore other funding options to obtain this equipment. 2.4 Phases of Project: It was decided to conduct the project in three phases to ensure that quality of service was provided to project participants. This also allowed for the therapists to work through each case thoroughly and resolve any issues before accepting a referral for another client. A client whose equipment is still being reviewed or installed after the commencement of the next phase would be seen until their case is completed. There are four therapists from ILC’s Assistive Equipment Service who are currently working on the project and who liaise with PHCS staff to coordinate the initial assessment visit with the client and thereafter to trial the equipment and be involved in the implementation. The therapists have also carried out follow-up visits to ensure the equipment is working effectively and is fit for purpose. For the duration of the project the equipment and associated monitoring fees will be covered by project funding. Following the completion of the project the monitoring fees of equipment will be the responsibility of the client. To this end it is necessary to establish a realistic budget with the clients as to the likely ongoing costs of the Telecare implemented. The first phase commenced in September 2013 with 7 clients assessed. Clients were referred by PHCS and their suitability for the project was determined by the therapists at ILC. The clients had a range of diagnosis and disabilities. The clients referred were from a diverse range of socio-economic backgrounds and had various living arrangements. This necessitated a collaborative approach between ILC therapists, PHCS staff, the client and their carers and/or family to ensure equipment and strategies implemented were suitable and understood by all. To facilitate this initial home visits were conducted with all stakeholders present. Further home visits were conducted with the client and at least PHCS staff in attendance. This promoted understanding of the equipment and assessment process by all parties, as well as providing clarity of process and expectations of what the project could provide. Phase two commenced in February 2014 with 6 clients assessed as part of this phase. Phase three commenced in July 2014 with 5 clients assessed as part of this phase. This will be the final phase of the project prior to evaluation being carried out in September 2014. During the initial assessment clients are encouraged to contribute towards ideas for Telecare technologies which they think will be of assistance to them. It was found that clients had often thought about what could be implemented to improve their wellbeing. Telephones including smart phones and related accessories have been the most trialed items of equipment as part of this project along with personal alarm systems. There are then a number of “self activating” alert sensors which are compatible with these systems so the individual does not have to physically activate the alert. As telephones and smart phones are a mainstream item there are many different models and styles, some with built in accessibility features, most without. When researching models for trial clients were asked what their current equipment and strategies were. With smart phones it was also vital to look at adjusting the settings of the handset and provide accessories e.g. Bluetooth headsets and mounts to facilitate usage. Further Equipment Case Examples •Smart phones with emergency call system apps: To support community safety and independence in the community. A client who uses public transport independently with his power wheelchair was recently knocked down by a truck. He had a phone at this time which he could not access easily. We have been able to provide him with an iPhone and he is now able to call for help easily should a similar situation happen again. The accessibility features when activated allowed for one touch dialing and multiple contacts stored. •Charging mats: To support individuals to use and charge their smartphones independently without requiring assistance. •Emergency call systems for the home: To support individuals' to summons help in an emergency. This type of system has recently been installed and implemented in a client’s home who has been burgled multiple times. The call system will allow him to summons help when someone is potentially breaking into the house or feeling threatened. The system is also set up so that regardless of whether the client is home or not once the sensors have been activated it will send an alert to the alarm centre to let them know that an intruder is trying to gain access. The call centre will then contact the necessary services on behalf of the client. •Epilepsy bed mat: To alert a carer or the call centre to a specific cause for assistance. Further equipment trialled: •Falls detector •GPS devices •Bluetooth head sets: •Sip/puff •Big button phones •Enuresis detector •Adapted switch access for certain devices •Environmental sensors (e.g. Smoke and gas detectors) •Carer flash receiver and pillow vibrator alert 2.5 Equipment Review: Following a trial of the purchased equipment a review is undertaken to ensure client satisfaction and usage. This involves an informal interview during a home visit. The purpose of the interview is to discuss how the equipment is being used and whether it is meeting its intended purpose. In some cases minor adjustments have been necessary to maximise the benefit for clients. Overall the equipment trialled with clients initially has been suitable for provision permanently. This may be due to the detail of information and needs gained from the screening and initial interview process. 2.6 Evaluation: Client Evaluation will be carried out by representatives from both PHCS and the ILC. To ensure open, honest and unbiased feedback this will be conducted by people who have not been involved in client contact and the implementation of Telecare equipment. A Focus Group Evaluation is to be carried out with staff from PHCS to ascertain their feedback after their involvement in the project and the outcomes it has achieved for their clients. This will be carried out by someone independent of both organisations. There will also be a re-survey of staff within the Assistive Equipment Services Team and the PHCS staff to compare the level of knowledge regarding Telecare before and after the project commencement. The survey will also look at staff’s confidence in assessing for Telecare equipment. 2.7 Initial Outcomes: PHCS staff have reported a growing understanding and knowledge of the scope and aims of the Telecare project and what items can and can’t be included under the umbrella of Telecare. Greater awareness of how assistive technology can be used with a variety of peoplenot just disability focused, but applicable for older citizens. Individuals have been very well informed and empowered to discuss their needs openly and how they can see Telecare supporting these needs to live safely and independently. These individuals therefore have greater control and are making decisions about their own care and how Telecare will support them in their lives, with ILC and PHCS supporting to implement these options. PHCS have been very motivated with regards to educating their clients about the project and supporting the ILC. The project has also produced a great deal of interorganisation learning. 3. Conclusion This project was undertaken as a need was identified for further exploration of Telecare technologies and its uses in client service provision in Western Australia. The collaborative approach towards the implementation of this technology area has provided clear educational and practical knowledge as well as awareness of what Telecare is to the clients, family and staff involved in the project. It is hoped that this knowledge will spread through the organisations and on to others in the service provider sector. Through seeing how Telecare technologies positively enabled clients to live more independently and reduce their reliance on care staff it is hoped that such strategies can be applied across a range of disadvantaged client groups. For example the general aged and dementia populations. A limitation of this project is that the long term use of the equipment put in place is not assessed. A project which looks at the longevity of equipment and the drop out rate of would be of value to show what percentage of equipment is abandoned and the reasons for this. Correspondence Email: [email protected] ARATA 2014 c/- A.M. Meetings Plus P/L PO Box 16 Ascot Vale Phone: +61 (0)3 9372 7182 Summary This presentation explores the background, objectives, findings and recommendations of a recent collaborative project conducted by the Independent Living Centre of WA and Perth Home Care that involved the assessment, implementation, monitoring and review of Telecare technologies for a number of individuals in supported community living arrangements.