Rhianwen Jones, North Wales Regional Telecare Strategic Manager, has worked with older people’s services for over 30 years. Rhianwen is the line manager for Galw Gofal/Care Connect in the North Wales Regional Call Monitoring Service. The service is run by a local authority, in collaboration with the Isle of Anglesey, Conwy Flintshire and Gwynedd Councils.
Galw Gofal/Care Connect has over 22,500 clients linked to the service, 52% of which are aged over 80 years, all with unique care needs and circumstances. Prevalence rates in the UK are that 1:5 people aged 80 have dementia.
In this blog Rhianwen describes the discussions at the Dementia-friendly technology workshop which took place at TSA conference on 18 November.
Technology in action in North Wales
Our service provides a call handling platform enabled to monitor a wide range of telecare and telehealth equipment designed to support people to live in their own homes in a safe environment with dignity and thus maximising their independence and potential.
The service receives over 54k calls per month from a variety of telecare sensors prescribed to manage the risks associated with daily living, such as environmental safety, personal safety and security, social well-being, personal care and health. The call monitoring service facilitates appropriate responses to these calls. The service works predominantly through non-visual communication.
It is vital to understand the different challenges people with dementia face in order to ensure effective solutions are prescribed to meet their individual assessed need.
There are over a 100 different types of dementia, a brain disorder that results in memory loss, confusion, problems with speech und understanding. Some of the types include Alzheimer’s, a progressive condition which accounts for 62% of cases, Vascular Disease which may be sudden onset or progressive, Korsakoffs Syndrome, a condition related to alcohol abuse resulting in a memory defect in which new information fails to be learnt, Dementia with Lewy Bodies which presents as stiffness, slowness of movement and tremors or Picks Disease where people may often behave in an unacceptable, sometimes rude, manner and with repetitive compulsive routines. Individuals may be affected by more than one type of dementia.
The workshop was excellent and the following key learning points are worth describing in a little more detail…
Vital to have the correct information – When we receive a telecare referral, it doesn’t always give us enough information. What type of dementia, what stage of dementia, what is the person’s normal routine, what can they do (not what can’t they do), how is their cognition and communication abilities, what risks do they face, do they wander out and what are their usual anxieties? The information needs to be regularly reviewed and updated as their condition progresses.
Involvement of families – It’s so important to work with families, friends and carers to understand more about the person. Effective networks of informal responders are vital to support individuals with dementia. However we also know that friends and some families withdraw their support over time, as they struggle to deal with the stress or inconvenience of responding.
Working together – There is a strong need to work collaboratively to share information. For example GPs hold a great deal of information about how their patient’s dementia is progressing but that information isn’t shared with the monitoring centre. We have to work well with social care teams and the emergency services too and share information.
Better use of data – In my experience the assessor rarely looks at the valuable data stored in the telecare monitoring centre about the history and trend of calls, for example incidents and interventions handled by friends and family, and the type of alarm calls raised, etc.
Response service – We need to understand the consequence of our actions. So what if a responder enters a person’s property and is faced with a very distressed individual who sees a stranger in their house? Therefore workforce training and staff awareness of dementia is vital as is providing dementia awareness training for carers.
Identifying trends in behavioural patterns – We have to be so careful with call handling as we only have a one dimensional view of the user. In other words we have sound, but no sight of the situation. Can we really trust what we are told? Someone may say they are perfectly fine but in reality they could be in a dire mess. So we can have a look at the data to see if this has happened before or if this was out of the ordinary. A triage approach to response with the support network is essential.
So for me, there are three key elements of success when it comes to dementia-friendly technology
- Prescription of the correct equipment – Tailored to the individual to meet the right assessed need. So make sure you know what is available, try to ensure positive risk taking. Follow ethical policies being mindful of Deprivation of Liberty guidelines. Make telecare part of the solution in the design of the care package and develop a trust in telecare. We need to ensure an in-depth understanding of dementia and how it affects every individual.
- Compliance – Work collaboratively to ensure robust initial and regular updates of information. Provide training for responders, carers and the individuals themselves, where possible, so they understand the necessity of telecare and how it works. If the pendant isn’t worn or if the GPS tracker isn’t taken out with you, it’s pointless having it. Dementia awareness is vital.
- Response – Be clear who responds, build relationships with their carers, the emergency services and health, share information effectively to ensure that the individual supported has a positive experience when they need help and not a traumatic one.
The interventions provided to support individuals with dementia need to be regularly reviewed and must evolve as the needs of the service user progresses.
Find out more about the Dementia-friendly technology charter