1. Extra Care Housing as a Community Hub Supported by Telehealthcare Solutions Kevin Alderson Health & Social Care Policy Director Tunstall Healthcare Ltd

2. Overview What do we mean by Telehealthcare – what is it, how does it help? Telehealthcare – in Extra Care

3. Telehealthcare brings people the freedom and peace of mind to live in their own home longer Telecare is the real time, 24 hours a day monitoring of risks to a person’s independence Telehealth status monitoring captures body vital-signs measurements and health surveys for individuals with assessed needs

4. Caring for mum with dementia Barbara is in her 80s, has moderate dementia and lives alone. She had been walking away from her home during the night and her family had been keeping a close watch on her and escorting her home on occasions. In addition she had been leaving pans on the cooker unattended This was causing a great deal of stress for her daughter and the rest of her family. THE SOLUTION A telecare package was installed including a “property exit sensor” which sent an alert to the 24 hr Careline. The operators managed to reassure Barbara and encourage her to shut the door and come back into the house 87 times in a 3 month period. Only on 3 occasions were the family called out. THE OUTCOME “Since telecare, I have started to go out again and spend time with ALL my family, and I know Mum will be ok. The equipment really gives me peace of mind.”

5. Stephen – telecare has enabled independence Stephen in his early 20s has epilepsy and suffers around 1-2 seizures a week usually at night His mother wants him to live at home and he wants his independence THE SOLUTION We installed a telecare epilepsy package: –epilepsy sensor placed in the bed to alert of seizures at night –fall detector (body worn device) for during the day Both would send an alert to mum (and 24 hour monitoring centre) so she could go to her son’s aid and provide the necessary medication, should he have a seizure. THE OUTCOME “I was so pleased with telecare, I agreed to Stephen getting his own flat near the family home.” Stephen’s mum

6. Tehream is a single mum who cares for her 2 sons, (7 & 12), who are severely autistic and profoundly deaf Her younger child is currently in foster care with regular home visits Tehream has not had a full night’s sleep for ten years and was finding it increasingly difficult to manage as her son grows bigger and stronger She could not have a cooker as the children have an extremely high pain threshold and are at risk of injuring themselves Her eldest son left the bath running and flooded the kitchen and both are prone to leaving the house by the windows and doors, causing danger to themselves Caring for children with Disabilities

7. THE SOLUTION A telecare solution that allows Tehream to know as soon as an incident occurs, via a pager during the day and the under pillow vibrator at night. THE OUTCOME “I have been able to get a good night’s sleep for the first time in many years, as I no longer have to stay awake at night worrying about my sons’ activities. I also know I’m not completely alone in caring for my children. They would both be in foster care if it wasn’t for telecare.” under-pillow vibrator Carer Pager Flood Bed sensor Smoke Property exit Home unit

8. Telehealth – Patient’s Comments A Telehealth unit was fitted in Pauline’s home in December 2009. “Telehealth saved me an admission to hospital between Christmas and New Year, when there was an abnormal reading on Boxing Day and the following two days. I was really grateful as having to go to hospital would have really spoilt my Christmas.” “Despite only having the unit for a couple of months, it has already saved me three admissions to hospital. After various abnormal readings my doctor diagnosed a chest infection and I was prescribed antibiotics. Before Telehealth I would have left it too long causing my condition to deteriorate and would eventually ended up in hospital.” A Telehealth unit was fitted in John’s home in March 2010

9. And don’t forget the carers… John's wife said: “Before we had the Telehealth fitted I was constantly worrying about John. I would never leave him alone in the house in case he became unwell. “Not only has Telehealth improved John's quality of life, it has benefited mine too. I now have more freedom and can pop into town for a couple hours, knowing he is safe. I feel a sense of reassurance knowing that if John feels unwell he can take a reading and speak to the doctor over the phone. I would definitely recommend Telehealth, it has so many benefits and not just for patients, but also for those caring for them.”

10. A compelling case Better quality of life for vulnerable citizens Better quality of life for carers also…… Better use of resources for Community Care Department and Acute Care Services Greater job satisfaction for front line staff

11. How does it work?

12. Telecare Service Monitoring Centre can support: Administration duties, Emergency response coordination Lifestyle monitoring Quantify results, Coordinate installation and removal, Equipment inventory Valuable communication hub for the whole service Monitoring Centre Telecare units and Sensors in clients’ homes Response in the Community Based in client homes Extra care housing Residential housing Nursing homes etc. Free phone telephone number

13. Telehealth Service Monitoring Centre can support: Administration duties, Non clinical triage Quantify results, Coordinate installation and removal, Infection control Equipment inventory Valuable communication hub for the whole service Clinicians perform daily triage of patient caseload Monitoring Centre Telehealth monitors in patients’ homes Clinicians, Community and Trust based Based in patient homes Extra care housing Residential housing Nursing homes etc. Free phone telephone number

14. Hot Off The Press!!! WSD –(Whole System Demonstrator programme) Results –15% reduction in A&E visits –20% reduction in emergency admissions –14% reduction in elective admissions –14% reduction in bed days –8% reduction in tariff costs –45% reduction in mortality rates

15. Telehealthcare delivery model Managed Response Social Care, Housing, Community Nursing, Friends, Family, Therapy, Meals, Voluntary Services… Emergency Response Response Centre Alerts and Reassurance

16. Telehealthcare Solutions are Highly Adaptive Dementia Help to manage and monitor environmental risks Conditions Arising From Ageing Help remotely protect, support and respond to age- related conditions Chronic Diseases Sophisticated health status and vital signs monitoring to enable individuals to be cared for in their homes Physical Disabilities & Sensory Impairment Help users react to alerts and stay in touch with carers Learning Disabilities Manage the safety and security risks Mental Health Help those who suffer panic attacks or phobias to know they can contact someone immediately Telehealthcare Solutions

17. Integrating telehealthcare across health and social care brings significant benefits Benefits to social care provision include:  Need for residential/ institutional care (either avoidance or delay)  Requirement for home or day care  Additional supported living costs Benefits to health care provision include:  Hospital admissions (e.g. falls), A&E visits and 999 call-outs  Early discharge and avoidance of delayed transfers of care  Continuing health care/nursing care Benefits to carers include:  Peace of mind and degree of independence  Quality of life & respite opportunities  Quality of assessments Benefits to end users include:  Ability to live at home independently and for longer  Quality of life, choice of care and mobility; control  Anxiety

18. Telehealthcare in Extra Care

19. Communal facilities Office Resident Apartment Telecare in Extra Care Monitoring Centre Door callers Web interface - Configuration - Maintenance Scheme manager or mobile carers Radio Receivers

20. Communal facilities Office Resident Apartment Telehealth in Extra Care Monitoring Centre Door callers Web interface - Configuration - Maintenance Scheme manager or mobile carers Radio Receivers

21. Requirements workshop highlighted some of the main problem areas:  Feeling of isolation and loneliness  Depression and mental illness The project is planning details of a two-phased approach, including piloting of:  Links to Telehealth monitoring - enabling feedback mechanisms  2 way video conferencing support  Calendars of ‘bookable’ events and reminders  Enhanced telecare alerting  Assessment of different user interfaces  Access to supporting applications eg. photo galleries, video and radio on-demand, plug-ins to external content, event booking, simple games etc. Virtex – snapshot of key activity

22. Project VirtEx The TV’s role in addressing social exclusion Fighting Social Exclusion

23. Offering various social engagement capabilities Picture sharing Calendar applications Events diary Sharing life’s experiences Exercise mind and body Link up with distant loved ones “On demand” services Wii

24. with event diaries to plan activities...to engage

25. ...to connect linking up loved ones over long distances

26. Extra Care as a Community Hub supported by Telehealthcare A compelling case….. Better quality of life for vulnerable citizens Better quality of life for carers also…… Better use of resources for Community Care Department and Acute Care Services Greater job satisfaction for front line staff

27. Thank you for listening kevin.alderson@tunstall.co.uk 07740 578000