clients view the service extremely positively, but:
- less than 8% wear it at all times
- over two-thirds of clients wear their personal trigger most or all of the time
- almost one-third of clients wear their personal trigger only some of the time to not at all, mostly because it is too sensitive or they forget to put it on
- almost two-thirds have never used their personal trigger to summon help
Link to abstract. The full paper can be downloaded – at the time of writing – from:
http://www.distancelab.org/database/publications/Taylor.10.Trigger.CHI.pdf (1.2MB)
Google’s html cached version is here.
In the body of the report we are reminded that in 2003, a telephone survey of 200 community alarm service clients in Scotland found only 21% wearing their personal trigger at the time of the call and that there is a self-defeating element to the provision of pendants: “Clients are advised to remove their trigger for sleeping to avoid strangulation. The problem is that people forget to put it on again when getting out of bed during the night, when accidents frequently occur. According to Tunstall, 70% of falls occur at night and falls account for 10% of acute hospital admissions in the UK each year. For older people, the consequences of a fall can be fatal.”
© Telecare Aware
The report is helpful in spelling out the reasons people gave for not wearing their pendant. Contrary to the authors’ expectations, only 3% (and the majority of the respondents were women) said it was because the pendants were unattractive, and the authors indicate that they intend to follow up the survey with work “to rethink the personal trigger from a fresh and less technological perspective.”
We wish them well and will look forward to the results.
Pendant alarms
I am not surprised by the results of this survey and they don’t contradict my work (reference 1) performed in Scotland, nor similar surveys in England and in Wales. However, I think that the views of service users need to be collected in the right context, and that general views may hide a wide range of knowledge concerning the purpose of the pendant and the alternative methods of raising an alarm.
Now that we have many examples of old community alarm services running alongside telecare services (which include a number of specific sensors such as fall detectors and inactivity monitors) we should be analysing the use of each alarm. This helps determine the appropriateness of prescription, and the value placed on the device by the end-user.
Last year I analysed the alarm records of one of the best telecare service providers in the country (my opinion!) and found that the most used method of raising an alarm was the active integral button on the home unit. The pendant was second, inactivity monitor (passive movement detector) was third, and bed occupancy was fourth. When the data were adjusted to account for the fact that all service users had a home unit and pendant but only 70% had a bed occupancy sensor, for example, the fraction of alarms raised automatically by the telecare sensors and system was almost exactly half the total. Thus, despite all the effort to detect problems in a “smart” way, service users continued to make use of “the red button”.
This leads me to ask:
1) Does the individual’s own feelings of isolation and vulnerability influence how often they wear or carry their pendant?
2) Do we want them to press the button more often? (and if so why?)
3) Will they do so if the pendant was personalised or made more attractive or less obvious to wear?
4) Should pendants have more than one button (as they have in France) where one might be for alarms and the other for information?
Actually, I could ask many more questions also. But what we mustn’t forget is that the pendant is the most efficient “fast dial” button that we have. It opens up a voice channel to a centre that not only knows who has pressed the button, but they also know their characteristics and their location i.e. at home.
This is not the case with m-care (at least not yet), so the pendant may not be redundant for quite a while. The successful merging of telecare and m-care may be the most interesting challenge that faces the industry over the next 2 or 3 years.
Falls detectors also unused
The report does not surprise me and I agree an evaluation of each of the alarm raising equipment, I would ask the question what about the falls detectors?
Through the discussions I have had with customers they find them very large and cumbersome and only those who feel most at risk indicate that they actually wear them. Again I raise the question of purchasing equipment for the sake of it, as I believe managers should place a great importance on such reports and giving customers a choice of equipment styles.
Unfortunately the Telecare service I work for seems to ignore these factors and purchase bulk equipment from one manufacturer, limiting the choice and styles and, to make things worse, issued thousands of falls detectors to tenants based in sheltered housing schemes on the basis everyone gets one (an obvious target hitting exercise).
On visiting the tenants over half have to think where they last put the falls detector another large proportion will tell you its in a draw somewhere and only the most vulnerable are actually using the equipment. I believe more thought on the design aspect and user input is necessary and a range of equipment should be made available.
The Telecare manufacturers, I would suggest, are not at the top of the tree when it comes to user design and Telecare centers should have to report on equipment type usage to justify the mass spending and future purchasing of equipment.
Pendants – More options
This report doesn’t surprise me either. My own great grandmother wouldn’t wear one. She said they were for “old people” and she was 99 when she said that. Unfortunately, we learned the price of this the hard way when she fell and broke her hip. My father and I developed an automated wellness calling system to help address this concern. We launched earlier this month as Telecare Aware reported. This new study is more proof positive we need more options for our loved ones.
Rachel Scharff
http://www.finethanx.com
PERS
I belive we need to ensure that people have “Buttons” in key places in the home. Near the bed, in the shower and near the favorite chair, This allows some level of security even when residents do not what to carry them. Systems such as GrandCare can also help with other types of monitoring.
we devolpe the system that makes the pendant part of the ordinary use at home. not only for alarm
@ David – Please feel free to tell us more. I could not find any information relevant to this on your website http://hh-img.com/
Steve
I am a private individual, age 79, living on my own in London.
Is there a central comprehensive source for information on all the reliable providers of
Security Confirmation services for elderly?
I am aware of AlertaCall — are there others?
Thank you for any help . B. Barry
Miss B Barry
London Telecare:
http://www.uktelehealthcare.com/
UK Map of providers:
http://bit.ly/10EE4f6
Telecare Services Assn Directory including Code of Practice Members:
http://www.telecare.org.uk/service-provider-directory
SendTech have created the SenCit mobile connected care monitor which provides a simple solution to many of these problems:
http://www.sendtech.co.uk/SeN-Cit/index.shtml
It also get’s around the age old problem of people not wanting to use it because “it’s for oold people” as it doubles up with cool additional features such as an intruder alarm, boiler breakdown alert and power cut notification.
This link has the report.
http://www.agamanolis.com/distancelab/database/publications/Taylor.10.Trigger.CHI.pdf
[Thanks for the update, Chris. Ed]
According to the report more than a third of users have used their alarm to get help. That seems like a very strong argument for having Telecare technology at home.
Simon Budd
http://www.lifeline24.co.uk
It’s interesting that this old chestnut continues to attract attention. A shift to mCare is inevitable – but I wouldn’t mind betting that the best mobile solutions will include an alarm trigger which will, more than likely, have a neck pendant option – because that’s what lots of people want when they feel isolated or at risk. If it looks and feels better than fantastic, but I doubt if this will be the dominant factor in them deciding if and when to wear it. Thankfully, people are heterogeneous – perhaps increasingly so as they get older – so the one-size-fits-all approach is not going to work (except for the 50% perhaps who like to be the same as everyone else!)
I think that we need to move this argument on to other issues of user control and the potential for telecare or mCare to improve use and performance. Take medication compliance as an example that various experts would suggest costs the health economy as much as accidents and non-elective hospital admissions. They will tell us that people only need to be reminded and they will comply. They forget that people choose to forget at times, and also choose to save their meds for a raining day (especially if they are expensive and have to be paid for privately). Education helps but not for everyone. So we can take this horse to water – but how much they choose to drink will remain their own concern.
The panic pendant works for many people but doesn’t work for others. We need to become smarter in understanding who will use it, and to take a whole of market approach in offering alternatives to those who reject it. We no longer expect a single provider to cover the market, so it is time that providers understood all the options and procured services appropriately. They have a responsibility to educate the market and that means making commissioners, health, housing and social care professionals, and the public aware of what’s out there.
These are exciting times as telecare and mobile care meet. Those that embrace the opportunities will thrive – but those that resist the changes will drop by the wayside.