Telecare: what role for nursing?
Telecare (health care delivered at a distance, using ICT methods for communication) is becoming something of a buzzword in the world of social care at the moment. This follows the injection of public funds (in all parts of the United Kingdom) to support local authorities in developing telecare services that will help more people live independently at home. An increasing proportion of those people will also be “patients”.
The logic for the Government’s promotion of telecare is sound. Many people, often with chronic medical conditions, want to live (and die) at home. They want to stay in control of their lives as much as they can. A new range of technologies is now available by which this becomes increasingly possible.
Older people are and will remain the largest group of telecare beneficiaries. But taken more broadly (and thinking in health care terms) the evidence for telecare being successful relates to an increasing range of circumstances and conditions – for example, falls, dementia, respiratory disease, epilepsy and learning disability.
Telecare uses communications technologies to assist the provision of care and support “at a distance”. It offers communication that can involve (and potentially give more power and control to) the patient – by which more general issues around the individual’s health and well-being can be addressed. The key is not the technologies themselves. Rather it is the services that are underpinned by them.
Leaving patients to their own devices
Nurses, especially those working in community settings, will have been aware of social alarms over the last 30 years. The alarms in sheltered housing and the carephones in people’s homes will be familiar items. For increasing numbers, the alarms and carephones will have been linked (often using radio) to fall and smoke detectors, an array of movement, chair or bed occupancy and other sensors, or automated lighting and cut-off devices – for example, for unlit gas.
Given the range of devices available, telecare means that different devices and sensors can be provided according to a person’s particular health or social care needs.
Accompanying these are “telehealth” devices by which patients or their carers can take vital sign measures which are then sent to a monitoring service. When measures are outside certain set parameters for such things as blood pressure and blood sugar levels, these exceptions can be acted upon through advice, personal visits, referral to the GP and so on, as appropriate.
Services that used to be more concerned with the core tasks of providing reassurance and responding in emergencies are now addressing more of the subtleties around assessments and response protocols – often for people with acute needs and/or chronic conditions. Needless-to-say they cannot do this effectively without the input of nurses and other health care professionals.
Maximising the benefits
But there is much that the nursing profession can learn from those services too. The care and support role performed by staff whose experience is rooted in social alarms has engaged them in aspects of assessment that take on board the way that people interact with technologies. Few others have such skills and knowledge.
There can be little doubt that telecare has a growing part to play in health care and there are real benefits to nursing staff engaging with local telecare services. This will be especially the case where the service is accredited in accordance with the Code of Practice of the Telecare Services Association and has shown, therefore, a commitment both to maintaining high service standards and to working in partnership with other agencies.
There are, of course, both challenges and opportunities associated with the way that health and social care professionals work together. The important thing to note is that real benefits for many patients are beginning to be realised through the development of telecare services. Telecare is, therefore, more than a buzzword. It offers a distinct and exciting way forward.
Dr Malcolm J Fisk is Chairman of the Telecare Services Association.
Email: malcolm.fisk@dsl.pipex.com
Visit the RCN website to review our online Telecare section .