National Dementia Strategy – an ‘amber’ light to the deployment of telecare
Nick Goodwin
The long-awaited first national dementia strategy – Living well with dementia: a National Dementia Strategy – was published on 3 February 2009. The aim of the Strategy is to ensure that significant improvements are made to dementia services in three key areas: improved awareness, earlier diagnosis and intervention, and a higher quality of care.
The Strategy identifies 17 key objectives for local implementation to ‘significantly improve’ care and aroused much media interest in its support for a national network of memory clinics.
Objective 10 of the Strategy focuses on housing support and considers the potential of telecare to support people with dementia and their carers to prolong independent living:
Considering the potential for housing support, housing-related services and telecare to support people with dementia and their carers.
The needs of people with dementia and their carers should be included in the development of housing options, assistive technology and telecare. As evidence emerges, commissioners should consider the provision of options to prolong independent living and delay reliance on more intensive services.
The guidance argues that there are many positive housing options and assistive technologies that are part of mainstream care for people with dementia and that contribute to their independence and safety. Indeed, the guidance points to key pieces of evidence that have highlighted the importance of flexible and responsive care packages in meeting the needs of people with dementia, including a Housing Corporation/Housing 21 study, which found that these needs could be met where health, social care and housing worked together to provide a whole system strategy [1].
However, the Strategy did not make any specific recommendations on more recent innovations such as telecare. Although it points to one scheme that showed improved quality of life and cost-effectiveness [2] the Strategy argued that the evidence base was otherwise ‘sparse and inconclusive’.
Instead, the guidance argues that central, regional and local teams should keep in touch with initiatives in the areas of housing and telecare and make appropriate commissioning decisions ‘as data become available’. The guidance makes specific reference to the ‘field trials’ being undertaken within the Whole System Demonstrator programme to provide the proof for such investments.
The decision in the Strategy to give an ‘amber’ rather than ‘green’ light to telecare applications appears to be appropriate given the existing evidence. Developing the evidence base to support the case for investment is clearly important for those seeking to develop such innovations. WSDAN seeks to play a role in this by developing an on-line searchable directory of the evidence that will be available later in the year.
For more information we recommend a dedicated Department of Health sponsored online information resource – AT Dementia – that provides information about assistive technology and how it can support dementia sufferers and their carers.
In addition, at the end of 2008, the Telecare Learning and Improvement Network prepared a summary of telecare activity and dementia from 150 social care authorities based on data collected by the Commission for Social Care Inspection (CSCI). The article provides some example of outcomes and the mainstreaming of services.
Nick Goodwin is a Senior Fellow at The King’s Fund and co-project lead for WSDAN
References
[1] Vallelly S, Evans S, Fear T and Means R (2006). Opening doors to independence: a longitudinal study exploring the contribution of extra care housing to the care and support of older people. London: Housing Corporation and Housing 21.
[2] Woolham J (2005). The effectiveness of assistive technology in supporting the independence of people with dementia: the Safe at Home project. London: Hawker Publications.