This article was first published on Independent Age
The number of people living with dementia in the UK is growing and is creating an increasing challenge for already stretched health and social care systems. However, in one part of the UK, technology is helping to meet that challenge.
Over the past two years Hampshire County Council, working with the PA Consulting led Argenti Care Technology partnership, has provided a range of technology (sensors and monitors) to support people living with dementia. This complements the council’s strategy of utilising people’s own strengths and family networks to maintain their independence and reducing their need for more formal and traditional council services.
Over the last four years, Argenti has delivered a ground-breaking approach that has brought real benefits to over 8,500 individuals across the county and achieved measurable efficiencies and saved the council £4.7m in the first 3 years of the service.
One of the biggest impacts has been in supporting people to stay in their own home and remain independent for longer. There is a high correlation between a person with dementia and their carers being unable to cope, and that frequently results in the person going into residential care. However, four out of five people referred for care technology support remained at home without needing additional services. Additionally, 90% of the carers supporting these people now report that they worry less about their situation, meaning they are better able to support their loved one.
A critical factor in the scheme’s success has been the way it was developed in collaboration with social care, third sector and the police and those who work directly with those newly diagnosed with dementia.
One of the issues identified early on in the service design process was that providing care technology to someone who has fairly advanced dementia means there is a greater likelihood they will reject unfamiliar technology. Yet, social care services are not typically aware of people until their needs have escalated. What was needed was to identify people recently diagnosed with dementia and get their agreement to be referred to the care technology service. This was achieved through active engagement with multiple local organisations to ensure there was a shared understanding of the benefits of care technology and to develop a simple way to refer people.
As a result, users are now being referred quickly and easily to Argenti for a personal care technology assessment, after an initial consultation and discussion about the benefits and outcomes. The individual care technology assessment, which includes input from care teams and technology specialists, asks the key question; ‘if the desired outcome cannot be achieved using technology, what other intervention would be needed?’ This helps to provide a clear understanding of the benefits to service users, referrers and to the council and these can then be individually tracked and measured.
An example of how the service improves outcomes for its service users
An example of the effectiveness of the service can be seen very clearly in the case of Mr H who lives with his wife. Both are retired and had full active lives but following Mr H’s diagnosis of dementia he stopped driving and this left him frustrated and feeling trapped.
Mrs H became very anxious as she was afraid her husband would get lost when he was out, so she found herself accompanying him everywhere he went and locking doors so he wouldn’t go out without her. This further added to his frustration. As things developed Mrs H felt under increasing pressure and struggled to support her husband. At the initial assessment it was apparent that without some technology support, Mr H was likely to need much more extensive and costly help, including potentially a residential placement.
Mr H was then assessed by the Argenti team who designed, configured and installed a personalised care technology solution. This included an Oysta (a small mobile device which incorporates GPS tracking) which meant he could be located instantly if he became disorientated or perhaps had a fall when out. In addition, door monitors were provided to alert carers if Mr H left the house at inappropriate times.
As a result of this intervention, Mrs H’s anxieties are now much reduced, her husband has regained some of the independence he had lost and he now goes out alone again, and his wife no longer feels a need to lock their doors. Mr H returned to attending his regular social gatherings, no longer feels smothered and there is no need to introduce further care or restrictions on him. Crucially the risk of Mrs H not being able to support her husband is much reduced.
PA Argenti have tracked the benefits of cases like this across the more than 8,500 service users throughout Hampshire, including 800+ specialist dementia installations. These benefits include greater support for service users to remain independent and at home for longer, enabling carers to better support their loved one and reduce the risk of carer burnout. It has also reduced adult service costs by delaying and avoiding the need for other more costly services.
There are a number of key lessons learned from this work. The first is that a focus on outcomes is vital. There is also a clear need for trust in the professional judgement of local care practitioners and the technology must be tailored to individual need. This will only happen if the approach is co-designed by all stakeholders to ensure the benefits are understood and maximised for all involved.
By taking these lessons on board Hampshire and Argenti have developed a highly successful service that is making a real difference to the lives of those with dementia.
Robert Turnbull and Steve Taylor are care technology experts at PA Consulting Group.