This week, the English parliament approved a new “health and social care” tax, corresponding to an increase in National Insurance contributions from 12% to 13.25% of salary (i.e., a whopping 10.4% increase!!). This increase is to pay for the home care needs of older people, disabled citizens, and others with high care needs. That is, for carers to visit these citizens in their own homes, and help “with tasks such as washing, dressing, eating and taking medication.”
Home care is not only very costly, but also very difficult to source because there is a shortage of qualified staff for this type of care (made worse with immigration restrictions). Moreover, as we are dealing with vulnerable people, there is also the risk of abuse (physical, emotional, financial…) by unscrupulous staff and agencies.
Homecare seems like an area where technology could be very helpful – not just in terms of being available 24/7 (whereas home care is only for a few hours a week), but also in terms of being cheaper and its performance less variable than human carers. Local authorities could, for instance, use a combination of sensors and motion detectors, coupled with machine learning algorithms, to monitor the movements of vulnerable adults at home, and alert someone when there is an alteration in behavioural patterns, as discussed in the paper “Sensors in Smart Homes for Independent Living of Elderly”, authored by Pireh Pirzada, Neil White and Adriana Wilde.
Such a scheme is being trialled in a pilot study in the UK. Though, to be fair, the whole idea of assistive technology in the home (also known as “telecare”) is not new. Numerous attempts have been made over the years, with the technology generally proving to do really well… but users proving to be very resistant.
The key to understanding this resistance is to focus not on what the technology can do, but, instead, on what (or, rather, who), the technology replaces. This is what researchers Martina Čaić, Gaby Odekerken-Schröder and Dominik Mahr found, in their investigation of use of robots in elderly care. The researchers adopted a care network perspective, looking at how the robots fitted in the overall care network of the research participants, including relatives, neighbours and formal caregivers. Čaić and her colleagues reported the findings in a paper entitled “Service robots: value co-creation and co-destruction in elderly care networks”, which was published in the Journal of Service Management, and is available here.
The researchers found that a vulnerable person’s care network offers support in three key areas of that person’s life:
- Physical health – in the form of safeguarding
- Psychosocial health – via social contact
- Cognitive health – through support of cognitive functions
The participants could see that assistive technology might support all of these areas. Namely:
- Physical health – Assistive technology could enable independent living to the elderly person, while providing relief and reassurance to the carers
- Psychosocial health – Assistive technology could communicate on behalf of the elderly person if they needed something; and reduce the burden that they place on their relatives (in terms of time and money).
- Cognitive health – Assistive technology could step in if the elderly person loses their mental abilities.
However, the participants could also see disadvantages of using assistive technology. They were:
- Physical health – Assistive technology was seen as an intruder, who might expose to their care network things that the elderly person would rather keep private.
- Psychosocial health – Assistive technology was deemed to lack tacit knowledge and understanding; and there were fears that the technology would replace – rather than complement – the humans in the care network.
- Cognitive health – Assistive technology might reduce the elderly person’s cognitive abilities by pre-empting their needs and stepping in to the things on their behalf.
When it comes to home care, there is a lot more that is provided than doing the shopping, preparing the meal, or giving medication. And, for that, technology is still very much lacking, despite recent developments.
Would you like to have this kind of assistive technology in the home?