Putting your home in order?
Health management is constantly
bombarded by conflicting philosophies of care, whereby the needs
of the patient are increasingly important whilst balancing the
books. Higher standards and quality of care are expected as the
resource allocations in many cases are decreased. The spiral
continues, placing the health manager in the invidious position
of the giver and denier.
An ever-increasing group,
which will for the foreseeable future be incrementally rising,
is the elderly. Other groups, which place a high demand on resources,
are the disabled and cognitively impaired. Each of these groups
requires quality care within constrained resources. Is there
a technological solution to this crisis?
The answer is ‘Yes’.
The solution is the intervention of smart home technology into
this area. Smart home technology uses common devices, such as
‘magic-eyes’ for burglar alarms, to enable and empower
individuals with physical and/or cognitive disabilities. Devices
such as door or window openers are commonplace in offices and
supermarkets, but now have the ability to be used within the
domestic residence. The devices themselves are not the main features,
although they are intrinsic, as the way that these devices are
networked together is the central feature of a smart home.
The networking of devices
allows more functionality to be given to the device, so that
a door opener can be connected with the lighting circuit, such
that when the door opens the will be turned lights on automatically.
All this is fairly simple, and no longer seems futuristic. What
is new is the use of these devices in developing specified homes
for individuals with physical or mental impairments or the elderly
who might have degenerative conditions. Systems that are specifically
meeting the needs of the individual provide empowerment and can
add to the quality of life of an individual allowing them to
retain some measure of control over their environment. Moreover,
through smart home technology, individuals have the possibility
of living non-institutional based lives. The possibilities are
phenomenal, considering this technology can be applied to people
of age, the disabled and the cognitively impaired. It could be
used for degenerative conditions as well as rehabilitation.
Although this sounds hypothetical,
smart technology is being currently used in these areas. Within
Scotland, a number of Health Trusts and social work departments
are using environmental control systems to facilitate individuals
with disabilities. There is a smart house for a patient who acquired
a brain injury, a smart home rehabilitation flat for patients
with acquired brain injuries, and numerous other smaller localised
projects, which use some form of networking of devices. The reality
is smart home technology does have a critical part to play in
future health care initiatives.
Health managers should investigate
this technology, as there are potential savings by its use.Although
the initial expenditure can be perceived as fairly high, this
should be seen as a one-off payment as opposed to the cost of
institutional or community care packages.This does not mean that
community care packages will cease for patients who have their
homes adapted to smart home, care packages will still be required,
but the expenditure on each package will be able to be decreased
over time in many cases.Early intervention by proactive health
managers can also save money in the long term.An example of this
could be installing the minimal smart home technology for a patient
in the early stages of dementia, to allow the informal carers
and the patient to remain at home for a considerably longer time.As
the condition increases in severity, more devices can be configured
to enable the patient to be cared for within the community with
minimal external intervention.
A recent development in
this field is a software package that enables trained health
workers to design complex smart homes that specifically meet
the needs of the stakeholders and end users. The software is
design to be run on a laptop computer and allows the user of
the tool (known as the Process Facilitator) to design and configure
highly complex networks as a result of an assessment of the end
user, discussions with the main stakeholders (Health, Social
and Housing related). After these discussions the Process Facilitator
(PF) is able to draw up a provisional network design which is
graphically displayed in order to consult with the stakeholders
and end users to ensure that all needs are catered for. The software
also allows the PF to add the networking configurations and settings
to the proposed devices and provides a rough cost estimate for
the installation.
The utility of this tool
is manifold. By its use the PF is saving the stakeholders money
as installers and engineers will not be required until the installation
has received approval. Health managers are able to consider the
option of smart home technology and assess the cost compared
to other more conventional solutions. The PF acts as a mediator
between the differing interest groups to provide the best solution
for the patient considering the constraints that might apply.
The developers of this software
are currently seeking health care professionals who wish to train
as Process Facilitators. Training is crucial, as once the specification
is agreed the PF is solely responsible for the implementation
and appropriateness of the design. Furthermore, it is envisaged
that a network of PFs will exist throughout Europe who will be
facilitating the design of appropriate smart homes for differing
client groups with this software. Smart home technology can be
a cost effective and resource driven answer to better quality
care at no additional cost.
Guy Dewsbury 15-03-2000
Copyright 2000, G.Dewsbury,
RGU; CUSTODIAN, TIDE DE4004
Smart Thinking: Socio-Medical and
Assistive technological Research Today
The
Independent Health Research Consultancy
