Case study: The Safe at Home scheme
The Safe at Home scheme, Northamptonshire, uses a range of technologies to help people with dementia overcome problems in their homes by reducing levels of risk, helping people feel safer and supporting relatives and carers. A demonstration house is available locally where people with dementia, their carers and care professionals can see how the technology could benefit them.
Dick Beeby is a Project Worker with the Safe at Home scheme. He has provided the following case studies to demonstrate the benefits and limitations of implementing assistive technology and the importance of comprehensive assessment and evaluation.
Case study 1
Mrs X lived in her own home in Northamptonshire. She had been widowed for 5 years and lived alone in the house. Her son and daughter lived locally and visited her every day. She was becoming increasingly forgetful and disorientated and sometimes had difficulty finding her way home when she had been out locally. This was causing her some distress.
Mrs X was referred to the Safe at Home scheme to see if assistive technology could be of benefit to her. Her son and daughter visited the demonstration house to look at the range of equipment available and discuss its possible use both for now and in the future. They were interested in using assistive technology to help enable and support their mother in her wish to remain living at home. Mrs X had some awareness of her memory difficulties and was willing to accept the technology, although she was anxious about change.
Assistive technology installed
Following an ongoing assessment of Mrs X's needs, a detailed action plan was completed. It was agreed to install a gas sensor and cut off valve, radio smoke detector, door alert for the back door and a lifeline telecare alarm unit that would be linked to the local community alarm service. A calendar clock, picture telephone and automatic pill dispenser were also installed. The technology was installed in stages as problems arose and were discussed at regular reviews.
Installation of the telecare equipment involved a number of people and took around 3 hours to complete. In recognition of the likely anxiety that Mrs X would feel on the day the equipment was installed, it was agreed that she would be taken out for the day by her daughter-in-law.
The assistive technology installed helped Mrs X to remain living in her own home. The technology also helped to identify areas in which Mrs X needed more help. For example, as the smoke detector was being set off when Mrs X was cooking it was decided to arrange outside help from carers at lunchtimes.
Case study 2
Mrs Y was living on her own in a maisonette near to the centre of town. Her daughter lived locally and saw her mother regularly. Carers visited on weekdays to help remind Mrs Y to take her medication. Mrs Y also had a pendant call system to call the community alarm centre if she needed help. However, she sometimes turned off the plug to electrical appliances including the unit which put through the pendant calls.
When the Safe at Home project worker visited Mrs Y at home, she agreed that she had some difficulty with her memory. There was also some concern about her safe use of the gas cooker and the fire risk from things being left on the cooker. Although she had a smoke detector in place there were concerns that she would not respond appropriately in the event of an alarm.
Assistive technology installed
Following a detailed assessment it was agreed to install a smoke detector that was directly linked to the community alarm centre so that they could respond appropriately in the event of a fire. Within 3 days of the installation the unit for putting the calls through to the alarm centre went missing and was never found. It was therefore arranged to install a replacement unit, power and telephone points into a cupboard under the stairs.
Mrs Y was also given a calendar clock and a carousel medication dispenser.
During the time the medication dispenser was in place there were occasions when the dosage tray was not in the right place. It was felt that Mrs Y might have caused this as she was reluctant to accept the need for its use. The calendar clock was accepted and helped initially but was subsequently removed when it was felt that Mrs Y was unable to make appropriate use of it.
The early disappearance of the unit linking calls to the community alarm centre may have been due to Mrs Y not fully understanding its purpose and having some anxiety about it. There were also some technical problems with the unit and the smoke detector. The resulting noises from the equipment caused some distress for Mrs Y and coincided with a deterioration in her mental health. These and other factors eventually resulted in Mrs Y going into residential care.