Activity monitoring to support independent living in Dutch homecare support

Objective: Detecting changes in activity performance by persons living at home may provide to be a powerful tool to support them to live independently. To this end a new care arrangement had to be developed in which commercial available technology is used by a homecare organization and informal carers. The objective of this study is a) to organize the conditions needed to deliver care support to people living independently and b) to investigate the effectiveness thereof.

Main Content of paper: A commercial available technology was identified by which activities of seniors performed in their own home can be monitored. A combination ofInfra Red motion sensors is installed in the house by which data are collected. Data analysis results in information to healthcare professionals as an urgent alert (by voicemail) or as a non-urgent alert( through a web-interface). The communication infrastructure was organized on a 2417 basis. Careworkers of a homecare organization identified clients that could benefit of this supporting service. A care arrangement was agreed between the client and the care organization. In this the actual use of the infrastructure was specified. The conditions are first piloted on a small scale project; thereafter an implementation study is started. During this implementation study an increasing number of clients are supported by this arrangement. Also the number of formal and informal careworkers increased.

Results: During the project the conditions needed to implement this arrangement as a regular service to support independent living elderly are investigated. These comprised of establishing standard operation protocols at the technology and at the service level, protocols to introduce new clients and (informal) careworkers in using the infrastructure, protocols for data management as well as the financial conditions involved. Based on the effects obtained during the project the conditions needed to organize continuation of this service as part of routine procedures of a home-care organization are analyzed as well. A societal business case was developed. In this the following elements are described 1) the business model consisting of: a) indentification of the preferred user groups ( frail elderly living independently; informal carers, professional carers) b) the technical and organizational conditions c) the costs and revenues of service delivery, and 2) the societal case consisting of a) revenues at the care level, b) revenues at the wellbeing level. Taken together the societal business case was used as a negotiating paper used to organize the conditions required for the continuation of this service. At time of completion of this paper the negotiations are closed. It is concluded that the care organization is enabled to continue this service until the end of 2012.

Conclusions: The use of technology to support people living independently may be incorporate in a service arrangement to deliver care at a distance. Implementation research demonstrates the effectiveness thereof. Organizing structural conditions requires a change in the perception of both clients, careworkers and care organizations.