Adult Social Care Outcomes Toolkit (ASCOT)

[SOURCE: Personal Social Services Research Unit (2019) The Adult Social Care Outcomes Toolkit. Personal Social Services Research Unit and University of Kent. (The website can be accessed here)]

Assistive technologies have been available for many years. They generally use information and communication technology (ICT) to support people with health and/or social care needs remotely, often in the individual’s own home, although there is now growing experimentation and utilisation in other settings such as nursing home facilities, and on a mobile basis. (Parts of this entry are adapted from Barlow & Knapp; 2014).

Development of assistive technologies has been driven, on the supply side, by technological advances in sensing equipment and data processing, and on the demand side by growing policy concerns about the affordability of conventional health and social care arrangements for supporting older people as populations age. Another demand-side factor has been growth in expectations about what individuals with care needs should receive, both in terms of the amount and quality of care, but also in terms of more personalised support arrangements.

There are many types of assistive technology, of varying degrees of complexity. They are delivered in many different ways, including mobile phones, smart sensors, consumer devices (e.g. ‘Fitbit’), personal computers and television. They are designed for a variety of different populations, with a variety of different health and care needs. Terminology is also wide and includes telecare, telehealth, telemonitoring, home monitoring, telemedicine, assistive technology, assisted living technology, welfare technology, remote care and smart homes. These and other terms are often used interchangeably to describe remote delivery of health and/or social care to people outside conventional care settings. For example, a recent scoping review by Lorenz et al. (2017) mapped existing and evaluated technologies that support the life and care of people with dementia, their unpaid carers and paid carers, and other professionals: there was an impressive plethora of new technologies but only a trickle of robust studies of their effectiveness or cost-effectiveness.

A defining feature of these assistive technologies is connectivity between the long-term care user and (paid) care staff delivering care and treatment. The purpose of the connectivity is to provide better flows of information about individuals and data to help with their care. Assistive technologies could deliver: information and advice; safety and security monitoring; vital signs monitoring; or lifestyle monitoring (e.g. tracking movement). These technologies involve more than just the deployment of physical devices; they usually need to be accompanied by organisational and service delivery changes underpinned by interactive and non-interactive transmission of digital data.

Two salient considerations about assistive technologies should be emphasised. First, the speed of technological development is rapid, so that evaluations might sometimes be out of date by the time they are completed. Second, technology developers and suppliers, as well as public and private purchasers, are increasingly looking to customise or personalise technologies to fit better with the needs, circumstances and preferences of individuals with long-term care needs, and also with the care or support setting (where appropriate). Both of these considerations can cause complications when thinking about social investment.

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