Understanding the impact of a proactive telecare intervention in supporting independence, health, and well-being in older adults

Fothergill, Lauren and Latham, Yvonne and Hayes, Niall and Holland, Carol (2024) Understanding the impact of a proactive telecare intervention in supporting independence, health, and well-being in older adults. PhD thesis, Lancaster University.

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Abstract

Background Telecare devices are remote care technologies used to monitor emergencies and lifestyle changes, to support independent living in older adults. There has been recent interest among policy makers in proactive telecare services, which provide well-being calls or encourage users to regularly confirm their well-being, to prevent crises. However, there could be better understanding into how proactive services support health and well-being. This research explores how using a proactive telecare service can support older adults’ independence, and what potential health and well-being benefits may be elicited from its use. Methods An existing proactive telecare service was evaluated called OKEachDay, which offers users a device to confirm their well-being through pressing an OK button. Four studies were conducted: (1) a qualitative study exploring the experiences of key interest groups in using OKEachDay, (2) a realist review of how telecare can support older adults, (3) a cohort study assessing the association between OKEachDay user engagement patterns and hospital admissions, and (4) a feasibility study on OKEachDay. Results Older adults reported that using OKEachDay contributed to feelings of safety and reduced anxiety related to managing risks at home. Daily engagement in confirming well-being boosted autonomy in older adults. Participants valued being connected to an additional social network. However, individuals have differing needs, and varying levels of social and financial resources, which must be assessed to ensure older adults are best supported. The technology was found to be acceptable and feasible to evaluate, suggesting that this proactive telecare system may be a scalable intervention to older populations. Conclusions This research highlights the unique benefits of using a proactive telecare system to support independent living, such as promoting autonomy and offering social resources, which may promote health and well-being. However, OKEachDay must integrate into an individual’s life and available resources. A future full scale randomised controlled trial is required to evaluate the effectiveness and cost effectiveness of this intervention.