The community alarm service in Durham and why it’s important.

Pam Mills, describes experiences with a community alarm service developed by the Durham County Council’s People at Home and in Touch project, for use in Durham County, in northeast England. …

The community alarm service in England uses dispersed alarm and radio waved pendants to summon help, which has over time evolved into “telecare.” Telecare is the continuous, automatic and remote monitoring of real time emergencies and lifestyle changes over time in order to manage the risks associated with independent living. Today, with more telecare peripherals commercially available and the use of Electronic Assistive Technologies , the community alarm service requires a broader systems approach to addressing potential service needs.

In 2004, a Durham County initiated a pilot program to develop a service model for the delivery of telecare in one area of the county, which if proved successful, could be adopted and adapted by other localities in County Durham.

The aim of the pilot was to test and further develop a service model for telecare that could be integrated into mainstream services. Among the objectives were as follows:

• To design a service model in conjunctions with key stakeholders such as Health, Housing, Social Services, the Voluntary sector and service users, and identify any successes or gaps in the service process and new ways of working.
• To determine whether the provision of telecare can help manage risk and support people in their own homes, prevent inappropriate admissions to hospital or residential care and whether it can facilitate earlier discharge from hospital.

The main findings about telecare use were as follows. Use of telecare could

• Facilitate early hospital discharge
• Prevent inappropriate or early admission into residential care
• Prevent re-admission to hospital
• Detect falls and so lessen the long term consequences
• Initiate a response to emergency situations
• Improve clients’ quality of life and give them more choice in their own care arrangements
• Give informal carers respite and peace of mind

Here are 2 cases which indicate the successes achieved using telecare tools and services with the elderly in Country Durham.

Milly
Milly is 85 and suffers from early stage dementia. She lives alone but receives a lot of support from her two daughters who take turns to have her for days throughout the week, bringing her home in the evenings. Milly’s short term memory has been gradually deteriorating and one night last winter she went out late in the pouring rain and was knocking on neighbours’ doors in a distressed state. Worried neighbours called the police who took her home. After this incident Milly went to stay with one of her daughters for a while but felt frightened to go back home again.

This was obviously a huge concern for her family who were becoming increasing worried and anxious about her safety, especially at night. A meeting was set up with the social worker to try to come up with a solution. The family were thinking that residential care was the only option even though Milly was physically in good health, however the social worker was keen for them to try other methods of support before they resorted to seeking a residential care placement. The options put forward to the family were increased home care support through the day, a sitting service or respite care to give the family a break, overnight stays, or connection to the community alarm service and the installation of a telecare wandering device which would let the Warden Services [the warden being a supervisory resident for sheltered housing residents in England] know if Milly had left her house at night after a preset time.

A Warden Services supervisor visited the family to decide upon the most appropriate response for their circumstances, which in their case was for the mobile wardens to go out if the alarm went off as they could get there a lot quicker than any of the family.

Milly still likes to go to the local shop for her paper every morning and the family were very keen for her to retain this element of independence, so they asked for any alarm that went off after 8 am to be ignored until they arrived to disarm the wandering device. This solution has worked very well for Milly and her family. Milly feels safer and the family have peace of mind in the reassurance that the telecare device provides. She now attends Day Care twice a week for social stimulation and this, along with the excellent support she gets from her family, and the use of telecare, means that Milly is now able to stay in her own home.

Susan
Susan is 58 and lives alone. She is profoundly deaf and has poor speech. Susan was becoming increasingly distressed and embarrassed by the number of times her smoke alarm was being activated but, because she couldn’t hear it, the fire engines would arrive only for it to be a false alarm. She asked for the smoke alarm to be taken out.

Susan also had the problem of not hearing the doorbell and as she sometimes sleeps late because of her deafness she was missing people who were calling. She was referred to Tremeduna’s Integrated Team’s telecare project which is part of Durham’s effort to mainstream telecare. Community alarm staff, who work in partnership were sure that a solution could be found to the problem.

A vibrating pillow was installed along with two strobe lights, one to tell her if the doorbell is being rung and the other to tell her if the smoke alarm has been activated. Because of Susan’s poor speech, it was agreed that if a smoke alarm went off which was a false alarm, Susan was to tap the bottom of her Lifeline unit as a code to the control centre staff that it was a false alarm and they weren’t to call the Fire Service. This arrangement was included in her notes so that all operators would know the correct response. The solution has worked really well and Susan still has the safety and re-assurance of having the smoke alarm.

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