This older cohort of people suffering from heart failure appears to have needs not unlike those of patients with 'terminal diseases'. When people are diagnosed with more familiar terminal illnesses, in particular cancer, they are given ongoing explanations, reassurance and support. Similar professional input is needed for patients with advanced heart failure and their carers.

This paper reports findings from an attitudinal survey towards telecare that emerged from twenty-two focus groups comprising ninety-two older people, fifty-five professional stakeholders and thirty-nine carers. These were convened in three different regions of England as a precursor to telecare service development. The results from this study suggest that informants' views were shaped by prior knowledge of conventional health and social care delivery in their locality and the implication is that expectations and requirements in respect of telecare services in general are likely to be informed by wider perceptions about the extent to which community care should operate as a preventative strategy or as a mechanism for crisis management. to 'mainstreaming' telecare services in the homes of older people.A major impetus for the formation of the consortium was the inclusion of three project partners where live telecare installations were planned to take place within the lifetime of the project. These provided field sites for action research that constituted three very different physical settings, each representing a major type of housing for older people.Barnsley's patients are living in mainstream housing stock, much of which comprises ageing terraced and semi-detached houses and post-war council flats that were not inclusively designed. The Anchor Trust is developing a technology-enabled retirement village in South Bucks, with houses and bungalows for sale to more affluent older people as well as affordable housing in the form of flats and bungalows for rent, whilst Thomas Pocklington Trust, a leading provider of housing for people with impaired vision, is currently upgrading its extra care housing scheme for older people in Plymouth. Before embarking on any telecare interventions in these varied physical settings, the consortium felt it was important to benchmark the opinions and attitudes to telecare held by older people, care professionals and informal carers in all three areas where the service would subsequently be introduced. What is Telecare?Promoting the independence of older people forms a key part of the government's health and social care agenda, and new care delivery models supported by information and communication technology (ICT) are being developed to assist in realising this goal [2,3].Telecare is one such model that uses ICT to bring health and social care directly to the end user by providing safety and security monitoring, physiological health and activity A typical telecare service involves a system connecting sensors of various kinds that are dispersed in the homes of (or worn by) an older person, to a call centre. The sensors are either activated directly by the user, or raise an alert passively by recognising and responding to a change in the user's status such as a fall. The alert goes to a call centre, which then triggers a response that may involve informal carers, resident or mobile support staff or an emergency service, as required [8]. In some ways, then, telecare is simply an e...

Universities of Leeds2 Summary A literature review was conducted to identify the "trigger factors" associated with a need for increased levels of care and support for elderly people. An expert panel then prioritised the trigger factors into one of five bands of importance. The literature review produced 2037 hits. Of these 1768 were excluded after reading the abstract and 111 after reading the full paper, leaving 158 papers for inclusion in the review. From these papers, 102 unique factors that triggered a need for greater care and support amongst elderly people were identified. The expert panel ranked 36 of the trigger factors into the top three bands of importance. Subsequent analysis suggested that telecare could be used to assist, prevent or minimise the impact of some 66% of these 36 trigger factors and 75% of the top 12 factors. This suggests that telecare has a significant role to play in the support of elderly people and should be a major consideration when re-designing services.

The launch of the £80m Preventative Technology Grant in 2006 has resulted in a considerable interest in telecare. Yet where in this emerging area should efforts be concentrated, and what lessons can be learnt from previous trials to aid future deployments? Based on practical experience and the work of the Housing & Telecare Learning & Improvement Networks at the Care Service Improvement Partnership (CSIP), Department of Health, this paper presents some of the common issues experienced and identified when implementing telecare. It makes a number of useful suggestions on how organisations working across housing, health and social care can make best use of telecare when planning, commissioning and delivering services.

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