Studies in Co-Creating Assisted Living Solutions
Many people live their everyday lives while managing varied health and social care needs, often with the support of carers, clinicians, other practitioners and organisations. If new technology is added to the mix, what happens?
Studies in Co-Creating Assisted Living Solutions (SCALS) is a five-year programme funded by the Wellcome Trust and led by Professor Trish Greenhalgh.
Our focus is on understanding what the different kinds of technologies mean for health care, and for the patients, carers, professionals, policymakers, designers and developers who work with those technologies. Rather than studying the technology, we aim to understand the effects of technology in the course of people’s everyday lives and care.
The goals of the SCALS programme are:
- To inform local, national and international policy on assisted living.
- To inform the design, distribution, installation and support of assisted living technologies by service organisations, care professionals, industry and patient networks.
What are assisted living technologies and why are we researching them?
Health and social care in the UK is often depicted at being at crisis point. The population is ageing, chronic illness is increasing, and financial pressures in the public sector make efficiency savings essential. While there are no easy fixes, new technologies that support the delivery of remote care and self-care show promise - these allow people to continue to live independently and safely in their own homes.
In recent years there has been significant investment in technological innovations intended to create the 'smart home', such as remote monitoring technologies to support heart failure. However, uptake of these technologies remains substantially lower than first thought.
If installed at all, they are often abandoned (and sometimes deliberately disabled) by the people they are intended to help. With rare exceptions, anticipated efficiency savings for health services have no materialised, and the evidence on whether these technologies reduce acute hospital admissions is conflicting.
Why don't these technologies work?
Research has already demonstrated that the lives of older people with several medical conditions and social needs are often complex and evolve over time.
Technologies designed to help these people often fit awkwardly into their lives, since designing a technological solution that is personalised to an individual is particularly challenging when balanced with an organisation’s need to satisfy professional standards such as contracts, service level agreements, protocols and guidelines etc.
It is this challenge - balancing individual needs with the pressure to standardise - that the SCALS study team seeks to explore.
SCALS: A fourth-generation study of assisted living technologies in their organisational, social, political and policy context
Greenhalgh T. et al, (2016), BMJ Open, 6