Telecare and Telehealth
The technology behind the service
There are many different types of telecare sensors and alarms. They have different functions and they may work together to provide support and protection. The starting point is a telephone line, usually a landline, and a power supply. A growing number of telecare services operate on mobile phones.
Carers should always seek the full agreement of the person who will use the services before installing telecare in their home. You should check regularly that the personal alarm is worn at all times and offer encouragement when needed.
TSA is an independent association which does not recommend the equipment of any manufacturer. We always advise that you should seek help from a trained adviser before choosing or installing a telecare and/or telehealth system.
Here is an introduction to some of the most widely used telecare and telehealth services today.
The starting point for all dispersed telecare systems is the base unit which is connected to the telephone landline and power socket. An experienced adviser will point out the best location for this to be placed in the home. The base unit receives signals from personal sensors and from other sensors positioned around the home.
Personal sensors (sensors you wear or carry around), buttons or alerting devices communicate with the control box by radio signals and are not connected to the control box by wires. Base units today have a speaker and a microphone inside them so that you can speak to the monitoring centre. You can be some distance away from the base unit and still be able to call for help.
Personal alarms are used to trigger an alarm in an emergency. They can be used from any part of the home or the garden which is within range of the base unit. When the control box is fitted, the range in your home will be tested and confirmed.
Personal alarms are supplied as pendants or with wrist straps so that you can choose the most comfortable and practical version for you. Some personal alarms are designed for people who have limited movements in their hands and fingers and your telecare adviser will provide more details. There are also personal alarms which can be supplied with belt clips.
Pull cord alarms may also be useful in areas where the personal alarm is not worn particularly in bed or when you are bathing.
Home or personal health sensors
Here is an overview of the types of telecare equipment which can be used to keep you safe while you are in your own home. The information on the buttons and sensors should only be used as a guide. Your telecare adviser will provide a full explanation of how they are used and whether or not they are needed as part of an individual telecare package.
Activity monitors are used to monitor movements in the home. If the sensors do not detect movement for quite a long period of time, they will trigger an alarm call to the monitoring centre. The call will bring help in case you have fallen over or are feeling unwell and need assistance. Activity monitors are sometimes called inactivity sensors, passive infra-red detectors (PIR) and although they monitor movements, they do not take pictures or video. If the monitors sense no movement in a room for a prolonged period of time, then they will trigger an alarm call to your help centre in case you are lying on the floor in another part of your house or garden.
When an activity monitor is placed in a kitchen, it will monitor when you are entering the kitchen, and therefore eating meals regularly. As the help centre will alert a carer if there has been no sign of activity over an agreed timescale, they can be helpful for people who are forgetful or experience some confusion in their daily lives.
This sensor is placed on a mattress or a chair and the monitoring centre receives an alert when the person has got up and not returned within an agreed period of time.
An occupancy sensor can also be programmed to switch lights on and off which can be a very important aid when getting in and out of bed.
Elderly and vulnerable people living alone can often be targets of crime and a bogus caller button may help to reduce anxiety for both the carer and the person you care for. These buttons can be placed next to the front door or at the bedside. They are often called panic buttons and can be programmed to make no sound so that when the button is pressed the operator can listen to a situation and intervene when necessary.
Police services may issue these buttons for people who they consider to be at risk.
Gas, oil, coal and solid fuel fires, boilers and water heaters can all cause the dangerous gas known as carbon monoxide. This gas can cause headaches, sickness and dizziness but it can also be fatal because it has no smell, taste or colour
The detectors are designed to provide an immediate alarm when they sense dangerous levels of carbon monoxide inside the home. When increased levels of carbon monoxide are detected an alarm will sound and help will be called through the control box. This function is the key difference between a telecare detector and a standard carbon monoxide alarm which does not alert a monitoring centre.
Natural gas detectors also detect unsafe levels of gas and raise an alarm at the monitoring centre.
Epilepsy sensors are used to detect epileptic seizures in bed. The sensors monitor vital signs, such as heart rate and breathing patterns and, when a seizure is detected, an alarm call is automatically sent to your carer and to the monitoring centre. The sensors are usually positioned under the bed sheet in an area which is under your chest when you are in bed. They are firmly tied to the mattress and will not move while you are sleeping.
As carers need to make regular checks at night when people who experience epileptic seizures are asleep, this sensor can help to reduce the disturbance which is caused to their sleep.
A fall at any age is likely to leave you shaken. But when an older person falls, the experience can be both traumatic and serious. Lying on a cold floor for any length of time can lead to a number of health conditions. Sadly, a fall is the main reason why older people are forced to give up their homes and move into sheltered accommodation.
A fall detector, worn on a cord around the neck or around the wrist, can sense a serious fall and raise an alarm at a monitoring centre. It detects impact when you are not in a vertical position and, if the alarm is not cancelled, the help centre will try to speak to you and ask you to describe what has occurred. The operator will then arrange for help, either from the carer or the emergency services if necessary — this will depend on the responses you have previously agreed with the monitoring centre.
Fall risk sensors can be used with fall detectors to sense the events which may lead to falls. A chair occupancy sensor may be recommended and at night a bed occupancy sensor can help to guard against falls which occur when getting in or out of bed.
All falls are serious—for more information on how to prevent a fall or what to do in the event of a fall visit:
Help the Aged also produce important advice on dealing with falls on their website.
Telecare smoke alarms automatically sound an alarm in the home when they detect smoke. They also send an alarm to the monitoring centre at the same time—and this is how they differ from the standard smoke alarms fitted in the home.
When an alarm is received, your call centre operator may talk to you about the cause before calling for the fire brigade—if a toaster has burnt the toast or a pan has boiled dry and the smoke has triggered the alarm it will not be necessary to call the emergency services. This procedure will be discussed with you and your carer in full before any response procedures are agreed.
A telecare smoke detector may be recommended with a temperature extremes sensor.
These sensors are used to give early warning of overflows and any leaks which may become floods. Water dripping on the floor may make the surface slippery so it is a hazard which can lead to loss of footing and a fall. When a sensor detects water it will trigger the control box to alert the monitoring centre.
Flood detectors provide reassurance when people are concerned that taps are not always switched off. They are usually placed on a flat surface under a sink or in the bathroom, under the bath or behind the toilet.
The risk of forgetting to light a gas ring or a gas fire increases when people experience difficulties with their memory. Gas shut off valves physically cut the gas supply when triggered by a gas detector sensor connected to a telecare control box. A key operated switch on the control box is used to switch the gas supply back on when the reason for the leak has been investigated. These shut off valves would be fitted only by registered Corgi fitters.
Wet blankets and sheets are distressing and uncomfortable and incontinence sensors provide an early warning when dampness occurs in bed.
An incontinence or enuresis sensor is a thin, discreet sensor pad placed between the bedding and mattress—it raises an audible alarm and sends an emergency call to the monitoring centre for assistance.
The sensor should be placed on top of a waterproof protective sheet but under the cotton bed sheet.
Medication management units are very helpful if you have to take tablets at different times of the day or if you have difficulty remembering whether or not they have been taken. The unit is pre-programmed to prompt you to take your medication and will dispense the tablets when they are due to be taken. If the tablets are not removed at the pre-set time then the monitoring centre is automatically alerted and a carer, a friend or relative will be contacted to remind you about the missed medication.
Pill management units are usually rotating carousels with 28 sections — enough for a week’s tablets if taken four times a day or for a month, if medication is taken just once a day. As the telecare system only dispenses the tablets at the correct pre-set time, the risk of repeating a dose in error is greatly reduced.
These sensors can be helpful if you are disorientated or confused when you leave home, or if you sometimes go out at inappropriate times during the day or night.
The sensors are placed above a front door and/or a back door and they detect when someone leaves the property and does not return within a pre-set period of time. When this occurs the monitoring centre is automatically alerted and will contact a carer or service to assist you.
A property exit sensor can be set to work at certain times, during night time hours for example, and it can also trigger an alarm if you accidentally leave your door open.
Telecare sensors which detect extremes of temperature automatically alert the monitoring centre at the same time.
A temperature extremes sensor will detect a fire in a kitchen where a smoke alarm may raise a false alarm. It will also alert the monitoring centre if the temperature is too cold in the house — this could be if the central heating breaks down or if an outside door has been left open in cold weather.
See telecare fire and smoke alarms.
Telehealth is where electronic sensors or equipment that monitors vital health signs remotely, are placed in service user's home, or they are given equipment that can be used while they are on the move. These readings are automatically transmitted to an appropriately trained person who can monitor the health vital signs and make decisions about potential interventions in real time, without the patient needing to attend a clinic. Below is a list of different types of Telehealth technology, and the services they offer.
A blood pressure monitor measure's a user's blood pressure and heart rate without the need for a nurse or a visit to a GP. Blood pressure monitoring may also be helpful in the detection and treatment of hypertension.
The Pulse Oximeter provides immediate and reliable readings of oxygen saturation levels. It is an accurate tool offering information to determine the interventions needed for patients with asthma and Chronic Obstructive Pulmonary Disease (COPD).
The Glucose Meter allows a clinician to identify trends and track historical readings to ensure the patient's blood glucose is within their ideal range.
The Body Weight Scales are for taking daily weight measurements which are automatically updated and monitored by a clinician. Any fluctuations in weight can indicate an increased level of risk.
Smart shoes have been developed as another way of helping with falls. They are built with a sensor so that they can send an alert if the service user has a fall. They also tend to have a biult in GPS sensor, so that if a service user goes missing, the monitoring centre would be able to find them thanks to the sensor.
