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Setting the scene: ICT & Ageing, the cared person’s perspective
- Some findings from the “ICT & Ageing” study -
Lutz Kubitschke, empirica
Joint DG INFSO ICT for Inclusion & JRC IPTS Information Society Workshop: "Long-term care challenges in an ageing society: the role of ICT and migrants "Brussels, January 19th 2010,
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 2
Research background
• ICT & Ageing - European Study on Users, Markets and Technologies(2008 – 2009 )
• Commissioned by DG INFSO ICT for Inclusion
• Three core aims:
– benchmarking current market situation across selected countries & investigating barriers towards market development
– identifying ethical issues
– supporting clustering activities re EU-funded projects
• Core research team:
• National correspondents in 16 selected countries:
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 3
An early vision
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 4
The spectrum of needs & current technologies
Telecare
Home Telehealth
Smart Homes /Assistive Technology
Mainstream ICTs
First generation
Social alarms
Second generation
Sensors
Third generation
AAL
Voice
Data Video
Environmental controls /Home automation
X10
Zigbee
Health management devices
Callcentres
iTV
Web-based
Monitoringcentres
HIT
Vital signsmonitoring
Audio/videoconsultation
AugmentativeCommunication
Devices
Voice
Mobile
Video
Games
Social contact Entertainment/leisure
Depression
Chronic disease Medication adherence
Health promotion
Wellness
Activities of daily living
Manage home
Memory/cognitionDementia
Go places
Monitoring
Prevention
Security
Falls
SafetyGet help
Memory/cognitivedevices
OSGI
KNX
Intelligent Transport
Intelligent Cars
Navigation/orientation
DrivingPublic transport
On-demand
Age-friendlydesign
Tracking
Sensors
Controls
Actuators
Robotics
Assistivetechnology
Work
Accessibility
Work-from-home
Workingcarers
Teleworktechnologies
Age-friendlyworkplace
Computers Handhelds
WebText
Web
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 5
Illustration of the spectrum of care related technologies
Active alarms / social contact
Passive / activity monitoring
Home telehealth
Automation / augmentation / enabling
Social alarms
Videophones
Self-managementRemote monitoring
Environmentalcontrols
Robots
Surrogate pets
Medicine dispensers
Wandering
Inside
Exit
Falls
Lifestyle
‘Granny cams’
Hometreatment
Cognitiveaids
Objectlocator
Cookersafety
Monitoring centres
WII
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 6
Service domains & key opportunities
Social care
• security / safety• social / reassurance• monitoring /
assessment
activitiesof daily living
(ADLs)
Housing
Health care
• self management• remote monitoring
• security• safety• comfort
Remain in own home aslong as possible:
• preferred by most people
• less costly than institutional care
Reduce need for /better target humanresources:
• formal care staff• family carers
Improve quality of life:• older people• family carers
Reduce health system costs:• reduce time in hospital• prevent (expensive)episodes/ care needs
• reduce physical visits
Improve management ofchronic conditions:
• better monitoring,treatment adjustment
• improved medical outcome• improved quality of life
Patient empowermentand quality of life:
• enable more self- management• facilitate living at home, with
health conditions• reduce need for physical visits,
hospitalisation, etc.
Provide new housing options as alternatives to institutional care:
• keep older tenants in mainstream housing arragments• develop specific housing arrangements such as serviced
housing
integratedcare
Enable personal mobility:• social integration in the community• healthy life style / quality of life
homehospital
Mobility• security/safety• reassurance• comfort
Social care
• security / safety• social / reassurance• monitoring /
assessment
activitiesof daily living
(ADLs)
Housing
Health care
• self management• remote monitoring
• security• safety• comfort
Remain in own home aslong as possible:
• preferred by most people
• less costly than institutional care
Reduce need for /better target humanresources:
• formal care staff• family carers
Improve quality of life:• older people• family carers
Reduce health system costs:• reduce time in hospital• prevent (expensive)episodes/ care needs
• reduce physical visits
Improve management ofchronic conditions:
• better monitoring,treatment adjustment
• improved medical outcome• improved quality of life
Patient empowermentand quality of life:
• enable more self- management• facilitate living at home, with
health conditions• reduce need for physical visits,
hospitalisation, etc.
Provide new housing options as alternatives to institutional care:
• keep older tenants in mainstream housing arragments• develop specific housing arrangements such as serviced
housing
integratedcare
Enable personal mobility:• social integration in the community• healthy life style / quality of life
homehospital
Mobility• security/safety• reassurance• comfort
Social care
• security / safety• social / reassurance• monitoring /
assessment
activitiesof daily living
(ADLs)
Housing
Health care
• self management• remote monitoring
• security• safety• comfort
Remain in own home aslong as possible:
• preferred by most people
• less costly than institutional care
Reduce need for /better target humanresources:
• formal care staff• family carers
Improve quality of life:• older people• family carers
Reduce health system costs:• reduce time in hospital• prevent (expensive)episodes/ care needs
• reduce physical visits
Improve management ofchronic conditions:
• better monitoring,treatment adjustment
• improved medical outcome• improved quality of life
Patient empowermentand quality of life:
• enable more self- management• facilitate living at home, with
health conditions• reduce need for physical visits,
hospitalisation, etc.
Provide new housing options as alternatives to institutional care:
• keep older tenants in mainstream housing arragments• develop specific housing arrangements such as serviced
housing
integratedcare
Enable personal mobility:• social integration in the community• healthy life style / quality of life
homehospital
Mobility• security/safety• reassurance• comfort
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 7
ICT enabled forms of support potentially available to older people
• Telecare (social care from a distance)– 1st generation (push button alarms)– 2nd generation (‘passive’ or automatic alarm dimension)– 3rd generation (advanced sensors, life style monitoring)– mobile telecare (mobile alarms) – video-based telecare (visual communication with formal care staff, family
carers)
• Home telehealth (medical care from a distance)– chronic disease monitoring/management– discharge from the hospital
• Smart homes (automated/intelligent home environment)
• Holistic / integrated care approaches (integration of social and medical care and housing components)
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 8
Groups frequently addressed by current telecare solutions
• older people at risk due to general age-related physical decline
• older people at risk due to age-related cognitive or other forms of mental decline
• older people who need support having being discharged from hospital
• older people who live alone and/or need social contact or are at risk of social isolation
• family carers
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 9
1st generation telecare – the mostwidely available form of telecare today
• Current levels of take-up of 1st generation telecare (social alarms) vary considerably across countries; even in the more mature markets this varies from around 3% to more than 15% of older people (aged 65+)
• For 2nd generation telecare, only the UK has a level of take-up that might reach or even exceed 1%, and most of the others have very low levels of provision and take up.
Estimated penetration of social alarms (% older people aged 65 years and older)
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
PL BG SI JP FR IT NL HU DE ES US DK FI SE IE UK
%
Source: Benchmarking exercise conducted for this study
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 10
Estimated demand potential for telecare across EU 27
• Based on current penetration levels of 1st generation telecare, a potential telecare market of between 2.6 and 12.8 million end users can be estimated across the EU27, depending on the penetration scenario applied.
• When considering current demographic projections this demand potential would increase during the coming two decades to between 3.7 million and 18.4 million potential end users, respectively.
(Data source: Own calculation based on Eurostat demographic projection)
2.6
5.1
8.6
12.8
3.1
6.2
10.3
15.5
3.7
7.3
12.2
18.4
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
Low (3%) Moderate(6%) High (10%) Very high (15%)
Penetration scenarios
No
. o
f p
ote
nti
al e
nd
use
rs i
n M
io
2009 2020 2030
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 11
Provision & financing of mainstream telecare
• In most countries the bulk of current users can be considered to be 'public' clients, although there is also a strong private provision (and purchase) market in some of these countries also. Provision is mainly commercial/private sector in a few countries (IE, PL).
• For more advanced telecare, charging practices have not been fully defined in most countries. Charging practice in the UK, the most developed market, seems to be generally modeled on existing charging for social alarms, although sometimes at a somewhat higher rate to take account of the enhanced service being provided.
Public financing/ reimbursement
(universal, needs-based)
Public financing/reimbur
sement, with varying user co-
payments (means-tested)
Mostly out-of-pocket
DK, HUDE, ES, FI, FR, IE,
IT, NL, SE, SI, UK, JP
PL, US
Source: Benchmarking exercise conducted for this study
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 12
Integration of telecare into social care more generally
• There can also be considerable variability in the extent to which such services are embedded within mainstream social care, e.g. when it comes to the provision of the physical response in case of an emergency situation.
• Quite different models are apparent across the countries covered in this study. In some countries the main response is by formal care staff (at least during working hours) whereas in others there is reliance on family carers, and in others some mixture of the two can be found.
• Also, in some countries (e.g. NL, DE), higher charges are implemented in cases where the user prefers a response by formal care services.
Source: Benchmarking exercise conducted for this study
Formal care staff
Family carers
Mixture
FI, SE, DK, HU ES, IE, IT, FR, PLSI, DE, US, NL, JP,
UK
Who provides the (physical) response ?
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 13
Some drivers & barriers
• Drivers:
– Key factors driving telecare deployment vary across countries (e.g. public provision/reimbursement, embedding in mainstream/social housing services, promotional effort of equipment/systems suppliers)
– Streamlining of provision/reimbursement systems for variouse items of equipment can given a stimulus to smart home developments (e.g. NL)
• Barriers:
– Variability infrastructural readiness across countries
– Fragmentation of provision/reimbursement situation
– Lack of demonstrated business/quality case
– Required organizational change when transforming from pilots to mainstream
– Tensions between servicing a mixed housing market in mainstream housing markets in relation to smart home technologies
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 14
Some emerging trends
• As more useful (electronic) devices appear it is likely that they will be purchased as consumer goods by older people or by their families on their behalf (e.g. medication reminders, object locators).
• There is emerging interest in the application of more general purpose consumer goods (such as the Nintendo WII) to support activation of older people, and in ’brain trainer’ type devices (or online services) that purport to help people to maintain cognitive capacities as they grow older.
• In the housing market, some countries have seen growing provision and demand for private retirement-village type schemes, some of which are beginning to include basic telecare and smart home facilities.
Some findings from the “ICT & Ageing” study, Brussels, 19th January 2010 15
Further information
Study Team
www.empirica.com
European CommissionDG INFSO and Media
Lutz Kubitschke Oxfordstr. 2, 53111 Bonn, GermanyE: [email protected]: (+49) 228 98530 0
www.wrc-research.ie
Kevin Cullen 3, Sundrive Road, Dublin 12, Ireland E: [email protected]: (+353) 1 4927042