Everyone wants to stay independent for as long as possible. Technology can help, but it can be intrusive. Katie Puckett reports on a system that will help elderly people stay in their own homes while it stays out of sight
From the outside, Naida Jones' hall cupboard looks just like anyone else's.

But take a look inside and you'll find not coats and umbrellas, but a laptop computer running state-of-the-art software. A tenant of Beaver Housing at Siedle House 鈥 a sheltered housing block in Greenwich, south-east London 鈥 she is one of 10 people taking part in a technology pilot that helps elderly people live independently in their own homes. The 10 鈥 tenants of Beaver, and Moat and Hyde associations 鈥 are the first of many who will benefit when the service is launched nationwide later this year.

"Having the equipment there certainly makes me feel a lot safer," says Jones. "You don't even notice the sensors if you don't know they're there, and the computer is shut away so you don't see that either."

The Greenwich Millennium Homes Project, the fruit of nearly three years' labour by researchers at Brunel University, has been running since April 2002. It is exactly the kind of scheme that sheltered housing providers and social services need if they are to meet government targets for tackling the spiralling costs of caring for the UK's ageing population. Anti-bed-blocking measures announced in the government's 2002 report, Delivering the NHS Plan, mean that, by 2006, an extra 100,000 people must be looked after at home rather than in hospital or residential care. "Telecare" technology is seen by many as key to achieving this and there has been much research into it, although only a handful of schemes are in place.

Basic systems to alert care workers when residents are in danger are widespread 鈥 conspicuous red cord and pendant alarms, for example, are a common sight in care homes and sheltered accommodation. More advanced schemes have included high-tech methods of monitoring resident behaviour and health or installing elaborate systems to control every aspect of the environment (see factfile, below).

But Millennium Homes is different from anything that has gone before. There is no new technology for the resident to get to grips with and the sensors are almost invisible until someone points them out. And, crucially for the tenants, there is no breach of privacy because no information leaves the house apart from when a call for help is needed. "With nine out of 10 of them, we had a conversation about whether the technology would be like Big Brother watching them," says Cathrine Hammond, a secondee from the Department of Work and Pensions Disability Unit, who is managing the scheme.

But what really sets Millennium Homes apart is the underlying premise, developed by Professor Heinz Wolff, founder of the Brunel Institute for Bioengineering. Instead of monitoring for ill health or accidents, the system acts as an extension of the elderly person's brain 鈥 a crutch against memory failure. "It's like clearing your throat occasionally, as you might do with an elderly aunt," explains Wolff. "It catches potentially hazardous situations, training the tenant to be more independent."

Millennium Homes is designed to support people who are capable of looking after themselves most of the time but have occasional lapses of memory or who react unpredictably to situations in daily life.

"So many of our clients who are over 60 live in street properties, where they're at risk," says Barry Sprules, chief executive of Beaver Housing. "The residential environment doesn't suit everyone, but it's not sufficient to visit one or twice a week.

"People don't see this as an intrusion into their lives, but they know it's working quietly behind the scenes so they get support if they need it."

The kit 鈥 capped at 拢5000 a property by BT for the pilot project 鈥 consists of a network of up to 40 sensors and a computer system that pieces together the data to spot unusual situations and alert the resident. For example, imagine it's 10 o'clock at night and the sensors detect that the elderly person is in bed, but the back door is open. The computer will then telephone the resident to warn him or her, and they can then shut the door or dismiss the warning by pressing a certain key, perhaps because they are waiting for a cat to return home. If they fail to respond, the computer will try to contact them via a loudspeaker but, if subsequent warnings go unanswered, it emails the local support centre for help (see graphic, left).

This focus on maintaining an elderly person's lifestyle has attracted the attention 鈥 and cash 鈥 of Huntleigh Healthcare, a major supplier of equipment to the NHS. When a 拢355,000 research grant from the Department of Trade and Industry came to an end in January, Huntleigh stepped in with 拢400,000 to fund two more years of research. The company intends to approach health and social care providers with a commercial service based on the project later this year, and is already talking to social housing providers about partnership arrangements.

"We liked the philosophy that Heinz had developed," says Bernard Wignall, corporate development director at Huntleigh Healthcare. "The big difference between this and other systems is that it was designed to help the person be independent, not just to call for help." Wignall is particularly impressed by the way the computer program interacts with the tenant to help them keep on top of things. "If the back door is open, you could just put an automatic door closer on it, but that's not being independent. Independence is managing your own life 鈥 all you need is a little reminder to do it," he says.

Huntleigh intends to offer not only the equipment but the installation and resident support services that must accompany it. The company hopes its investment will be enough to stimulate widespread adoption of telecare across healthcare, social services and housing. "Everyone is saying they can see the benefits, but until now, there's not been a major company saying they'll provide a complete integrated service and make it real," says Wignall. Costs will be "of the order" of the 拢5000-a-property price in the pilot, he says, although this would depend on the building and the facilities required. There will be a number of financial options, with service charges separate or bundled with the cost of installation.

So far, Beaver's tenants are pleased with the impact telecare has had on their lives, even though the equipment itself is unfamiliar. "At first, I found the idea of computers and all this technology monitoring me pretty scary 鈥 we didn't have stuff like that in my day," says Bill Marlin, another resident of Siedle House. "But my family think it's a great idea, and aren't so worried about me living alone."

Other schemes

  • The Joseph Rowntree Foundation and its partners have run a number of high-tech pilot schemes since 1998. These 鈥渟mart鈥 houses are equipped with computers and switches that control just about every aspect of the environment and security. To date, there are two elderly residents living in homes with the complete kit and 10 others with elements of it.
  • West Lothian council has closed three of its six residential care homes and has built 62 new properties fitted with technology to detect intruders and monitor movement, flooding and temperature extremes, linked to a 24-hour contact centre. It has also fitted basic technology in 1300 private homes. The total cost of the scheme was 拢11m.
  • Aspire Housing Association set up a telecare showroom in a sheltered scheme in Staffordshire. It held two training courses for local healthcare and social services providers in April and, since 1 May, it has received requests to install the technology in six homes.
  • Fold Housing Association in Northern Ireland has been using smart technology to care for people with dementia for nearly two years. It has 30 residents living in telecare-supported housing in Londonderry, and five bungalows for couples, all equipped with a combination of sensors and monitoring equipment.