Mental health

There has been an increase in studies that have highlighted the potential benefits associated with the use of telecare. A large proportion of the existing studies points to the benefits associated with early provision of limited telecare package to elderly people in the low-needs category (Barlow, Bayer & Curry 2005, Kingsfund 2010). The existing studies posit that such an approach could significantly delay the move into a higher needs service band. It is noteworthy that a needs service band has associated costs that depend on the neediness of an elderly person.

Findings show that telecare packages if deployed early can minimize the number of the elderly that move into residential care due to feeling unsafe and vulnerable. Since there is no clear definition of the model that can be used in telecare, there are different approaches that have been adopted in providing access to telecare for the elderly. Since the modelling approach affects the services that the elderly receive, they may influence the overall benefits associated with telecare services and the effects that they have on the lives of the elderly.

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Small successful telecare schemes are central to the consensus that telecare can significantly reduce the demand for hospital resources. However, extrapolating the results from the small successful scheme to the general population presents the danger of perceiving telecare as successful without considering a host of internal factors that may affect the benefits associated with telecare services. The design adopted in implementing a telecare package or strategy influences the benefits it will have on the target population and is therefore an issue of critical importance.

Providing telecare packages that suit the needs of an elderly person is also vital in improving the overall benefits associated with telecare. It is noteworthy that no two elderly people share the same needs due to differences in their physical health, family support and home environment. Moreover, designing telecare packages is limited by scarcity of data on telecare cost implications. This is mainly blamed on the small scale and short term nature of telecare trials (Barlow, Bayer & Curry 2005).

Furthermore, there have been few attempts to model the cost effectiveness of introduction of telecare at large scale. However, the existing costs models have predicted return on the necessary investments after a period of up to ten years. This implies that investment in telecare should be looked at as long term investment. Expected savings in the model arise mainly from a reduction in the time and financial resources spend in hospital and residential care.

Extrapolation of results for UK telecare programs under the assumptions that nearly 1. 6 million households would use the alarms shows that savings in the excess of ? 1 billion would be made (Kingsfund 2010). After the first ten years, the benefits associated with telecare were expected to increase mainly due to a reduction in installation costs (Kingsfund 2010). The time lag effect has been elaborated by various researchers as being a characteristic feature of the telecare models.

Under the most optimistic set of assumptions, independent researchers have established that institutional care populations may drop by 11% relative to non-telecare cases (Kingsfund 2010). However, under pessimistic set of assumptions the drop is less than 1% (Kingsfund 2010). A common similarity of the models that the benefits associated with the use of telecare are brought out more clearly in the long term for instance two decades. Moreover, the benefits associated with the use of telecare are pronounced for users with mild or medium needs.

This is because this group can use telecare independently in a home settings thus leaving room for reduced care costs. The existing models generally assert that telecare development should focus mainly on elderly people that are not fragile to positively affect care homes. Other pilot studies have established that telecare can considerably shift people from residential care. The benefits associated with this shifts are then redistributed around the care system (Kingsfund 2010).

The department of health in 2005 established two telecare models which showed that at a strategic level, it is feasible to attain the potential shift in service provision (Kingsfund 2010). The model further showed that there is need to be cautious in asserting that there are large short term financial savings made in the implementation of telecare. Another reason for the time lag in gaining benefits associated with telecare is explained by the time required to ensure that patients remain in their homes for longer before going to residential homes (Barlow, Bayer & Curry 2005).

Therefore, delaying entry of the elderly into residential homes and hospitals is the main impact of telecare on overall costs associated with managing the elderly. Commensurate increase in the number of visits and hours of home care is also associated with an increase in the number of the elderly that remain in their homes (Gortzis et al 2008; Kingsfund 2010). It is however noteworthy that under the assumption that telecare will result in a large number of patients remaining at home rather than relocating to care homes, there is likely to be an increase in domiciliary care.

It is therefore evident that though there is a general consensus that telecare is associated with cost benefits in the long term, the complex modelling required to construct the costs benefits analysis and assumption made affect the accuracy of the predictions. Another variable that has been noted by researchers as adding to the complexity of the cost benefit analysis model is the fact the technology is changing quite fast (Kingsfund 2010). Though there is a general reduction in the cost of technology, this is a short term trend that is not expected to persist over a period of twenty years.

This has resulted in an increase in emphasis on the psychological and physical benefits associated with the use of telecare. It is noteworthy that the focus in telecare transcends simple economic considerations and involve ensuring that the elderly person are well taken care of and provided an environment where their social and personal needs can be met easily. Psychological Benefits Elderly people have psychological needs that emanate from their life experiences. These needs affect the overall mental health of the elderly.

In some cases the problem may manifest in various medical problems for instance depression, dementia and even loneliness. The proneness of the elderly people to senility, stroke and Alzheimer disease which is associated with loss of intellectual ability may result in depression and a feeling of loneliness. Other causes of loneliness include guilt and the feeling of being useless (Buckland, Frost & Reeves 2006). The feeling of being neglected may become more pronounced in residential care rather than in homes.

Elderly people in their homes are less likely to feel that they have been neglected. This peace of mind is vital in minimizing the severity of conditions associated with ageing for instance depression, stroke and high blood pressure. Moreover, the feeling of being useless is reduced in cases where the elderly can visualize the achievements that they have attained in their lifetime. In cases of depression and psychological problems it is often advisable to provide the patients with emotional support (Castleton 2006).

Being around family and in familiar surrounding is helpful in improving availability of emotional support and allowing the elderly appreciate the achievements they have made. Moreover, the people who have been with an elderly person for a large proportion of his life are better placed to provide material and moral support required by the elderly to engage preventive strategies and live a happy life (Barlow, Bayer & Curry 2005). Managing conditions like Alzheimer’s disease requires patient to take on activities that will keep their brain cells active.

Being near family rather than elderly people provides elderly people with the opportunity to exercise their brains. However, these benefits are dependent on the existence of members of family that can provide the elderly people with the required moral support (Horton 2008). This is not always the case since a number of elderly people have no access to close family members which necessitates use of care and residential homes. One of the major implications of the use telecare is that it increases the likelihood of spending more time away from residential homes.

However, there are risks associated with being away from professional help for instance lack of support and help and a feeling of neglect. Though the use of telecare does not directly address loneliness among the elderly people, it provides a platform for elderly people to be near their family and friends. In so doing, telecare ensures that elderly people have the moral and emotional support required to deal with the physical and psychological challenges they face (Sixsmith & Sixsmit 2008).

Telecare diverts the risks associated with elderly people being home alone and ensures that they have easy access to professional help. This implies that telecare provides a platform for family and friends to continuously support elderly people while they are at home and also reduce the risk of the elderly remaining unattended. The latter benefit mitigates the risks associated with housing elderly people within a family setting rather than a residential home.

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