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: info@empirica.comT: (+49) 228 98530 0

www.wrc-research.ie

Kevin Cullen 3, Sundrive Road, Dublin 12, Ireland E: wrc@wrc-research.ieT: (+353) 1 4927042