Technology must enhance not destroy care for older people
Open any newspaper or listen to the news and you’re likely to hear about our ageing population. Whilst the number of older people in Northern Ireland has been growing for the past three decades, it seems as if the message is finally getting through. More of us are living longer lives than ever before with improved health, lifestyles, and the prevention and treatment of disease all contributing to increased longevity. Add into the mix the fact that the birth rate in Northern Ireland isn’t growing with any pace and you have a major shift in demographics and one which is being experienced all over the world.
This change is viewed as both frightening and exciting by Government, organisations and individuals alike. It is great news that we are living longer than ever before and our ageing population brings many benefits for society. Lots of families rely day to day on their older relatives offering childcare and most third sector organisations rely heavily on older volunteers who give up their time and expertise for free. Many older people are also the primary carers for their spouses or siblings, saving our health services millions of pounds each year.
That being said, it would be unrealistic to expect that there are not challenges associated with such a change in the population. It is frequently stated that our ageing population is leading to increased demand on the health service and there is no doubt that this is true. Combine this with the fact that public expenditure, particularly on health and social care services, isn’t increasing at the same rate as the ageing population and we are faced with a real dilemma. How do we ensure older people get the care that they need when the pot of funding available isn’t quite enough?
It’s clear to me that health budgets must be spent more effectively and new ways of delivering services are required. Comprehensive planning and innovative thinking must become the norm within Government and Health and Social Care Trusts to ensure that all of the services and support required by older people will be available, when and where they are needed. Without this, problems in our current health and social care system will continue to spiral and more older people will end up at crisis point and in A&E and hospital wards across the country.
When faced with a challenge it’s vital that we adapt and overcome. With the oldest population on earth, Japan has taken a creative and innovative approach, using technology to revolutionise how they care for their older people and prevent the collapse of their health system. Animal robots are used to comfort people living with dementia whilst human-like robots are used to deliver food – a sci-fi equivalent of ‘meals on wheels’. Automated cars are being developed for older people and GPs are increasingly using technology to reach older patients.
Whilst their commitment to finding alternative approaches has to be commended, whether technology enhances or destroys care for older people is up for debate. To date, Northern Ireland has not embraced technological change in the way which can be seen in Japan and regular use of robots in hospitals and homes is rare. Whilst some smart homes and hospitals across the country are advancing at pace in this area, in Northern Ireland terms it is still something more likely to be seen in a futuristic movie. Yet from automated checkouts to online GP consultations there is no denying that we are slowly moving towards a state where technology is replacing the human touch and the impact of this on older people cannot be underestimated.
Whilst technology can require a high level of initial investment, it’s typically considered a more economical way of doing things and with a finite pot of money expected to meet an increased demand for health and social care services, many could argue that this holds the answer to our problems. In addition, technology could alleviate a whole range of issues faced by today’s older people, for example with more older people living in rural areas and less money being pumped into community transport, driverless cars and buses may well offer a solution in the much longer term.
Japanese developments which assist older people out of bed and bring food can also enable older people to maintain their independence and privacy as care workers may no longer be required to enter into the homes of those who need some levels of assistance. For people who need greater levels of care, assistive technology could help ensure consistent standards of care, helping to remove human error and even the rare risk of abuse, cruelty or neglect.
Whilst there is opportunity for technology to change and even improve how we look after older people here in Northern Ireland, it fundamentally removes the human touch from the provision of care to another human being. With half of older people saying the television is their main source of company, are more machines really going to help older people? The impact of isolation is well documented, with researchers estimating that the "epidemic of loneliness" costs £6,000 per person in health and social care services. In fact, a lack of social contact is reported to be as damaging to our health as smoking 15 cigarettes a day.
Whilst we are nowhere near to the scale and scope technology being used in Japan, Northern Ireland has taken small steps to move towards using technology in the provision of services traditionally carried out by people. The shift towards online government services, the closure of local branches in favour of online banking and the use of virtual technology by some GPs in NI are some of the recent changes which have been brought in and from speaking to older people it’s clear that these moves aren’t popular. Not only are they not accessible for those who don’t have or cannot afford internet access in their own homes, they can be intimidating to many who simply do not know how or want to use them. Whilst Japan appears to have considered some solutions by using more common forms of technology to help older people such as offering virtual GP appointments through the TV rather than a computer, it still doesn’t remove the issue that the doctor may have been the only human contact that an older person has that day. Gone is the time when older people knew their local chemist or the person who delivered their daily ‘meals on wheels’ and for many without families, neighbours or friends, constant isolation is a familiar experience.
Technology used to provide care for older people can also be seen as unethical and intrusive - do we really wish to become a society where palliative care is delivered to a dying person by a machine with no compassion or emotion? Add in the risk of security issues for example if a cyber-attack shut the system down or if there is a glitch in the system then technology doesn’t seem such an attractive way of providing care for some of the most vulnerable in our society.
Whilst there is no doubt that technology can play a valuable role in providing care for older people, I believe the key lies in using it to complement care provided by people. It must be used in a way that helps older people and cannot be driven by organisations who wish to cut staff costs and do more with less funds. Older people’s needs and wishes must be at the heart of developments in health and social care, with meaningful co-production and there must always be an option of human contact no matter how advanced technology becomes. We simply cannot accept the digital by default approach. If the benefits of technology are to be realised in a way that empowers and assists older people rather than treating them like an entity in a production line, these must be the end rules of the game.
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