Connecting social care

Technology can help bring people together and make the last phases of life more liveable but we found that poor internet access is stopping people from making the most of the possibilities to remain connected. We explored why this infrastructure is not in place and have some recommendations to change that - starting with putting wifi in every care home.

Why?

Social inclusion is a right, but isolation is a growing problem.

Projects to unlock communication and social activity for older people are common, and many use new technologies, but these generally assume the basic infrastructure of internet connectivity.

Today, there are around 417,000 people living in care homes, most aged over 85, but we estimate that over 70% of care homes with ‘old age’ provision do not provide residents with internet access.

There are some care homes that I go into and there are no computers, nobody has a computer. There are also care homes that have computers just in the manager’s office and at 5pm when they go home, the computer is locked away and nobody has access to a computer, end of. Nowhere that I have been into has wifi.

If we change this, patients, staff and families will be able to connect socially and be able to manage their care, their health and their lives. They can benefit from accessing the consumer internet and use existing technologies, such as Skype, to overcome isolation.

Once basic internet infrastructure is in place, and the potential of existing technology is understood, there is more scope to address skills and support, and to create the new products and services that really support residents' and care workers' needs.

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What we learnt

People don’t want to feel alone at the end of their lives. They want to feel valued and useful but that’s difficult when you have little social contact.

The most important thing is knowing that somebody cares for as you can feel so lonely and vulnerable.

Knowing that I have someone at the end of a phoneline is really helpful. You panic when you can't breathe and that makes it worse. You feel like somebody cares.

Life gets very enclosed, very narrowed down. It is hard to stay positive when you feel everything is shrinking around you.

A carer might come in at 9.30 and have 20 mins to wash them and then they will be left on their own until evening time. How difficult is that? How does that make someone feel who was previously independent and managed their own life? How connected do they feel to anything any more, just stuck in their home? I think it’s incredibly sad. Being isolated like that alongside the fact that the person is facing the end of life... is that how my end of life is going to be? I’ve got months/years of being less independent, relying on others and generally just not enjoying life.

Technology exists that can help connect people. But without basic internet access, they are no use.

We’ve had people whose families live abroad, for example, and perhaps they want to connect after many years of having no relationship. I remember a patient, last year, using Skype to connect up with their family in South Africa, and it probably was the single most important thing that that gentleman did.

Innovations can’t scale or create enough demand because people can’t access or use them in the settings that they need to or would be most useful.

What we have done

Research

Full report Research findings

We looked at recent research into the impact of internet use on the elderly and others in situations where they might feel socially excluded.

Studies such as this by Naumanen and Tukiainen suggest that people who use the internet feel more connected than those who don’t:

I can go on the internet and I can search, I can go on Google Earth which I’d never seen or heard of before and I think that’s fantastic, I’ve got relations in South Africa, I’ve been there on Google Earth, I’ve walked up the path and I’ve looked straight at the house.

An evaluation of the Get Connected initiative, which provided IT services to care homes, noted how residents could use websites to explore interests and hobbies and communicate with family members overseas. There were other benefits to staff and family members.

But our research found the majority of care home residents do not have internet access.

We estimate that 70.5% of care homes with 'old age' provision do not provide residents with internet access. This affects an estimated 283,000 residents.

We spoke with care home providers to understand the challenges that prevent them from providing wifi. Broadband providers offer residential and business packages, neither of which is a good fit for many smaller care homes. Care homes may also lack the skills and time needed to help residents with technical issues.

We also looked at the number of initiatives aimed at connecting socially excluded people. These range from people sharing the homes of people who are feeling isolated, to running groups which visit the elderly and cooking clubs to share meals with neighbours.

These could scale up and become more effective if more socially excluded people were online.

Read more about our research findings.

Service design

We thought about what kind of internet and wifi package a care home would need. Their service needs to be:

• Affordable
• Easy to purchase, install and maintain
• Reliable
• Fast
• Manageable and understandable by staff

Care homes have needs that are very different to those of a conventional small business, or a typical family home.

Imagine 20 residents all making a video call at peak times - which is likely to happen if they are connecting to family members in the evenings and weekends. The wifi will require additional bandwidth and powerful routers to manage that number of connections.

Prototyping

We were interested in new ways of connecting people who might be suffering social isolation and thought about matching people up and giving one another ‘gifts’.

We also prototyped story postcards as an example of how people might be connected.

But we realised none of these new solutions would work unless we could change the infrastructure to give people access.

We think it is more important to focus on enabling people to use the existing technologies.

What we recommend next

All care homes should have wifi.

We think that the provision of internet to care home residents would have a huge impact - not just improving residents’ lives, but also helping staff and families and unlocking the potential for new initiatives to scale up and make a real difference.

Full report Guidelines for wifi

We would like to make setting up wifi in these spaces an easy and attractive offer for care home owners. Wifi should be:

• offered at a low price point, reflecting the social importance of this service and the affordability of care to many families
• provided with a full survey of a care home and recommendations made for appropriate broadband connection speed, number of wifi hubs, and where best to locate them
• packaged with network management tools
• supported with high quality after-care service

Because care homes we've spoken to have concerns about their own technical skills needed to provide wifi and appropriate support, we have developed some good practice guidelines for setting up wifi.