Is the Social Alarm System Sustainable for an Ageing Population in the Digital Age?

Introduction

As the UK transitions from an analogue to a digital telephony network, the demand for effective and sustainable home-based care solutions for an ageing population is growing. Existing technologies like social alarms and emerging sensor based systems are vital in supporting independent living. However, given the current digital shift, it's crucial to evaluate these technologies' long-term sustainability and effectiveness. This blog explores the need to adopt sensor-based systems now, arguing that upgrading analogue social alarms to SIM-based models could be a missed opportunity leading to greater costs and poorer outcomes. I will also explain how leveraging national infrastructure systems, such as Low-Power Wide-Area Networks (LPWAN), can mitigate the higher costs associated with deployment of advanced sensor-based systems.

Challenges facing the Care System for an Ageing Population

The care system aims to provide health and social care services that enable individuals to maintain independence and quality of life at home. With a growing elderly population and a shrinking care workforce, service delivery challenges are increasing. Technology, such as social alarms and sensors, offers potential supporting solutions, but their viability and sustainability, particularly in the context of the impact of budget spend created by the UK's shift to digital telephony, need scrutiny.

The Analogue to Digital Telephony Shift

The UK is in the process of transitioning its telephony network from analogue to digital, expected to be completed by Openreach by January 2027. This transition has significant implications for telecare services, particularly those relying on traditional analogue systems.

1. Compatibility Issues. Many existing social alarms are designed for analogue systems and may not be compatible with digital networks. The current solution is to "upgrade" or replace these systems with sim-based social alarms and cloud based ARCs, but this involves substantial costs and logistical challenges.
2. Increased Costs: Upgrading to digital social alarm devices is expensive, furthermore early adoptors may need to fund a further upgrade and augment the service with sensor based systems as the reactive technology limitations become clear. Is this an opportunity to use budgets to invest in sensor-based systems now that provide better value and long-term benefits?
3. Service Disruption: Transitioning to a digital network can cause temporary service disruptions, potentially putting vulnerable users at risk. Whilst careful planning, robust communication strategies, and temporary support measures can minimise disruptions, it is evidently clear that sensor based systems are cheaper, faster to install, and easier to deploy. Either way, operating with a mix of analogue technology communicating over a digital infrastructure will never be reliable and is arguably not safe for telecare.

Social Alarms - A Reactive Solution with Limited Future Potential

There are many known benefits attributed to the social alarm

1. Immediate Assistance - Social alarms offer a direct line to emergency services or caregivers at the press of a button, ensuring swift help during emergencies like falls or medical crises. However, it may surprise you to know that most of the new "digital" social alarms are simply connecting to an ARC over the mobile network. So a mobile device or App, procured at a fraction of the price is arguably more accessible and is just as reliable as a social alarm. Additionally a sensor based approach will be more proactive, and has SOS buttons and pullcord options too!
2. Simplicity and Ease of Use - Social alarms are ideal for elderly individuals who may struggle with more complex devices due to cognitive impairments or physical limitations. However, as mentioned, this requires the person to reach a cord or press a pendant button, and of course wear the pendant! Additionally, there is stigma associated with the style of equipment, and the term "social alarm" that makes it wholly unattractive to people living in general housing and especially younger individuals. A limited peripherals range and narrow manufacturer base also limits the applications for other individual use cases. In contrast, there are literally thousands of Ambient sensor types available from Global manufacturers and they could not be more simple or easy to use. The person just has to live their life and none of the existing challenges exist.
3. Peace of Mind - The presence of a social alarm can provide reassurance to both elderly users and their families, knowing that help is readily accessible in case of an emergency. Arguably families are not entirely satisfied since the presence of alternative monitoring systems, including CCTV, mobile devices, and sensors are being introduced. The industry concern is that these are unregulated consumer purchases - perhaps another blog!

Challenges and Viability Concerns

1. Reactive Nature. Social alarms are reactive, requiring the user to activate them, which can be problematic if the user is incapacitated or unable to reach the device. This reactive approach increases the workload on the care workforce, and in an ageing population, those emergencies may be more frequent and less predictable.
2. Workforce Strain. The increasing number of elderly individuals using social alarms can overwhelm emergency responders and caregivers, leading to delayed responses and potential burnout. As the care workforce diminishes, the strain on remaining staff could make reliance on social alarms unsustainable.
3. False Alarms. False alarms can lead to unnecessary emergency responses, further burdening the care workforce. Implementing auto-messaging services, refresh training and additional verification steps can mitigate false alarms but they may not sufficiently alleviate the issue. In contrast an ambient sensor system coupled with simple event based rules, machine learning and AI is a far more effective approach!
4. Analogue to Digital Transition. Many social alarms are analogue-based and may not function correctly on the new digital network. Upgrading to digital social alarms is costly and will not provide significant advancements in proactive, preventive and personalised care.

Sensors Deliver A Proactive and Future-Proof Approach

What exactly do sensors deliver?

1. Continuous Monitoring. Sensors provide ongoing monitoring of the home environment and the individual's activities, offering real-time data and alerts for situations like mould prevention, falls, or inactivity, allowing for early intervention.
2. Non-Intrusive. Passive sensors do not require user interaction, ensuring monitoring even if the individual cannot actively seek help, making it an ideal solution for those with complex needs and severe mobility issues.
3. Comprehensive Data Collection. The data collected by sensors can track health trends, predict potential issues, and customise care plans, enhancing overall care quality and reducing emergency incidents. When this data is coupled with event rules, machine-learning, and AI the system can help to support remote food and medication prompts, control heating and ventilation, highlight social isolation and much more.
4. Integration with Smart Home Systems. Sensors integrated with other smart home technologies, create a holistic approach to home health and safety that can adapt to the evolving needs of the individual.
5. Digital Compatibility. Sensors operate on digital platforms, making them well-suited for the new telephony network. They are designed to leverage the benefits of digital infrastructure, offering more reliable and advanced functionalities.
6. Cost Mitigation. Leveraging national infrastructure systems like Low-Power Wide-Area Networks (LPWAN) can reduce the need for expensive individual hubs in every home. LPWAN provides extensive coverage, low power consumption, and the ability to connect a vast number of sensors, significantly lowering the overall cost of deploying sensor-based systems.

Industry Perceptions, Challenges and Mitigations.

1. Complexity and Setup. Sensor systems are no more complex to install and maintain. Just like Telecare they require some technical expertise. However, professional installation services and user-friendly systems with robust customer support help to educate the sector, simplify the setup and minimise ongoing maintenance.
2. Privacy Concerns. Continuous monitoring can raise privacy issues. However, open engagement with individuals via workshops to deliver transparency about data collection and usage, along with customisable privacy settings, will help to alleviate individual concerns. Opt-in consent, secure systems, and clear data management policies are crucial.
3. Initial Cost. Advanced ambient sensor systems are no more expensive than a digital telecare unit upgrade. A typical home can be equipped with sufficient sensors for around the same price as a digital telecare box! In fact utilising LPWAN can significantly lower system infrastructure costs thus making sensor systems far more affordable than the Telecare equivalent. Exploring funding options like insurance coverage, government grants, or subsidies can also help to offset costs. Finally, starting with a basic system and scaling up as needed can make the investment more manageable.
4. Too much data. The main challenge for adoption and scale of sensor based systems is a fear of the data lake that will drown the telecare system! However the care system is crying out for more data to inform outcomes and meet the challenges. It's true, sensors provide an abundance of data, but when supported by a good platform to integrate the systems and manage the data, coupled with professional support to assist the providers, they will deliver better services and outcomes.

The Argument for Sensor Adoption Now

Given the transition to digital telephony and the increasing demands on the care system, it is imperative to adopt sensor-based systems now. While upgrading analogue social alarms to SIM-based models may seem like a straightforward solution, it represents a short-term fix that overlooks the long-term benefits of proactive sensor technologies.

Missed Opportunity!

• Innovation Stagnation. Upgrading to SIM-based social alarms does not leverage the full potential of digital technology, missing out on innovations that can significantly enhance care.
• Long-Term Costs. Although initially cheaper, SIM-based alarms may incur higher costs over time due to their limited functionality, a need for augmenting systems, future upgrades and of course false alarms and capacity burden.
• Care Quality. Sensor systems offer a comprehensive, proactive approach to care that can reduce emergency incidents and improve overall health outcomes, unlike the reactive nature of social alarms.

Cost Mitigation Through LPWAN. No More Hubs, No More Data Silos!

Adopting sensor-based systems now, particularly those utilising LPWAN, can mitigate costs by reducing the need for individual hubs in every home. LPWAN is widely available across the UK and is a key infrastructure that offers broad coverage and low power consumption, making it an ideal solution for connecting multiple Sensors across wide areas like grouped properties, care homes, retirement villages, urban communities, plus towns and cities efficiently. This approach not only reduces installation and maintenance costs but also enhances the scalability and reliability of the care system. Crucially, the use of LPWAN based on a national infrastructure continues to deliver data even if there is a power cut!

Conclusion

The sustainability of the care system for an ageing population hinges on adopting effective, affordable, and accessible technological solutions within the context of the UK's transition to a digital telephony network. While social alarms offer a simple and cost-effective solution, their reactive nature, increased strain on the care workforce, and compatibility issues with the new digital network highlight their limitations.

In contrast, sensor-based systems offer a proactive, future-proof approach to care, providing continuous monitoring, early intervention capabilities, and better alignment with the digital infrastructure. By leveraging national infrastructure systems like LPWAN, the costs associated with sensor deployment can be significantly reduced, making them a more viable solution for supporting an ageing population.

By understanding the benefits and weaknesses of each technology and recognizing the missed opportunities in not adopting sensors, we can work towards a more sustainable and effective care system. Moving towards proactive sensor-based systems is not just a strategic choice but a necessary step to ensure the health and well-being of elderly individuals at home in the digital age.