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Scotland's older people should be able to live the life they want, and technology is a key enabler

2​2 February 2023



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By Dr Lynne Douglas is chief executive of Bield Housing & Care and a former director in the NHS

Although healthy life expectancy is a National Performance Indicator in Scotland, the number of healthy years that people can expect to live has dropped consecutively since 2017.

This particular indicator measures quality of life: the amount of time people spend in good health, where they aren’t hampered by disabling illnesses or injuries. For women in Scotland that figure is 61.1 years and for men it’s 60.4.

Prevention and promoting early intervention for those developing impaired health is a key strand in the public service reform agenda and critical to addressing the capacity gap currently seen across our system in care provision.

Digital services help individuals to build skills, empowering them to self-manage their health. Tech systems can also identify people at risk of reaching a crisis so preventative support can be put in place.

Evidence shows that if older people use technology - whether that’s recording their vital signs via a monitoring app, watching physio exercises on YouTube or video-calling friends – then health deterioration can be slowed and pressure on statutory services reduced.

A barrier to assistive technology in older people can be fear and hesitancy around apps, websites and everyday devices, which can reduce adoption of these solutions.

Bield Housing & Care is one of the largest providers of housing and support for older people in Scotland – we have over 5,000 tenants with an average age of 76. But a significant proportion of the men and women we support lack confidence around technology.

This was underlined when, in 2022, we invited tenants over 70 to use texting to improve their health. Our team asked people what information would help them. Some requested ideas on managing a condition like diabetes – such as tasty food swaps. Others asked for exercise tips or advice on staying warm. Personalised texts with videos, infographics and web pages were sent to tenants and the response was striking. Some were happy to click on NHS content, but most other sites were viewed with suspicion. We found digital literacy in this group an issue.

This work highlighted the barriers facing tenants. Their unfamiliarity with tech, combined with a distrust of what many see as ‘big brother’ web companies is off-putting.

Many older adults don’t think technology is for them. They aren’t aware of how it can help them do the things they are interested in or how it can transform the way they connect with the people they love.

Equipment and tech-enabled devices are often given to older people without meaningful conversations first. Asking someone about their passions and what they want to do more of in life helps to personalise digital solutions. It also means we don’t make decisions on behalf of individuals and then run the risk of them not engaging.

This co-production approach is one we’re putting front and centre of ‘Technology for our Ageing Population: Panel for Innovation’ (TAPPI). It’s a new project that I’ll be talking about, alongside frailty at Digital Health and Care Scotland in February.

Led by the Housing Learning and Improvement Network (Housing LIN), the TEC Services Association (TSA) and funded by the Dunhill Medical Trust, TAPPI aims to improve the way digital is co-designed and used in housing and care for older people.

Bield is one of six organisations involved in the UK and we’ve recruited two champions – Alice, 88 and Peter, 82 who will guide our work, engaging other tenants and employees around technology; flagging barriers and helping us redesign the way digital is used across our homes.

That might involve asking new tenants what matters to them before they move in. We’ll also be asking about frailty. Some tenants have spent time in hospital, and others, with reduced mobility, worry about falling or not being able to look after themselves. We want to help people to feel safe at home and reclaim their independence.

Our staff are being trained to have these important conversations and our digital engagement leads will show tenants how to use different kit. Two thirds of our staff are over 50 and we’ll develop their digital literacy too.

A digital living space will allow tenants and staff to try equipment and we’ll be monitoring adoption levels as well as evaluating the impact that tech is having on people. We hope to combine big data with Community Health Index (CHI) numbers to examine the social and economic outcomes of our work.

Ultimately, I want to develop a body of knowledge that aids the public service reform agenda whilst improving outcomes for people; increase digital literacy, and join the dots between housing, health and care systems to make that a reality. Scotland's older people should be able to live the life they want, and technology is a key enabler.

Dr Lynne Douglas is chief executive of Bield Housing & Care and a former director in the NHS. Find out more about TAPPI here

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