Care navigators decision-making in prescribing Telecare for older people.

Abstract

This aim of this study was to explore the decision-making process of Care Navigators in prescribing Telecare for older people living at home. The study took place in the South of England. A structured model of decision-making was used as the theoretical framework and a qualitative approach was employed. Care Navigators (n=7), acting on behalf of the Local Authority as 'external trusted assessors' were interviewed according to a semi-structured interview schedule. Documentary evidence of decision-making (Telecare Reasoning Forms) (n=10), were also analysed and added to the interview data. The main themes identified were the process of decision-making, training needs, and the support of Care Navigators and partnership working. Care Navigators adopted a complex decision-making process involving information gathering, information synthesis, consideration of alternatives to Telecare and implementation. Decision-making has a strong ethical dimension, especially around funding. Training focused on the functioning and technical aspects of equipment. However, other training needs were identified in order to support decision-making, for example, assessing mental capacity. Peer support networks were valuable to Care Navigators and they developed good relationships with social care and Telecare provider staff. However, professionals making referrals to the Care Navigators for Telecare often did not understand their role or funding eligibility. In conclusion, Care Navigators are well-placed to prescribe Telecare in terms of knowledge and decision-making skills. Comprehensive training is necessary in order to support decision-making. Peer support and education of professionals referring for Telecare is also advocated.