Abstract
Summary Developments in communication technology can reduce dependence on others and facilitate independent living for disabled people. Recently developed telephone-based services allow users to call up help quickly, as and when they need it. But the dominant model of provision emphasises vulnerability, assumes a need for protection and imposes rules about appropriate use. The article identifies the influence of manufacturers and providers of communication alarms in perpetuating paternalistic approaches to services for older disabled people and limiting the potential for user determination of need. Emergent models which aim to facilitate user-control face low expectations among users, the entrenched attitudes of providers and the dominance of the market in influencing practice. The mixed economy of social care is likely to increase the gap between providers' interests and users' needs.
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