Implementation of CareTV in care for the elderly: The effects on feelings of loneliness and safety and future challenges

Abstract

Background: The number of lonely elderly is expected to increase due to demographic changes. CareTV is a technological solution, which allows users to interact with carers, family and friends from their home. In prior research users mentioned that CareTV expanded their social contacts, but it had not been measured if feelings of loneliness as a consequence have decreased. Objective: Investigate whether CareTV is a valid instrument for elderly to engage in meaningful social contacts by a video connection to avoid loneliness. Evaluate the implementation process and identify the remaining future challenges. Methods: From March 2008, elderly people receiving homecare from Proteion Thuis were informed about CareTV and asked to participate in the study. The CareTV duplex video/voice network allowed clients to communicate 24 hours, 7 days a week with a nurse practitioner. Applications of CareTV are (1) Alarm Service (2) Care Service (3) Good morning/good evening service (4) Welfare and housing and (5) Family Contact. During the one year trial period, feelings of loneliness and safety were measured using a questionnaire. In addition, clients' experiences were evaluated in open questions in the survey. The implementation was evaluated retrospectively with a framework developed by Broens. Results: 180 clients of homecare organization Proteion Thuis were connected to CareTV. 130 clients with the average age of 73.2 years were included in the study. The results show that the average feeling of loneliness at group level significantly ( p< 0.001) decreased from 5.97 (sd 2.77) to 4.02 (sd 3.91) between the start and end of the study on a scale from 0 till 11. Social loneliness (5-items) as well as emotional loneliness (6-items) showed significant decreases. To evaluate safety, no sum score could be calculated, but on item level: for 5 out of 9 items, most clients felt less safe after one year. For one item most clients had improved feelings of safety and for three items, most clients had an equal score. Evaluation of implementation shows what has been done and what needs to be done in future for the specific determinants. Conclusion: Feelings of loneliness significantly decreased within one year. As loneliness is a problem in an estimated 30-40% of the elderly, CareTV seems to be a suitable instrument for elderly, to live longer at home with less feelings of loneliness. Feelings of safety on item level did not seem to improve, this might be due to the fact that no validated scale was used. On the other hand, individual clients indicated that they felt safe with careTV. In future, a study with a validated safety scale should be performed in order to clarify the effect of CareTV on feelings of safety. The analysis of the development and implementation process indicates that the business development approach may be strengthened and that the homecare organization itself may take the lead in that process.