The use of Telecare to support people with dementia to remain living in their own homes

Abstract

There are currently 820,000 people in the United Kingdom living with dementia and around 670,000 partners, family members, and friends providing them with support. The behavioural disturbances and memory loss that typify dementia can make the role of caregiver extremely challenging. The consequent burden that many carers experience is closely associated with the care receiver’s admission into institutional care. Due to the UK’s ageing population, the number of people with dementia is set to rise to over one million by 2021. Consequently, the UK government is keen to explore different options to support carers, and to meet the increasing demand on care services. One such option is telecare, which uses information and communication technology to help manage the risks of community living for people with dementia, and to support care delivery.

This thesis presents a hybrid simulation model, TeleDem, which explores the influence of telecare on the number of people with dementia able to remain living in their own homes. Discrete Event Simulation (DES) is a widely used Operational Research (OR) tool for modelling complex stochastic systems, and its successful use in healthcare applications and care pathways has been well documented. The hybrid approach used in this thesis enhances the capability of DES by combining it with elements of Agent Based Simulation (ABS) in order to capture the complexity of this human centric system. Statecharts, a key component of ABS, are used to convert the passive entities associated with traditional DES into autonomous beings (or agents) whose behaviour is determined by their environment and their interactions with other elements of the system. In the TeleDem model these transformed entities are better equipped to reflect the human beings they represent; capturing each person’s disease progression, level of dependency, and their informal carer’s level of carer burden. These factors then govern the person’s movement through the social care system. The TeleDem Simulation models the potential experiences of thousands of hypothetical telecare service users. This enables the exploration of a range of scenarios to inform planning decisions for the provision of telecare services for people with dementia.

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ORCID for Sally Brailsford: orcid.org/0000-0002-6665-8230

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