Telecare and Assistive Technology

Telecare is the use of electronic devices and sensors to monitor the safety and wellbeing of people living at home, enabling them to summon help or triggering an automatic alert when a problem is detected. It forms part of the broader category of assistive technology, which includes any device, product, or system that helps a disabled or older person carry out daily activities more safely or independently.

The most familiar form of telecare is the personal alarm — typically a wearable pendant or wristband with a button that, when pressed, connects the user to a 24-hour monitoring centre. The operator can speak directly with the user, assess the situation, and contact a responder (a family member, a volunteer responder, or in an emergency, the ambulance service). This basic system has been proven to reduce response times to falls and other medical emergencies and to give older people and their families confidence to live and be supported at home.

Telecare has evolved considerably beyond the pendant alarm. Modern systems can include:

• Fall detectors: Worn on the wrist or waist, these detect a sudden impact and change in posture consistent with a fall, triggering an automatic alert even if the user cannot press a button
• Movement sensors: Installed in key locations (kitchen, bathroom, bedroom) to detect expected patterns of activity and alert carers if the pattern is broken — for example, if no movement is detected in the kitchen by a usual time in the morning
• Door and window sensors: Alert when external doors are opened at unusual times, particularly useful for people with dementia who may leave the home at night
• Environmental sensors: Detect hazards such as smoke, carbon monoxide, extreme temperatures, or flooding

Most local councils in England provide a telecare service, often delivered through the adult social care department or through a commissioned provider. Council telecare typically includes equipment installation, a monitoring contract with a 24-hour response centre, and usually a regular check of the equipment. The typical cost for a council telecare service is £4–£8 per week, though this varies by council and scheme.

Access to council telecare usually starts with a referral from a social worker, OT, GP, or hospital discharge team. Some councils allow self-referral. A basic needs assessment helps determine which telecare devices are appropriate. For people with a care package or direct payments, the cost of telecare may be included in the care package budget. For others, the weekly charge is paid privately but is still subsidised compared with commercial rates.

Many councils have commissioned technology-enabled care (TEC) programmes that go beyond basic alarms, proactively using assistive technology to prevent or delay the need for more intensive care services. If you are being assessed for a care package, ask specifically about what telecare or assistive technology options are available through the council — not all social care workers proactively offer this as an alternative to or complement to personal care.

For those who are deafblind, have complex communication needs, or require highly specialised equipment, councils may refer to specialist assistive technology services through the NHS or independent providers. The Royal National Institute of Blind People (RNIB) and Sense are examples of organisations with specialist expertise in assistive technology for sensory impairments.

The private telecare and assistive technology market has expanded significantly, offering a wider range of products than council services typically provide. Private providers include dedicated telecare companies (such as Tunstall, Alertacall, Careline365, and Age UK's own telecare service), high street retailers, and technology companies offering smart home products adapted for older users.

Private telecare services typically charge a set-up fee plus a monthly monitoring fee, ranging from around £10 to £30+ per month depending on the sophistication of the service and devices included. Premium services may include:

• Daily check-in calls to confirm wellbeing
• GPS tracking devices for people who go out independently
• Video doorbell systems so users can see who is at the door from a tablet or phone
• Medication management devices — automated pill dispensers that prompt at the correct time, dispense the right medication, and alert carers if a dose is missed
• Cognitive assistance apps and reminder devices for people with memory difficulties

Smart home technology — including voice-activated assistants (Amazon Echo, Google Home), smart lighting, smart plugs, and automated blinds — can be adapted to support independence for people with limited mobility or dexterity, allowing control of the home environment without needing to reach switches or operate complex controls. These technologies can also be configured to support cognitive or communication needs, though setup support may be needed from a digital inclusion service or specialist OT.

For people with dementia who are at risk of getting lost or leaving the home unsafely, GPS location devices can provide reassurance to carers and a lifeline in emergencies. GPS trackers can be worn as a wristband, watch, or in a pocket or bag, and allow a carer or family member to locate the wearer via a smartphone app in real time. Some devices also have fall detection and two-way calling.

Using GPS tracking raises issues of consent and dignity that should be considered carefully. Where the person with dementia has capacity to decide, their agreement should be obtained. Where capacity is lacking, a best interests assessment (typically involving family and professionals involved in care) should support the decision. The Mental Capacity Act 2005 provides the framework for this. SCIE and the Alzheimer's Society publish guidance on the ethics of GPS tracking for people with dementia.

The Alzheimer's Society operates the Herbert Protocol in partnership with police forces — a scheme where carers complete a profile of the person with dementia (description, photograph, habitual routes, medical information) that can be shared instantly with police if the person goes missing. Registering for the Herbert Protocol is free and can significantly speed up a police response. Contact your local police force or Alzheimer's Society branch to register.

Councils and NHS bodies are increasingly adopting digital social care programmes that integrate telecare with care coordination software, enabling care teams to respond to alerts more efficiently. If you manage care for a relative, ask the council's social care team whether their telecare system integrates with the broader care package and how alerts are handled out of hours.