Tag Archives: assistive technology

Digital Leaders Week: Digital government – looking beyond Britain

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Image: Digital Leaders

This week, the Knowledge Exchange blog is marking Digital Leaders Week with a look back at some of our digital-themed blog posts from the past, and focusing on more recent digital developments.

Our blog has often taken an international view of digital transformation, looking for lessons that might be learned from cities and countries around the world that have been leading the way in making the most of digital technologies in society.

Singapore is one country that has been blazing a trail in digital readiness, and in October 2015, we reported on the city-state’s efforts to ensure that more and more government services could be delivered electronically.

Among the earliest innovations was eCitizen – a first-stop portal for government information and services:

“When the portal was first introduced it pioneered the concept of cross-agency, citizen-centric government services, where users transact with ‘one government’ (the ability to access several government services via the one website).”

That was impressive enough, but, as the Smart Nation website explains, Singapore has continued to explore how digital innovation can improve citizens’ lives. From assistive technology and robotics in healthcare and environmental news updates to autonomous vehicles and an app linking parents and schools, Singapore’s digital revolution is transforming the way its citizens live, work and play.

Closer to home, Estonia has been leading the way on digital government. Our blog post from August 2015 reported on the country’s pioneering approach:

“In Estonia, digital has become the norm, and most government services can now be completed online. They have managed to find a way of creating partnerships between the government, a very proactive ICT sector and the citizens of Estonia. As a result, the country of just 1.3 million people has become a leader in digital government.”

The article went on to highlight some of the key elements in Estonia’s approach to digital government:

  • An ID card (installed on a mobile phone), providing every citizen with secure and instant access to online services such as internet banking and public transport.
  • A national register providing a single unique identifier for all citizens and residents in Estonia.
  • Estonian government services, including verification of citizens’ identities, enabling them to vote in e-elections. Once a voter’s identity has been verified, the connecting digital signature is separated from the vote. This allows the vote to be anonymous.

In 2017, Wired magazine called Estonia “the most advanced digital society in the world.” And with good reason:

“Estonians have complete control over their personal data. The portal you can access with your identity card gives you a log of everyone who has accessed it. If you see something you do not like – a doctor other than your own looking at your medical records, for instance – you can click to report it to the data ombudsman. A civil servant then has to justify the intrusion. Meanwhile, parliament is designed to be paperless: laws are even signed into effect with a digital signature on the president’s tablet. And every draft law is available to the public to read online, at every stage of the legislative process; a complete breakdown of the substance and authorship of every change offers significant transparency over lobbying and potential corruption.”

Our blog noted that there were lessons for the UK to be learned from the Estonian experience:

“…it’s clear that when government, the private sector and citizens come together, it is possible to create a society that is digitally connected.”

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In 2019, Idox Elections has gone from strength to strength, delivering local and European Parliament elections in the UK. In addition, Idox made electoral history in Malta, using an Electronic Vote Counting Solution to count the country’s European Parliament election ballots for the first time. Idox’s e-counting software successfully reduced the counting time from days to hours, delivering the poll results in record time.

Assistive digital technology and older people: technology “bricolage” in dementia care

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A key focus of social care teams today is helping people to grow old at home, safely, with dignity and with appropriate levels of care if needed, without breaking the budget. Increasingly, local authorities are looking to advances in technology to facilitate this “growing old in place”.

Telecare packages and assistive technologies are often the preferred way for care teams to deliver social care in a home setting. And in situations where care is required around the clock (for example, support for people with dementia and other life limiting degenerative diseases), families and carers are adapting everyday technology and integrating it into their care-giving in order to supplement the telecare provided by local authorities.

Notruf und Hilfe für Rentner und Kranke

 

Bricolage in dementia and elderly care

Bricolage means adapting an object to allow it to carry out a function which was not necessarily its original intended function. Relatives who care for loved ones with dementia, often adapt everyday objects to help them with their day-to-day caring. They find new, innovative and often non-conventional ways to use technology in diverse ways.

dementia post it

One example from dementia care was a man who bought a chicken ornament with a sensor which “crowed” whenever anyone walked past it. He placed it beside the front door so that if his wife, who suffered from dementia, walked up to the door to go out, he would hear and be able to go to her.

Other examples of technology being adapted include: setting alarms and reminders on mobile devices to remind people to take medication, or using webcams to act as personal CCTV so familly carers can monitor loved ones when they go out, or go into the next room.

These examples show that objects don’t have to be digital in order to be effective. The rise in capability of digital technologies and the relative decrease in cost, however, means it is often quicker and easier for families to invest in additional technologies themselves, rather than waiting for an assessment and an allocation of additional technology from their council.

Image by Buddi

Image by Buddi

Ethical challenges

Although there may be practical motivations, some charities have expressed concern about the ethics of some of the practices regarding adaptation of digital technology to form part of an assistive care package. While they recognise the strain of caring is significant for many people, rigging up a webcam in each room to allow you to “monitor” a loved one, or attaching a GPS tracking bracelet, for example, while often done with the best of intentions, could be interpreted as a breach of human rights.

Active assistive technology (technology which requires an active call for assistance) rather than passive technology (which is constantly monitoring) may be a better way of using technology ethically. It may also be used as an additional stimulant or interactive tool to allow patients to communicate. Apps and interactive devices, such as tablet computers, can inform a carer or loved one that someone had been using the app (providing a type of reassurance and monitoring) and the activities the app promotes might also be a visual stimulant and a communicative tool. The Dementia Citizens project has adopted this method and aims to help people with dementia and those who care for them, using apps on smartphones and tablets.

Dementia Citizens from Nesta UK on Vimeo.

Final thoughts

If we are mindful of the ethical challenges of integrating more technology into care, it might be possible for families and carers to work with social care and assistive technology development teams to adapt the tools available in a more empowering way. It might also mean that the onus is not on carers and their loved ones to build what they can from the standardised telecare provided by local authorities.

Bricolage in assistive care has, for many families, become the norm without them realising it. By adapting and supplementing assistive technology, like telecare packages, with non-assistive technologies or adapted additional digital technologies, families and carers can create a bespoke and personalised care package.

In future, understanding the extent to which families and carers adapt the technology given to them, could help creat more flexible care packages which can be more easily adapted to suit individual needs.