The telecare hype

‘Telecare’ is an umbrella term referring to the technical devices and professional practices applied in ‘care at a distance’, care that supports chronically ill people living at home. With telecare, the formal or informal carer is not in the same place as the person receiving care. Instead, carers use new communication tools such as webcams, electronic monitors, email and websites to interact with patients, transmit data and provide instruction. Strictly speaking, the telephone is also a distant-care device and it is often central to making telecare practices work. The term telecare, however, commonly refers to the new technical arrangements for care or, as the critics might say, to a new hype in care.

Hype is indeed a part of the introduction of telecare in health care. Innovations in telecare have seen optimists and pessimists hurrying onto the soapbox to proclaim their opposing views. Innovative practices are by definition not well researched, and these soapbox speeches emphasise either their pros – the promises telecare is bound to fulfil – or their cons, the nightmares it will inevitably bring.

The promises heard most often in the Netherlands, where the research reported in this book took place, concern improvements in efficiency.

Telecare promises to support care for a rapidly ageing population, when fewer younger people will be available to care for a rising number of older people with chronic diseases. This will have an even greater effect because telecare promises professional long-distance carers reciprocal support from their patients. Decision makers portray modern patients as active, eager and well able to care for themselves. They claim that telecare will help patients manage their own care even better. In addition to claims for the more efficient use of personnel capacity, there is a very different efficiency promise: telecare will reduce the cost of health care. Both types of efficiency alternate in telecare proclamations (see Chapter 7).

The inevitable nightmares, on the other hand, are full of grim images of care turned cold. Older people, instead of moving into a care institution when their minds and bodies start to fail, will have to stay at home, surrounded by all kinds of cold mechanical devices, receiving no support from caring people.