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Technology is quickly becoming an integral part of care systems across the world and is frequently cited in policy discourse as pivotal for solving the ‘crisis’ in care and delivering positive outcomes.
Exploring the role of technology in Europe, Canada, Australia and Japan, this book examines how technology contributes effectively to the sustainability of these different care systems which are facing similar emergent pressures, including increased longevity, falling fertility and the consequences of the COVID-19 pandemic.
It considers the challenges and opportunities of embedding technologies in care systems and the subsequent outcomes for older and disabled service users, carers and the care workforce.
This final chapter provides a summary of the main issues identified within each of the selected nations covered in the book. It emphasises key points of convergence across these nations, including the array of care ‘systems’, internal diversity and fragmentation of such systems, prevalence of sustainability discourses, the ‘ageing in place’ agenda, precepts of ‘choice’ and ‘control’, the digital divide, and divergent and variegated responses to the COVID-19 pandemic. The chapter and Policy Press Short conclude with recommended priorities for policymakers and practitioners and identifies areas requiring further research within the field.
This introductory chapter reviews and positions this edited book’s underpinning concepts of care, technology and sustainability. It defines the editors’ and contributors’ cross-national, comparative analytical approach to characterise the ‘state-of-the-art’ within each nation and evaluate thematic areas of policy and practice divergence and convergence. It concludes by presenting nations included in this volume (England, Australia, Germany, Canada and Japan) and justifying their selection with reference to contemporary research on their orientation to care regime and welfare regime typologies.
This chapter explores Japan’s demographic changes, the shifting role of the family and related pressures on care provision. The author outlines the country’s approach towards introducing technology into the long-term care (LTC) system, including in residential care settings and for those living in their own homes. The integration between LTC and technology-based services reflects great hopes and possibilities to overcome various challenges related to the ageing of Japan’s population.
Germany is facing significant challenges in meeting the demand for care against the societal background of advanced population ageing. The use of assistive technologies is considered an important element in solving care worker shortages and in enabling older people to ‘age in place’. Today, 80 per cent of Long-Term Care Insurance (LTCI) beneficiaries are being cared for at home. In this light, the lack of a clear government strategy on Assistive Technologies (AT) for home care is amazing. Various central government departments work with varying, partly conflicting objectives. While social care is strictly regulated by legislation, AT are only beginning to make their way into legal frameworks. Three prerequisites for a successful integration of AT into home care delivery are identified in this chapter: 1. nationwide fast and reliable Internet access; 2. a clear central government strategy for integrating AT into legislation governing social care; and 3. co-creation of AT by scientists/engineers and their intended user groups.
This chapter begins by setting out the context of the English adult social care system, including funding and policy, key statistics, and the hopes invested by the government and local authorities in the use of technology to cut costs while improving the quality of life of older adults.
The deployment of digital technologies intended to facilitate the delivery of care is then examined, including telecare and telemedicine devices; robotics and information and communications technologies (ICT); consumer electronic devices, apps and websites; and ICT infrastructure and data. The impact of the COVID-19 pandemic on technology uptake and use is also discussed. The next section presents recent research evidence on the use of different technologies in English social care, including studies of telecare as well as other digital technologies.
The chapter concludes by setting out several key challenges facing the effective implementation of technology in the care sector in England.
This chapter focuses on policy and practice related to care and technology in Canada. The authors highlight that the federated government structure (a central federal government and thirteen semi-autonomous provincial/territorial governments) results in overlapping jurisdiction over continuing care services, and the lack of a legislated mandate to provide these services means that Canada lacks a national social/long-term care (LTC) ‘system’. The chapter then describes how technology is harnessed in the delivery of care in Canada, with a focus on four key areas: 1. care management/coordination; 2. smart homes; 3. outdoor tracking; and 4. communication technologies. Recent empirical evidence related to technology and care in Canada is also explored.
Australia’s major aged care policy reforms in 2013 introduced a consumer-directed care (CDC) funding model as a core component that sits within the policy framework of ageing in place. CDC is intended to provide older people with choice and control in their living and care arrangements through access to needs-based, means-tested home care packages (HCPs) that specifically allow for the purchase of technology to provide support to remain in one’s own home. Available evidence indicates technology use (assistive/digital) can support older adults’ independent living and improve physical well-being, self-care and social connections. This chapter provides an overview of Australia’s policy framework around aged care and ageing in place, and reports on our research studies identifying issues related to knowledge and use of technology (scoping reviews, interviews), including the role of health professionals. Recommendations are made for advancing research along with strategies enabling professional support for older adults’ use of assistive/digital technologies.
This chapter sets out the rationale for comparative social care research in the four nations of the UK, along with key theoretical approaches and research methods. It highlights the extent to which social care in England, Scotland, Wales and Northern Ireland is facing a crisis, further deepened by the COVID-19 pandemic. It defines adult social care and gives an overview of the devolution settlements in the four nations. It sets out the method for the interviews and document analysis that are drawn on in the rest of the book, and summarises the chapters that follow.
This chapter summarises the findings of the book and considers how policy makers can more productively engage with the tensions between the two care paradigms in order to move towards a more sustainable care system. By making these paradigms explicit, the book exposes key points of difference, and why care reformers often speak past each other because they are focused on different means and ends. The paradigms shape both specific mechanisms for reform as well as broader questions about what sustainability means in a context of care. Drawing out the paradigms enables us to ask questions about wellbeing, fairness, quality, rights and sustainability in care.