Improving the lives of the Elderly in our society

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by Deepak Samson – Founder & CEO of Ethelcare

Most of us will live into our old years thanks to the advances in healthcare, improved diet and the vast reduction of heavy industrial work with the long hours endured by our forebears.

Inevitably the result in many advanced economies is an ageing population – in the UK alone there are more than 12 million people, roughly 20% of the population, over the age of 65. This should be seen as a great success. However, it comes with ever-increasing demands on our healthcare systems and on close family and friends – all of whom are doing their level best to ensure a longer life means a happy and dignified one also for their elders. Sadly around 5 million live alone.

Most of us are aware that Health and social care services in the UK were facing unprecedented challenges even before Covid. When the NHS and Social Care system was designed in the late 40s and 50s, it never really took into account that most people will be living longer and with complex needs. This growing realisation became a crisis when Covid hit.  Covid decimated, albeit temporarily, an already struggling system. Post the worst of Covid (hopefully) at least in the UK, there is now an appreciation that we can rebuild our health and care systems in a different (and better way) way – one which best serves the ageing demographic and puts a greater emphasis on independence and wellness (rather than institutionalised and episodic care.)

There is wide recognition that providing good quality care and support for elderly people at home not only improves the quality of their lives but can prevent minor ailments escalating to the point where hospitalization is required.  Demand for ‘care at home’ continues to rise, both within the publicly funded and private domiciliary care systems, and both are regularly short of capacity and post-covid more so.

This has a direct impact on both ends of the hospital system, with admittances into hospital by elderly patients, many of which could have been prevented with improved home care services, and delays to their hospital discharge as insufficient support is available in the community.

Part of the problem is that funding in many systems is based on ‘(re)activity’, not prevention – funding a healthcare provider to fix a broken leg is straightforward; much harder to fund someone to prevent the leg from breaking in the first place.

Last year, in the UK alone, 1.4 million requests were made for adult social care support but regrettably, only 410,000 people were given some sort of support.  Apart from being chronically lonely and struggling with personal care, many of the remaining 990,000 will struggle to manage their medications at home without enough support. On top of this, the role of home care workers is not highly rewarded, meaning there is a vast turnover of such staff – approx. 30% per annum, which exacerbates the problem and unsettles those lucky enough anyway to receive these services.

One of the few benefits of the Covid crisis has been the widespread adoption of remote, cloud-based Technology. Consumers as well as Healthcare professionals, traditionally the most conservative to relinquish their handwritten notes, are more and more attuned to technology being an integral part of their lives. Although Telehealth has been a multi-billion business for a while, it is aimed at the ‘digital natives’. This Netflix phenomenon is or will be seen to be playing an increasingly central role in caring for many of those previously ‘left behind’.

There is now a new breed of Entrepreneurs looking at ElderlyTech. It is now possible to combine the friendly easy to use requirements of the Elderly and their loved ones- who can have access 24×7 with the more stringent data needs of healthcare professionals. Designing a system that achieves both, demands years of research and sensitive implementation.

With all the years’ experience of being a former NHS Manager, I founded Ethel to do both, and so improve the quality of life of the Elderly, give reassurance to their family and friends and help to relieve some of the pressures on the NHS and Social Care, as well. I hope you agree that this is a ‘Nobel Mission’!

What is Ethel?

While working in the NHS, I realised that there was a multitude of ways that tech could help the Health and Care Services to cope with its workload, especially in elderly care. It boils down to the workforce – currently, a significant number of health and care staff (and family carers) visit elderly patients and relatives, in order to make sure that they get personal support and also (increasingly) help them with their medication.

This massive dedication of people, time, and money seems out of sync in the high-tech world of smartphones, tablets and watches. However, where smartphones make communication easy for digital natives, it is not so simple for the cohort of the population that has never engaged with smart technology (and these are the ones that need digital services.)

Thinking about how easy communication is nowadays, but how unfamiliar elderly people are with digital technology, I set out to create a solution which at one end enabled organisations to manage large cohorts of the elderly population at home and on the other end enabled an elderly person to engage with technology and receive ‘digital care service’ from staff and family.

I created Ethel, a platform for organisations and families to manage their patients and loved ones. The Ethel platform also includes the Ethel Smart hub – an extra-large touchscreen tablet solution, specifically adapted to be extremely easy to use for people who have never used this kind of technology before.  It is adapted for elderly people in a number of ways – very large, always-on, and all the management of the device is done remotely, by a family member or carer.  To tackle visual and dexterity problems, all of the icons and buttons on Ethel are limited in quantity, large, and generously spaced.

The Ethel device is so minimalist in design and so intuitive,  that whilst there is a whole ecosystem of technology working away in the background, all the user needs to know is that if they press a photo of their son, Ethe will call him.  I think the best analogy is a cash machine. There are six buttons, and you use those six buttons to get money out, check balance, etc.  Essentially what you have done interacts with a very complex piece of hardware and software, but you don’t need to know that, you just need to know that when you press certain buttons, money comes out. So I designed something that works for elderly people, in the way that an ATM works for us.

We don’t have enough of a workforce to visit everyone who needs to remember to take their medication, but if they don’t take their medication, they end up back in the hospital. So, what I have found is that care teams and families are crying out for tools to look after elderly loved ones, and medication management is one of them.

With more people in the UK living with mild dementia, they are perfectly able but frequently forget to take medication. A prompt at the right time not only solves this problem, but it also is less intrusive than having a person walking into your house and giving instruction. Ethel works on a ‘manage by exception’ approach, instead of sending a carer to an individual’s house every day, interventions only need to happen when a red flag is raised – such as a failure to interact with the green button – which is both a less invasive and far more cost-effective way of delivering care.

As well as medication, Ethel also works as a tool to help individuals with their outpatient care. Through Ethel, a doctor or physio can record videos of rehabilitation exercises that the patient needs to remember to do and upload it to their ethel, along with a reminder prompt. Then the next day, Ethel will bring up the prompt, along with the video explaining how and what they need to do. This way not only can doctors be reassured that the patient is doing the correct exercises, but also keep track of whether or not a patient is adhering to their physiotherapy schedule.

As a health and care system, we are extremely entrenched in our ways of doing things, especially in social care. When something has been done a certain way for fifty years, it is difficult to see a path to a new way of delivering services. But despite the challenge, Ethel was able to find clients willing to take the leap and thankfully is now being used by 10 local Authorities, providing an enhanced level of care but at a fraction of the cost.

What’s in store for the future?

In five years’ time, I want Ethel to be the solution of choice for elderly home care, where it’s a hybrid model of virtual care and hands-on care. It is entirely possible to have a level of acute hospital care delivered in a person’s own home.  And patients who are medically fit to be discharged home, are not in an NHS bed but discharged home with a complete digital wraparound service through the Ethel platform.

Covid has just shown us why we need a blended approach to home care.  And this is just the beginning, Ethel’s leadership team have strong plans for its future which includes sensors, AI, wearables and even fintech! I am grateful to have the support of my friends at ScaleUp Group in this ‘Noble Mission.’

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