Background: Older adults that have Technology Enabled Care (TEC) have some of the highest risks of falls but struggle to access evidence based proactive approaches.

Approach: We used participatory design to explore the problem and test solutions within Lanarkshire in the West of Scotland with some input nationally. Stakeholders engaged with included older adults, those they draw on for support and care from and the professional workforce across independent, voluntary, health and social care sectors. Lived experience input was supported by local and national 3rd sector organisations. In total 6 lived experience workshops, 2 professional interviews, 2 professional workshops were held. We also completed 1 lived experience national survey with 73 responses.

Results: Older adults told us they were unaware of how to prevent falls and blamed themselves for happening.  They described tensions between themselves and informal support.  Staff who provide formal support were often unsure what to do if someone fell.  Specialist staff didn’t always know about people who fell due to difficulties sharing information.  All staff wanted to be able to see the information that different services hold about a person to see the fullest picture. Currently rules around sharing information make this difficult. Therefore, to access support, people repeatedly tell parts of their story to different staff at different times.  Those that are drawn on for support and care were more open to using digital tools than older adults.

Implications: Learning from our participatory design and the national role out of a single digital TEC system we plan to support people to access services differently. Firstly, providing a digital space to have information about themselves stored in ways that are secure and only they control; Personal Data Store (PDS). Secondly providing individuals and their informal support a virtual front door (website or similar). This will give personalised community support/ guidance. Included will be physical activity interventions, including evidence-based falls-prevention classes.  We will then link these electronically to relevant professional teams including TEC infrastructure but also to the PDS.

Later they may need support from the staff who respond to falls, leisure teams or similar.  They can then share their ‘About Me’ information and history from their PDS to aid personalised support.

Recognising the challenges of digital literacy in older adults we will pilot this model with at least 20 people that provide support and care. They will help mediate input for those they support. For a number of those will already use TEC. This will all be done in a research environment initially with fake data. If possible, we will step this up to using the persons own data. We will ensure we have consent to do this and take feedback from those involved to refine the model and separately evaluate the work.

This pilot will give stakeholders a common understanding of it including benefits, building confidence and supporting sustainability. It has the potential to improve both relational and proactive care whilst sustaining services. This, at a time when it is most needed.