Big brother or brave new world? Telecare and its implications for older people's independence and social inclusion

Telecare is advocated as a means of effectively and economically delivering health and social care services in people's homes, using technology that can monitor activities and safety, provide virtual home visiting, activate reminder systems, increase home security and convey information. Significant planned investment by central government will be rewarded if telecare results in fewer older people requiring institutional care, and more remaining independent in their own homes longer than would otherwise be the case. This paper, which reports on focus group work with older people, carets and professional stakeholders, considers key issues rarely addressed in provider-led studies. Emerging social policy implications centre on the potential impact of telecare on service users' autonomy and privacy and, controversially, as a replacement for human support. We argue that the development of relevant policy and practice in respect of telecare has to pay close and careful attention to concerns held by all stakeholders, particularly in regard to individual choice, surveillance, risk-taking and quality of service.