Guide Guide 6 Telecare and telehealth: what it is and how to get it Telecare and telehealth is technology that can be used to help you live safely and independently in your own home. This guide covers the different types of telecare and telehealth, how to get it, and how to decide if it is right for you. The Independent Age advice service offers free information and advice on issues affecting older people. All the guides we publish are available from our website www.independentage.org and paper versions can be ordered by calling 020 7241 8522. You can also call our advice line on 0845 262 1863 to arrange an appointment to speak to one of our experienced advisers. Independent Age is a unique and growing charity providing information, advice and support for thousands of older people across the UK and the Republic of Ireland. There are differences in the ways each country cares for and supports older people. The information in this guide applies essentially to England, although there may be similarities with countries in the rest of the UK. We also produce five separate guides for both Scotland and Wales covering the needs assessment process; paying care home fees and making a formal complaint, which are the key areas where the policy and legislation differs significantly from England. All of the guides we publish may be downloaded from independentage.org or posted to you if you call our guide order line on 020 7241 8522. This guide was last updated in June 2013. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 2 Contents 1. What is telecare?.............................................................. 5 2. Types of telecare.............................................................. 5 Movement detectors.......................................................... 6 Alarms............................................................................. 6 Sensors............................................................................ 6 Reminders......................................................................... 7 Sensory impairment alarms.................................................. 7 Carer’s alerts...................................................................... 7 Location sensors................................................................. 8 Activity monitoring – telecare and non-telecare systems........... 8 3. When to use telecare......................................................... 9 Is telecare appropriate for you?............................................. 9 4. How can I get telecare?..................................................... 11 What if the telecare package offered is too limited?.................. 12 What to do if you want to complain........................................ 12 Will telecare affect my existing package of home care services?.. 12 How much does telecare cost?............................................... 14 Can I get telecare privately?.................................................. 15 Does the condition of my home affect my ability to use telecare? 15 5. Examples of how telecare can be helpful or unhelpful........ 16 Supporting independence...................................................... 16 Reducing independence........................................................ 17 Supporting mobility.............................................................. 18 Supporting carers................................................................. 19 Supporting people with dementia........................................... 21 6. Care homes and telecare................................................... 22 7. What is telehealth and how do I apply for it?.................... 23 Guide 6: Telecare and telehealth: what it is and how to get it April 2013 3 8. Things to consider............................................................. 24 Guide 6: Telecare and telehealth: what it is and how to get it April 2013 4 1 What is telecare? Telecare means using technology to support people in need of care or assistance. For example, you may be familiar with community alarms worn as a pendant or the pull cord alarms, often found in sheltered accommodation and accessible toilets. This is telecare equipment. Telecare sensors have now also been developed to detect other problems. For example, sensors can be used to detect if you have not moved for some time, if you have left a tap running or left the gas on. The telecare sensors will then alert you, your carer or a response centre, to the problem. Most systems use a telecare control box connected to your telephone line, which connects you to a response centre, although some systems also require an internet connection. If you trigger an alarm or sensor, a member of staff from the response centre will call you back to see if you are alright. You do not have to pick up your phone, as you will be able to hear the member of staff through a loudspeaker on the telecare control box. If you do not respond, the member of staff will contact someone you have identified to help, such as your carer, neighbour, or another support staff member. They will come out and see if you are alright, or call the emergency services if needed. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 5 2 Types of telecare The different types of sensors and detectors are listed below. Movement detectors If you are prone to falls or experience confusion, sensors can monitor your movements. They can also detect if you are in or out of your bed or chair, how much movement there is in a room, or when you are leaving a building. Pressure mats can be placed beside beds, to detect if you have fallen down or fall detectors can be worn on your clothes during the day. Sensors can also be linked to other electrical equipment in the house, such as bed occupancy sensors that link to the light switch when you get out of bed, or to the bathroom light switch so you are not struggling to find your way in the dark. Alarms Alarm buttons or cords can be placed around your home, so that they are easily accessible if you need to call for help, and you can also wear a personal alarm as a watch or pendant. Alarm systems can even be used to provide support against bogus callers or intruders. Sensors Sensor can detect problems such as: gas, if a cooker has been left on unlit; water, if a tap has been left on or there is a water leak; heat, to detect fires; extreme temperatures, to detect if it is very hot or cold; and carbon monoxide or smoke. Sensors in more sophisticated systems can link to automatic systems that could shut off the gas supply, as well as alerting you, your carer and/or a response centre. There are also enuresis (bed- Guide 6: Telecare and telehealth: what it is and how to get it April 2013 6 wetting) sensors, which can detect moisture and can be placed between the mattress cover and bed sheet. Reminders These include medicine dispensers, which use a sound alert to remind you to take your medicine. The compartments of the medicine holder will open at the right time, on the right day. You, your carer or care worker (or in some cases, your pharmacist) will need to fill the medicine holder beforehand. Voice message reminders are also available, to ask if you have taken your medicine, or had lunch, for example. If you do not respond, an alarm is raised. Sensory impairment alarms If you have a sensory impairment, these devices can sound, flash or vibrate to tell you if the alarm has been raised. For example, if you are blind and there is a fire, you could be alerted by hearing an alarm sound. Vibrating alarms can also be placed under pillows, which may be helpful at night if you have a hearing and/or visual impairment. If you have a hearing impairment there are also beacons, which can show you visually that the alarm has been raised, as well as inductive loop systems to help you hear the operator clearly during alarm calls. Carer’s alerts If you are a carer, there are devices that feature both sound and vibrating alarms. These alerts can help you not to worry quite so much about the person you care for and may even help you get more sleep, knowing that you would receive an alert should the person you care for get up at night, or leave their room for longer than is usual, for example. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 7 Location sensors These are used outside the house for you to either call for help while you are out, or for you to be traced if you get lost. Activity monitoring - telecare and non-telecare systems These systems monitor the movement and activities of your household. They give useful information on your needs and can be used by social services to tailor a care package to your needs or to check that your existing care package is working. Friends or relatives can also monitor your activity to make sure that you are, for example, moving around your home and using your kitchen at meal times. Your relatives would, of course, need your consent to monitor you in this way. They would also need to think carefully about if or how they could use the information being reported. For example, just because someone is in the kitchen, it does not mean they have prepared or eaten a meal. Other monitoring systems may ask you to press a button at specific times during the day to confirm that you are ok. If you do not press the button, then staff from a response centre will phone you. Please note, not all activity-monitoring systems are connected to response centres or are available 24 hours a day. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 8 3 When to use telecare The first thing to consider is whether telecare is the best option for both you and your carer, if you have one. For many people telecare raises concerns, from feeling like they are living with ‘Big Brother’, to the security of their information, particularly with regard to monitoring systems. There are also issues about agreeing to telecare, particularly for people with dementia who are not able to give their consent. If this is the case, then the people who knew the older person well before they lost their mental capacity should be consulted, and/or the older person’s wishes and previously known preferences should be considered. It may be helpful to have an independent advocate to help make this decision. Is telecare appropriate for you? It is important to consider how you will use the sensors in order to ensure the full benefit of the system. It may be helpful to consider the following: • Will you be able to use the equipment properly? Are the buttons suitable for any disabilities you may have, for example, arthritis? • Can you hear the response centre staff if they should call you? • How will you know if you have triggered a sensor? Can you hear the control box being activated or do you need a visual alert? • Will you recognise the equipment and what it is meant to do? If you have a condition like dementia, this could be very disorientating; you may not understand what the noise is, whether a heat detector is sounding or where the voice is coming from if the response centre staff are calling you. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 9 Even if you fully understand and agree to telecare systems in your home, they may not suit your lifestyle, or you may forget to use them or simply not like them. If, despite this, you would still like to use telecare, ask the company or your local council for other suggestions of telecare devices that may be more suitable. Your existing system may require adjusting to meet your individual needs. Case Study Patrick had fallen in his home a number of times. Each time he fell, he was not wearing his pendant because he did not like wearing it. He was assessed for telecare and it was suggested that he could wear a fall detector on the waistband of his trousers. Patrick felt that he would forget to put this on when he got dressed in the morning, and he was not sure he would be able to fit the fall detector onto his waistband, as he had arthritis in his hands. A telecare specialist asked if Patrick ever wore a watch and Patrick said that he did. The telecare specialist suggested that Patrick consider wearing a watch fitted with an alarm inside it. Patrick liked this idea, as the watch did not look like an alarm. In his review, Patrick said that he found the telecare wristwatch easy to remember to wear and felt comfortable with it. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 10 4 How can I get telecare? Different councils offer different telecare services and have different eligibility criteria to receive telecare. You will need to contact your local council social services to find out what is available in your area. Councils will often include information about telecare on their website. To find out if you are eligible for telecare from the council, you will need to be assessed by your local council social services. Before requesting an assessment for telecare, it is important to consider if there is other help from the council that you may also benefit from. For example, if you have mobility problems and don’t want to just rely on a telecare alarm system once you have fallen, you may also benefit from an occupational therapy assessment to see if aids and adaptations in your home may prevent you from falling in the first place. If you feel you may also benefit from services such as meals being delivered, attending a day centre or carers visiting you, it may be more appropriate to ask for a full needs assessment from social services. For more information on the assessment process, see our guides: Assessment and services from your local council in England (Guide 12), Assessment and services from your local council in Scotland (Guide 52), Assessment and services from your local council in Wales (Guide 72). Guide 6: Telecare and telehealth: what it is and how to get it April 2013 11 What if the telecare package offered is too limited? If the telecare package offered is not suited to your needs, you may want to request a re-assessment, highlighting why you think the package offered is not meeting your needs and what additional help you require. However, some councils restrict the telecare they offer so, if they cannot provide any more assistance you may want to consider adding additional sensors yourself. Since the different companies offer different equipment, you will need to check the additional sensors would be compatible with your existing system. You will also need to check with social services and the telecare provider that they are happy for you to have additional sensors fitted and to ask them whether this would affect the charges for the telecare service. You can find out more about the different telecare products available, and how they work, from the Disabled Living Foundation (0845 130 9177, livingmadeeasy.org.uk). They are an independent charity and will not try to sell you products or services. What to do if you want to complain If you are not happy with the assessment or the services offered by social services, then you may want to consider making a complaint to them. For more information about making a complaint, see our guides: Complaints about community care and NHS services in England (Guide 18) Complaints about community care and NHS services in Scotland (Guide 54) Complaints about community care and NHS services in Wales (Guide 74) Guide 6: Telecare and telehealth: what it is and how to get it April 2013 12 Will telecare affect my existing package of home care services? Telecare can only alert you (or someone you have selected) to something that needs attention; it cannot replace the need for one-to-one care and support from another person. Introducing telecare services may, however, reduce the need for some home care visits from care workers. For example, if you receive telecare to remind you to take your medicine, you may not need care workers coming to remind or supervise you to take it; or if you have regular home care visits throughout the day to make sure you have not fallen, these could be replaced with telecare sensors which would raise the alarm should you fall. However, it is important to bear in mind that losing face-to-face support could end up leaving you feeling more isolated and lonely. The council must review your needs assessment before any services can be cut and replaced by telecare services. As part of this review, your emotional and social wellbeing needs should be taken into account. If you are worried about becoming socially isolated, it may be useful to find out if there are any befriending schemes or social groups in your local area. The Independent Age advice service can register you for our social inclusion projects, such as face-to-face befriending, Telephone Buddies and Live Wires, our telephone-based book and discussion groups. We can also provide you with the details for other national and local befriending schemes and also social groups, depending on the services in your area; and look for local community transport schemes to help you get out and about (0845 262 1863, independentage.org). Your local Age Concern or Age UK (0800 169 65 65, ageuk.org.uk) may also know of befriending schemes available to you. Some social groups for older people may also provide, or know of, transport to help Guide 6: Telecare and telehealth: what it is and how to get it April 2013 13 you travel to and from events. How much does telecare cost? Services provided by the local council are rarely free. You may have to pay for telecare in full, or contribute towards the cost depending on your income and savings. The value of your property will not be taken into account. The council will carry out a financial assessment to decide the size of contribution they think you can afford to make. Many councils charge a lower rate if you receive benefits like Pension Credit or Housing Benefit. We would recommend that you consider having a full benefits check, to ensure you are receiving everything that you are eligible to claim. The following organisations may be able to carry out a full benefits check, often during a home visit: • The Pension Service (0845 301 3011, Wales 0800 731 7898) • DIAL (01302 310 123) • Local AGE UK or Age Concern (in your phonebook or online) • Citizens Advice Bureau (England 08444 111 444, Wales 08444 77 20 20, adviceguide.org.uk, or in your phonebook) There is no set way that councils charge for telecare. Councils may charge different rates depending on whether your sensors are connected to a call system or you require a call out service to check on you. However, most telecare schemes are heavily subsidised by the council, with the sensors being provided free of charge, and a weekly charge to cover the cost of maintenance and the response centre costs. Every council should provide clear information on how they charge for their services. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 14 Can I get telecare privately? There are many companies that sell telecare equipment, although not many of these provide response centres or come out to visit you if a sensor is triggered. Before buying equipment yourself, it may be worth seeing if you can use the same response centre as the local council; and to check that the equipment you decide to purchase is compatible with their system. You can find out more about the different telecare products available, and how they work, from the Disabled Living Foundation (0845 130 9177, livingmadeeasy.org.uk) or your local Disability Living Centre. Contact Assist UK for details of your nearest Disabled Living Centre (0161 832 9757, assistuk.org). Does the condition of my home affect my ability to use telecare? Many telecare sensors are battery operated so will not be affected by your telephone connection, or the state of repair of your house. If you have a control box that needs to connect to a response centre, this will need to be plugged into an electrical socket and your phone socket. This means you may need to have your telephone socket or your electrical socket moved so they are closer together. You will also need to have a telephone connection that is in good working order. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 15 5 Examples of how telecare can be helpful or unhelpful Supporting independence At some point, you may find it difficult to manage in your own home but still wish to retain your independence. You may find the thought of care workers or family members checking in on you intrusive or it may be difficult for family members to do so on a regular basis. Minor issues such as forgetting to take your medicine or turning off the cooker can lead to much greater hazards, and may be easily resolved with telecare, enabling you to continue to live safely and independently in your own home. Case Study Barbara lives alone in her own flat and has always been independent and self-reliant. She has recently had some memory problems, but is very clear that she wants to remain in control of her life. Things came to a head when she had a fall after forgetting to take her medicine a few times. There was also an incident where her bath overflowed into her neighbour’s flat, when she left the tap on while she answered her phone. Her daughter, Susan, grew concerned about her mother’s ability to cope and worried about her safety. Susan wanted to keep her mother safe and started phoning Barbara several times a day to check she was OK. Barbara was increasingly irritated by Susan’s constant calls to check how she was and whether she had remembered to take her medicine. Following an assessment from social services, Barbara agreed to the installation of a medicine dispenser and a flood detector, which would alert her if needed. This meant Barbara was able Guide 6: Telecare and telehealth: what it is and how to get it April 2013 16 to take back control of her medicine, without needing to be continually reminded by a care worker, or her daughter. Barbara would also be alerted if she left a tap on, so she could turn it off before causing a major flood. These simple telecare solutions gave Barbara back her confidence, as well as her dignity. Knowing that the sensors were connected to a call system that could offer assistance should she need it, provided both Barbara and Susan with reassurance. Neither felt the sensors were too intrusive. Reducing independence You may find telecare intrusive, or feel that you are being undermined by even the suggestion of such equipment. You may have concerns over being monitored or accidentally triggering the alarms, or you may worry that you will be confused by the alarms and this could make the situation worse. You may simply feel that telecare does not provide the right solution for you and would prefer to look at the alternatives. Case Study Mary was an active 83 year old who sometimes forgot to take her medicine. One day she had a fall in her hallway as she hadn’t taken her medicine all week. It was so serious that Mary had to go into hospital. Her family were concerned and wanted her to consider having telecare to remind her to take her medicine and to wear a fall detector. Mary hated the idea - it made her feel as if ‘Big Brother’ would be watching over her, but to please her family she agreed to have an assessment with the telecare assessor from her local council. Talking to the telecare assessor, it became clear that Mary usually forgot to take her medicine with her when she went out. The assessor suggested Mary used a daily pill dispenser, which fitted inside her handbag. The telecare assessor also arranged for a fall specialist to visit Mary’s home Guide 6: Telecare and telehealth: what it is and how to get it April 2013 17 who suggested that the fall might have been due to rugs that had become loose and poor lighting in the hallway. The local Home Improvement Agency arranged for a handyperson to fit rug grippers so that the rugs lay flat and for an electrician to fit additional and brighter lighting in Mary’s hallway. Supporting mobility As you get older your mobility may be affected, which may cause you to have falls or worry about falling. Moving home to somewhere more suitable could be one option but it may not always be the right solution if it affects other areas of your life, such as staying close to friends, family and neighbours who support you. Remaining in familiar surroundings is particularly important for those with sensory impairments. Telecare can provide an important safety net. With the use of fall detectors, bed and chair occupancy sensors, and alarm buttons, you can be supported to live in your own home, while ensuring that help can be called for, if you need it. Telecare cannot stop you from falling so it is important to consider asking the council for a full review of your needs. This might include an OT assessment, carried out by an occupational therapist, to look at minor aids and adaptations that could help prevent you from falling or having accidents in your home. For more information about home adaptations, see our guide Housing: Adapting Your Home to Stay Independent (Guide 28) Case Study Eric had been recently widowed having shared his current home with his late wife for 40 years. Over the last few months, he had had several falls while Guide 6: Telecare and telehealth: what it is and how to get it April 2013 18 getting out of the bath. He had not been seriously injured but had been badly bruised. His friend and neighbour for many years, Gary, persuaded him to contact social services. Eric felt embarrassed about the falls and was not keen to be helped to bathe by a stranger. His social worker suggested he have an assessment from an occupational therapist. She recommended and arranged for a number of handrails to be fitted to the bath and bathroom, as well as a non-slip mat and bath seat. As Eric had found it difficult to get up after the falls, and did not want to have help with bathing, she recommended that he have an alarm button near the floor of the bathroom, so that if he did fall he could raise the alarm. She also recommended that he wore a wristwatch fitted with an alarm in case he fell while walking around his home, which Eric was happy with. His friend Gary, who already held a key to Eric’s house, said that he was happy to be contacted to help Eric in these circumstances. Eric felt that his concerns over his dignity and independence had been listened to, and he felt comforted by the support package that had been put in place. Gary was pleased that he no longer needed to worry. Supporting carers Telecare can provide reassurance to both you and the person you care for as it may not be possible, or even desirable, for you to always be there. Telecare may allow you to get some rest, knowing that you will be alerted if you need to be. Pagers and under pillow alert devices that vibrate can be used should there be a problem while you are asleep or out. For example, you may be scared of leaving your spouse or relative alone, and may find it difficult to meet friends, attend a support group or even carry out the weekly Guide 6: Telecare and telehealth: what it is and how to get it April 2013 19 shop. Fall sensors, along with a personal alarm, connected to a pager, may give both you and the person you care for sufficient reassurance to enable you to go out. If the person you care for becomes confused or anxious when you go out; refuses to, or cannot, use the alarm devices, then a ‘sit in’ service may be more appropriate. It is important to consider how the person you care for uses the equipment and whether it is realistic that they will do so. Case Study Joan cared for her 70 year old mother, Gloria. Gloria had become increasingly anxious about being alone in her home after having two falls and often called Joan during the day and would be very worried and upset. Having been assessed by social services, it was suggested that Gloria try using a fall detector on her belt. It was explained to her that if the detector was triggered, a response centre would ring her to check if she was OK. If she was fine, no action would be taken so she need not worry about triggering it accidentally and the police and ambulance turning up. If she was not OK, the response centre would call her daughter, and if she could not help, would an ambulance be called. Gloria was not sure, but agreed to try it. After four weeks, the telecare was reviewed. Gloria said that she felt much happier knowing help would come if she needed it, and despite her fears she had not triggered the detector accidentally. Joan was much happier about going out so they decided to continue using telecare. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 20 Supporting people with dementia Telecare can help people with dementia to remain in their own home. This is important so they can have the benefit of being familiar with their surroundings. However, it is important to consider how a person with dementia will feel about the devices and whether alternative solutions could be used. People with more advanced dementia may not know how to attach the fall sensor, so a movement sensor set in their bed or their chair may be a better way of monitoring whether they fall. Some people with dementia may feel they need to leave their house, and may be in danger of getting lost, or having a road accident. Property exit sensors fitted to the door can either alert the carer when the person with dementia has left their home, or the sensor can be linked to a response centre who can speak to the person with dementia to try and persuade them to remain in the property. Case study Adam had begun walking frequently at night. He often walked some distance from home, along busy roads, and did not know where he was. Despite many attempts from his carers to find out why he wanted to go out walking at night, he was unable to explain why. It was decided to fit an exit sensor and a communication box by the front door. The response centre could then gently suggest to Adam that he might want to go back to bed. For Adam, this proved very successful. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 21 6 Care homes and telecare Telecare can also be useful when providing care in a care home. It can help care workers to provide support to care home residents when it is needed, rather than disturbing residents (particularly at night) to check on them. Enuresis (bed-wetting) sensors let staff know when a resident needs their sheets and incontinence pad changed, rather than having to disturb or wake a resident up to see if these need to be changed. Sensors can also be used to alert staff if a resident has fallen out of their bed or chair. Sensors can sometimes be more effective than alarms or routine checks by care staff, for example, if the resident falls and is unable to reach the alarm or if a resident is unable to understand how to use the pull cord. They could also be less intrusive than care staff repeatedly checking on the resident. For residents who experience confusion or walk around a lot, sensors can be put on their bedroom door to alert staff when the resident leaves their room at night. This can make it easier for staff to respond quickly. However, staff should not completely rely on sensors to alert them of the need for attention. Residents should have additional means to communicate their need for help and assistance. This is particularly important where someone has a condition, such as dementia, that restricts or prevents their ability to make their own decisions. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 22 7 What is telehealth and how do I apply for it? Telehealth (or telemedicine in Wales) is a way of monitoring your health remotely. Telehealth can monitor conditions such as asthma, heart failure, diabetes, hypertension, chronic obstructive pulmonary disease (COPD), stroke and drug and alcohol addiction. In some areas, telecare and telehealth have been combined to form one system known as telehealthcare. Equipment in your home, such as blood pressure monitors and weighing scales, can send readings to a health professional, such a doctor or nurse, through an internet or telephone connection. If your daily readings are abnormal, the telehealth system will alert the health professional. You may also be able to speak to them via a visual screen if you are concerned about your health that day. Telehealth can help you to return home earlier from hospital, as your condition can be easily monitored from home. It can also reduce hospital admissions and the need to attend outpatient clinics and GP appointments. If you have a health condition that fluctuates, you may be anxious about your health and unsure when to seek help. Telehealth can help you to feel reassured that your health readings are within safe limits, and help you to monitor the effects of your medicine. How do I apply for telehealth? Unfortunately telehealth is less common than telecare. It will be up to your doctor to decide if they feel that you would benefit from this service. You can contact your local doctor to discuss whether a telehealth scheme is run in your area and whether they think you would be eligible. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 23 8 Things to consider When considering telecare or telehealth, it is important to make sure that you have thought about the following issues: • Have your views about telecare and how you would like to live been fully taken into account? Do you consent to using telecare? • Do you understand how telecare will work? Will telecare make your daily life feel safer, or will it make things feel more complicated and increase your anxiety? • Will telecare increase your independence or decrease your ability to do tasks yourself? • Will the data collected be protected? Is information stored securely, both by the telecare response centre and the activity monitoring system? • Is telecare really the most appropriate solution for you and have other options been considered? • Have you understood the possible impacts of telecare? For example, fewer visits from family members and friends to care for you, or possibly fewer visits from care workers, which may affect your social services care package or your personal budget. • Are neighbours, carers or relatives willing and able to respond to an alarm or alert in a short space of time? • As your needs change, how will telecare be reviewed and when? This guide is not a full explanation of the law and is aimed at people aged over 60. Guide 6: Telecare and telehealth: what it is and how to get it April 2013 24 If you would like free, personal advice on telecare, telehealth or any issues related to social care, benefits, loneliness or isolation, please call our advice line on 0845 262 1863. If you have found our advice useful, please consider making a donation. We receive no state funding and rely on income from individuals, trusts and other sources to continue providing our services to hundreds of thousands of people in need. For further information on how to support us, please see our website independentage.org or call 020 7605 4288. © Independent Age, June 2013 Independent Age 6 Avonmore Road London W14 8RL T 020 7605 4200 E [email protected] www.independentage.org Advice line 0845 262 1863 View our page on Facebook Follow us on Twitter @IndependentAge The Royal United Kingdom Beneficent Association Independent Age is the operating name of the Royal United Kingdom Beneficent Association Registered charity number 210729
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