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Lifestyle, or behavioural monitoring is an important element of telecare research where changes in activity profiles are used as a proxy to highlight a change in an individual"s health or care status. However, despite the promise of this approach for users and care providers it has been slow to develop. A literature review was undertaken to establish the current position with regard to lifestyle monitoring and to use this to inform requirements for the future development and implementation of such systems. In total, 74 papers met the inclusion criteria. Only 4 papers reported trials involving 20 or more individuals with a further 17 papers reporting trials involving one or more individuals. Most papers (n=53) were concerned with technology development initiatives. With respect to the technologies and strategies employed, motion monitoring dominated, followed by door and electrical appliance usage. The predominant monitoring strategy is that of detecting changes in activity levels. However, it was noticeable that little attention was given to determining when or how changes in the profile of activity should be used to raise a call for assistance from a health or care professional.

Previous surveys have suggested that community alarm users are in general satisfied with the service provided. However, there is also evidence that users would like additional options that could be provided by a telecare system. Inner-city users of community alarms were consulted about their current systems and the extension of these to incorporate telecare options. The users lived in 160 homes in three multistorey apartment blocks. The average age of the 176 users surveyed was 76 years. Seventy-seven per cent of users were interested in automatic fall detection, 68% in lifestyle monitoring, 57% in telemedicine and 46% in videoconferencing. Nineteen of those interviewed (11%) did not want any of the suggested enhancements. The survey showed that elderly people are not technophobes, since 58% possessed either a microwave oven or a video-recorder, and also showed that the majority were prepared to accept new technologies that would support their independence.

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