Care in the cloud: How technology is changing the face of care

Hearing the right song at the right moment can change your day.

For Ian Williamson, his day changes when he hears Jimmy Shand playing his accordion. The sound takes him back to his childhood, sitting on the living room floor with his mother, listening to Shand, Scotland’s “king of the polka”, play the songs that have accompanied countless ceilidhs and weddings over the years. 

Ian’s mother died a number of years ago and he lives in a care home now, but the music takes him back to memories as a child in Bo’ness. It opens the door to a wave of emotions that ensures he returns to Shand’s music over and over again, playing his songs through a tablet that sits on the table in front of him.

“Ian uses the tablet for his music, he listens to it all the time,” says Kim Anderson, team leader at Broom Court care home in Stirling. “He uses it to click through to Jimmy Shand on YouTube whenever he wants, which he can do with no problem at all.”

When he was three months old, Ian sustained a severe brain injury, altering the course of his life in an instant. Then, as a teenager, he was hit by a lorry, leaving him almost deaf and in need of nearly constant care. 

Ian struggles to do a range of things throughout the day, but he can use his tablet independently.

“The tablet allows Ian to follow his interests,” says Anderson. “He’s a big Bo’ness United fan and he can watch the highlights and games on there whenever he wants, without one of us [carers] putting it on for him.” 

In March, Public Health Scotland published data showing that there are an estimated 34,290 residents aged 18 years and over living in over 1,000 care homes in Scotland. The majority of those residents – 88 per cent – are aged over 65, with many living in private facilities like Ian. 

As Scotland’s population ages, the number of people relying on care homes like these is set to increase. According to the 2024 mid-year census, an estimated 20.5 per cent of the population are aged over 65, with only 16.2 per cent of the population aged between 0 and 15. There were also 62,000 deaths in Scotland compared to only 46,400 births, a continuation of a 10-year trend that has seen deaths outstripping births by a comfortable margin each year.

As a result, the cost associated with caring for adults as they age and move into needing care is expected to rise, both for the Scottish Government and members of the public.

Free Personal and Nursing Care (FPNC) was introduced by the Scottish Government in 2002 for people aged 65 and over if they meet certain eligibility criteria. In April 2019, the provision of FPNC payments was extended to all criteria-meeting adults, with current rates set at £254.60 a week for personal care and £114.55 a week for nursing care.

The Scottish Government’s stated goal is to “ensure the right support is available for older and disabled people so that they can live safely and independently in their own homes, for as long as possible”. To support this goal, the government invested over £75m into the Independent Living Fund, which is intended to give some of the most disabled people in Scotland access to the support they need to lead independent lives.

“I am determined to ensure we protect vital services that the people of Scotland value and depend on,” says social care minister Tom Arthur. “This includes using technology as an integral part in the provision of equipment and home adaptations. Telecare services support people to live safely at home with greater confidence and independence, often preventing or delaying admissions to care homes and hospitals.”

That support could be provided through home nursing equipment like pressure-relieving mattresses, telecare products such as motion sensors, and digital equipment such as the tablet Ian uses to play his music.  

His tablet is loaded with CleverCogs, a digital interface that enables him to access many of the services offered by Blackwood Homes and Care, his care provider. 

“The appetite for the use of tech, particularly from our customers with more complex disabilities, has always been a pleasant surprise,” says Stephanie Sutherland, head of business development at Blackwood. “I think there’s an assumption that there would be a natural barrier there. But the curiosity and the appetite to access and utilise tech has always been there.” 

At Blackwood, all staff and residents are linked into the CleverCogs system. It’s designed to act as the first port of call for most of a resident’s needs, allowing users to see everything from their schedule for the day to when their next medication will be administered.

The system also includes a remote responder feature that allows carers to check in on residents virtually. Traditionally, if someone needed support, they would press a button to call carers, who would then physically visit to see what was wrong. With the remote responder feature, the carer can check in with the caller before attending through a video call system, avoiding wasted call-outs. 

“We support a lot of customers with mental health and addiction issues,” says Sutherland. “So those customers can hit a button that will open a video call to a support worker who can talk them through whatever might be happening. It might be a blue light triage sort of event, but it might also be nothing more than ‘I’m feeling a bit lonely’ or ‘I’m feeling a bit anxious’.” 

For Matt Deighton, this remote responder technology can act as a virtual lifesaver. Hanging around his neck is a lanyard with a pendant on it, tuned to sense the tell-tale signs of a health emergency and alert a dedicated team of carers if no one is around. “I wear it because I’m epileptic,” says Matt. “It comes in handy if I have a tonic-clonic seizure or anything related to that. It makes my life easier when I need it.” 

A tonic-clonic seizure often happens without any warning signs and consists of two phases. In the tonic phase, an affected person loses consciousness and becomes stiff as their muscles contract. This can lead to falls and the possibility of accidental bites before the stiffness evolves into a rhythmic jerking and twitching of the arms and legs that can cause additional injury in the clonic phase. A seizure that lasts longer than five minutes is a medical emergency known as status epilepticus, which can cause irreversible brain damage or death without quick treatment.

For Ian and Matt, technology can act as the gateway to a different time or a lifeline in the case of emergency. But as the sector advances, the potential of new innovations like artificial intelligence (AI) to revolutionise the way care is delivered is almost limitless.  

Nazia Gillani is a PhD researcher at the University of Edinburgh, where she is developing an AI-powered system to help older people live at home for longer. Gillani works with older adults, carers and clinicians to hone the system’s design, which uses AI to predict an individual’s decline and send timely alerts to help prevent falls.  

“Imagine a 76-year-old woman who was always very active and independent,” says Gillani. “But after retirement, she started to move slowly, sit more and her routine changes. However, these changes were so gradual and subtle that no one noticed, not her GP or her daughter and not even herself until a fall happened. Then it was too late.” 

Gillani says this is a common scenario for many people as they age, where small changes in routine and mobility can lead to falls and injuries that could be avoided if the signs are spotted before they happen.  

Between April 2024 and March 2025 there were 28,455 emergency admissions to hospital for an unintentional injury for those aged 65 and over in Scotland. Just over 87 per cent of these admissions were the result of a fall, with nearly 8,000 of these falls resulting in a hip fracture. As a result, over five per cent of unscheduled bed days in Scottish hospitals were caused by hip fractures, costing the NHS both time and money.

Gillani says this number is expected to rise if preventative measures aren’t taken to prevent falls from happening in the first place.

“There are some solutions for fall alerting on the market, such as wearables and mobiles, but they all have limitations,” says Gillani.  “But in the case of wearables, when I’ve talked to older adults, they say that they forget to wear them. And some older adults just leave the wearables on the counter because they don’t want to wear them, so carers really worry about that.” 

One hypothetical solution to this problem, where older people won’t consistently wear fall detection technology, is the installation of cameras to monitor their status at all times of the day.

Unsurprisingly, Gillani says that this idea is incredibly unpopular with older people, who don’t want to lose the privacy and intimacy of their homes in return for the possible benefits of a faster response time to a fall. Her system is different. 

“It can be placed in decorative pieces like a vase where it can learn a person’s routine,” says Gillani. “For example, when a person usually gets out of their bed or a chair, and how often they move in their hallway. It can then detect if there is meaningful deviation and raise an alert to a carer.” 

Gillani hopes that this system could be implemented in homes to increase the independence of older people while also decreasing the burden on the health and social care sector. 

Craig McNiven has worked as a carer and the self-described “technology guy” at Broom Court for nine years. After graduating with a degree in game design and software development, McNiven fulfils his daily care duties while also ensuring that the care home’s technology is in working order. 

“Technology is making our roles so much easier,” he says. “For staff, the ability to take notes as a voice message on your phone and have AI transcribe it is saving us half an hour a day looking at a screen.”  

But does that time saving come at a human cost? Will human-led care eventually be replaced by a faceless android, devoid of human emotion and only concerned with delivering the next pill on time? Who would listen to Ian’s songs if only a robot was there to hear them? 

“The idea of the traditional carer is probably going to be phased out a little bit in a way,” says McNiven. “It’s great that we’re pushing forward with digital, but at the same time you still need that physical and emotional contact with a person. It’s much more important than a voice on the end of a computer.”