It has been estimated that older people spend 80-90 per cent of their time in their home. Although housing type and condition are widely considered to be important contributors to health and quality of life, many older people still live in unsuitable housing .
Furthermore, 19 per cent of men and 33 per cent of women aged 65-74 lived alone in the UK in 2005, whilst 29 per cent of men and 60 per cent of women aged 75 and over lived alone . The World Health Organisation  and the Royal College of General Practitioners  described older people living alone as an at-risk group, which should be targeted for specific attention. They require more home visits, make more use of community services  and are most likely to be depressed, lonely, and unhappy .
The use of technology to support independent living is mentioned explicitly in many recent government documents. Policy for older people in the UK and in EU countries, particularly in Spain and the Scandinavian countries, and in Australia, focuses on a vision of active ageing and independent living by providing modern and 'person-centred' services to meet their needs, helping them to live in the community as long as possible, and by supporting their carers. One component of an effective policy on active ageing and independent living is the provision of appropriate built environments that take the special needs of older people into consideration .
Additionally, in most developed countries there is increasing interest in and financial support for new models of housing. For example, the Department of Health for England provided investment through the Extra Care Housing (ECH) Funding Initiative of £87 million in 2004-06, £60 million in 2006-08 and £80 million in 2008-2010 to local authorities and their partners to construct new living units for older people .
ECH has no single universally accepted definition, and indeed its use is presently restricted to the United Kingdom. An equivalent term in North America and Australia is 'housing with care' or 'assisted living' (AL). ECH is specially designed housing with more personal care, more communal space and facilities than are found in a traditional sheltered housing scheme but without the institutional features of a care home. Setting decent standards of housing and services within ECH would enable older people to remain in their homes for much longer than would be the case in more conventional forms of sheltered housing .
As older people are heavy users of health and social services, residential technology may reduce unnecessary hospital admissions, support hospital discharge, and provide intermediate care . The use of appropriate devices could potentially meet a wide range of needs and consequently improve many aspects of older people's quality of life such as physical health, psychosocial well-being, social relationships, and their physical or living environment .
In the future, new technologies and particularly domestic appliances will inevitably play an increasing role in many aspects of our lives. In its simplest and practical terms, technology can be defined as any device or system that controls and manages the physical environment . In practice, as Agree and colleagues [, p.270] believed, "the distinction between assistive technology, other household technology, and the environmental modifications may not always be clear". Assistive Technology (AT) is "an umbrella term for any device or system that allows an individual to perform a task" [, p.325]. AT can also be defined as "any equipment or system that is used to maintain and improve the functional capabilities and independence of people with cognitive, physical or communication difficulties [, p.3]. Furthermore, telecare facilities can be combined into a 'lifestyle reassurance package' with bed and chair occupancy sensors, passive infra-red movement detectors, a 'security package' that includes CCTV, intruder alarms, flood detectors, extreme heat detectors, a 'fall package' that comprises fall detectors, and finally, 'specialist devices' include wandering client systems, and epilepsy bed sensors .
HBT is here defined as technological devices that are owned or controlled by the household, such as kitchen appliances, personal computers, assistive technology, and telehealth monitors.
The use of HBT devices and quality of life in older people
Various telecare, telemonitoring, telehealth and telemedicine technologies are now well established and widely used. They are used in combination with information and communication technologies (ICT) to deliver care and social services as with emergency alerts and remote monitoring [ and ]. Blackburn and colleagues  concluded that using household technology devices including 'lifestyle reassurance packages', 'fall packages', and 'specific devices' prevented older people going into hospital and could speed up hospital discharge by providing added support in their own home. The respondents in their study said that the devices gave peace of mind to their family members. They also experienced more social functioning and more satisfaction and security with pull-cord alarm systems and warden services.
The Scottish Executive developed telecare programmes for 75,000 people across Scotland, including 9,000 people with a diagnosis of dementia . The study used equipment ranging from smoke alarms, flood and heat detectors, fall detectors and movement sensors to environmental controls. The findings revealed that the participants benefited from an increase in their independence at home. The residential technologies also postponed and diverted people from hospital and residential care admissions reduced.
The project Opening Doors for Older People  was launched to increase the level of care as needs increase, rather than moving the person into increasingly intensive care settings. Smart technologies, specifically a 'lifeline' unit, passive infrared detectors, flood detectors, heat sensors, and smoke detectors were installed in 1,950 newly built housing developments designed to offer housing with care with an onsite staff team for those who could not manage in their own homes. Nearly all the respondents in the study reported a positive impact of the smart technology, which had been important in relieving worries about falling and about home security.
The accumulated evidence indicates that HBT enhances older people's quality of life in several ways:
Technology interventions help older people to remain in their comfortable setting and within a familiar community . Moreover, staying at home would no longer involve social exclusion because of information and communication exchange through the Internet with the outside world .
Assistive technology could help older people live independently and ease the challenges of caused by age or long-term chronic conditions by supporting daily living activities .
Telecare potentially facilitates the delivery of far more customer focused housing, social and care services to people in their preferred environment .
Assistive devices can reduce unnecessary hospital admissions, speed up hospital discharge, and provide intermediate care .
This paper reports a study of the use of HBT devices in ECH schemes and considers the connection between the use of such technology and the quality of life.