Striking the perfect balance between resident security and independence is no easy undertaking. To accommodate the needs of their disparate resident population, continuing care retirement community operators are increasingly adopting layered security approaches that can be customized to meet residents’ evolving needs.
Of course, solutions that work within tight budgets, make the most effective use of caregiver time, and keep dignity and privacy at the forefront are also a top priority for forward-thinking communities. And solutions vendors are doing their part to fulfill all of those requirements.
“Today, capabilities are available that provide for a virtual presence without intruding into an individual’s daily life, and that is good for everyone,” said Kelly Besecker, vice president of sales and marketing, AFrame Digital Inc.
Today, many operators are saying goodbye to hard-wired pull cord systems, disruptive alarms and independence-robbing locks, and instead turning to integrative, passive and proactive security solutions. Nurse call and emergency call systems are just one example of this shift. Wearable, pendant-type technologies that can tie into an existing nurse call system are becoming more common, as are two-way communication capabilities that give residents the peace of mind that help will be available whenever needed — both inside their residence and throughout the community.
“The key element for both caregivers and residents is what happens when the resident presses the button or pulls the cord,” reasoned Jim Kelley, vice president of sales and marketing for Digital Care Systems Inc. “Without two-way voice, the system is in the same category as the old hard-wired pull-cord system, which is certainly yesterday’s technology. In today’s world, a quick response via voice from the caregiver provides the resident assurance that the call was heard and the caregiver receives the information they need to respond properly.”
The CARE-CALL wireless emergency call system from Digital Care Systems features two-way voice communication that provides site-wide coverage, in-residence paging and task tracking, and self-testing, without the need of an active telephone jack.
Wearable security devices are also becoming more discreet, thanks to customizable and personalized “skins,” and even tags that can integrate a fully functioning watch.
“Some [monitoring solutions] in the marketplace that looked like a watch, but didn’t function as a real one, actually caused confusion in some residents,” said Chris Konicek, marketing manager for Accutech. Proper function and, above all, safety, also hinge on a strong battery, he stressed. He added that Accutech’s RFID-based ResidentGuard tag features a faint LED so staff can visually check each battery weekly.
Increasingly, vendors are offering solutions that can easily integrate with a community’s existing technologies to eliminate costly duplication and maximize operators’ capital investment. “Today, there’s the ability to provide all resident monitoring technologies over a single communication platform, essentially making them one of the community’s management tools,” said Jon Ross, general manager, 3M Track & Trace, HomeFree Systems. He added that HomeFree provides a single platform that supports wander management, nurse call, fall management and device management capabilities.
Low-key monitoring
Providers must be able to monitor residents in a transparent way that ensures their safety — even as residents rightfully want to keep as much autonomy as possible. So it’s hardly surprising that many of the newer technological monitoring innovations emphasize subtle resident observation.
Mike MacLeod, co-founder of Status Solutions, a manufacturer of alert services, noted that it’s not uncommon for friction to develop between operators, residents and families when it comes to balancing privacy issues with independence and safety.
One way to ensure that balance is through “inferences,” MacLeod said. “It refers to checking in on people and making an inference based on motion or audio, whatever events there might be, with medicine cabinets or refrigerators opening, for example.”
Status Solutions’ Situational Awareness and Response Assistant helps operators make better inferences. SARA is an automated alerting system and awareness engine that sends voice and text alerts via phone, email, etc. SARA provides a wireless sensor network, integration tools (to existing systems and devices) and broadcast communication.
Detailed info
A growing number of operators also are seeing value in strategically placed monitoring sensors that can be uniquely programmed to capture specific resident health and activity data.
Typically, motion sensors integrate with a central computing engine to develop a baseline of resident health and behavioral information. That data can then help pinpoint any trends, or actual or perceived deviations in health status or normal routine. AFrame’s wearable monitoring device comes with an integrated panic button and an array of sensors that interact with a mesh network throughout a care setting to provide a “visual safety net,” according to Besecker.
In addition to more traditional monitoring functions, caregivers can use wireless medical devices on the AFrame network to detect changes in health status, such as blood glucose levels, heart rate, blood pressure, and weight. The watch can even monitor skin temperature, with “on” or “off” threshold ranges set per individual.
“Alerts based on these [types of] data can be delivered real-time to any pager, smart phone or device, or any voice or data device already used in the facility, including iPads and other mobile tablet or notebook devices,” Besecker said.
Wireless sensors are widely used at Walnut Creek in Anaheim, CA, a continuing care retirement community that’s part of Front Porch senior living communities. A baseline unit is placed in each of Walnut Creek’s residences and sensors are added and tailored based on resident need.
“Every unit has a sensor unit, but those sensors will be used differently. In memory care, every time someone gets out of bed, an alert goes off,” said Kari Olson, CIO of Front Porch and president of Front Porch Center for Technology Innovation and Wellbeing. “In independent living, that same sensor can be used to alert staff if no motion is detected. It’s about being imaginative and using tools in different ways to honor the needs and wishes of residents.”
To further enhance data collection and analysis, Walnut Creek relies on just one monitoring system to integrate sensor-based monitoring, nurse case, emergency response and resident wandering.
Some operators are finding that creative use of sophisticated technologies can keep even more challenging residents in their current residence longer.
Redstone Highlands. a CCRC in Pittsburgh, for example, has taken a layered, a la carte approach to technology, with an independent living resident serving as its primary pilot.
The resident, who is prone to wandering and needs some assistance with medication, has maintained her independent living status by having her home outfitted with a door monitor and a computer-based medication management system to prompt her to take her medication. (A missed dose prompts a phone call from staff.)
Motion sensors throughout her residence also allow staff to assess her movement and sleep patterns.
“We’re using technology to prevent her from having to transition to a secured personal care unit before she’s ready,” said Geoffrey Gehring, NHA, RN, executive director of home health and home care provider Senior Independence of Southwestern Pennsylvania.
With the door monitor in place, she can come and go all day long, but if she opens the door after 11 p.m. or before
6 a.m., an alert will be sent so staff can check on her.
Without the assistive and monitoring technology in place, she would assuredly have moved into personal care, Gehring noted.
Customized tech
While today’s sophisticated resident security and monitoring solutions indeed play an important role in an operator’s ability to provide the best care and the safest community possible, sources stressed that even the most advanced technologies have their limitations.
Many times, what works in one facility or residence may not always be well suited to another.
“There is no one ‘right’ solution that will apply to every resident and every circumstance so it’s up to [each community] to determine the best way to blend its own needs with the unique needs and wishes of the resident,” said Olson.
Equally important is a community’s understanding that no technology will ever trump the importance of live interaction with a caring staff member.
That point strongly resonates with James Spahn, M.D., a surgeon and wound specialist who works closely with senior housing operators.
“I sometimes see an over-reliance on technology and less importance being placed on the role of the actual people,” he stressed.
From the October 01, 2011 Issue of McKnight's Long-Term Care News
