How to do it ... Resident security
Monitoring in caregiving is getting more “personal” than ever. We live in the age of watchers, pitting privacy issues against vested interests in security. Technological advances have greatly enhanced resident monitoring, but they have also added new challenges. Solutions call for a delicate balance between automation and personal freedom.
1 Fixed passive monitoring systems such as bed and toilet alerts have their place, but they can't take a resident's blood pressure. Many facilities employ both kinds, but have problems finding the right balance.
Fixed tech can get costly, especially if it isn't being used, says Jack Zhang, CEO of Vitall. He advises operators to supplant their programs with newer personal devices that monitor vital signs and other activity in real time.
2 Cellular technology and WiFi have given personal monitoring the highest level of mobility yet. Experts advise facilities to exploit its potential.
“In this age of mobile phones, don't invest in telex,” says Zhang, referring to what he calls “old school” landline-based tech.
Mike MacLeod, the president of Status Solutions, says tablets and smartphones not tethered to a nurses' station or alarm panel become “mobile command centers.” This not only improves staff response and productivity but also provides greater peace of mind to residents, MacLeod says.
3 Technology has made monitoring more passive and more discreet, but providers must remember, that some residents still consider it intrusive. Many view it as a sign of advancing age.
“Old-style pendants of the past were a stigma signaling, ‘I'm old and frail,'” says Zhang. Smaller, discreet alternatives like wrist monitors can help mitigate the pendant problem.
In sum, providers have to consider the resident's need for dignity. Yet there are obstacles. Memory care residents often remove or disable monitoring devices attached to their wrists, for example.
“We've found the best solution is the simplest,” says Jennifer Davis Ridenour, product manager for Philips Healthcare, Home Monitoring.
She adds that such devices need to be comfortable, small, lightweight and resistant to tampering or being cut off.
4 Experience shows compliance improves when residents and staff understand the need for monitoring.
“The most successful senior living communities build security and safety into their culture, and staff understand how it helps them do their jobs more efficiently and deliver better care,” notes Steve Elder, senior marketing manager at Stanley Healthcare.
Initial safety briefings with refresher talks down the road is another way, according to Jim Kelley, vice president, sales and marketing, Digital Care Systems.
Bryan Fuhr, co-founder and vice president of marketing for Healthsense, advises to stress how monitoring keeps residents as independent as possible. Also, to allay concerns over privacy, tell residents no passive monitoring devices have microphones or cameras, he adds.
5 The most efficient monitoring programs are integrated and provide a seamless flow of information and a resident status snapshot at any given moment. Few facilities might truly achieve this.
“Trying to respond to alarms from multiple systems causes confusion, inefficiencies and distractions, leading to alarm fatigue and negative impacts on resident care,” says MacLeod. “But situational awareness technology can be used to keep an eye on all ‘the stuff,' so staff can pay more attention to residents.”
6 An over-reliance on technology can actually doom any monitoring program if caregivers stop “caring.” And the ubiquity of so many beeps, bells and whistles going off can dull the senses of even the sharpest nurses and aides. Consider: More than 560 alarm-related patient deaths in all kinds of care settings were reported to the FDA from 2005 to 2010.
“It's important to make decisions about safety and security technology in the context of care and staff workflow,” says Elder. “Technology is not a substitute for care, but a very effective tool to help deliver better and more proactive care for residents.”
Mistakes to avoid
Becoming over-reliant on technology as a substitute for personal care.
Leaving out the “why” when fitting a resident with a personal monitoring device.
Neglecting to consider residents' need for privacy and dignity.