An infux of memory care residents and other shifts are challenging operators to keep residents safe from harm. And while many assisted living facilities may already have a level of systems in place, a periodic review of new protocols and equipment is essential to keep up to date, security specialists say.
“The move to memory care is a major step on a number of levels, and certainly has security implications,” says Steve Elder, senior marketing manager for Stanley Healthcare. “There are a variety of security risks that AL communities need to manage.”
Elopement of dementia and Alzheimer’s residents is certainly of paramount concern, as are the risks that come with the natural process of aging, such as falls, seizures and other medical emergencies, Elder says. And while rare, the potential for resident-on-resident and resident-on-staff attacks also must be recognized and prevented. Overall, assisted living centers must manage general security with appropriate visitor management policies and systems for access control, intrusion detection and fire prevention, among others.
Because a certain percentage of dementia residents is prone to restlessness and wandering, assisted living communities must be ready to address this behavior from multiple angles. Wander gardens have become staples at assisted living facilities and these areas have demonstrated great therapeutic value. But “in terms of security, at some point residents who are wander-prone will need the protection of a secure unit,” Elder says.
In assessing the functionality and effectiveness of a secure dementia unit, facility operators should consider how comfortable residents are with living there, says Sam Youngwirth, owner of Ciscor.
“If you enter a dementia care area and you notice the emergency call system — whether it’s audio, with buzzers or alarms, or visual, with flashing lights, the system is outdated,” he says. “The system should blend into the environment and should not induce stress to the residents.”
The mindset is changing within the security industry from a reactive approach in responding to incidents to a proactive one of trying to get out in front of an incident using predictive technologies, Youngwirth says.
“We know that when residents deviate from their ‘norm,’ the probability of an incident can increase,” he says. “Our system helps caregivers learn individual resident patterns and sends an alert when a resident deviates from the ‘norm,’ giving caregivers an opportunity to intercede before an incident happens.”
Technological advancements have created “an exciting time in resident safety and security,” Elder says. Information systems for wander management and emergency call now capture a wealth of data that can be used to improve care plans for better and more personalized care, he explains.
“This business intelligence also helps raise efficiency by revealing things like staff workflow patterns and staff-to-resident contact time,” he says. “Another growing trend is system interoperability; for example, exchanging data between a real-time location system and an electronic medical records system to extend the functionality of both.”
Wander monitoring systems are becoming more advanced, so Wes Columbia, technology studio lead for Direct Supply Aptura, advises facility operators to create a plan that includes a thorough evaluation of the community’s processes.
“When evaluating systems and processes, make sure to involve stakeholders from clinical, maintenance and IT,” he says. “These three perspectives all provide a unique point of view that help the community make sure that what they design meets the best interest of everyone.”
Columbia favors a “digital signature”-based verification for wander monitoring because the technology prevents false alarms and helps staff “feel comfortable that they are responding to a real alarm and not just interference.”
Alert buttons and medallions have been on the market for several years, but this type of wearable technology also has drawbacks, says Jack Zhang, CEO of Vitall, which offers a wrist-worn monitor that automatically sends out a distress call.
“The truth is that residents may fall and not be able to press a button for help,” he says. “They could be unconscious, confused or scared. By implementing a solution that offers a fall detection algorithm, a distress alert will go out as soon as the device detects that someone has gone from standing to lying down. There is no need for anyone to press a button — help will already be on the way.”
While automated security systems have improved tremendously, no amount of technology can substitute for a well-trained and attentive staff, Columbia says.
“Accountability is key — your staff must know that they’re responsible for the care of the residents all the time,” he says. “Thorough semi-annual training of all the care staff should be done for any of the resident monitoring and wander management systems. What’s more, key codes and other credentials should be changed monthly so that the system is kept up to date, and to prevent residents from learning the codes.”
Elder advises facility operators to provide a comprehensive overall policy and detailed individual care plan for staff to review regularly.
“In this context, solutions that give caregivers actionable information at the point of care help them respond more quickly to a resident in need of assistance, while eliminating sound alarms and other alert mechanisms that can detract from quality of life for all residents,” he says. n