Regardless of the setting — from aging-in-place at home to independent living communities — today’s seniors are living longer while managing chronic health conditions. More than anything else, technology is allowing them to do so mostly on their own terms.
This in part explains why the average age of move-in across the various levels of senior living has risen considerably in recent years, according to Majd Alwan, Ph.D., senior vice president of technology for LeadingAge and executive director of the Center for Aging Services Technologies, or CAST.
It’s happening right now in more than 250,000 independent facilities alone, according to Jerry Wilmink, chief business officer for CarePredict.
“Independent seniors like to be around their peers and family, and they value safety and security,” he says. “They typically are able to perform most activities of daily living, like eating, bathing, dressing, grooming, and toileting. They also may be able to perform most instrumental activities of daily living, which … let a senior live independently in a community or in their home.”
Wilmink asserts that although seniors value their independence, many don’t want to bother with many IADLs, such as yard work, cooking, cleaning and securing and taking their prescription medicine. “This is where technology can provide a safety net,” he says. Examples include wearable tech that monitors vital signs, provides med alerts and summons help at a button-push with real-time location.
Owner-operators can thank baby boomers for fueling resident security tech. “Many already wear smart watches or fitness monitors and use home automation to keep their residences comfortable and secure,” says Mike Webster, director of senior living, fall management and security solutions for Stanley Healthcare.
Safety over autonomy
Still, owner-operators and their residents, respectively, recognize and welcome giving up a little autonomy now and then in the interest of personal safety.
Senior living providers are called on every day to make difficult decisions that subjugate residents’ autonomous desires for security.
An easily adoptable safety feature “without much loss of privacy or autonomy” includes things such as automatic shutoff mechanisms on stoves and ovens, Alwan says.
Another includes various kinds of elopement safety tech, such as emergency notification and response systems and location tracking and access control technologies and software, Wilmink says.
Such tech not only saves lives but staff time.
“By using technology like access control and wander management systems or mobile devices for communications, a facility can drastically reduce the amount of time it takes to respond to a wide range of urgent situations,” notes Micahele York, product marketing manager for Secure Care. “By using technology to help manage specific situations, a facility can free up its nurses and other caregivers to focus on providing care.”
Real-time location systems also can help stem aggressive behavior and prevent resident conflicts from occurring, says Syed Ahmed, senior living segment leader for Philips Aging and Caregiving. Systems can notify community staff when residents with past incidents are close to each other, or when one resident tries to enter the room of the other.
A complementing technology is video surveillance.
Aside from its obvious benefits, video monitoring also can vindicate a staff member when resident-on-resident violence occurs, observes Patricia Howell, RN BSN, WCC, CFCS, clinical support manager for McKesson Medical-Surgical Extended Care. Video surveillance, however, requires a great deal of privacy assurances and can give overworked caregivers a false sense of security, she warns.
Cybersecurity issues are on the rise, and facilities find themselves grappling with balancing their needs to protect their own operations against residents’ demands for online privacy.
“While cybersecurity historically hasn’t been a big area of concern for senior living, that’s changing as systems and technologies become more sophisticated and collect more data,” Webster says. “In some ways, the more advanced systems make senior living more of a target for data breaches and other attacks.” Webster and others believe assisted living rapidly is becoming an easy target for cybercriminals simply because the infrastructure needed to thwart them isn’t quite good enough.
Patrick Hardy, LL.M. CEM, MEP, CRM, president of Hytropy, a continuity and disaster preparedness solutions provider, believes some cybersecurity vulnerabilities are self-inflicted.
“Many of the breaches we hear about today result from risky behaviors that employees are engaging in on the computer, such as opening phishing e-mails and accidentally providing passwords to cyber belligerents,” he says. “Employees need to be informed and trained on digital applications, and common ways that cyber criminals are accessing sensitive information.”
Still, senior living managers must continue to grapple with a host of weighty decisions when it comes to crossing the fine lines between independence and security.
“There are different security and privacy expectations in independent and assisted living,” says Laura Wasson, executive director of sales for Tech Electronics. “Residents in independent living would have to request a certain level of security. However, there is a fine line between providing the level of security a resident in assisted living needs to be safe while not invading their privacy.”
Owner-operators would do well to heed the advice of vendors that absorb many of the tech gripes residents volunteer during facility visits. “In addition to cameras, residents complain about obtrusive exit door lock systems with pin pads,” Ahmed says. “Seeing staff members use a code on the pin pad to unlock the door often makes residents feel trapped.”
Webster agrees. “The most common complaint I hear is that devices — whether wearable or mounted on a wall — just look too institutional,” he says. “Sometimes communities treat seniors like patients, and they really don’t want to be treated that way.”
Floor and mattress-based sensors can alert staff every time a resident leaves his or her bed to void to develop better protocols to treat incontinence, and imbedded sensors can analyze urine in toilets and saliva on toothbrushes to inform better decisions around diet and infection. But what if you’re the one whose bathroom habits are being analyzed?
Similarly, although video surveillance has become the new norm in facility common areas, different rules apply in more private areas, Webster cautions. Ahmed suggests facilities deploy location systems that achieve what video does in a less obtrusive way because they “allow staff to see the general location of a resident relative to a floor plan, without seeing a live visual of what the resident is doing.”
It’s easy to see why privacy issues are top of mind.
And with the cacophony of bells and whistles and beeps comes alarm fatigue, and false alarms — a dangerous condition in which both caregivers and seniors themselves become so jaded that they ignore, or worse, disable them.
In late 2016, serious privacy gaffes with video surveillance prompted the Centers for Medicare & Medicaid Services to develop stringent rules to protect resident privacy and prohibit photos and video/audio recordings without residents’ permission. Protections even extend to residents’ personal space and clinical records for covered facilities.
When a major healthcare tech vendor’s nurse consultant placed her mother in an assisted living memory care facility several years ago, “she lost her sense of modesty and our family’s peace of mind,” she said on condition of anonymity. Once, when left briefly unsupervised in an activity room with other residents, a caregiver returned to find the woman “with her hand down the front of the pants of the man sitting next to her, and his hand was over hers.”
In the end, attaining balance requires technology that is “thoughtfully deployed,” James Jansen, product manager for Direct Supply Technology Solutions, points out.
“It needs to provide a joint benefit for residents and caregivers, typically in a discrete, non-threatening way,” he says. “The right mix of security technology changes depending on the location. In a public space, you’re providing safety measures for everyone.”