Resident safety is an equal-opportunity landmine for providers.
Three out of five assisted living residents affected by dementia, for example, will wander as a way of coping with their condition-related confusion and restlessness, according to the latest statistics from the Alzheimer’s Association.
In addition, more than half of seniors who elope will suffer serious injury or death if not located within 24 hours, and serious injury can occur within mere minutes.
As the aging population continues to grow, and the number of those with dementia and Alzheimer’s disease consequently rises, wandering is increasing at an alarming rate. To make matters worse, skilled nursing facilities can be prone to security threats posed by intruders, unwanted guests or temporary visitors.
Due to all of these factors, it’s important that senior care and living communities plan ahead and proactively manage those at risk, says Syed Ahmed, living segment leader at Philips Aging & Caregiving.
A lot of planning and care are typically put into a facility’s selection and use of resident security measures, which may include wander prevention, fall management and nurse call systems, as well as personal emergency response systems, or PERS. Yet, a lot factors could sabotage well-intentioned efforts. Whether it’s people, policies or materials, unforeseen problems can lead to lapses.
It’s critical that resident security systems are not only easy to use, but also help to future-proof operations for senior living communities, Ahmed says.
“As the senior population continues to grow and more older adults are beginning the transition from their homes to senior living communities, executives need to bolster their security infrastructure and seamlessly access actionable data related to the safety of their residents,” he says.
“Rather than adopting various disparate systems that often lend themselves to blind spots and miscommunication, a comprehensive solution can efficiently receive and process input from all points in your community, including alerts from residents, signals from transmitters and notifications about door activity and potential resident wandering.”
Avoiding self-sabotage
So how can facilities do their best to ensure resident safety and security? It can be a cumbersome process, and many facilities make the mistake of focusing simply on the incidents or symptoms of the problem — like falls or wandering — rather than conducting a comprehensive assessment of the underlying issues in an effort to develop an appropriate solution, says Majd Alwan, Ph.D., executive director of the Center for Aging Services Technologies (CAST).
“Falls, for example, may occur as a result of any number of circumstances, including a resident’s neurological condition, side effects of a medication, weakness of the lower extremities, a sudden drop in blood pressure or environmental factors such as thresholds, steps, lighting or throw rugs,” he notes.
Each of these circumstances requires a different solution, so facilities must first identify the condition or underlying issue they would like to address — whether by technology or some other intervention, such as a change in medication, rehabilitation or exercise regimen, and then take the additional steps needed to help the older adults that are affected.
Once an assessment of a facility’s issues is complete, it may be appropriate to reach out to a senior care technology company for help in determining best options, believes John Kuccaro, strategic account manager at Beacon Communications.
“Companies like ours can work closely with facilities to understand what types of devices — be it cell phones, pagers or radios — staff has on them during their shift and what security technologies will work best with what’s already in place,” he says.
They will also be able to help administrators of older buildings better understand the cost differentials between using a hard-wired system — which often requires running new cables — and wireless systems.
Understanding the likes, dislikes and preferences of a technology’s end-users — in this case, both the older adult residents and the staff — is also key to the successful implementation of resident security systems, Alwan notes. It’s important to engage residents and staff early on in the planning, product demonstrations and selection.
“Residents may find a personal emergency response pendant to be stigmatizing and refuse to wear it, or a safety monitoring system that produces loud audible alarms may lead to staff becoming alarm fatigued and unresponsive, regardless of the priority or level of urgency,” he explains. Administrators could be left footing the bill for a system that just collects dust because the potential users of it haven’t bought in.
Use discretion
One way to avoid alarm fatigue is to work closely with product manufacturers and local installation experts to set alarms to go off only for events to which you plan to take action, says Brian Dawson, president of Silversphere.
“Just because we can monitor almost everything these days doesn’t mean we should,” he says. He adds that it’s important for long-term care administrators to work closely with IT experts to ensure the systems they are considering are able to operate effectively with one another.
“If you end up with different systems that don’t talk to each other, you’re going to end up with whole feature sets you don’t use because it will require staff to input information in more than one place, which, in reality, won’t happen,” he says.
Alwan agrees, noting that understanding data, workflows and integration needs — or hiring someone locally with expertise in product integration and interfacing capabilities — is critical to resident security system success.
“Getting fall or elopement alarms integrated with the nurse call/notification system and the electronic health record system is not only crucial for basic resident information but also for a facility’s fall or wandering risk assessment and flags that may affect the priority of the alarm,” he says.
On a more basic level, Alwan points to the importance of ensuring a system’s ease of use by residents and staff. He says that factors such as how often batteries need to be changed or charged and whether a device is waterproof if it’s a wearable should be considered during the selection process.
Choosing a system that has easily replaceable parts is also a benefit when it comes to resident security, says Brad Hyder, marketing manager at Tektone. While the company prides itself on offering many mobile options for its nurse call systems, facilities can also opt for standard computer monitors or Apple TVs that can be bought anywhere for displaying calls as they appear on the master station.
“These systems can really be designed to meet the specific needs of any facility,” he says.
Maximizing freedom
When it comes to memory-care units, Ahmed recommends that facilities consider comprehensive security solutions that help monitor the perimeter of the building, and resident activity on and off campus through real-time resident locating capabilities that allow staff to see where residents are at any moment.
Because each resident can present a different risk of elopement, communities can create and schedule personalized wander boundaries for individual residents and care groups, he says.
Some systems can even include controlled access and wander management solutions that can be tailored to lock specific doors and elevators to protect residents with cognitive impairment from unsafe wandering. Residents in need of wandering protection wear an unobtrusive marker, and when they approach an exit door, staff will be notified and can lock the door in real-time.
“With these types of systems that analyze resident activity in real time, and deliver comprehensive incident and trend reports, senior living communities can deliver proactive care before wandering issues escalate,” he says.
Kristen Wylie, senior product marketing manager of senior living at STANLEY Healthcare, notes that it’s also important that facilities work to keep residents safe from unwanted visitors or intruders by capturing complete information on all visitors as they enter the community.
STANLEY offers a simple sign-in solution that captures essential information and a photo of visitors when they enter the community. The system records when a person arrives and leaves, and can notify administrators via text or email when a specific visitor signs in. The technology also supports detailed background checks of vendors and third-party caregivers that can include immunization and criminal records.
Alwan notes that CAST offers several resources for facilities, including its Safety Technology for Long-Term and Post-Acute Care: A Primer and Provider Selection Guide.
The guide is intended to help administrators better understand the uses and benefits of safety technologies, and includes a matrix to help them plan for, select and implement the technology solutions that best fit their requirements.
From the October 2019 Issue of McKnight's Long-Term Care News
