Securing long-term care

Paul Baratta

Long-term care is not only an area of professional focus for me. It’s also important to me on a personal level.

Like so many others, I have experienced the decline of an elderly parent and witnessed their journey through the managed care system. Sadly, I have also lost a loved one who contracted COVID-19 in a long-term care facility.  And I am also part of a growing demographic facing a future where the need for elderly care is outpacing resource availability. All of these experiences inspire me to find ways to improve quality of care and independent living for seniors.

In this blog I’ll examine the top safety challenges in long-term care, the value that technology can add, as well as considerations when selecting and implementing technology in a managed care setting.

Top safety risks in long-term care

Challenges that have plagued long-term care for years will only intensify as the global population ages. A growing incidence of dementia and comorbidities – coupled with the fact that people live much longer than they used to – means that care providers must continually strive to keep pace with an ever-increasing demand for care.

For years, the sector as a whole has grappled with caregiver recruitment, low worker morale, poor public perception, and disparities in care quality. As if that wasn’t enough, add to that a global pandemic.

This combination of factors contributes to some of the top safety risks facing long-term care today.

  • Wandering and resident elopement: With the increased incidence of dementia among long-term care residents, this is a constant challenge for managed care facilities. Not only can wandering lead to resident injury or death, it’s also one of the costliest risk exposures in long-term care.
  • Falls: The CDC projects that the number of older adult fatal falls will reach 100,000 per year by 2030 – with an associated cost of $100 billion. Even non-fatal falls can cause serious injury, lengthy hospital stays, and diminished life quality for long-term care residents. But it’s not only residents who are at risk. Slip and falls represent the primary cause of lost days from work for healthcare staff, which only further adds to the worker shortage problem.
  • Aggression and abuse: As the threat of workplace violence continues to increase, healthcare professionals remain disproportionately affected. Aggression and abuse not only contribute to days away from work, but they are also driving some to leave the profession altogether. In addition, resident on resident abuse is a common problem, particularly among those with dementia or other mental health illnesses. And sadly, the World Health Organization recently reported that 1 in 6 people aged 60 years and older experienced some form of abuse in community settings, while 2/3 of staff admitted to committing abuse in the last year.
  • Infection control: Long-term care residents and staff accounted for nearly a third of all COVID-19 related deaths in the US during the first year of the pandemic. So it’s no wonder that infection control has risen to become a top safety concern within managed care. And it’s not just COVID, influenza and other respiratory viruses can also be life-threatening for residents with comorbidities and suppressed immune response. But a balanced approach to infection control is needed. One that offers reasonable protection for the elderly and infirm, but that also captures the health benefits of active social engagement between residents and their friends and family.

Technology that enhances safety and increases efficiency

Technology has long been an integral component of any healthcare environment. With advancements in digital health, the evolution of robotics and 3D printing, and the emergence of artificial intelligence, technology is helping improve patient outcomes, increase personal safety, and amplify healthcare efficacy. Let’s examine how technology addresses some of our long-term care safety concerns.

Monitoring technology

Believe it or not, there are still long-term care facilities that primarily rely on physical wellness checks for their residents, but this is not sustainable long-term. It’s also intrusive, disrupts sleep, and leaves residents vulnerable for extended periods of time

Monitoring technology is therefore a good complement to physical wellness checks – improving resident safety and independence. For instance, wearable technologies that pinpoint resident location enable residents to move more freely, but also minimize the risk of elopement when integrated with door sensors. Motion and pressure sensors in resident rooms alert caregivers to nighttime movement and fall risks without being intrusive or compromising resident privacy. And visual monitoring via remote video surveillance allows caregivers to validate alarms and perform wellness checks much more efficiently and less intrusively than physical wellness checks alone. This is particularly true in the home health sector, where caregiver presence may be minimal and non-actionable alarms more resource intensive. A remote visual monitoring system such as the one used by the Grimstad municipality in Norway can drastically reduce false alarms, thus saving time and costs while improving patient care.

We can also expect to see an increase in the use of video as a primary sensor for fall detection or prevention in the future, as edge-based deep learning processing combines with advanced image quality technology to yield more accurate event alarms.

Communication equipment

The ability to signal a caregiver is extremely important, especially for residents with limited mobility. In long-term care, two-way audio devices remotely connect residents with a member of staff – either actively through the touch of a button, or as an event-based alert using sound detection and advanced audio analytics. It’s technology that both increases resident safety and protects their personal integrity. Because sometimes, a simple verbal exchange is all that is needed. And by minimizing unnecessary physical contact, it’s also possible to limit the spread of infection.

Other relevant communication equipment in long-term care are smart phones, virtual video visitation, and other assistive technologies that support social interaction between residents and their friends and family. This can greatly improve resident satisfaction, particularly when geographical distance or global pandemics prevent them from meeting their loved ones in person.

Additionally, there is a host of multi-sensory devices to communicate important information to residents with impaired hearing, such as digital signage or strobe lighting.

Restricted access and door sensors

Restricting access not only minimizes theft and protects property, but it also facilitates free movement through your long-term care facility while mitigating the risk of wandering and elopement. These days, restricted access is also an important means of infection control. And as automation replaces traditional “locks and keys”, long-term care facilities can more securely manage visitors as well as staff turnover. Automated access control offers more flexible user access options ranging from multi-factor authentication in critical areas like medication cabinets, to wearable fobs that automatically open a door for an approaching resident. It’s technology that not only secures the inside of the long-term care facility, but it can also automate vehicle entry and exit to and from parking lots and delivery bays.

Stakeholders in focus

While there is no doubt that technology offers many benefits for long-term care, acceptance and adoption are key to a successful technology implementation. And the needs of all relevant stakeholders must be considered.

For staff, the technology needs to be intuitive and easy to use. It also needs to have a real value – offering them personal protection, absolving them from liability, or reducing their workload. This is especially true of monitoring technology, which might be perceived as a tool for unwanted oversight and a violation of worker integrity. One way to help overcome this barrier is to work closely with caregiver and healthcare employee unions to develop policies and guidelines related to technology use.

For residents and their families, the technology should enhance safety, provide peace of mind, increase their freedom, and encourage social interaction. It should also protect their privacy and personal integrity while making their lives a little easier. Technology use must conform to relevant legislation and be ethical. With respect to monitoring technology, clear processes and transparency around how and when the technology is used helps build confidence and trust with residents as well as their families.

For facility administrators, the technology should enhance resident safety and well-being, increase worker efficacy and satisfaction, reduce costs, and diminish liability risk. Administrators must also be able to trust that the technology they implement has a high degree of cyber protection and includes features that ensure legal compliance and ethical use. It’s important that administrators consider all stakeholder needs, include their teams in developing formal governance and training programs, and openly discuss with residents and their family members how the technology will be used.

The decade of healthy aging

Scientists say that the first 200-year-old has already been born, while the United Nations has declared the 2020s the decade of healthy aging. By connecting people, technology, and processes to address our long-term care challenges now, we can all look forward to more active senior living and expanded possibilities in our “golden years”.

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