The growth of the elderly healthcare market has resulted in a boom in assisted living facilities offering the medical care elderly people need with unprecedented recreation and freedom of movement. The challenge for these facilities is to be more than a nursing home yet to provide the kind of medical care patients and their families require. To accomplish that, most assisted living locations are using technology to help provide extra sets of eyes.
Assisted living residence (ALR) facilities are an alternative to traditional nursing homes or hospitals. Part residence and part medical facility, these businesses promise a more pleasant atmosphere and comfort than most nursing homes, along with recreational activities such as golf, swimming and movies.
ALRs began to appear in the United States in the mid-1980s and have expanded rapidly. More than 1 million Americans live in an estimated 20,000 assisted living residences, according to the Assisted Living Federation of America. At the same time, according to a Medicare Current Beneficiary survey, the number in traditional nursing homes has been on a steady decline.
According to Health Policy Tracking Services, published by Netscan, families can pay between $2,000 and $5,000 per month for residency, and they have higher expectations than previous generations. Families expect their loved ones to have freedom of movement, privacy and comfort, so technology that provides those elements becomes a facility selling point.
Give them what they want
Just like traditional hospitals, ALRs face a host of challenges when they select a security system. ALRs should provide the proper security for patients and their visitors, and they should keep a traceable record of what happens to ensure the liability risk is low. To reduce that liability, facility owners attempt to build a safety net using technology that can ensure residents receive care when they need it and in a timely manner.
Accountability is the No. 1 issue for these facilities, according to Dave Jacobs, national sales manager for Ciscor, Norman, Okla., a provider of integrated security systems.
“If someone gets hurt and there is no way to get the response they need, [the facility owner has] a huge problem,” he said.
What Ciscor tries to provide is a safety net within a safety net. Assisted living homes can cost many thousands of dollars yearly and are under pressure to provide the kind of service and safety that justifies that expense.
In most cases, clients are given a pendant or call button to allow them to quickly signal for help if they have an emergency. With many of the available wireless systems, the ALR can record the time a button was pressed and send a message to multiple active employees at the facility; it will continue to send the message until someone responds and indicates he or she will be responsible for the visit. The alarm continues until the employee actually arrives at the resident’s room and presses the button again to indicate the emergency has been attended to. The Ciscor system also sends an e-mail to facility maintenance staff when a battery is running low in any of the devices.
ALR security also needs to be flexible enough to extend outdoors. Many of today’s assisted living homes have acres of gardens, trails and walkways that allow its residents the freedom to walk alone or with others around the grounds. If a resident has an injury or medical emergency, however, they still may press their pendant alarm, and if there is a receiver located within 300 feet, a member of the facility staff can receive the alarm and determine the individual’s location on the grounds. Ciscor offers 900-MHz receivers that can send a signal back to the central location at, for example, the nurses’ station or to staff pagers.
However, every facility is different, so each system must be designed to the specific facility, Jacobs said. Some residences need door-access codes. Others use panic buttons. Some need motion sensors around a bed or at a doorway.
“You have to be like a menu,” Jacobs said. “We can help anywhere along the way. Most want all the bells and whistles.”
Most importantly, end-users want to select a system that offers flexibility and ease of installation. For new construction, contractors need to ensure their customers are getting what they want before they run the conduit, Jacobs said. In some cases, facility owners fail to select a security system early enough, not realizing a good wireless system or other security technology needs to be part of the construction process.
“If you have a large facility, you can hardwire it with a wireless overlay,” Jacobs said.
Bosch Security Systems, North America, Fairport, N.Y., -created Security Escort as a wireless security solution for college campuses 15 years ago, but the bulk of its growth has been in assisted living.
“That is the biggest area of growth right now,” said Hal Faith, Bosch manager of systems support for Security Escort. “More people want a home-like atmosphere, but the family is still looking for help when it’s needed.”
With Security Escort, the patient has a link to the nurse or emergency services using a pendant and receivers deployed around the building or yard. The system also comes with features including motion detectors or door contacts that are programmed to send an alarm if a specific time passes and no one has opened a particular door or passed through an assigned area, indicating someone may be in trouble.
In one assisted living facility in Connecticut, a transmitter in the doorbell is designed to send a page to all staff during off hours, so all the staff is instantly alerted if someone attempts to enter the door at night. In other cases, patients with dementia can be tracked through their identifying pendants, automatically locking doors or sending alarms if they attempt to leave the facility or enter an area such as a swimming pool.
Like Ciscor, Bosch offers an outdoor security system with receivers deployed every 300 feet to locate residents as they walk through the campus or on trails.
With the technology in place, many systems are undergoing software improvements, allowing facilities to better track records, including who has received a visit to their room, who has received which medications and other details that, until now, relied on pen and paper or manual data input.
Facility owners or managers also can begin tracking their own staff members, knowing which residents the staff has attended to, where staff members are in the facility and where they have been. But the growth of the ALR industry still may be outpacing the growth of technology for meeting demands.
“The industry is growing, and it will keep growing,” Faith said. “Assisted living is going to grow by leaps and bounds. We’re all living longer and staying healthier. Some of these places today are just fantastic.”
Foresight is necessary
As more electrical contractors venture into low-voltage and wireless network integration, they must stay ahead of the technology and be able to properly explain it to facility owners. The business is beginning to extend far beyond security tracking systems. Most ALR facilities now use a network of cameras and fire alarm systems. In most cases, facility managers have thought through the building’s security system before construction, but that doesn’t always happen, Faith said, which is where the contractors step in.
“Some don’t realize what they need until after the fact, and then they’ve lost a lot of their flexibility,” Faith said.
With an eye to future technology growth, Philips, Framingham, Ma., offers Lifeline, which incorporates personal emergency response, magnetically locked doors and monitors placed around the campus of a facility, using RFID technology.
“What we do is set up a safety bubble with a proprietary wireless network with the ability to monitor any device that is communicating,” said Paul Baril, marketing manager. In this way, as technology grows and expands, new Philips devices could be plugged into the network, he said. (Although Philips offers an on-call center, a facility can opt to monitor its own residents).
“The industry is growing, changing, and there isn’t a standard yet,” said Saul Shapiro, product marketing Lifeline solutions manager. Because of that, many facilities (some with 40 residents and some with many hundreds) each need a custom system.
Philips sends a staff of experts to each ALR to discuss their exact needs, and anyone doing the installation has to consider the variety of customer needs, Shapiro said. Typically, ALR facility managers are not knowledgeable about the technology, so building the appropriate system requires that both vendors and installers meet with the owner to discuss what the facility needs.
“You need a good residence safety backbone to detect and respond to all the devices,” Baril said, adding that some of the devices still are being developed but will be in demand soon.
“Because the industry is so fragmented and there are so many processes, it’s very important to understand the community’s needs and understand the products,” Shapiro said.
“Our end interest is to ensure our product is configured properly,” Baril said. “We go through a whole needs analysis and define up front what their needs are. We go all the way to understanding the materials of the building and know how they will work with the network. Every system is a custom system.”
The trend in ALRs is toward the independence and comfort provided by technology. For now, each solution needs to be custom built, with input from the vendor as well as a knowledgeable integrator and installer.
SWEDBERG is a freelance writer based in western Washington. She can be reached at firstname.lastname@example.org.