Resident monitoring systems signal a change

“We’d rather be in the fall prevention business than in the fall detection business,” says Jim Anderson, Care Technology Systems Founder and President. “We’d rather be in the fall prevention business than in the fall detection business,” says Jim Anderson, Care Technology Systems Founder and President.

Seniors housing operators are using advanced technology to reduce falls and improve staff response time in an era of increased accountability.

By Susan Fishman

Safety and peace of mind are key considerations for prospective seniors housing residents and their families when choosing a community today, marking a turnaround from decades past when lifestyle and a facility’s amenities were of the utmost importance. 

Many elderly people are moving into seniors housing communities at a later age than in the past, often arriving with more chronic conditions and the need for an increased level of care. 

With 7,000 new enrollees to Medicare every day, the seniors housing population is expected to rise dramatically in the next 15 to 20 years. Given that demographic, the trend in rising acuity levels is likely to become more pronounced with time.

Consequently, seniors housing facilities are being held more accountable for quality of care and service. Progressive providers recognize that they need to work smartly by employing innovative monitoring and detection systems that can help improve care, reduce falls, increase the length of stay and maximize staff efficiency. 

The innovations

Two companies are making great strides in advanced monitoring systems for seniors. Roseville, Calif.-based Care Innovations, a joint venture between Intel Corp. and General Electric, has developed a wireless monitoring system used primarily in assisted living and memory care facilities. 

The QuietCare system uses strategically located sensors that detect residents’ motion as they move about, enter or leave their residence. It also monitors the use of doors on refrigerators or medicine cabinets. 

Algorithms are used to analyze data sent from the sensors to detect out-of-the-ordinary patterns, or events that may put residents at risk. QuietCare also is designed to help improve staff response and facilitate personalized care.

The system is currently in use in more than 100 different senior housing communities, comprising roughly 5,000 installa--tions across the country. 

“Because people are moving into these facilities at later ages, and with higher acuity levels, they are determining where and when to move based on the ability of that community to provide them with peace of mind,” notes Bryce Porter, sales manager for the Americas at Care Innovations. 

“With QuietCare, families value the comfort that comes from knowing that, as their loved one ages, the facility can anticipate his or her needs and reduce some of the risks in that community.” 

A similar system designed for senior living communities and individual homes by Nashville-based Care Technology Sys-tems Inc. is Quiet-Response, which also provides data analytics and remote monitoring. The company recently announced the launch of a new component in the system, the Active CarePendant, which enables caregivers to respond more quickly to a senior who has fallen. 

Equipped with multiple sensors, the Active CarePendant detects if something is amiss and sends alerts even if the senior can’t press the button to ask for help. 

“We felt we needed a better pendant solution than just the press-of-the-button version we had,” says Jim Anderson, founder and president of Care Technology Systems. “We wanted to consumerize the product to make the pendant smaller, with a better battery life and water-resistant.” 

The Active CarePendant is offered both as a stand-alone product and as a part of the Quiet-Response monitoring system, which consists of sensors integrated into the background of the senior’s daily life to document normal routines. 

When a condition is atypical, or signals a potential safety issue, notifications can be sent by text, email, page or phone, allowing caregivers to respond to the issue. The system uses a wireless hub that communicates with a cloud-based server. Reports and statistics are generated for staff via a web interface. 

Care Technology Systems partnered with Cambridge, Mass.-based BioSensics, which develops wearable healthcare sensors, to produce the pendant. The device employs BioSensics’ patented fall detection algorithms based on 10 years of research supported by the National Institutes of Health (NIH). 

It also complements the QuietResponse system, utilizing a process called Motion Scoring, to reveal life patterns that will predict falls and other behaviors.

“Once we have enough of these systems out in the general population and can begin to study the data, we’re optimistic that we can begin to spot trends that precede a fall,” notes Anderson. “We’d rather be in the fall prevention business than in the fall detection business.”

The results

Over the past several years, Care Innovations QuietCare customers have found that the system enables them to focus more on the individual needs of each resident, empowering them to be proactive in their delivery of service and care. 

“The confidence that our staff is doing the right things — and that we are paying attention to the personalized aspects of each resident’s needs — has skyrocketed,” says Kari Olson, chief innovation and technology officer for Front Porch Communities and Services, based in Burbank, Calif.

Of course, providers are also looking to reduce falls, increase length of stay and improve staff efficiencies. Recent statistics indicate hospitalization costs for falls average around $17,500. Statistics also show that one out of every three seniors will fall this year. These new technologies can potentially mean significant healthcare cost savings to senior living centers, families of seniors and the healthcare industry in general. 

Although QuietCare can’t detect whether a resident actually fell, the data collected around the leading causes of falls, such as urinary tract infections, or UTIs as they are called (which can cause confusion, dizziness and frequent bathroom trips), can help detect trends and alert staff to the risk of a fall and the need for assistance. 

According to Porter, two different studies in more than a half dozen locations equipped with the QuietCare system revealed a 58 percent reduction in falls, a 63 percent increase in length of stay and more than a 20 percent decrease in hospitalizations. 

Because Care Tech’s Active CarePendant is so new (it was launched in September 2013) the data is still yet to be collected. But according to customers like Kim Gulley, executive director of Southern Manor in Winchester, Tenn., the system is invaluable when it comes to peace of mind. 

“Before the Care Tech program, a resident may have been going out of the building at night and
we wouldn’t have known it,” she notes. 

“We were always concerned about falls. We were always concerned about safety at night. We don’t worry about that anymore. With this system, [our residents] always have a way to get help.”

The costs

QuietCare is most effective when it becomes part of the overall standard of care, with the cost burden shared by community and resident, according to Porter. Typically the communities pay for the equipment to be installed, and the resident pays the monthly service fee, which can range from $15 to $60 per month, depending on the plan. 

With the QuietResponse system, assisted living facilities generally absorb the cost, offering the system as part of the housing package. Inde-pendent living facilities may absorb the cost or offer it as an upgrade. 

“A lot of independent living operators see this as a potential new revenue stream, and in that case they essentially become a resaler for us,” says Anderson. “Assisted living facilities may feel a certain obligation to provide the system, knowing that residents are more frail and have a higher acuity.”

The Active CarePendant typically runs about $200 per apartment, which includes a radio frequency cloud, dubbed a “care cloud.” The senior is monitored in the common areas of the building and at his or her residence. The full QuietResponse system is roughly $700 per apartment, including the pendant.

The challenges

One potential concern of resi-dents about these new monitoring systems is that they are being watched and that there is a lack of privacy. Care Innovations says that once residents recognize there are no microphones and no video cameras, there is strong acceptance. 

“There are just heat sensors detecting whether there’s motion or not,” notes Porter. “Residents’ comfort level goes through the roof once they realize that if they don’t don’t get out of bed in the morning, someone can attend to them within minutes.” 

Duncan Woodward, a resident at Southern Manor and an Active CarePendant user, agrees. “I feel safe,” he says. “I don’t feel like I’m being tracked or watched, but I know I can get help when I need it.”

Compliance is perhaps the biggest challenge to a pendant system. The Active CarePendant is unique in reporting to caregivers when the pendant isn’t being used during non-sleeping hours, so staff, family or caregivers can step in and ensure the resident wears it.

From a liability standpoint, these systems are measuring when seniors are in need and how fast facilities are responding. Some facilities shy away from that sort of thing, says Anderson, but it can also benefit them.

“We’ve found that the facilities that don’t want to get better will run and hide from this system,” explains Anderson. “The progressive providers that realize you can only manage what you can measure, and that want to get better, will embrace this.”

Despite the challenges, many see these monitoring systems as a smarter, more innovative way to understand what residents need and what staff members are doing. 

“You can now customize when and where you deploy service resources and staffing,” says Porter. “So it does impact workflow. People can identify the hot spots sooner and deploy time and resources to those areas in order to get the best outcomes.”