A study in the Journal of Clinical Psychiatry.
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Communication about change matters more than the technology
A while ago I considered the question of monitoring a person (wearable devices) or monitoring the place in whcih someone resides (remote sensor-based monitoring). From that entry: "Each requires someone to educate seniors on the role of the devices on or around them so that they can actively participate -- and opt in to the idea of being monitored." I am glad that I wrote that. Here's an example where that did not happen:
I received an e-mail from the adult son of a couple who live in an independent living facility where administration decided to install a remote monitoring sensor system. There was no advanced warning to residents; monthly costs were adjusted to account for the new technology; residents were not a) asked in advance if they would find it acceptable or b) informed in advance about what it was and how it worked.
Frankly, it doesn't matter what facility or whose device it is -- preparing the residents appropriately for change is required whether it's the installation of webcams, telehealth monitoring, alarm systems, PERS devices, PCs, VoIP phones -- you get the idea.
From his e-mail:
- "...My parents are dealing with an installation of this product at the facility where they live. It's deployment (and associated costs) were a bit of a surprise and done without any warning to residents.
- No doubt many providers mean well, but they should go out of their way to provide implementation materials to administrators and require it's communication BEFORE decisions are made that disrupt the daily living of the elderly.
- FYI - My Dad asked around and the results of his simple survey found that (41 of 74 residents responded) 85% are "upset" about the action. 55% is a pretty good response rate for elderly folks who don't often express strong opinions out of concern they will be singled out as uncooperative. A natural response from those who find themselves in the care of others."
This is a very big detail about resident rights -- apparently seeking uniformity of environment and standardization of costs, in this example, all apartments are retrofitted with a device, but residents may be offered a change to opt out of being monitored. As more facilities see how they can use technology to help their residents, right to privacy agreements already signed when folks moved in must be amended with new wording -- and updated signatures.
And finally, this son shared with me the list of questions he gave to his Dad to share with the facilityadministrator. Clearly a long background with enterprise tech deployments. ;) And of course it does raise the spector of a worrisome proliferation of obsolete boxes which now fill the store rooms of enterprise IT storage rooms.
"And here's a few questions the administration should have already asked. If not, they should ask them ASAP or get someone who has done technology implementations to help them ask the right questions. Otherwise, they (and you) may get stuck with costs over time that are predictable now.
1) What is the hardware upgrade plan? (ie. how long are these devices good for?)
2) What is the software upgrade plan? Since this is new h/w & s/w you can expect frequent changes as more facilities come on board and things are improved.
3) What is the training plan for staff? Who pays for that?
4) If the database is to remotely stored and maintained; at what cost, how often is the data consolidated/analyzed, who pays for remote access h/w, s/w?
5) How long is the duration of the contract?
6) How much is the contract cost and is it negotiable depending on services provided? (ie. are there tiered levels of data service - can we start small and build up?)
7) Any cost to canceling the contract early (if it doesn't do what is promised)
8) What are the contractual deliverables to facility administration?
9) What impact will it have on residents living conditions? Do you need to maintain "x" feet of clearance from furniture?
10) Can other electronic devices (ie. computers/televisions/cell phones) interfere with these devices?
11) Where is the VENDOR response center located? (US or offshore?)
12) Who pays for the telephone access to VENDOR computers?
13) Who owns the data collected?
14) Who gets access to the data collected?
15) Is the data sold to other companies?
16) How secure is the data?
17) How is resident privacy protected?
18) When VENDOR comes to visit, will relatives of residents be notified? Can they attend? Since this is something that directly effects residents on a daily basis they should at least be informed that this is happening"
Comments welcome -- from vendors too!