A study in the Journal of Clinical Psychiatry.
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How not to deploy remote monitoring technology
Tech is useful, but deployment approach needs some work. So here's an article about Senior Lifestyles Corporation and their deployment of QuietCare in a Florida (Fort Pierce) Assisted Living community. Was this a happy experience, like the NY Times article last year about keeping frail individuals longer in their homes through effective remote monitoring? Sadly, no. This one cites a family member describing the additional $200/month charge for QuietCare as 'elder abuse' while contemplating legal action. Another resident circulated a petition protesting the installation, and the local ombudsman has now weighed in and discussed the situation with the press. Hmm. That didn't go well.
Yet the remote monitoring benefit was not disputed. In the article, the benefit of QuietCare use was stated clearly: "The system records how many times a resident uses the bathroom at night, what time they get out of bed in the morning and other variables, to establish a baseline behavior profile for each resident. Should a resident diverge from that 'normal' behavior — like suddenly making seven bathroom trips a night — it might indicate a urinary tract infection, according to Tom Ostrom, senior vice president at Senior Lifestyles Corp. The system has therapeutic value, he said. “Studies indicate it increases length of stay (in assisted living facilities) by 58 percent. The number of falls in one study dropped by more than 50 percent,” he said."
SLC has triggered an unintentional firestorm. Earlier this year the firm proudly discussed its plans for QuietCare deployment across its 70 communities, announcing in various press releases as rollouts were completed. In contrast, this website has also received an anonymous comment from an aide who believe that motion sensors like QuietCare also are being used to verify the arrival and departures of aides who may feel overworked and over-watched. The issue: as residents become more frail, assigned resident numbers per aide may go up as costs are cut when occupancy levels go down.
It doesn't need to be this way. Remote monitoring should not be viewed as a malevolent plot. No one died; no one was even injured. Communication and planning could have avoided this ruckus and presented it as a desirable feature helping residents remain longer in their assisted living residence versus needing a nursing home. How could it have been handled?
Choice a) If an organization only knows how to or must install in all units, they can still turn it off for those who don't need or want it, enabling the device when a new resident moves in.
Choice b) Remote monitoring can be bundled in with higher service tiers that include other aide-based assistance (like help with dressing) -- noting the value when the aide isn't available.
Choice c) It can be bundled into pricing for new residents -- once it is explained as one of the (attractive) features of moving in and feeling safe over time -- right up there with grab rails on the way to dinner, pull cords in the bathroom, or other safety features.
All three of these choices, with proper marketing to families, can be combined with staff training in advance of deployment -- like any other system -- about the purpose, benefit, and usage. But pricing needs to match the perceived benefit in a particular market, not cover the cost and create revenue in one-size-fits-all approaches, independent of location.
Tech deployments are mostly not about technology. Bottom line, if the staff feels mistreated, underpaid, overworked or misunderstood, any change can be viewed as adversarial, especially the introduction of motion sensors that (at first glance) may appear to replace labor -- versus their benefit -- to supplement labor by adding an additional way to help the frailest. In many senior housing communities, management is already skittish about technology deployment -- why self-inflict more pain by sending a letter notifying all of a price increase to cover something residents and families don't understand? Maintaining the one-price-fits all mandatory stance in the face of resident outrage? In the midst of a bad economy?
What's it mean? In the long run, tech-enabled services should be tactical improvements that residents and their families are willing to pay for. Remote monitoring is an option for those who are still in their own homes as well -- who don't want to move as they age. But the firestorm this time combined with this approach won't help that happen.