Senior Technology With Staying Power

by Jeff Shaw

Emerging out of the pandemic are some unique tech tools that have become part of everyday life at many senior living communities.

By Eric Taub

It’s often said that seniors and technology don’t mix. Whether it’s remembering how to use a television remote, send a text message on a smart phone or stream a Netflix video, the conventional wisdom has long been that the elderly frequently find those types of tasks to be a challenge. Seniors often forget the skills they learn, and which younger people master and take for granted.

But thanks to the pandemic, those assumptions are being challenged, as senior living operators have turned to technologies they hope can ensure that residents remain mentally and physically healthy. 

While some may be novelties, disappearing once the pandemic ebbs, others will likely have staying power, creating operational efficiencies, as well as easing residents’ stress, creating well-being and ultimately improving physical and mental outcomes.

Underlying them all is the newfound embrace of video conferencing. Products such as BlueJeans, FaceTime, Skype, Teams, Zoom and others have exploded in popularity and serve as the backbone for other important applications, such as telehealth, social engagement tools and online learning.

Important prerequisite

But before senior living operators can employ any technologies, they’ll need the underlying infrastructure to make it possible: high-speed, ubiquitous broadband, available throughout every nook and cranny of a senior living residence.

“Technology innovation in our communities was a silver lining when COVID-19 hit. But to make any technology work, you need to  have the bandwidth,” says Patricia Will, founder and CEO of Houston-based Belmont Senior Living, a 31-community group operating across eight states and Mexico. 

Due to the pandemic, the company upgraded its broadband at a cost of $175,000 per community for a total investment of about $5.4 million. Belmont wanted to guarantee that all areas of every residence could access a high-speed signal between 250 and 500 megabits per second, not just in common rooms and apartments. 

“Thanks to broadband, my 91-year-old father streams Netflix and contacts people using Whatsapp,” says Will.

When the Statesman Group was constructing its first U.S. facility in Phoenix, the company made sure that fast Wi-Fi was built into the plans, says Nicolle Blais, COO of the Scottsdale, Arizona-based company. Residents are guaranteed a 250 megabits per second bidirectional connection speed throughout the facility.

With broadband as the backbone, here are some technologies that have become popular with senior living residences during COVID, and are likely to have staying power once the pandemic ebbs.

Videoconferencing, telehealth

As the pandemic took hold and social distancing was implemented, video conferencing went from a business tool to an integral part of most peoples’ lives. And nowhere was video conferencing more important than in senior living, where at-risk residents were often forced to remain in their rooms most of the day, dramatically limiting social interactions while increasing depression and reducing mental acuity.

Thanks to video conferencing technologies, senior living residents have been able to reconnect with friends and family. While a virtual visit is not akin to a live one, the live video connection has enabled social interactions to continue, something that would not have been possible if the pandemic had hit 20 years ago before the widespread availability of broadband.

That increased interest in videoconferencing is evident by Zoom’s skyrocketing growth in the U.S. From December 2019, when the pandemic first had an impact, until April 2020, the volume of Zoom calls increased 30-fold, from 10 million to 300 million per day, notes Ron Emerson, Zoom’s global health lead.

Zoom’s video conferencing technology has enabled the growth of telemedicine, a tool that’s become particularly important as the elderly have been warned to shelter in place to avoid infection. Emerson notes that the use of Zoom for telemedicine has experienced the same growth rate as videoconferencing overall.

“During the pandemic, we had a wakeup call when we saw the emergency rooms filling up,” says Belmont’s Will. “Telemedicine has become an enduring godsend for us. We can now perform triage in a resident’s apartment.”

“Telemedicine is bringing back house calls,” says Krish Ramakrishnan, BlueJeans co-founder and now the company’s chief of innovation and products. 

Thanks to telemedicine, an in-person visit to the doctor’s office that used to take up an entire day — the resident had to prepare for an appointment, be transported, wait to be examined by the doctor and then be driven home — can now be accomplished in minutes. That saves not only time, but also helps maintain the resident’s emotional state.

Using BlueJeans’ recently announced telehealth platform, physicians can bring in family members to the chat. The company recently announced an agreement with Apple, whereby lab tests and vitals stored in the Apple Health app can now be viewed by a physician through the BlueJeans telehealth platform.

Owned by Verizon and based in Basking Ridge, New Jersey,  BlueJeans offers a number of telehealth-
specific features, including a virtual waiting room where a patient can watch instructional videos until the doctor is ready, and a single click to join the session. 

To make the technology easier, the platform will eventually call the patient when the session is about to begin.

Features of the BlueJeans platform include: 

• integration with remote patient monitoring (RPM) tools, enabling a physician to receive alerts once certain indices pertaining to vital signs are reached, such as a rapid weight gain or quick change in blood pressure; 

• fall detection technology built into an Apple Watch that will transmit a fall event to the BlueJeans platform, which will then alert the appropriate caregiver. 

Thanks to telehealth and future RPM capabilities, “soon, going to a doctor will be as infrequent as going to a bank,” Ramakrishnan predicts. 

Zoom is also emphasizing new telehealth features. The technology is already integrated into the Epic telehealth application. This allows patients to launch into Zoom from a MyChart patient portal on a personal computer or mobile device. Zoom is also beta testing the ability for iPhone users to click on a link to bring up Zoom in a browser, with no app needed.

The company is also focusing on offering software development kits (SDKs) to third-party vendors to allow them to integrate Zoom into social networking applications. Eventually a user will only need to touch one button to be brought via Zoom into, for example, an exercise app. 

Social engagement

The increased isolation of residents due to COVID restrictions has heightened the need for tools that allow the elderly to communicate with others. Independa,  a social engagement tool that enables senior care residents to communicate with loved ones via their TV, has observed a growing interest in its product.

Independa, based in San Diego, offers users the ability to communicate via video with family members and between residents. The platform enables staff to broadcast upcoming events and issue medication reminders. Family members can post messages and photographs using the Independa mobile app.

“We were looking for something that could connect our residents with their families, as COVID had an emotional impact on our population,” says Eric Kinger, chief experience officer for Keystone Management Services, with over 900 residents in 43 locations. The upfront cost to Keystone was $300 per device, and it will pay $10 a month per device for the subscription.

Kinger had considered using a voice technology product such as Amazon’s Alexa, but decided against it, as that would have introduced a new product, with required new skills that its residents would have had to master. As a television-based device, “we chose Independa because of the simplicity of the product,” he says. 

In order to make Independa work, “we spent a lot of time upgrading our Wi-Fi,” says Kinger. The company now has Independa in over 100 units across six communities. 

“Once residents saw the remote, they realized, ‘I could do this.’ It was just as simple as a cable TV remote and they got really excited,” explains Kinger.

The Statesman Group recently installed Independa in its new community in Phoenix, The Manor Village at Desert Ridge. The developer and operator chose to use Independa because of its TV-based technology, and its ability to enable engagement between residents and their families, while also monitoring the resident’s use of the platform to ensure that engagement was taking place, says Blais.

Once the COVID pandemic eases, “the need for Independa will not decrease,” emphasizes Blais. “The ability for residents to communicate with families and each other will always be important.” 

Blais expects to eventually roll out the Independa technology to its 10 other properties located in the Canadian cities of London, Ontario, and Calgary.

Social engagement involves more than simply visual communication between parties. The elderly need to keep their minds active and alert to stave off mental decline.

One way to do that is with interactive games. But the COVID pandemic increased the reluctance of senior communities to use standard games due to the potential of infecting residents as they touched game pieces.

Obie has developed a different approach. The system uses an overhead projector, mounted eight to 12 feet above the ground, to transmit interactive games to a flat surface. Players manipulate the game board by touching the projected image. Once residents finish playing, staff need only wipe the table or other surface upon which the game was played.

Based in Israel, the 15-year-old company began life selling interactive games to companies such as McDonald’s as a way to entertain kids while they waited for their food. 

“The pandemic shined a light on how important engagement is for senior residents,” says Dennis Jakubowicz, U.S. chief revenue officer for EyeClick Senior Living, Obie’s parent company. As a result, the company repurposed its offerings, developing 54 games designed to engage seniors and those with dementia. 

Sold via subscription and available in 200 facilities in North America, the system appealed to The Virginian, an LCS-managed senior living community in Fairfax, Virginia. Its ease of use was part of what attracted Andrew Carle, The Virginian’s executive director, to the product.

“This isn’t a generation that will read a 60-page manual,” he says. “Obie has no manual and no setup requirements. With four different challenge levels, it’s particularly good for seniors with dementia because it addresses dementia’s ABCs: apathy, boredom and a lack of communication. Anything that fires up the synapses is a good thing.”

“The outcomes we’ve seen with Obie are incredible,” says Dawn Platt, national director of memory care programs for Discovery Senior Living based in Bonita Springs, Florida. Platt cites the example of an adult son who regularly visited his mother at the residence, but due to her mental decline he was barely able to experience any reaction from her. After playing with Obie, his mother smiled and socialized with him.

“The improvements we’ve seen are not measurable like athletic accomplishments,” says Platt, “but using Obie provides residents with a sense of well-being, improved behavior and a resultant improved quality of life. With Obie, we’ve seen everything from a sense of excitement, to smiling and laughing more, to greater social interactions.”

Education delivery model adapts

The pandemic forced educators to look at new, socially distanced ways to provide learning. GetSetUp, a nonprofit, San Francisco-based organization backed by $10 million in investments, provides free online classes in a wide range of subjects geared to persons over 50 years old. 

Classes are customized for learners in six countries, but can be accessed no matter where the viewer lives. Subjects range from tech help, to fitness classes, to those that feature guest speakers, such as travel writer Rick Steves, the longtime host of “Rick Steves’ Europe,” a travel series on public television.

Each class is live, which enables attendees to ask questions and communicate with each other. Similar interests have brought people together, meeting in person and becoming friends. The company also creates customized classes for various senior living communities and is confident that they’ll remain popular even once the pandemic is over.

“As you age, it’s really exciting to be exposed to virtual communities,” says Liz Miller, the company’s communications director. “We offer a whole world to seniors, one that senior living communities alone couldn’t.” 

What’s next?

Artificial intelligence (AI) is expected to eventually fuel interest in remote patient monitoring, telling caregivers not only that an event has occurred but also predicting the likelihood that it might in the future.

“Remote patient monitoring and in-room sensors will be of interest to us, but only when they incorporate predictive analytics,” says The Virginian’s Carle. “We don’t need to know if someone fell; we need to predict fall risk, the risk of getting a urinary tract infection and other events. It’s coming.”

“Memory care residents are three to four times more likely to fall, and they can’t tell you what happened,” notes Belmont’s Will. 

Belmont installed video cameras in resident rooms, enabling staff to see the event that led up to the patient falling. 

“Sometimes they’re on the floor just because they wanted to sit there,” says Will. By analyzing the footage, Belmont has been able to cut the number of unnecessary emergency room visits in half.

Once AI is available, Belmont looks forward to adopting it. “We’re just at the cusp of technology,” says Will. “Adoption of these new solutions will take a lot of education and training.” n

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