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Assistive technology in the ALF: monitoring technology can lead to better senior living.

No longer evoking fears of "Big Brother," personalized per·son·al·ize  
tr.v. per·son·al·ized, per·son·al·iz·ing, per·son·al·iz·es
1. To take (a general remark or characterization) in a personal manner.

2. To attribute human or personal qualities to; personify.
 monitoring technology has gained popularity over the past several years. Consumers, including long-term care long-term care (LTC),
n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders.
 residents, have started to understand and welcome the advantages this technology offers.

Many individuals who historically would have been dependent on institutional supports can now use noninvasive assistive technology Hardware and software that help people who are physically impaired. Often called "accessibility options" when referring to enhancements for using the computer, the entire field of assistive technology is quite vast and even includes ramp and doorway construction in buildings to support  to live in homelike settings, such as assisted living as·sist·ed living
A living arrangement in which people with special needs, especially older people with disabilities, reside in a facility that provides help with everyday tasks such as bathing, dressing, and taking medication.
 communities (ALF ALF - Algebraic Logic Functional language ).

Long-term care providers, including ALFs, spend much of their time juggling regulations and increasing resistance by consumers to the institutional model of care. Historically, residents' families and friends have worried about the care their elders receive in the ALF setting and have clamored for assistive devices assistive device Public health Any device designed or adapted to help people with physical or emotional disorders to perform actions, tasks, and activities. See Americans with Disabilities Act, Architectural barriers, Assistive technology.  such as personalized monitoring to help them balance parenting for their own children and provide appropriate care--often long distance--for their elderly loved ones loved ones nplseres mpl queridos

loved ones nplproches mpl et amis chers

loved ones love npl

There are also case managers who assist ALF residents in getting the care they need. These individuals have long been the backbone of identifying proper supports for residents, but a combination of decreased funding and increased caseloads has limited their options to crisis management. Think about how they might benefit from being able to monitor ALF residents from afar.

And finally, community agencies and providers have long emphasized supports to keep residents as independent as possible, but they struggle to attract and retain qualified caregivers to aid residents, even as the number of support requests grows.

Tech-savvy solution

Fortunately, monitoring technology can be used in the ALF setting to solve several issues. Here are a few samples of how monitoring technology increases opportunities for resident independence in the ALF:

1. Family and friends can access the Internet at any time and from anywhere to trend activities such as sleep patterns, meal preparation, or the timeliness of medication dispensing. Caregivers can design customized parameters to be notified of exceptions to normal everyday patterns, such as prolonged inactivity, a door or window being opened at unexpected hours, or an electric stove In cooking, an electric stove is a cooker which uses electricity as a source of energy. History
Lloyd Groff Copeman invented the first electric stove in 1896 while working for the Washington Power Company.
 being on for longer than normal. Automated phone, text message, and e-mail alerts can let families and friends know immediately if there's a potential problem.

2. Case managers can access individualized in·di·vid·u·al·ize  
tr.v. in·di·vid·u·al·ized, in·di·vid·u·al·iz·ing, in·di·vid·u·al·iz·es
1. To give individuality to.

2. To consider or treat individually; particularize.

 reports containing valuable information about an ALF resident's daily activities. Using this information, they can create a more accurate and useful individualized support plan. Additionally, they can verify visits by professionals (e.g., nurses, physical therapists, occupational therapists occupational therapist A person trained to help people manage daily activities of living–dressing, cooking, etc, and other activities that promote recovery and regaining vocational skills Salary $51K + 4% bonus. See ADL. , etc.) through the use of an entry and exit access code.

3. Community and home health agencies can use medical and disease management devices to analyze data trends as well as receive notifications for specified data anomalies. Data are stored at a password-protected Web site. There is also a benefit in tracking employees through access codes to ensure accurate billing.

4. ALF providers can be part of the paradigm of community services by becoming part of the response team of caregivers. ALF employees can receive alerts and notifications for certain types of nonalarm events for which central station response might not be appropriate or effective.

This direct monitoring connection between the consumer and the assisted living center allows for a more tailored response in the event of a potential issue at the residence. It also lets care providers establish an early link with potential ALF residents who currently live independently but may need long-term care support in the future. By using electronic monitoring, ALF providers can offer their potential consumers supports to age in place.

With all of these advantages, what is preventing technology from being embraced as a form of service and support by ALF residents? Following are some of the hurdles standing in the way of monitoring devices:

* Funding obstacles: Much of today's long-term care funding comes from Medicaid and Medicare systems designed in the 1960s, when little affordable technology was available. New support systems make better use of limited resources. Most states already have, or are in the process of implementing, proper funding mechanisms to cover electronic supports, thereby stretching the available dollars while increasing residents' options.

* Fear of what we don't know Don't know (DK, DKed)

"Don't know the trade." A Street expression used whenever one party lacks knowledge of a trade or receives conflicting instructions from the other party.
: By embracing the concept of electronic monitoring, many seniors, caregivers, and service providers will be exposed to new equipment and to a new service delivery system. ALF residents may fear that they are being spied spied  
Past tense and past participle of spy.
 upon or are losing opportunities to touch base with their family members or caregivers. ALF caregivers may believe they are being replaced or forced to become computer geeks Computer Geeks is an Internet discount retailer of computer hardware, peripherals and consumer electronics to businesses, resellers and consumers. Computer Geeks focuses on purchasing manufacturers' excess inventories, closeouts and out-of-date products which allows the company to , induced to give up traditional hands-on caregiving to sit behind a screen all day. Using technology for monitoring support and data collection will require ALF providers to learn and use a new skill set. It is human nature to avoid something we perceive as challenging or difficult.

* Fear of losing control over what we know: Healthcare providers have always had to rely on what people tell them. Not all consumers recognize trends in their own behavior or are aware, forthcoming, or totally truthful about their problems. Just what will a sensor sense? Residents may have concerns about this that you will have to help them overcome.

* Fear that technology will replace the care component: Contact with family, friends, and the community are vital components of a resident's everyday life. Will being able to log in or receive a text message replace direct interactions? This is another area in which you may need to ensure your residents that monitoring technology won't replace the assistance they already receive from your staff.

To implement technology as a valid platform of service provision, ALF providers, caregivers, and family members must integrate these tools into the continuum of care. Caring for people requires being with them. Technology should enable and inform caregivers--not replace them.

A field guide to monitoring devices

Some of the monitoring technology currently available for the senior housing and care markets includes the following:

* Personal emergency response systems

These devices are standalone stand·a·lone  
Self-contained and usually independently operating: a standalone computer terminal. 
 systems of limited scope that may require a long-term contract. The responders are usually police, fire departments, or emergency medical services An Emergency medical service (abbreviated to initialism "EMS" in many countries) is a service providing out-of-hospital acute care and transport to definitive care, to patients with illnesses and injuries which the patient believes constitutes a medical emergency.  (EMS) personnel. The facility will incur charges for fire department and EMS responses as well as for false alarms.

* Central station monitoring

Monitoring in this scenario is provided by a licensed security company. Central station monitoring limits the types of events monitored and the reports and data available to residents or care providers. The role of the central station should be to supplement--not replace--local care providers, such as assisted living facilities (ALF). That's because ALFs have the advantage of relationships with residents and knowledge about their particular situation and history.

Residents and care teams should know exactly what to expect from a central station system. Questions to ask the security company include, "How does the central station system ensure that it has current data on which to base a response?" and, "Will this system provide notifications to the caregiver support team?"

* Prepackaged pre·pack·age  
tr.v. pre·pack·aged, pre·pack·ag·ing, pre·pack·ag·es
To wrap or package (a product) before marketing.

Adj. 1.

These systems are available through retail outlets retail outlet npunto de venta

retail outlet npoint m de vente

retail outlet retail n
 and infomercials. They usually have limited reporting features and expandability.

* Personalized activity monitoring systems

Some of these systems are expandable and allow creation of an individualized plan of support with flexible notification options, but without requiring a long-term contract. Look for systems that can accommodate unique devices, such as stove and pressure sensors A pressure sensor measures the pressure, typically of gases or fluids. Pressure is an expression of the force required to stop a gas or fluid from expanding, and is usually stated in terms of force per unit area. A pressure sensor generates a signal related to the pressure imposed.  and medical monitors.

What are the costs?

Hardware costs typically range from $200 for a personal emergency response system to $500-$950 for a basic, but individualized, monitoring system. Specialized systems cost more.

Monthly costs generally begin at $40 but can go much higher depending on the level of oversight offered and whether the service plan includes central monitoring. Central station monitoring services The general surveillance of known air traffic movements by reference to a radar scope presentation or other means, for the purpose of passing advisory information concerning conflicting traffic or providing navigational assistance.  may require an extended contract of one to three years.--Allen Ray

Allen Ray is president and CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board.  of Community Management Initiative (CMI (Computer-Managed Instruction) Using computers to organize and manage an instructional program for students. It helps create test materials, tracks the results and monitors student progress. ), Inc., a company that delivers programs, supports, tools, and services designed for caregivers of the elderly and disabled. Through affiliations with CMI and other companies, Ray has been involved in providing services to seniors and developmentally disabled adults since 1989. If you have questions or would like more information, please contact him at or call 888/684-3581.
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Author:Ray, Allen
Publication:Contemporary Long Term Care
Date:Apr 1, 2007
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