Departure alert devices.

Recently Nursing Homes/Long Term Care Management asked leading vendors of departure alert devices and technology to evaluate recent developments in their field and speculate on future needs.

Don Kost, vice-president of sales and marketing at RF Technologies/Code Alert, says that "the biggest trend in wandering devices is integration, with wandering device manufacturers partnering with general communications companies." In this way, he says, companies can offer complete Windows-based telephone systems that include antiwandering devices and door locks and elevator deactivators that are linked to nurse call systems, smoke and fire alarms - even quick-response units for residents who wear alert pendants. "The future will see a growth in voice-to-voice technologies, as well," he notes.

What's more, says Kost, all these activities can be monitored by a single computer that keeps detailed records. Mapping capabilities let facilities identify and respond readily to problems via pagers or cell phones.

Integrated systems, both hard-wired and wireless, mean that the devices can be linked on multibuilding campuses. Such electronic linkages "let people be used more effectively," says Kost, and "reduce a big cost factor in the labor-intensive assisted living environment."

Mike Chylewski, senior vice-president of operations for Care Trak, says that antiwandering devices are "actually life safety devices, much like fire extinguishers, which are necessary to have on hand in hopes they will not be used. They are survival factors." He notes that the industry is now working to make transmitters smaller, lighter and less obtrusive, so they can be placed in wearables such as watches, belts or even in gym shoes in the case of some younger or more active wearers.

It is not enough, however, for a facility to use antiwandering devices simply to monitor doors, says Chylewski, because residents are savvy enough to escape via windows, kitchen exits and loading docks, often "helped" by visitors who inadvertently disarm doors. Going a step beyond door guards is now possible with new technologies that protect wanderers even outside the building, tracing their movements up to a mile away.

"Actually," says John Brasch, president of Senior Technologies, manufacturers of the WanderGuard[[R] departure alert system, "the industry has had 15 years to develop its technology, with three to four generations of improvements now adding their benefits. Today is an era in which government regulation and plaintiffs' lawyers are adding their own pressures for facilities to improve and standardize their procedures." The next step, he says, includes technology, but goes beyond simple hardware to focus more broadly on "a total program for resident safety and security."

This, Brasch says, would include staff training, documentation systems and periodic reviews of the physical plant to assess the adequacy of current procedures, as well as effective communication with families and the public. "What we need now are sound and comprehensive systems, used routinely," Brasch concludes.

Brian Martin, president of Instantel, Inc., notes that "the technology for antiwandering devices has been here a while," though progress is being made with miniaturization, longer product life and better transmission. However, coming to the fore are portable locators that can find wanderers after they have left the building, as well as integrated systems that use cameras to record resident exits and pagers that can summon busy staff who spend less time at nursing stations. "It all has to do with speed," he says.

These trends have evoked more interest in devices that identify and record the names of residents - and the number of residents - who set off alarms, both at the exit and the nursing station, instead of simply locking doors or summoning caregivers, he notes. The ability to record names helps facilities deal with families who are in denial about their loved one's ability to escape. It also helps facilities to know which residents are likely to turn up where, important information in an era of high staff turnover rates. Finally, portable locators have saved lives by finding wandering residents before they have suffered from prolonged exposure.

"The challenge is to protect residents while giving them freedom," concludes Martin.