Multi-faceted monitoring.

Deer Lodge Centre, a 444-bed facility offering chronic care, personal care, rehabilitation and special services for the cognitively impaired, faced a dilemma. Though most of the cognitively impaired residents live in a secured Alzheimer's ward, many would get into danger if their movements were not restricted. But these restrictions could not be imposed at the expense of the other occupants, staff and visitors, who wanted the facility to remain as homelike as possible. New technology helped to resolve this, with a system combining monitoring, recording and automatic door locks to apply safety measures specifically when they are needed.

The system is called Roam Alert, from EXI Electronic Systems in Winnipeg, now owned by Cornerstone Innovations Inc., in Vancouver, BC. It is based on a central processing system in the security office. Exciter antenna units are placed at detection areas near doorways and elevators, and these create a radio frequency. Units are located at 42 exterior doors and at some of the interior doors, all of which are programmed to lock when signaled appropriately.

Residents deemed by the nursing staff to be at risk for wandering wear transponder bracelets. If a resident with a transponder approaches one of the protected exits, an alarm is set off. At elevators, the alarm has two stages: a soft bong to get the attention of the wanderers and give them time to become aware of the problem and correct it, followed by a secondary silent alarm to the security department. If the exit has a magnetic door, it is locked, while automatic doors are disabled and elevators are stilled. If the exit is nearby, a security staffer then goes to get the wanderer, but if the exit is remote, a two-way radio call is placed to someone near the door to go return the person to the ward. When the alarm is registered with security, a call is sent to the ward to let the staff know they have a missing resident. Exterior cameras can track wanderers, and the system keeps a record of all of this activity, showing the location of the alarm, which resident was involved, how quickly the alarm was responded to and acknowledged, and by whom.

During a fire emergency, the doors are unlocked for safety reasons, but the system still sends a signal to the console that residents are exiting, so that a record is kept of who is outside the facility. Also, overrides can be used to let the staff take residents out of the facility for legitimate reasons, but the system still keeps track of this activity.

Our systems committee chose this type of system for various reasons. The transponder gave us just the right kind of information - not just an alarm, but actually telling us where the situation was and who was involved, and recording all this. We've had the system for nearly four years. It helps us to relieve a legal burden, as it protects the residents without putting them in jeopardy from restraints. It makes them more secure while adding to their quality of life, because it is a less intrusive and confining way of protecting them. Finally, it prevents subjecting our more cognitively intact residents to unnecessary restriction.

Rick Rogers is director of property services at Deer Lodge, Winnipeg, Manitoba, Canada