NURSE CALL / WIRELESS COMMUNICATIONS.

Two-way communications in nursing homes and assisted living facilities have stepped up a notch in recent months with the emergence of several new products. Many adapt ground breaking wireless technology or upgraded hardwiring to expedite the nurse call system. Staff are able to respond to resident situations and act as a team, no matter where they happen to be located in the facility at the time. Recently Nursing Homes/Long Term Care Management asked several of the leading manufacturers how this technology has evolved and where it is heading.

Ethan Walker, President, CISCOR: "Our emergency call system, the Senior Sentry, can either be hardwired, wireless or a combination of the two. We recommend fixed call switches in the bathrooms and bedrooms as the primary emergency call device. Pendants may then be given to those residents who will be dedicated to wearing them. If pendants are the only signaling device, many residents will feel encumbered by them and will put them in a drawer or otherwise misplace them and be left with no call system at all.

"Residents' lives depend on emergency call systems, and so every aspect of that system, whether hardwired or wireless, should be supervised. A supervised system will tell us if a wire has been cut, an electronic board has failed or a wireless pendant has been dropped on the floor one too many times. If the computer doesn't hear from any pendant within a user-defined window of time, it will alert staff that the pendant is missing. Also, pendants should send in a low-battery signal so their batteries can be replaced before they fail. Unsupervised life safety systems are a lawsuit waiting to happen.

"Hardwired systems will generally be less expensive for new construction, while wireless will be less expensive for existing facilities to install. Next to the wheel, there was never a greater invention than a pair of copper wires, and in the long run, hardwired systems require less maintenance. Also, there are no batteries to replace. An advantage to wireless systems is that they are mostly immune to lightning strikes, although properly designed hardwired equipment will also perform as well with lightning if opto-isolation is used. This isolates the wiring from the electronic equipment by a light beam in a chip."

Jerry Johnson, President and CEO, Cornell Communications, Inc.: "We wanted to give facilities the benefit of an alphanumeric pocket pager via an upgrade rather than having to replace their whole nurse call system. We developed a product called [VersaPage.sup.TM] that adds pocket paging to any current system relatively inexpensively.

"Another feature is simultaneous monitoring of smoke, door and patient wandering alarms, as well as the ability to signal maintenance people or the head nurse. We designed the system to connect with any low-voltage system or combination thereof at the same time.

"Another call option is strategic placement of digital displays around the building for staff that don't carry pagers; it's like a pager on the wall. Although the screens can only display four or five digits at a time, staff can develop codes, such as "R 5" for Room 5. Staff members simply have to look up to receive the call rather than having to run back to check the nurse panel."

Rosemary M. Gulati, Marketing Coordinator, Fidelity TeleAlarm: "We take a comprehensive approach. We like to be able to provide all of a facility's communications needs so that it only has to go through one vendor.

"We have in the works an automatic fall detector that will immediately call for help as soon as a resident falls. We're also working on a new wrist transmitter that will be lighter and perform more functions, such our [LifeCheck.sup.TM] feature, to show that it's working. We already feature a voice response system. When a call goes out, a voice message immediately identifies the person who is sending the alarm. With two-way communication, the caregiver knows how better to respond to the call.

"Reliability is most important for wireless products for long-term care. Our NurseCall system has intelligence within the main unit and does not need a computer to run the system. However, a computer can be interfaced with the NurseCall system for a facility that wishes to keep records and print management reports. We are the only system that will keep functioning if the computer goes down. We also have battery backups, so that if the power goes down, the system will keep on working. If the battery starts to get low, the transmitter will alert you months in advance so that you have plenty of time to change the battery."

Malik Talib, President and Chief Operating Officer, eXI Technologies, Inc., and Zahir Abji, President and Chief Operating Officer, eXI Wireless Systems, Inc.:

Talib: "Long-term care facilities will house a generation of people who are familiar with recent technological advancements. These people will expect as standard seamless wireless technologies that are not cumbersome and are effective in their approach of monitoring situations and protecting people in the long-term care setting. From an operator's perspective, these new technologies will create great efficiencies, such that if you don't grab onto them today, you're going to antiquate yourself quickly."

Abji: "We've been focusing on wandering systems, but the applications are starting to diversify. For example, for assisted living, it is now possible to make a pendant emergency-warning device with a difference. With sophisticated two-way technology, one can pinpoint a person's location on the premises and communicate back through the same pendant that their alarm has been received and help is on the way."

Talib: "We will also see some strong focus on adapting wireless institutional-type systems to residential homes, so that people may enjoy the same secure environment there."

Paul Van Hoof, Executive Vice-President, Code Alert/RF Technologies, Inc.: "We're going to see many more wireless communications products in long-term care facilities as active residents want more freedom to move about the facility.

"The ever-increasing usage of a wide variety of wireless devices will cause an increase in the level of interference. In order to address this issue, our wireless product sends completely redundant messages on a multitude of frequencies to maximize range and reliability, while minimizing interference from other messages. In the long term, we expect a trend toward more standardization of operating frequencies used by wireless communication equipment to reduce interference.

"We're also finding that there are more medium-sized long-term care facilities that do not require an elaborate system. To address this need, we're about to launch our mid-level QR7500 Quick Response System, which is targeted toward facilities that have fewer than 100 residents. It has most of the functions of a complete computer system, but it is much more cost-effective for these facilities. I also think we're going to see more integration of wireless products. For example, we already integrate the Quick Response System with paging and phone capabilities."