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Wandering: Technology to the Rescue. (Feature Article).


Few events are more terrifying for the administrator and staff of a long- term care facility than having one of their residents with Alzheimer's or another type of dementia wander off--perhaps in search of a faraway home or a time long ago--quite possibly into harm's way. Nursing homes and assisted living facilities are entrusted with the safety and well-being of people's mothers, fathers, grandmothers and uncles. How can those facilities ensure residents' loved ones that they will be kept safe without their sense of freedom and privacy being compromised?

Nursing Homes/Long Term Care Management asked several providers of wandering prevention devices what's new and how the latest technology works. Their responses follow.

Jeff Koziol, Marketing Manager, Locknetics, a division of IR Security & Safety: "There are really two aspects of wandering that need to be addressed: keeping wandering residents from entering areas where they shouldn't be, such as other residents' rooms and facility storage areas, and keeping wanderers from leaving the facility undetected.

"Our Locknetics On Board computer-managed locking devices can be used to prevent residents from entering areas where they shouldn't be. An electronic access-control device is placed on the access side of a door or opening, so that whoever is inside can leave, but only those authorized to enter can do so. This can be used on the outer side of residents' doors, to keep wanderers from rummaging through others' rooms, or on cabinets, to keep them from getting into supplies and equipment.

"For preventing residents from leaving the facility, a delayed-egress magnetic lock and a delayed-egress latching exit device are options. They allow free egress, but it's delayed. When the person leaving presses the exit bar, it sets off an audible alarm that lasts for either 15 or 30 seconds. For systems with monitoring capability, the alarm can also be sent to a nurse call panel to let caregivers know someone is trying to exit. Of course, if there's a fire, the power to the device is immediately cut and immediate egress is possible.

"For the delayed-egress openings, we have several means of allowing access from the other side. We have an iButton reader, which is a small, self-contained computer chip (about the diameter of a dime) that's carried on a fob and is placed into a port for entry; a keypad; magnetic cards that are swiped through a reader; and a proximity reader. The latter is especially suitable for residents--for instance those entering their own rooms with access-control devices installed on the doors. It's a much more 'forgiving' technology than the others, requiring only that an identification card or fob with an embedded antenna be passed within a 2-inch read radius. It doesn't require the dexterity needed for a keypad or other access devices."

John Mitchell, Director of Marketing, eXI Wireless Systems, Inc.: "We offer an expandable system called RoamAlert [Plus] ECO, which can be as simple as individual door alarms and as sophisticated as a computer-based system with its own server and workstations located at nurses' stations and in the security office. There are also several levels of coverage available in between. This system is much more flexible than our previous RoamAlert model and costs a third less. The new system is bundled, including the controller, antennas, bypass keypad, magnetic door switch, power supply, cables and documentation.

"The system involves the use of quarter-sized tags worn by residents. These are usually threaded through a strap and worn at the wrist, but some female residents' family members have decorated them and turned them into 'brooches.

"With the simplest system, a resident's tag 'wakes up' a controller device installed at a doorway when the resident attempts to enter or exit the door. This causes a warning signal to be sounded at the doorway. If the resident stays there for more than a few seconds, an alarm--which is louder than the initial warning signal--goes off, and the door locks. Staff can then come to the alarm location, assist the resident and clear the alarm.

"Staff members can temporarily disable the access controllers by entering a code into a keypad before passing within 6 to 10 feet of the controller device. If multiple doors are equipped with alarms, they can function independently of each other. The system also can be set up to cover specific 'zones.'

"The door alarms can be integrated into security systems already in place; they also can be programmed to trigger a camera or to interface with a paging system. RoamAlert [Plus] can be upgraded to an ID system--which displays specifically who is attempting to exit where--and on up to the most complex system, which shows on a display screen where on a facility's floor plan an alarm is sounding and who is there. Caregivers can then enter information and respond, and this event will be captured on a log."

Jan Aden, Sales Engineer, Electronic Contracting Company: "Monitor 32 is Windows-98-based software that integrates several manufacturers' systems--for example, wandering-prevention systems, delayed-egress magnetic locks, nurse call systems, pocket pagers, wireless telephones, intercom and closed-circuit television cameras. Our company custom-designs each Monitor 32 system to fit each client's requirements.

"Monitor 32 receives the alarms created on the various systems and automatically distributes the appropriate information to staff pagers or wireless telephones, as well as maintaining a history log of all system activity. The user then can generate customized reports reflecting system events, system pager activity and system telephone activity.

"When interfaced with a nurse call system that has audio capability, Monitor 32 enables caregivers to answer resident room calls from a wireless phone wherever they might be. The conversation can take place directly between the resident's room speaker station and the caregiver's wireless phone. This frees staff from being tied to a fixed location such as a nurses' station, as with a conventional system. When the caregiver hangs up the wireless phone, the system call is cancelled.

"The goal of this system is to enhance communication. Calls from residents and alarm information from multiple systems throughout the facility are automatically delivered to mobile staff via pagers and wireless telephones. This creates a great deal of flexibility for caregivers."

Timothy Neher, Chairman and President, Wherify Wireless: "The Personal Location System (PLS), using Global Positioning System (GPS) technology, will be marketed for use by the elderly toward the end of this year. It will be marketed for home use but can be used, of course, for residents living in nursing homes, as well.

"In facilities where PLS is installed, the resident will wear a 3.3-ounce device like a wristwatch, and an electronic perimeter--say, 50 feet--will be set up around the facility. When the perimeter is broken, the signal transmitted via GPS will activate a light on a computer, both at the nursing station and at company headquarters. Nurses and/or company staff, available 24/7, will use the Internet to gain access to a map of the resident's general location and a blip locating the resident within a few feet, wherever he or she happens to be. Unlike regular GPS, this 'assisted GPS' signal is not interrupted by urban structures or densely wooded forests, so the resident continues to be tracked. Headquarters will continue to feed back this information to the facility; at the same time, it will contact the nearest Public Safety Answering Point, a privately operated 911-call-routing service, of which there are 7,000 in the United States. In the event of an emergency, headquarters will try to bridge with the facility and the local 911 center to plan a response. Police will be able to locate the resident as quickly as possible.

"This will be originally marketed for children in the home setting, at a cost of $9 to 15 per month per device and $20 to 30 for the full service. We haven't costed out institutional rates as yet. The immediate purpose is to enable caregivers to keep their elderly loved ones at home a little longer. I know that when my grandfather had Alzheimer's disease, we could have used this device, and the insurance company would have liked it a lot."
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Article Details
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Publication:Nursing Homes
Geographic Code:1USA
Date:Dec 1, 2001
Previous Article:The year ahead for long-term care: Views from legislative advocates and analysts. (Cover Feature).
Next Article:Celebrate and Educate. (Not-For-Profit Report).

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