South Carolina Nursing Home Blog : South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

Miami Herald had a great article about how new technology is helping elderly people.  New devices monitor how well seniors are managing activities of daily living, aid with some tasks and help avoid any move to a nursing home.  Scientists, doctors, engineers and philosophers  gathered last month at a TEDMED (Technology, Entertainment, Design Medicine) conference to unveil solutions to some health care problems.

One of the devices that has been improved over the last few years is a pendant that can call 911 if the wearer falls.  Now the device can be programmed to answer the phone, reminders to take  medicine or alert to a fire, among other things.   It's one of several new products designed to help seniors stay in their homes.  At-home technology now can monitor senior citizens' movements, vital statistics, and sleep and bathroom patterns.  Many older people like having technology provide this extra layer of security because it doesn't require them to give up privacy.

The monitoring systems, which cost $150 to $200 a month, are more often prescribed to seniors for a limited time after a hospitalization or health issue. Some also are being used in assisted-living facilities where operators like the additional protections they offer.

Technology will allow seniors to avoid ``unnecessary early institutionalization'' because it will relieve the anxiety of loved ones. The ability to closely monitor a person's lifestyle also can help family members know when the older person is unable to remain home, said Katie Boyer, director of marketing for Home for Life Solutions, in Lee Summit.

Besides monitoring falls and daily activities, her company sells equipment that will turn off a stove if the user forgets. A built-in motion detector turns the appliance off if the user leaves the room and does not return in a specific time frame. As for managing medicine, systems exist that will dispense it at appropriate times and remind patients to take it. If the patient fails to take the medicine, the pills can move into a locked chamber to avoid an overdose.

GE has two products aimed at seniors: Health Guide allows users to check their blood pressure, sugar levels or heart rate daily. The information is sent to a medical provider who tracks it. If problems arise, the patient can have a teleconference with a nurse or schedule an appointment with their doctor.

The company also offers QuietCare, which uses sensors that learn daily activities and behaviors, and then watches for changes. The sensors will alert help if a person falls, goes to the bathroom at night and doesn't return to bed, or fails to get out of bed in the morning. Sensors also can be placed near the medicine cabinet or refrigerator, so monitors can track whether the person is taking their medicine and eating.

John Cobb, CEO of Senior Lifestyle, started to install QuietCare in some of his company's 70 senior living facilities this summer because he thought it would make residents safer. With QuietCare, his staff can keep track of residents' whereabouts at night, he said.

 

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PressConnects.com had a great article affirming the need for litigation; the article explains how a lawsuit initiated a change in policy and quality of care at several nursing homes.  The change was a result of the Rockfrod Incident.

Ortiz, bed-ridden from dementia, was a patient at a Rochester nursing home. His son, Felix Ortiz, suspected that his father was being neglected.

"I would walk into the nursing home and some of the workers were just sitting around, looking at their Avon books and not going into patients' rooms," Felix Ortiz said. "In my dad's room, it smelled like feces and urine. When you've been around your loved one all your life, you can tell what he's thinking, and I could see in his eyes that something wasn't right. There was a sadness."

In the spring of 2005, Ortiz's family authorized the state Attorney General's Office to install a hidden surveillance camera in his room. It documented that Ortiz wasn't being turned every two hours to prevent pressure sores, wasn't being given proper hydration, and was left lying for hours in his own waste while caregivers made bogus notations on his chart that proper care was being provided.  An investigation showed that supervision at the nursing home was so lax that employees who were supposed to be delivering care in some cases were sleeping, smoking, watching movies and leaving the nursing home for personal reasons while on the clock.

Eventually, 14 employees were convicted of criminal charges for falsely attesting that they had provided care to Ortiz, who died in June 2006. But his case now has a far-reaching effect on other nursing home patients across New York.

Under the settlement of a civil lawsuit brought by the Attorney General's Office against the company that formerly owned the nursing home, nine other nursing homes from Buffalo to the Bronx owned by the same company will install electronic point-of-care devices that require employees to document care as it's delivered, generating a central computer record to verify the care.

Point-of-care technology uses electronic devices to allow health-care facilities to record services, such as the dispensing of medication or the turning of bed-ridden patients, in real time. The information is used to create electronic medical records not only for patients' medical charts, but to help generate billing information for medical insurance. The point-of-care systems "will help insure that documented, consistent, high-quality care is given to each resident and allow us to capture care data in nearly real time and alert supervisors when a step is missed," the company said in a statement.

"Point of care is essential to the preparation and maintenance of electronic medical records, which will be an important step in delivering care across the entire spectrum of care requirements from doctor visits to nursing homes to critical-care facilities."
 

"Our loved ones who reside in such facilities deserve to receive the best care possible," Cuomo said in a statement. "This settlement helps revolutionize these homes to prevent patient abuse and neglect."

All nursing homes should be required to install electronic point-of-care devices in every patient's room.  The new system will allow caregivers to record resident information in their rooms instead of having to walk back to their station, thus saving time. The less time they spend with paperwork, the more time caregivers can spend with patients,  Many hospitals and some nursing homes currently use the technology. 

Felix Ortiz said the settlement is a tribute to his father, a retired factory worker and laborer who was known to his family for his physical strength. "He would be proud," he said. "To be part of a whole new revolution, saving lives and helping people -- that's the ultimate right there."

 

 

 

 

 

 

 

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The Dallas Morning News had an interesting article about new advancements in the field of fall prevention.  The article talks about a new business called Slip Doctors.  They treat floors with a chemical that will make floors more resistant to slips, slides and falls.  Slip Doctors also use a high-tech robot that scoots across the floor of a home or senior-living community and identifies slick spots. Slip Doctors joins an industry springing up from people's concern over falling.   Aside from promoting longer lives and greater independence, the new efforts to prevent falls may help control health care costs as the oldest boomers qualify for Medicare in about a year.

Every year, about a third of Americans 65 and older fall, and about a third of those who lose their footing require medical treatment, according to the federal Centers for Disease Control and Prevention.  More than 1.8 million older adults are treated annually in emergency departments for injuries from falls, 433,000 are admitted to hospitals and 16,000 die because of their injuries, the agency reports.   More than $19 billion is spent annually on treating seniors who fall. Without better prevention, that cost is projected to escalate to $43.8 billion a year by 2020, and Medicare will pay for most of it.

"The good news is that we can reduce the risk of falling. It doesn't have to be an inevitable part of growing old," said Lynn Beattie, vice president of injury prevention at the National Council on Aging.

 At the University of Texas at Arlington, researchers are putting older adults through a battery of tests to determine their risk of falling and to teach them to maintain their balance.  Patricia Elder, a 63-year-old Grand Prairie resident who worries about tripping because of her poor eyesight, held her ground by shifting her weight when she took the test.

Dallas-based AT&T Inc. and 24eight LLC of New York are working on a high-tech monitoring system that will signal caregivers when it detects someone is at risk of falling.  The system will use a shoe insole with built-in sensors that track changes in the wearer's gait, said Bob Miller, executive director of AT&T's communications technology research department.  "If, for example, someone becomes dizzy because of a bad reaction to medication, we should be able to detect the unsteady walk and alert caregivers in time to head off trouble," he said.  Texas Tech University will begin testing the monitoring system at a geriatric care center in Lubbock in about a month, Miller said. He expects the technology to be on the market within two years.

Low-tech approaches are also reducing older adults' risk of tumbling.  Many home health care agencies are creating services tailored to fall victims.  Gentiva Health Services, a national home health care company, aggressively markets its "Safe Strides" program.  A therapist evaluates each patient and designs an in-home exercise program to improve balance. The home is also checked for hazards, and medications are reviewed for possible side effects.

Older adults can significantly lower their risk of falling if they make better use of "old technology" such as walkers and canes, said Candy Wade, who teaches "Matter of Balance" classes to Dallas area seniors.  Seniors sometimes borrow walkers or canes from friends, Wade said, which can be dangerous because a walking aid needs to be fitted to each person.

The industry that's done the most to prevent falls is the one with the most to gain – long-term care providers such as nursing homes, assisted-living facilities and senior independent-living communities.  About 1,800 residents die each year from falls.

 

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Among older adults, falls are the leading cause of injury deaths and non-fatal injuries.  Falls account for the highest number of injuries in nursing homes and most of them occur when residents are in their rooms.  There are many ways to prevent falls or minimize the injury related to falls such as alarms, lowering the bed close to the floor, walkers and canes, floor mats, responding to call bells, and proper supervision by staff.  A new one that has been introduced is helping nursing home residents maintain optimal health.  Inside The Guardian House Alzheimer’s facility in Louisiana, each room is equipped with a Samarion Fall Prevention System. Guardian House CEO, Neal Rider said, “We have a ‘smart’ system, which is a computer system that will learn patient movement and activity.“

Each resident has an individual profile that determines the risk for potential falls. If they are categorized as a “fall risk,“ the computer and motion sensor devices will monitor their every move in bed and alert the staff if anything is abnormal.   The most important aspect is to have good staff in adequate numbers to respond to the alerts.  Looking at the computer screen as an alert comes in, Rider said, “You can see the unauthorized bed exit alert is coming in and you can see the individual getting out of the bed. It identifies where the person is in the building and where other individuals and staff are located throughout the building.“  Once the alert comes in, a nurse will immediately speak to the resident through the room television. Oftentimes, a simple reminder to stay in bed will keep a resident from making a potentially dangerous move.
This system takes the first of its kind preventative step in alerting staff before a fall happens. Guardian House Quality Assurance Manager, Kathy Richard said, “Our residents each have an electronic wristband, when they do a bed exit or they move - and the computer has programmed that that’s an unauthorized move, it will alert us.“

Another aspect to the Samarion system is its ability to prevent abuse in nursing homes. The same computer system working to prevent falls also monitors all interaction between residents, staff and visitors.

 

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John Leland of The NY Times wrote a great article about technologies helping people with health problems at home instead of in an institutional setting like a nursing home.

He writes that a flurry of new technologies are designed to enable the frail, elderly, or those who simply live alone to live independently and avoid expensive trips to the emergency room or nursing homes.   The article has several great examples.

Bertha Branch, 78, discovered the power of a system called eNeighbor when she fell to the floor late one night without her emergency alert pendant and could not phone for help.  A wireless sensor under Ms. Branch’s bed detected that she had gotten up. Motion detectors in her home registered that she had not left the area in her usual pattern and relayed that information to a central monitoring system, prompting a call to her telephone to ask if she was all right.   When she did not answer, that incited more calls — to a neighbor, to the building manager and finally to 911, which dispatched firefighters to break through her door. She had been on the floor less than an hour when they arrived.

Technologies like eNeighbor come with great promise of improved care at lower cost and the backing of large companies like Intel and General Electric.

But the devices are not usually covered by the government or private insurance plans.  Ms. Branch, who has severe diabetes and heart disease, said she could not live on her own without the system, built by a Minnesota company called Healthsense.

The cost for Ms. Branch’s basic system, supplied by a health care provider called New Courtland as part of a publicly financed program, is about $100 a month, far less than a nursing home, where the costs to taxpayers can exceed $200 a day. In the two years Mrs. Branch has had the system, she has fallen three times and been stuck once in the bathtub, each time unable to call for help without it.

Joseph Hayduk, 86, a retired Air Force lieutenant colonel, is greeted by a voice from a small box: “Good morning. It is now time to record your vital signs.” Mr. Hayduk has been using the device since 2006, after his second heart attack, through a program run by Meridian Health. The program asked him a series of questions regarding his medical condition and relays that information to Meridian Health.  There, a nurse calls all 18 patients in the program daily, starting with the ones whose data call for urgent attention. “This system’s invaluable to me, not only physically, but psychologically,” he said. “I don’t want to be in assisted living. That’s for people in wheelchairs and walkers.”

Philip Marshall, 85, another Meridian Health patient, uses a system tied to his cellphone to help him remember his medications. Mr. Marshall has high blood pressure and macular degeneration, and takes 10 pills a day. He cannot see a clock or work the buttons on most phones, so he uses a Jitterbug, a phone with big buttons and limited functions.

Drug compliance is one of the biggest problems for the elderly, especially those with memory loss. Until Mr. Marshall got Meridian’s Jitterbug system, his daughter Melanie, 55, said she had to leave work several times a month to help him with his drugs. “I’m answering the phone in meetings,” she said. “He’d forget whether he took a pill or whether he was supposed to take a pill.”

The system, which costs $20 a month, calls him after he is scheduled to take a pill and asks if he has taken it; if not, it asks him why not and sends automated alerts to his daughters.

This is the ultimate goal of personal health monitoring — that people who know they are being watched may modify their behavior to better their health.

The future of these technologies, and the terabytes they gather, can involve unprecedented information about the whereabouts and well-being of older people. In a program with Intel, Dr. Kaye is combing motion data for patterns that indicate the onset of dementia, years before the decline shows up on cognitive tests.

 

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Science Daily had an interesting article about how technology can assist in caring for residents at home instead of placing them in nursing homes. Many older adults want to remain active and independent and to live in their own homes and avoid moving to nursing homes. University of Missouri researchers are using sensors, computers and communication systems, along with supportive health care services to monitor the health of older adults who are living at home.

According to the article, motion sensor networks installed in seniors’ homes can detect changes in behavior and physical activity, including walking and sleeping patterns. Early identification of these changes can prompt health care interventions that can delay or prevent serious health events.

As part of the "aging in place" research at MU, integrated sensor networks were installed in apartments of residents at TigerPlace, a retirement community that helps senior residents stay healthy and active to avoid hospitalization and relocation. MU researchers collected data from motion and bed sensors that continuously logged information for more than two years. The researchers identified patterns in the sensor data that can provide clues to predict adverse health events, including falls, emergency room visits and hospitalizations.

"The ‘aging in place’ concept allows older adults to remain in the environment of their choice and receive supportive health services as needed. "Monitoring sensor patterns is an effective and discreet way to ensure the health and privacy of older adults."

In recent evaluations, the sensor networks detected changes in residents’ conditions that were not recognized by traditional health care assessments. MU researchers are perfecting the technology infrastructure so these technologies and supportive health care services can be made available to seniors throughout the country.

"Our goal is to generate automatic alerts that notify caregivers of changes in residents’ conditions that would allow them to intervene and prevent adverse health events," Rantz said. "Additional work is underway to establish these health alerts, improve the reliability and accuracy of the sensor network, implement a video sensor network, and refine a Web-based interface to make it even more user friendly and meaningful to health care providers."

The study, "Using Technology to Enhance Aging in Place," was presented at the 2008 International Conference on Smart homes and health Telematics. It was funded by a grant from the U.S. Administration on Aging and the National Science Foundation ITR grant.
 

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Emmy Pei works for a technology provider in the medical  industry called Direct Alert (www.directalert.ca).  She was kind enough to share an article with us and we are pleased to include it on our blog. 

Elderly Care with Technology

There exists a looming problem in the healthcare system for our baby boomer population, and that is the shortage of people available to provide hands-on care for the elderly and the aging. Enter...the robots. Or to be more specific, a robot named Pearl.

Developed by a research team at Carnegie Mellon University, Pearl is undergoing a trial run in a Pittsburgh nursing home, guiding residents around the building, helping them get from their rooms to the dining hall, or from the library to their physical therapy session. Pearl is also able to give verbal alerts to remind residents to eat or to take their medications.

Advancements in assistive technology will not only improve the care for elderly people in institutions like nursing homes and hospitals, but they will also help to keep them out of said institutions. Fall detectors, pressure mats, door monitors, and bed alerts and medical alerts all serve to improve home safety, increasing people’s ability to live in the comfort of their homes for much longer.

There are also several new options to address problems such as failing to take medications on time or remembering to take them at all. Smartmeds offers a wireless service that delivers notifications to take medications via cell phone calls. The On-Time-Rx software for Palm pilots provides a similar service, sounding an alarm and displaying a set of instructions at the appropriate time. More 21st century style options include wristwatches with preset alarms as medication reminders, or automatic dispensers which sound an alarm and dispense the pills at the right times. Also featured is the medical alert bracelets which carry the direct alert receiver. These two pieces can be worn with comfort and confidence.

One obstacle to overcome is the intimidation factor. Something as simple as cell phone buttons being too small, or wheel-mouse devices that are too sensitive can prevent some folk from adopting new technologies. Recognizing this potential pitfall, Jeffrey Pepper founded ElderVision in 1999, a company devoted to helping technophobic seniors get online. The Touchtone system replaces the mouse and keyboard with voice and touch-sensitive activation, making computers more accessible to a generation who grew up without them. To send an e-mail, for example, you can simply touch an onscreen photo of the intended recipient, instead of having to worry about typing it out.

Technological developments like these allow older generations to stay more connected, while enhancing their independence. With their health and well being in the hands of people who care and with the proper technological tools, senior citizens can live more relaxed and comfortable lives. And while the age of robots still remains on the horizon, residents of the Pittsburgh nursing home told the Carnegie Mellon team that Pearl is fine, as long as it's not seen as a replacement for human contact
 

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There is a new product called QuietCare which is a home monitoring system that tracks a resident's health, and alerts designated neighbors by e-mail or phone when something is wrong. 

The QuietCare monitoring system can keep up with meals and medications, and to alert others if he has had a fall or other emergency.

In an industry that is becoming proactive, QuietCare focuses on keeping aging or disabled people at home longer. Everything from computerized medication dispensers to concierge health-care managers aim to give the elderly and disabled the assistance they need to stay independent and safe.

With the cost of nursing home care skyrocketing and baby boomers reaching retirement, the country is facing an expensive health-care bill. Nursing homes are already crowded, and at a cost of $6,000 to $6,500 per month in Central Florida, providing round- the-clock nursing home care to an increasing number of seniors could be back-breaking for the nation's health-care system.

There certainly is no shortage of products designed to help seniors and caregivers.

AT&T offers home video monitoring, or so-called nanny cams, that some people are using to keep a watch on elderly relatives.

LifeAlert -- known for its marketing slogan "I've fallen and I can't get up!" -- markets emergency-button systems. Other companies offer similar personal emergency-response systems as well, with prices ranging from $200 to more than $1,500, plus monthly monitoring fees.

If taking medication is an issue, Guardian Medical offers a pill dispenser that can be programmed to dispense medication at certain times, and provide alerts by phone if pills are missed.

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