12/09/11

The information-technology wave is hitting long-term care facilities, and residents are starting to enjoy the ride. In fact, facilities are beginning to encourage residents’ personal interest in technology as part of the effort to improve their health and lives.

COURTESY CONNECTED LIVING, INC.  Resident Mary Deal of Brookdale Place in Birmingham, Ala., samples the internet platform called Connected Living.

As health information technology (HIT) has entered long-term care, a question has been whether it means anything to residents personally. Researchers who reported their results online this summer in the Journal of Aging and Health assessed nearly 800 nursing home residents before and after their facilities implemented HIT (J. Aging Health 2011 [doi:10.1177/0898264311408899]). Although 60% said they noticed no change and 7% said care had declined, 30% said that they felt the use of HIT had improved care and 71% said that they believed that handheld devices that track and manage information are positive innovations. A majority said they were glad such devices were being used in their facilities.

That many residents are unaware of HIT isn’t surprising, said Golden Living Chief Medical Officer James Avery, MD, CMD. "In many ways, HIT exists backstage. Just like a good Broadway play that works well, you don’t even notice the backstage movements."

He said he believes that HIT will dramatically improve resident care but that many of its manifestations will be unseen by residents. Astute and experienced patients and residents may notice that they don’t need to repeat everything that happened at the hospital or during the last shift or even details of a surgery that occurred 10 years ago, as it all is captured effortlessly.

On the other hand, engaging residents in technology can gain their buy-in to HIT while improving their lives through their own use of computers, said Kevin O’Neil, MD, CMD, chief medical officer of the Brookdale Senior Living chain of assisted living and senior communities. As they become more comfortable with technology in their own lives, they are more open to its uses to improve documentation and care, he said.

"Approaching residents with the idea of health information technology wasn’t as engaging to them," said Dr. O’Neil. Brookdale officials realized that technology had to appeal to residents on a personal level. With this in mind, the company has introduced Connected Living, a program that enables residents to access a customized home page that offers e-mail, photo sharing, music, audio books, video conferences with family members, and notices about daily events and special activities.

"We hope they will become comfortable with this technology and see the advantages for applications such as transfer of information," said Dr. O’Neil. To date, classes conducted to introduce the program have been well received.

While many long-term care facilities have computers that residents can access, many of the devices go unused, Sarah Hoyt, CEO of Massachusetts-based Connected Living, said. "When we walked into the Brookdale buildings, we’d find 5 to 10 computer users out of 100 people or more." This wasn’t surprising considering that most residents are in their 80s and have had little exposure to technology, said Ms. Hoyt.

Just placing computers in communities and expecting residents to use them isn’t enough. By motivating residents to connect with their kids and grandchildren, technology becomes less intimidating, Ms. Hoyt said. "Residents typically aren’t incentivized to participate in technology when it’s just about health. But when it’s about family and life, it has a purpose; and the adoption rate is much higher."

Just months after the program’s introduction, about 75% of Brookdale residents are registered computer users and 60% are active, regular users.

High Tech, High Touch

Not only does personal use of computers encourage communication, but it also contributes to residents’ health, said Ann-Marie Bland, senior vice president of marketing and product development for Connected Living. "We believe that social engagement is an important predictor of senior health, and Connected Living gives residents a sense of purpose and meaning." She noted that computer connections encourage residents to be more active in the community. "Often, people don’t want to come out of their rooms initially. Now they can use the computer to integrate into the community, find friends and activities, and so on. This is the most exciting thing we have found," Ms. Bland said.

This is a significant step, said Dr. O’Neil, because "we would like to see residents more engaged in all aspects of wellness. Part of this is finding something that gives them a sense of meaning in life. It not only builds on social platforms but encourages people to be more proactive on their care."

Connected Living links users to reliable sources of information on the topics they’re interested in, such as smoking cessation and weight loss, Dr. O’Neil said. "This is key, because one thing I often discuss with residents is the need to get reliable information sources."

Making technology and health information fun for residents is essential, said Ms. Hoyt. "When it’s fun, people will follow a path and get interested." It also is important to hold residents’ interest by continuing to motivate them. "We have weekly computer classes that are interactive and multimedia," Ms. Hoyt said. "They address everything from brain health to international travel. While [the residents] are learning about art and reminiscing about the war, we weave in health and wellness information. It drives excitement, and we have high attendance."

While such programs may seem a luxury, Ms. Hoyt said, "we’re seeing boomer families demanding this. ... Boomers have a choice, and increasingly they choose connected communities."

Dr. O’Neil added, "When my time comes to go into a long-term care community, one that is wired and has a health-information platform will be essential." CfA

Senior contributing writer Joanne Kaldy is a freelance writer in Harrisburg, Pa., and a communications consultant for AMDA and other organizations.

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