Technology is Finally Feeling Its Age at Senior Living Centers

This article, quoting Benchmark Vice President of IT Moulay Elalamy, was penned by Steve Bergsman and appeared in Real Assets Adviser, July 1, 2019: Vol. 6, Number 7

Moulay Elalamy

The Jewish Senior Life campus in Rochester, N.Y., is not small latkes. With 1,000 employees, it is one of the largest employers in the city as it offers such services for the elderly as independent living, assisted living, memory care, skilled nursing, adult daycare and outpatient programming. The community even has its own IT (information technology) department, which developed a mobile app called JSL Connect. It is downloadable from iTunes and Android stores. Recently, the senior community formally connected with the Rochester Institute of Technology to innovate tech programs throughout the campus.

In 2003, LeadingAge, the Washington, D.C., seniors advocacy organization, established the Center for Aging Services Technologies, but, generally, senior housing lagged hospitals and other medical groups in terms of implementing new technologies. That has all changed in recent years as tech modernization has come to the industry like an avalanche. Not only are common technical features such as tablets, voice-activation and GPS being adapted specifically for senior housing, but new companies have emerged to create cutting-edge programs for the industry.

“Technology for senior housing is changing as we speak,” says Moulay Elalamy, vice president of IT for Benchmark, the largest provider of senior housing in the Northeast. “The pace of change is also accelerating. Seven years ago, operators were just looking at wireless implementation in communities and moving some applications to the cloud. The increasing pace of technological advancements now allows us to focus on care instead of administrative work by leveraging AI and predictive models.”

New technology implementation can be expensive and not every institution will be able to keep up, or afford to keep up, which could create haves and have-nots in senior housing. Also, new buildings are already being constructed with high-technology infrastructure. Older buildings have to be retrofitted.

As Schon Alkire, innovative solutions developer for LifeWell Senior Living, observes: “Many companies will be spending lots of money upgrading infrastructure to support these newer technologies. You will still see smaller companies that either don’t feel the need to invest the capital; meanwhile, luxury communities will have to adapt to remain competitive.”

Just basic technology changes are coming fast and furious. Dr. Majd Alwan, a senior vice president of technology and executive director of the Center for Aging Services Technologies, rattles off a handful:

• Office operations: Tech for managing occupancy and health records
•Information communication: Providing wi-fi access to residents, staff and guests. Investing in social connectivity technologies for resident portals, notifications about socialization opportunities, communicate with peers within the community, wellness opportunities, menus, maintenance and concierge services
• Clinical: Medication management
• Telemedicine: Providing medical care remotely via telecommunications
• Monitoring: Access control, wander-management in dementia units
• Care coordination tools: Communicate with the outside healthcare community, including physicians
• Safety: CCTV and digital monitoring systems. Access control using fobs. Wearables that allow for tracking of residents, staff or assets. RFI (radio frequency identification) tags and GPS tracking
• Having said all that, there are two basics every senior housing community should invest in, says Gerald Wilmink, chief business development officer for CarePredict, a seniors technology company. The first is a wi-fi network that is robust, high-speed, secure and covers the entire community.

“Today, roughly two-thirds of American adults have broadband wi-fi internet service in their home,” Wilmink observes. “However, despite the necessity for real-time, connected solutions, broadband wi-fi is not ubiquitous in senior housing communities. The good news: Ziegler CFO Hotline Technology reports 74 percent of the chief financial officers surveyed stated their senior living organizations invested in internet connectivity in the past 12 months.”

The second necessity is wearable technology that can accurately monitor a senior’s health and provide proactive functions.

Older products in the market are reactive and can only report when a senior has fallen, but CarePredict is able to inform if a senior resident has an increased risk of a fall, as it has more than eight sensors and builds contextual information provided through motions, gestures, location, etc.

Wilmink says. “When a senior’s health begins to decline, he or she exhibits changes in behaviors and activities of daily living,” Wilmink says. “Before starting to run a temperature there might be changes in eating or toileting patterns.”

A proactive wearable monitors the daily activity of a resident and establishes a baseline. If a senior goes into the dining area and sits down, the wearable identifies the resident is in a particular dining area. When the resident is bringing food from table to face, the wearable is picking up a personalized gesture. It is near impossible to continuously see that type of gesture just through human observation or a single motion sensor. A proactive wearable creates the context that the resident is in that dining room and the behavior indicates eating. Once the wearable creates a baseline for a resident, if there is a sudden alteration, staff can intervene before the possibility of a health event increases.

Figuring out how to manage change requires a systematic approach, and every senior housing corporation or community has to figure it out for itself. Over at LifeWell, its philosophy has been boiled down to the acronym CAPS, which stands for connected, active, purposeful and safe living. All new technologies have to fit into one of those categories and some the company is currently working through include partnering with CarePredict to roll out RTLS (real-time locating system) technology in its communities.

“This involves a wearable,” Alkire explains. “Through artificial intelligence and machine learning, the technology figures individual resident behaviors over time, including how many minutes a resident spends in the bathroom or eating. Worn on the dominant hand, it knows the difference between brushing the hair or putting food in mouth.”

LifeWell has begun to get baselines from sleep, daily activity, walking patterns and socialization. “When one of the measurements begins to deviate from normal patterns, we can see it and intervene before it turns into a serious issue,” says Alkire.

As it is a RTLS device as well, LifeWell also knows where the residence is in its building at any given moment.

Other companies are working on similar technologies. Michael King, president and CEO of Jewish Senior Life in Rochester, says his company is also looking at wearable technology to “improve critical outcomes.” It is piloting a technology with an Israeli company that will help with stroke and cardio-pulmonary residents through assessments and improved results.

First-generation wearable technology offers a safety technology if a resident, for example, fell and could not get up. The resident could press a button on a pendant indicating to staff there was a problem. But, what if someone fell, clunked his head and became unconscious? How would anyone know? A second generation of those pendants incorporates gyroscopes and accelerators that can detect an acceleration downward and then sudden stop. When that happens, a warning goes to a call center. Also in the pendant is GPS tracking so location of an individual can be sent to staff, or if outside of the community, to a first responder.

Not everything needs to be so futuristic.

A recent trend for seniors is smart exercise equipment that tracks strength over time, which uses RFID technology in a wearable. “When the resident touches the equipment, the machine greets, for example, with a “Hi, Mr. Smith,” and then the seat adjusts to height and sets proper weights and reps,” explains Alkire. “As they are working out, the exercise equipment will count down, beep and let the participant know the exercise is complete.”

Finally, there is the iPod-based music and memory program. Generation-appropriate music is downloaded for residents, who have a tendency to be agitated or have behavioral issues. “This creates a relaxing or soothing environment,” says King. “The staff also downloads based on information from the family as to what kind of music the loved one enjoys. Our staff had to be certified for the program and it is used all over our campus.”

Baby boomers, who will be the next generation of senior housing residents, are much more acquainted with current technologies than the prior generation. Although the average age of a senior housing resident is 85, acuity levels are greater, says Wilmink. “Originally, senior housing was about a hospitality type of environment. It’s increasingly more about healthcare. The future of senior housing will be at a much different technology level than it is today.”