Resolutions For Your Senior Living Community

All too often, resolutions are about the things we give up, the things we choose to do without. No wonder they never get off the ground. This year at Tel-Tron, we’ve decided to take a different approach, by giving you a few ideas on how to enhance and enrich your community and it’s residents and to help make your community an even better place to live and work this year. Here is some inspiration to get you started:

ImageGo Green: A healthier lifestyle begins with a healthier environment, and with all the tools and resources available, it is easier than ever to ensure that your community is eco-friendly. Here are a few simple solutions:

  1. Get an Energy Star check: How energy-efficient is your community? An EPA Energy Star check is the best way to know for sure. Not only is an Energy Star certification mean that your facility is eco-friendly, but it also ensures superior comfort for your residents and a reduction of up to one-third in your energy costs. It’s a win-win!
  2. Recycle Everywhere: While most community have implemented recycling programs in their main living areas, this year, make a commitment to facilitate recycling throughout your community by using divided bins in residents’ rooms or on shared hallways. Education is also important. Since seniors did not grow up recycling, many of them know very little about it. Discuss what can and can’t be recycled, using physical examples, so residents are clear on the guidelines and your program is more successful.
  3. Reduce fabric waste: Fabric waste is a little-known environmental problem in the United States. Assist your residents in getting rid of unwanted clothing and linens with a centrally located donation bin. Donate these items to a shelter or a local thrift shop. Many of these places donate unwanted items to fabric recycling facilities, which turn them into cleaning rags, brushes, etc.

Make Connections: Fostering a sense of community is the key to having happy, fulfilled residents, and achieving it is easier than you think. Here are a few suggestions:

  1. Reach out to Residents: Most communities have feedback systems in place, but many residents are hesitant to publicly voice their suggestions, so be sure that you offer a suggestion box of another method for residents to anonymously give their feedback.
  2. Capitalize on Skills: Create a questionnaire to uncover the hidden talents and abilities of your residents, and ask those that are able to host programs around these skills. From woodworking, knitting, and scrapbooking to more active pursuits like yoga and dance, these offer a great way to make sure residents feel relevant and connected.
  3. Help Out: Most people feel a great sense of satisfaction and usefulness by helping others, so find a way to band together for a good cause, from organizing a food drive to stitching blankets for children at homeless shelters.Image

Resolve to Do Better: When residents stay healthy, the entire community thrives. Here are suggestions to help your residents stay on track:

  1. Host a Resolutions Party: Residents can pick a buddy to help them stay on track and offer feedback on ways that the community can help, perhaps by providing healthier meal options or more opportunities for exercise.
  2. Encourage residents to take up one new activity in 2014 that engages their mind, and create loosely organized clubs around these activities. Book clubs, language learning, or puzzles all offer great opportunities for mental exercise.
  3. Schedule a Wellness Check: Offer a free wellness check to residents from a trusted healthcare provider, and use the results to formulate or further develop resolutions.

For more information on how you can improve safety and security for your residents in 2014, visit www.tel-tron.com for details on our complete and customizable Emergency Call System solutions for your community.

The Value of Independence in Senior Living

A few years ago, I read an article comparing American values to the values in some developing countries. The writer emphasized that autonomy and independence are as integral to American culture as the proverbial baseball and apple pie. In some countries, particularly developing nations, interdependence is emphasized, but in the United States, our goal as parents is to raise kids who can survive, and thrive, without us. A couple of years ago, I found that, at virtually the same time, both of my daughters went through tricky transitions on the road to independence. One wanted to do everything herself, but couldn’t. The other could do most things for herself, but wouldn’t. It was a frustrating phase, but in retrospect, it taught me a lot about the role of independence in senior living.

TiedShoesSetting Realistic Expectations

The key to successfully maintaining independence in an assisted living facility is to set realistic expectations. Determining your residents’ abilities and capabilities is the first step. In assisted and independent living facilities, most residents can successfully handle the following tasks.

  • Using the restroom
  • Coming and going at will
  • Preparing simple meals and snacks
  • Selecting their own television shows, reading material, etc.
  • Brushing their teeth, showering, and other basic grooming skills

A well-meaning caregiver who steps in and intercepts when help is not required brushes aside a lifetime of independence, a process that can slowly erode the resident’s sense of self-esteem and autonomy.  There are many advantages to fostering independence in seniors, including emotional, psychological, and physical benefits, and a more independent group of residents lightens the load of caregivers, allowing them to focus on the residents’ who truly require help.

Utilizing Technology

Resident Check-In

Technology can help seniors maintain their independence or sense of independence for much longer. Technology such as resident Check-In, automated resident reminders, and wearable safety devices can provide the independence that seniors desire.

If you’re looking to give your residents the gift of independence, without compromising life safety or wellness, contact us at Tel-Tron.

Dignity Can’t Exist Without Independence

boyontoilet

Dignity at All Ages

It’s never cool to walk in on someone when they’re going to the bathroom. Even when that someone is 5. And you’re there to, you know, help. I have learned this the hard way. If a door is closed, knock. Dignity is important, even to a 5 year old.

Kids can teach you a lot about the value of dignity. And privacy. And independence. Further proof, if we needed it, that people don’t really change all that much when they get older. Their abilities may evolve, or in some cases devolve, but the need for autonomy remains the same. Dignity simply can’t exist without independence. It’s a fundamental component of happiness, whether you’re 5 or 95, and research supports this claim. Studies have repeatedly shown that maintaining independence is a primary goal and concern from many seniors.

Avoiding Dependence on Caregivers

A senior who enters an assisted living facility has been dressing himself and preparing his own meals his entire adult life. Slowly, however, with the well-intentioned care of an attentive staff, those tasks are taken over for him. Someone else pours his coffee, ties his shoes, and tells him when he can and can’t go out for a walk. All of this help can lead to helplessness.

Helpless Adult

Art Carr, Founder and President of Progressive Retirement Group, put it this way in a recent blog on the Senior Housing Forum: “…the cumulative effect of family, friends and/or healthcare professionals telling the senior that they CAN’T or SHOULDN’T continue doing specific tasks (e.g. laundry, yard work, cooking) and/or caregivers taking over responsibility for these functions weighs on the individual.  Ultimately, they’ll give in and become dependent on the caregiver – EVEN WHEN THEY COULD STILL DO IT THEMSELVES!”

Technology Aids Independence

Tel-Tron develops its products with independence in mind. We want your residents to maintain their independence and dignity for as long as possible. When technology is subtle and unobtrusive, it fits into a resident’s lifestyle, providing solutions that preserve privacy and enhance the assisted living experience. Tel-Tron’s Life-Safety products offer a wide range of customizable solutions to meet the needs of your Senior Living/Assisted Living facility, including:

Resident Check-In devices for Independent Living without intrusive staff checks.

Push-button call stations that blend in with the surrounding decor.

Incontinence alerts that provide silent alerts to caregivers.

Wearable wireless pendants for mobile, independent residents.

Automated wander-prevention solutions to reduce elopement risk.

Please contact us if you would like to discuss how Tel-Tron can keep your residents safe while maintaining their dignity.

Do You Have a Program Designed to Reduce Fall Risk?

Senior woman in wheelchair with caregiver

How do you use technology to mitigate resident fall-risk & maximize independence?

The risk is real
The awareness related to fall risks over the last few years is staggering. One in five hip fractures results in a death within a year of the incident. One in four seniors that fall and fracture a hip, who used to live independently, spend at least the next year in an assisted living or nursing home environment. It’s also a little concerning how little, as an industry, we’ve done to mitigate the risk. Fall detection is largely a waste, the damage is done, and unless the resident is unconscious automated fall detection devices do little more than let you know the horse is out of the barn.

What can you do?
Fall prevention programs need to be comprehensive and targeted. Do you evaluate the medications your residents are taking and develop specific and targeted prevention programs if their medication puts them at increased risk? If a resident has had a previous fall, do you know the likelihood of them falling again compared to those who have never had a fall? Are you putting technology and processes in place to create an environment which reduces a resident’s risk of a repeat incident? Knowing the precursors of a fall is a critical component to prevent it from happening.

For further reading on the risks related to falls and the possible outcomes, often life threatening, visit the CDC’s Website on Falls for Older Adults .

If you don’t currently employ technology to prevent a fall then contact your sales representative
(sales@tel-tron.com) to talk about what it takes to be successfully implement a fall prevention strategy.

To learn more about the benefits of Tel-Tron’s unique fall management technology, click here.

Maximize the Potential of Your Emergency Call System

Are Senior Living Management Teams Out of Touch? The Senior Care Investor www.seniorcareinvestor.com thinks so. In a year where many strong companies in our market grew at an impressive clip, others faltered. During these periods of growth the challenges of bringing on new buildings in different states of disrepair, staff members from different performance cultures, and resident occupancy varying greatly by geographical market have restricted earning potential for even the industry leaders. To steal a quote from the SeniorCare Investor’s most recent publication, “When someone figures out how to profitably run a large chain but maintain a mom and pop feel, then that company will top the return lists every year.” Whether you are the mom and pop provider or you’re trying to create that feeling within your community, personal attention to detail and a level of concern for the quality of life and security of your residents is what creates the “I’m home” feeling.

Being there when a resident needs you, responding with the same passion you would to your own family, being able to know when you miss and make it right; these are just the first steps to creating the feeling of home. You’ve got dinner, the air conditioning, the community bus, and putting green to worry about. Let us tell you when to worry about a resident’s security and emergency health needs require your attention. Let us take care of the compliance to your internal policies.

There is amazing new and innovative technology being created every day by us and companies like ours that goes under-utilized. Many of you already own it and just aren’t taking advantage of what you’ve already bought. All you have to do is invest the time to better understand how knowing what you don’t know can change the lives of your residents.

Here’s a quick tip to ensure that your key team members are really in touch with what happens at the front lines of your communities. Follow the steps below to enable a notification sent directly to your cell phone every time a resident waits more than ten minutes for assistance. You may think your front line is staffed appropriately and responding with the same passion you would, but this will let you know for sure.

Log into your Auditrak reporting package at www.auditrak.com and select the My Auditrak tab.

Select the Contact Methods link on your My Auditrak page and ensure that your contact information is correct.

 Once your contact information is correct go back to your My Auditrak tab and select the link for Event Notification Setup.

If I were interested in Emergency Call events I would select that option from the list, it’s the last item listed in the above image, then select the option for Report after and change the value to 10 minutes.  If I select SMS as the notification option I will now receive a notification every time an Emergency Call at the selected community reaches 10 minutes without being responded to by the staff onsite.  This will give any executive a real time feel for what’s happening at the community level.  Allowing you to intervene and change the experience of your residents in nearly real time can make the difference between the feeling of home and the feeling that they are alone an uncared for.

If you’re interested in having a discussion or seeing a demonstration about how the systems you already own can allow your team to better focus their time on what matters most and ensure that leaders in your company know when things aren’t right on the front lines send me an email at mgraham@tel-tron.com or give me a call at 386-523-1078 so we can start the changes today.

VERY Key Metrics – Ignore At Your Own Peril

Tel-Tron powers the systems technology at roughly 1,000 retirement communities, improving the quality of life for over 100,000 residents. We work with over 200 senior living clients and have a very long-term understanding of the good, bad and ugly of senior housing management.  I’ve been tempted to start a blog series on things I would do if I owned a senior living company or community.   Given the challenges we’ve helped folks through this week,  that temptation is growing harder and harder to resist.

Let’s consider this post the prologue to that series, which will provide a behind-the-scenes, outsider’s, perspective on some very fundamental changes senior living executives could implement that would change everything for them.  Here is an example.

Visual Management of Staff Response to Resident Emergencies

Here are a few snapshots from a daily dashboard – available to any Tel-Tron user – from Auditrak.com.  Check out these statistics and see if you agree with my recommendations.  This is a real-life 80 unit assisted living community, with a fairly aged population.  The staffing levels are similar to sister communities of similar size, but the needs here are apparently greater than the staff can handle effectively without intervention.

Take a look at the activity level for just the last 24 hours on this real-life emergency call system.  What we see is a disaster. If I were the Executive Director of this community, this would have my undivided attention.  What I see is that in the last 24 hours, there have been 74 emergency calls, most of which originated from a resident pushing their wireless necklace pendant.  The balance were from pull cords in the bedroom, with only a small number of alarms originating from a pull station in the bathroom.

Daily Activity Snapshot

THE AVERAGE RESPONSE TIME IS 42 MINUTES!!!!  The longest alarm took 6 hours.  One has to assume that the 6 hour alarm has some explanation, but the average is 42 minutes.  In fact, a resident living at this community would be far better served by calling 911, rather than using the emergency call system installed in the community.  What, I ask you, other than poor training, indifference, lack of understanding could cause the people responsible for caring for these residents to think this average is acceptable.

Let’s look at a Chart 2, also for the last 24 hours, which will show us the call distribution by hour for the last 24 hours.  What we see is that the average number of calls per hour is approximately 4.  There appears to be a peak before the dinner hour, and again between 10pm and midnight.  Even still, these peaks only represent 7-9 calls an hour.  Not a very heavy workload by any measure.

Chart 2

Next, let’s take a look at some performance gauges that this community has set for itself, using their own targets, in the three areas relative to staff response.

Performance Gauges

We already discussed the average response time.  Notice their own internal target is 5 minutes, with 8 minutes being allowed.  The longest response time has been discussed already, too.  The last metric, % of responses outside their target threshold, 72%.  An overwhelming majority of their resident emergencies are taking staff longer than 5 minutes to respond.  I know.  Not every alarm is an emergency.   However, there is no way to know the real alarms from the non-emergency alarms until staff responds.  It is imperative to treat each alarm as the real thing, or else when there is a real alarm it will be a disaster.  Worse yet, an avoidable one brought on by complacency.

Last chart.  This one is about profitability, which may make hiring more (or better) staff a reality for this community.  This is a chart that shows the top users of the emergency call system.  Take a look.

Frequent Users (and abusers)

Remember, there were 74 emergency calls in the last 24 hours.  These 7 residents alone accounted for 71% of the calls placed over that period.  They should be paying more than others.  Whoever is in room 218, if this is continuous over time, should be paying even more than the other 6.  They are using the emergency call system 3X as often as the person who is number 3 on the list.  Assuming each alarm takes 5-10 minutes of staff time, this single resident is getting 1-3 hours of staff time  – daily – that other residents aren’t receiving.  I’d charge for that somehow.

Surely there are a number of factors that go into determining how much a resident pays for assisted living services.  The amount of staff time consumed by excessive use of the call system should be among them.

These are just a few examples of the kind of data that is available on the Auditrak.com service.  These 4 charts are on a daily dashboard that is emailed to executive directors (if they request it), making review of the numbers almost effortless.  Failing to review these numbers – which is apparently the case at this community – results in poor performance across the board.  My guess is that their resident surveys aren’t that great either.

Technology Makes Top Ten Senior Living Trends for 2011

From Senior Housing News comes this article about technology. Click here for full article.

I highlighted things that stuck out for me.  One thing they failed to mention was the safety piece.  The barriers to entry into this “senior monitoring business” are very low.  With many companies, safety is a marketing buzz word.  I like the mention here of industry standards and the economic value of such, however, the life safety benefit of standards is the real deal.

Technology – Monitoring Networks, Apps, Devices and Systems Integrators

Ladies and Gentlemen, start your monitoring …..Through gadgets, apps, networks and the cloud! During 2010, a trickle of vendors released new monitoring systems and delivery options. The flood gates are going to bust open as the economy heals and companies are looking to invest and expand into high growth markets. Look for continued announcements and product offerings from old and new technology companies as well as acquisitions and roll ups of related products and services for the senior care market. Some products will be “me too” products that will provide additional market choices but few, real new features. Who will win? We’re betting on well designed products that are simple without feature overload at reasonable prices.

One of the areas that will start to accelerate in 2011 is systems integrators working in local markets to deploy various monitoring systems that employ industry standards  ***See UL2560 article here *** . If vendors work within established standards, the costs for deployment and support have a higher probability of being adopted faster than those that are built upon proprietary technology. These systems integrators will need to provide better service than the Geek Squad but also know about concepts on senior living design and general contracting besides the technical nature of deployment of these networks. What are we forgetting? The most important features: selling and servicing seniors and their children. How many local GC’s are ready for this? If you said very little, you’re probably being generous. The costs of a design and tech make-over may make your stomach turn at first but if amortized over an additional 5 years in the home versus assisted or skilled care, it will seem like a bargain.  In a society of instant gratification, that will be a hard sell.

So what about safety?  It seems most folks are interested in the fire alarm.  When it comes to the “wireless nurse call” system, a standard of mediocrity exists.  If the “emergency call system”  is ever used to save a life, shouldn’t it be designed to do just that. . . . in all conditions?   If a component fails, the power goes out for several hours, the annunciator panel becomes disabled, etc., it should still be capable of saving a life.  See Tel-Tron’s website for the real deal solution.

A National Standard for Emergency Call Systems (It’s on the way!)

In any Assisted or Independent Living community, the emergency call system is a significant link in the delivery of Life Safety for the residents. When help is needed, the expectation is that the emergency call system will reliably summon that help.

Despite this importance, however, emergency call systems are often treated pretty casually. Many think the various systems available on the market are all alike; they are not. Many assume that any system on the market must meet a nationally recognized standard; not so – there is no such standard – not today.

Nurse call systems for hospitals and nursing homes have had the ANSI/UL 1069 standard for many years. There are significant differences between application of nurse call and emergency call systems, however; applying a standard for nurse call to a residential property, such as Assisted Living or Independent Living, simply does not work well.

The standard for Assisted and Independent Living is coming, though. After almost seven years of work, a final draft of ANSI/UL 2560 has been posted on an internal UL web site for comment by members of the panel that will vote upon its adoption and other stake holders. Depending on the comments received, it will most likely be voted upon and adopted in early 2011.

 

The new 2560 standard covers hard wired and wireless emergency call systems. It requires minimum coverage of fixed call stations, allows portable devices (pendants) and specifies the maximum time from when an alarm is placed until it is reported. Generally, calls can be canceled only at the point from which they originated. (With certain exceptions, the call cannot be canceled from the desk.) All devices must be self testing and troubles must be reported within specified times. The standard requires backup power and obligates the manufacturer to state how long the backup power will last. It also requires that a battery powered device report a low battery and will continue to work for at least seven days after the low battery report.

The standard is very inclusive in terms of requirements. It provides no special advantage for any one manufacturer; most current manufacturers should be able to comply with only minor revisions to their products, if any. The standard also provides for future innovation by covering only the core life safety system. Ancillary features which were not envisioned by the standard can be added to the system provided they do not interfere with the operation of the core system.

This all started back in 2003 when Tel-Tron and a handful of other manufacturers formed the Emergency Call Systems Association (ECSA). The intent was to publish a consensus standard that would detail the minimum standards for an emergency call system. With no staff and no budget, the attempt never really got off the ground.

Then, in 2005, the National Electrical Manufacturers Association (NEMA) picked up the ball. NEMA’s “Health Care Communications Group” expanded its role and became the “Health Care Communications and Emergency Call Systems Group.” Many of the companies from the by then disbanded ECSA were represented and the effort for a national standard resumed. A task group was formed to draft a standard and both NEMA and UL agreed to provide staff support.

 

Like all ANSI standards, 2560 represents a consensus of manufacturers, users, regulatory agencies, and National Recognized Testing Laboratories (NRTLs) and other stake holders. By rule, and to avoid building standards around parochial interests, manufacturers are a small minority of representation on a Standards Technical Panel (STP). In the case of this standard, the STP consists of 17 members, only 5 of whom are product manufacturers.

A white paper on the proposed standard has been prepared by NEMA and is available here http://www.nema.org/stds/sbp1.cfm. (The document is free, but NEMA is not immune from bureaucracy, so you need to create an account to download it.) In some areas, the white paper was predictive, and there are some discrepancies between it and the draft standard, but it still provides a good overview of the standard.

Once the standard has been adopted, it will take some time for manufactures to demonstrate compliance to an NRTL and become “listed.” Our industry is moving towards the time when owners, developers, and managers of Senior Living communities will have a trusted third-party evaluation of the emergency call systems they are considering for purchase.

Tel-Tron has always been dedicated to lifting the reputation and quality of our industry. A national standard is one way to do that. Our Brian Dawson was founder and president of the original ECSA. Brian is also a member of the Hospital Communications and Emergency Call Systems Group at NEMA. I chair the Technical Committee of that group, was a member of the task group that created the original draft of the standard, and wrote the NEMA white paper. I am also a member of the UL1069 STP (to which this standard has been assigned) and chair the task group charged with handling ANSI/UL 2560.

As the senior living industry continues to mature, the time for this standard has come. Resident safety is too important a topic – from both the humanity and legal points of view – to take a chance on a product that cannot meet minimum standards. Most manufacturers and suppliers of emergency call systems provide quality and reliable products. There are exceptions, however, and this new 2560 standard will allow communities to purchase compliant products with confidence.

All Senior Living Communities Are The Same!

Exhibit ASeriously.  Take a look at the web sites for the top senior living providers and see if you can spot the differences between them.  I’ve posted a few screen shots from a few just to prove the point.  Look at the mission statement graphic.  Is there a senior living company in existence that doesn’t claim to do ALL of those same things?

  • Friendly/Caring Staff
  • Beautiful Rooms
  • Great Food Service
  • Fun Activities and Social InteractionExhibit B
  • Regular Laundry Services
  • Transportation as Needed
  • 24 hour emergency response system
  • Etc., Etc., Etc.

So it is reasonable to assume all senior living communities are the same based on what they “claim” to be able to provide.  Deeper understanding isn’t necessary.  The only method to choose one from another would be whichever is cheapest.  Make sense?  It’s only where you will likely live the rest of your life.

To a person, my clients would say that is a ridiculous assertion.  And they would be right.

Having been in literally hundreds of retirement communities all over the United Exhibit CStates I can say with certainty that while the list of offerings is similar, all senior living communities are NOT the same.

In about 100 ways that don’t show up well on paper, I could easily describe the difference between a run-down old building, with criminal care givers, operated by a fly-by-night company and a well run, thoughtfully built and superbly managed senior living community – maybe even operated by a equally high quality corporate owner.  Every senior living executive knows instinctively that not all senior living companies, or communities, are created equal.  Far from it!

So help me with this.  Some of those same senior living executives – decision makers –believe that there is equality between all emergency call system providers simply because they claim to offer similar services.  For example, most of us claim to provide:

Does not the same logic apply to our industry and theirs?  You can’t have it both ways.  Isn’t it the design, manufacture and delivery of products and services that makes ALL the difference?  Of course.  There seems to be a strong desire for the flexibility that comes from buying commodity products – multiple sources, hyper-competitive pricing, etc.  But just pretending that a market is commoditized doesn’t make it true.  It does, however, alter your perceptions – incorrectly and potentially dangerously.

If you are using a commodity-based mentality to judge a non-commodity product/service you will make two mistakes.  1) You will assume the low price companies are decent quality and just being competitive.  Wrong.  They are inexpensive because they are cheap and poorly made.  2)  You will assume the high price companies are not better than the low price guys, they are just out of touch with current market prices.  Wrong again.

Being the Designer and Manufacturer Matters

Making A Difference

Delivering On The Promise 78 Times and Counting

In about 100 ways that don’t show up well on paper, I could describe the difference between a cheap PC based system, integrated with generic wireless components made by someone else, delivered by a clueless bunch of software guys, and a highly specialized emergency call system, made in America by a company that has invented nearly every feature of modern life safety systems, delivered and supported by the most experienced and committed emergency call professionals in the world.

So, no.  Not all senior living communities are the same. Neither are emergency call companies.

How Long Should Emergency Call Systems Last?

Forever.  Not really, but that is probably the only answer any buyer wants to hear.  These are technically advanced systems, so a multi-decade expectation is probably not realistic anymore.  That kind of thinking is a throwback from the days that emergency call systems were nothing more than a light bulb and a switch.

“It’s just not right that after just buying your systems 12 years ago we should have to spend money to upgrade them to the latest and greatest.  The whole emergency call industry has us bent over a barrel.  We have to have these systems, and you force us to upgrade them.”  — Actual conversation with the CEO of a major senior living provider and long term client.  His expectations are common, but not realistic.

So what is a realistic time frame?  And what should senior living operators expect for an End of Life process.  This article will attempt to answer those to questions and others.  I am running a risk here by shattering the dream of some buyers who genuinely think emergency call systems should last for 20+ years (and never need service).  However, candid discussion, and setting realistic expectations is how Tel-Tron has been in business for 65 years and why we still have our first ever senior living customer as a client.  Here it goes:

Product Life Cycle

Senior living operators should expect to get 10 years of performance out of an emergency call system.**  I star this statement because their are many mitigating circumstances that will extend this time period.  But let’s assume for sake of this discussion that no changes or upgrades are made to the system at all during its life.  Why only 10 years?  It isn’t the hardware.

Using rugged design philosophy, level III manufacturing techniques, and high quality components (all of which Tel-Tron does) will result in a system that will function in a perfect, temperature controlled, never touched by a human being environment  for 20-30 years.  We just replaced an old Tel-Tron system at Shellpoint Village that had been installed and working for over 25 years.  It is not the hardware that gives out and requires replacement.

Sure, sometimes components become obsolete and a replacement needs to be sourced. And, occasionally new technology is invented and wipes out an entire design methodology.  This makes continued manufacturing difficult, but won’t cause the system you already purchased to suddenly quit.  Just because they invented high definition TV doesn’t mean your old set will all of a sudden quit working.  That’s Murphy’s law, which is out of human control.  But these and other issues do relate to the primary reason products become obsolete and manufacturers issue “End of Life” notices.  Manufacture-ability and Supportability.

MicroScan System - Introduced in 1982

Manufacture-ability – If new components or technology is invented, the cost of continuing to manufacture the old way eventually becomes prohibitive.  For example, in an older Tel-Tron product we used an EEPROM chip that was less than $1 each.  Today, that same component is $25.  In other cases, it isn’t a matter of expense.  The part is simply unavailable.

Supportability – Take the EEPROM chip example above.  At some point, Tel-Tron was forced to design a new circuit board using a different EEPROM chip, and was required to write new firmware to support the new EEPROM chip.  At the same time we made a few other improvements and released a new product version.  At that instant, we were now supporting two versions of the same product.  In the product design world, that is called legacy product support.  The problem is that while the two products do the same thing (and because we’re good, the new one is also backwards compatible), repair of the old version is not feasible.  Over the course of a decade this process can repeat itself several times and at some point, it is simply too costly to maintain multiple versions of the same product.  This same level of complexity ripples throughout the organization.

Technical support, installation, customer service – even sales – all need to stay aware of product versions and capabilities.  When the weight of maintaining an multi-version, outdated product line is heavier than designing a new platform from scratch, End of Life announcement can’t be far away. Senior living operators deal with this issue all the time in their business.  The product in their world is the physical plant (the building) itself.  How many times have operators looking to grow their business had to make the build/buy decision.  It’s the same concept.

Think of the complexity of owning a senior living building that was built in multiple phases, expansions and refurbishments, over the course of 20 years.  Different electrical systems, wiring standards, wall construction, fire supression systems, hallway widths, etc.  The list is endless.  Every once in a while the decision is made to demo the building and start over.  It doesn’t happen often, but it happens.  Or maybe, like in the case of the Tel-Tron building, entire system are replaced.  We needed a new HVAC unit.  It was so difficult to retrofit to the old ductwork, we ripped out all the ceilings and replaced everything.  Sometimes a new platform is required. Their is no way to avoid an occasional End Of Life event.

Instead, we should focus on how long a product should last from time of purchase until End Of Life, and how the transition handled.  These two areas are a matter of corporate policy and reflect the character of the organization and its leadership.  And…a subject for a future blog post.

Throw out that PC based system and get in the CLOUD!

Once upon a time, senior living communities paid someone to be at the front desk 24 hours a day.  They did this because the emergency call system consisted of a panel of lights and buzzers mounted on the wall.  If a resident needed help, a light would turn on and a buzzer would sound.  Someone had to be within earshot of this panel at all times, or calls for help would go unanswered.  Once they heard it, though, alerting the care givers that someone needed help was another inefficient and labor intensive task.

When Tel-Tron introduced pocket paging to the wireless emergency system call industry (100 years ago…) both problems were solved.  Care givers wore pagers and were alerted right away when a resident needed help.  This eliminated the need for panels of lights and buzzers, and the need to pay someone to watch them 24 hours a day.  This was a transformation of the way senior living providers operated their buildings and provided care to their residents.  Really, it would be hard to imagine not having pagers or some other mobile staff device today.

Portion of Auditrak Dashboard

What does this have to do with cloud computing?  Everything.  When Tel-Tron introduced Auditrak.com, another senior living transformation began.  With the release of the ethernet gateway for our CompanionOne product line, Tel-Tron’s nurse call system has completed it’s migration to the cloud.  What is the cloud and how does it help senior living, you ask?  Let me explain. (click here for the wikipedia definition)

In the pocket paging example above, people were slaves to the front desk, because that is where the alarm panel was located.  The “data” they needed to respond to resident emergencies was accessible from only one place – the front desk.  The same is true on PC based system today.

System programming information, resident usage metrics, audit trail reports, maintenance notifications, resident check-in data, even changing resident pendant codes is all located, stored and managed from the personal computer located on-site.  You have limited or no access to that data or functionality from outside the building.  You have limited or no way to keep all of that data backed up on a real time basis.  You have limited or no way to integrate that system with other systems located outside of the facility, such as your accounting, or resident management software.

Worst of all…..Once you buy a computer based system, you are saddled with never ending upgrades, maintenance contracts, having to replace the computer itself every couple years, your staff uses the computer to play games or surf the web (see previous blog about that particular nightmare), Microsoft changes operating systems routinely, loss of functionality during a power outage…  Really, the list of downside risks to a PC based system are endless.  What’s the answer?

Enter the cloud!  Instead of your entire emergency call system being controlled and run by a software program on a local PC, host all of that functionality in the cloud (on the internet).

Your on-site system includes all of the devices in the resident rooms, all of the mobile devices used by the staff, one or more alarm consoles, the wireless or hardwired monitoring infrastructure.  But the activity data, programming information, reporting software, charting and graphing software, trend analysis, and system monitoring is “hosted” offsite.  You access this site through an internet browser like Internet Explorer, Firefox, Google Chrome and Apple’s Safari.  Which means you do NOT buy a dedicated PC for the emergency call system.  You use any PC (or iphone, blackberry, ipad, etc) you want, from anywhere you want, whenever you want.

  • There is no software to upgrade on site, ever.  The hosted software is always current.
  • You don’t have to keep back-up disks, or tapes on site.  Your data is always on line and backed-up continuously.
  • You don’t have to worry about your staff breaking the computer, surfing the web, or otherwise messing up the PC.  Because THERE ISN”T ONE.  I know this is a mental leap.  But it is literally transformational to the industry.  Senior living CTO’s, IT managers, even maintenance people are loving the fact that their systems no longer are PC based or dependent.

Sample Report of All Alarms with a "Resident Wait Time" of more than 10 minutes

In addition, once your secure data is in the cloud, you don’t need to run reports any longer.  Establish operating parameters and reports will be automatically sent to you (or anyone else) whenever something occurs outside those parameters.  Two small examples:  Many Executive Directors get a report emailed to them every morning listing any emergency call where the resident’s wait time was longer than 10 minutes.  Regional Operations Directors have this same report sent to them monthly for all communities in their territory.  Regional Maintenance Directors get a weekly report automatically emailed to them of all system trouble items that have occurred, and not resolved in the appropriate time.  I know, that was three examples, but the possibilities are endless.

Last one..any notification can be sent via email, or text message.  Some Operations Vice Presidents want to know right away if there is an elopement activity such as a window alarm, or “screen removed” alarm in an memory impaired section.  Elopement is a big deal these days and an early heads-up is helpful.

I know this is a lot to take in and understand, but having your emergency call systems data hosted and managed in the internet cloud, means a whole lot less headache for on-site staff related to computers, and an almost limitless opportunity for growth and integration in the future.  Just as pagers changed the industry in the late 80s, cloud computing will change senior living over the next few years.  Just browse on over to Auditrak.com and you’ll see what I mean.

I didn’t talk specifically about this, but having a single hosted location for systems data and management is exponentially more valuable if a senior living operator has multiple sites.

One day we’ll look back and say…”Remember when we used to have a PC run our emergency call systems.  How did we ever survive?”

Enough Already. The PC has to go!

Dig hole in sand....Insert head!

All you have to do is read words in this picture, which was taken by one of our salespeople when touring a community that just installed a new emergency call system from a competitor.  WOW!  I cannot believe that someone would actually write that memo – clearly aware of the implications of not obeying – and think that just writing a note makes everything OK.

IT’S NOT OK!   You are tasked with making sure that a resident’s call for help gets answered.  And for lots of reasons, including this one, a personal computer is a completely inappropriate engine for an nurse call system.  In case you can’t read the picture, here is what it says.

“Please do not use this computer to go onto the internet.  This computer runs our nurse call system and is vitally important.  Thanks, Jane.”

Jane – Rather than writing a memo, you should have thrown that system out and replaced it with one that is not computer based.  Can any of you think of a single system that is a life safety device that runs on a Windows computer?  Please leave a comment to this post if you can.

Defibrillators? No.  Airplane Avionics?  No.  Dialysis Equipment? No.  Automobile Electronics?  No.

When you hear about someone who is on “life support,” do you think it would be wise to have that equipment run by a Windows computer?  No way.  So why is it OK to put the lives of senior living residents in the temperamental control of a Windows personal computer?  Short answer….It isn’t!  They freeze up.  They need rebooting.  Software needs updating.  They aren’t battery backed up for longer than a few minutes.  Really the list is endless.

Staff can close the program.  Staff can turn them off (on purpose, or on accident).  And, as in the case captured in this picture, staff can browse the internet while calls for help go unanswered.  It simply isn’t necessary.

On an enterprise quality nurse call system, the main servers, switches, routers and gateways use embedded systems, industrial microcontrollers, sophisticated power supplies, elaborate supervision and battery back-up methodologies.  There are design tolerances measured in sub-1% range.  User GUIs are browser based and access data on the system, but do not control the system.  Visit Auditrak.com, for an example of a killer call system GUI that resides in the cloud.

As I looked at the picture in the beginning of this article, I was so frustrated at the lack of seriousness with which Jane took her role as caregiver.  In fairness, Jane probably did not select that system.  Someone at her corporate office, who doesn’t have to respond to an emergency call – ever – probably picked it as a result of their beauraucratic purchasing system.  Still…the kind of compromise and accommodation Jane is forced into is simply not necessary.  There are other options.

Wireless Network….Heal Thy Self!

Every time I hear someone say “wireless emergency call systems are pretty much all the same” it makes my want to pull my hair out.  While it is true that many systems have a similar mission, there are very few similarities in how the mission gets

Click here for a tutorial

 accomplished.  Here is a HUGE, IMPORTANT, SIGNIFICANT, FUNDAMENTAL, MEANINGFUL  example.  Enough emphasis?

On most wireless networks used for emergency call systems, if one access point (transceiver) fails, YOU LOSE EVERY OTHER RECEIVER DOWN LINE.  That’s because signals “hop” from one transceiver to the next all the way back to the computer.  Any break in the chain and the call for help goes unanswered.  GOOD ENOUGH for email, surfing the web, etc.  BAD IDEA when the data being transmitted is a person’s call for help.

That is why Tel-Tron never designed an emergency call system using the point-to-point wireless networking scheme described above.  In 2008, we released our version of a wireless network using what is called a “Self Healing, Wireless Mesh Network.” Translation:  If any access point fails, the downline access points can automatically reroute.  The network self-heals.  And, since all Tel-Tron systems are fully supervised, the system will alarm and display which access point has failed.  As of this writing, no other company is offering this level of wireless network service.  (No other company designs and manufactures their own wireless products…..but that is a post for another time.)  For a neat flash based tutorial on this topic, please click here.

Even the chip manufacturer was impressed, and published a “Customer Success Story” on our implementation. Check it out.

I suppose a rough analogy is the difference between run-flat tires and standard tires.  With a standard tire, if you get a flat your trip is over until you change the tire.  With a run-flat tire, if you get a flat, you are notified, but your trip is uninterrupted.  That kind of safety and redundancy seems like a great idea if you were a woman driving alone at night through a sketchy part of town on your way home.  Or, if you were a senior living resident who was counting on your call for help getting answered.

There are hundreds of differences like this between wireless nurse call system providers.  So, no, emergency call systems are not all “pretty much the same.”

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