Tech-Savvy Residents Not Settling for Computer Labs in Senior Living

Senior living providers are finding that no longer does a computer lab satisfy the requirements of tech-savvy residents. Increasingly, the onset of tech use among residents in their 70s, 80s and 90s is pushing communities well beyond simply providing devices and an internet connection they can access in common areas. That means wifi throughout the community or campus and creating Internet cafe-like areas that also serve as social settings. Computer labs and business centers in senior housing communities are less important to senior living prospects today than they were two years ago, says Patti Aspenleiter, president of senior marketing agency Zillner, adding that the finding can be attributed to the increase in tablet and e-reader ownership in the last four years. As seniors become accustomed to the latest technology in their homes, they expect the same when opting for their next place to live. “Seniors have choices,” Aspenleiter says. “Seventy-one percent of seniors go online every day. It’s almost as common as using a meal plan. The main competitor of senior living communities is the home. If they can use that e-reader and iPad anywhere in their house and now they can only use that tablet in a computer room — that is a significant disadvantage.” In fact, overall tablet ownership among seniors has risen from 2% in 2010 to 25% this year, research shows. And more seniors are accessing the Internet from their cell phone, supporting the need for campus-wide wifi. In the last five years, the number of seniors going online from their phone has quadrupled from 7% in 2009 to 29% today. The growing number of seniors using mobile devices and going online antiquates the idea of a “computer room,” Aspenleiter says, adding that providers who wish to attract future residents — many of whom will be baby boomers and even more tech-savvy than the current senior population — would be wise to adopt campus-wide wifi to support such products. Wifi Is a Must For providers like San Antonio,Texas-based Morningside Ministries, offering wifi was important to resident satisfaction. “Five or four years ago a resident asked for wifi,” says Leo Cutcliff, executive vice president for Morningside Ministries. All three of the provider’s San Antonio-area senior housing campuses are continuing care retirement communities (CCRCs). While the CCRCs provided some type of Internet, Morningside began to roll out wifi to all of its campuses and continues to add wifi to its buildings undergoing redevelopment and its cottage properties. Cutcliff sees seniors’ growing use of mobile devices firsthand — some residents lead and attend iPad training classes every Saturday. “It’s interesting to hear a 92-year-old tell residents how her Kindle was synchronized to her iPad,” he says, adding that using the mobile devices creates increased dialogue among residents and between residents and their families. “I recall 10 years ago we would get numerous cold calls about video teleconferencing with families,” he says. “We would have to get cameras and residents would have to schedule a time. Now with [Apple’s mobile video conference platform] FaceTime, they can talk to each other from anywhere at any time.” Texas-based Buckner Retirement Services, Inc. began rolling out wifi at its campuses in 2006. And while the communities still have designated areas where residents can use computers, many residents have laptops or other mobile devices of their own. Buckner operates five CCRCs and two independent living communities in Texas. “Our residents use technology to check bank accounts, investments, retirement accounts, order products, print maps for travel,” says Kenneth Harpster, chaplain and go-to technology support person. “Some use it to access books for their e-readers; others use social media such as Facebook. Almost all who use the technology use it to stay in touch with family through email.” Internet Cafe Design Supports Learning And while offering wifi is a start, offering additional programming and spaces to educate residents on how to get the most out of their mobile devices via Internet is key, says Ginna Baik, national director of innovation and resident technology with the life enrichment team at Emeritus. “If you can provide a space for training then you can get residents to fully experience the benefit of their smartphone, or iPad,” Baik says. “Some are intimidated by technology, but when you bridge that connection that level of empowerment and how it changes their self image is priceless.” At Emeritus, whose $2.8 billion merger with Brookdale Senior Living will form the largest senior living provider in the nation, a new pilot program including some of its Illinois, Indiana and Missouri transforms common areas into Internet cafes. Residents can also borrow mobile tablets for use, Baik says, adding that after using a tablet many decided to purchase their own. The pilot was rolled out September last year. “In the Internet cafe we’re not just focused on the technology, but the seating and look and feel,” she says, adding that large-screen computers are also available for those who have trouble seeing the smaller, tablet screen. “It’s not a sterile, business environment with computers along a wall. It’s no longer grandma’s nursing home.” While all those communities are wireless, so that seniors can get online where and when they want to, the Internet cafe spaces encourage conversation among residents and serve as an education space. And, more communities throughout the Emeritus network are slated to become wireless if they’re not already. “With the merger things will change, but Brookdale has the same mindset [about providing the latest technology],” she says. “It’s important to both Emeritus and Brookdale.” Written by Cassandra Dowell [1] Posted By Cassandra Dowell On July 1, 2014 @ 6:26 pm ________________________________________ Article printed from Senior Housing News: http://seniorhousingnews.com URL to article: http://seniorhousingnews.com/2014/07/01/tech-savvy-residents-not-settling-for-computer-labs-in-senior-living/ URLs in this post: [1] Cassandra Dowell: mailto:cdowell@seniorhousingnews.com TSH Editor's Note: Folks, those of you who have been reading Technology for Senior Housing since our start in 2002, must know how frustrated we are with the length of time it has taken our industry to understand the content and message of this recent post. We've been shouting this speech from the Mountaintop since 1999. Good to see our peers in the media are finally catching up to us. BB

Engaging Patients in Chronic Disease Management

Of every dollar spent on healthcare in the U.S., more than 75 cents goes toward treating chronic diseases. Nearly 92 percent of older adults have at least one chronic condition and 77 percent have more than two, according to the Centers for Disease Control and Prevention (CDC). Bending the cost curve and improving care and health outcomes will require putting patients at the center of managing their disease. Researchers have been studying cost-effective strategies for improved chronic disease management, including targeted physician training for better patient-physician interactions at the point of care, patient self-management education and health IT tools. Stanford: in person & Online Learning Successful chronic disease self-management requires a holistic approach in which patients learn action planning, problem solving and decision-making skills head on, says Kate Lorig, RN, DrPh, professor at Stanford University School of Medicine and director of the Stanford Patient Education Research Center. In the 1990s, Lorig founded Stanford’s Chronic Disease Self-Management Program, a pioneering self-management program tailored to adults with diabetes, arthritis, high blood pressure, heart disease, emphysema, multiple sclerosis and depression, among others. Currently, more than 1,000 organizations worldwide have acquired a license to teach this program, according to Lorig. The National Council of Aging also administers the program at its popular www.restartliving.org [1] website. Available in person at community and health organizations and more recently online, the six-session, two-and-a-half hour workshop is taught by trained leaders—many of whom have a chronic disease themselves. People with different chronic health problems attend together. Subjects covered include: • Techniques to deal with problems such as frustration, fatigue, pain and isolation; • Appropriate exercise for maintaining and improving strength, flexibility and endurance; • Appropriate use of medications; • Communicating effectively with family, friends and health professionals; • Nutrition; • Decision making; and How to evaluate new treatments. • The program has undergone two major updates in 2006 and 2013. The key to the success of Stanford’s program is equipping patients to set and accomplish their own goals, says Lorig. “People find it works. They work very hard to accomplish what they want, with the whole idea of systematically using processes to feel more confident. It’s about empowering people in a systematic way.” Empowering People Works Numerous studies have positively linked Stanford’s Chronic Disease Self-Management Program to better care, outcomes and lower costs. Specifically, a national study of the program—published in November 2013 in Medical Care—concluded that it achieved the triple aim. Researchers surveyed 1,170 older adult participants from 22 organizations in 17 states and studied their healthcare utilization at baseline, and then 6 months and 12 months after the program. The study ultimately found that participation in the program significantly reduced emergency room visits by 5 percent at both the 6-month and 12-month assessments as well as hospitalizations by 3 percent at 6 months. This equated to a potential net savings of $364 per participant and a national savings of $3.3 billion if 5 percent of adults with one or more chronic conditions were reached, according to the study. “Given that older adults with chronic condition consume 75 percent of healthcare expenditures, these findings are encouraging,” the authors wrote. Another study looking at 761 patients with diabetes who participated in the online version found improvements in A1C levels, patient activation and self-efficacy. The program works because it does not tell people what to do, Lorig says. “We are problem centered. We ask people, ‘what is your problem that you would like to solve?’ and then help them set up ways of going about it. We are very experiential and we really want people to do self-experiments.” Health IT tools like apps can help a patient better manage their illness, but only up to a point, says Lorig. Technology tools tend to do one of two things: Capture data and give patients feedback, or capture data and give feedback to the doctors. “Those are useful in and of themselves,” she says, “but for patients to truly self-manage their conditions, they need knowledge and confidence to deal with emotional and physical symptoms.” As for patient engagement, Lorig calls that “window dressing.” While she supports greater patient access to data and stronger roles in healthcare decision-making, she is also a little skeptical. “If patients have access to health data, it doesn’t do them any good if they don’t know what to do with it,” she says. However, if patients understand what their data mean and how their behavior impacts these measurements (e.g., the effect on blood glucose after exercising or eating) then the data serve a useful purpose. Adherence in Older Adults Asthma is typically associated with children, but adults with the disease actually outnumber children 18.9 million to 7.1 million, according to the CDC. This perception is one reason why asthma is overlooked in the geriatric population, and subsequently hinders efforts to teach self-management techniques, according to Alan Baptist, MD, assistant professor of internal medicine at the University of Michigan. He is actively involved in the university’s Center for Managing Chronic Disease. Self-management of asthma is more specialized and best conducted in conjunction with treatment. However, “For people who develop it later in life, it’s difficult to get asthma education at all.” Baptist led a successful self-regulation intervention that improved asthma control, quality of life and healthcare utilization in older adults that, like Stanford’s program, taught participants how to overcome specific barriers related to their disease and set goals to overcome them. The intervention consisted of a health educator leading three group meetings and conducting three individual one-on-one phone calls. This approach works because it gets patients focused on managing their disease to handle real-life scenarios: like wanting to go on a walk with their grandchildren or go to a friend’s house without concern of having an episode. Doctors often focus on inhaler use, frequency of symptoms and interrupted sleep, but patients are worried about broader issues, Baptist says. “Overcoming obstacles must be about how they would define them, not necessarily the way physicians define them,” he says. Following these positive results, Baptist embarked on another intervention, but this time it is tailored to African-American adults ages 18 to 30 suffering from asthma. Given the busy schedules of this age group, “We looked at how to deliver the program in a format more appropriate and decided to digitize the entire process.” The Center for Managing Chronic disease, thus, worked with the University of Michigan’s School of Information, which built an intervention tool from the ground up. A separate website portal was developed so enrolled participants can access the program, which is available both on computers and mobile devices. The pilot is automated with no health educator, but prompts participants through the same goal-setting curriculum. Patient-Physician Communication Another Center for Managing Chronic Disease intervention looked to patient-physician communication to improve patient self-management of asthma. This intervention involved training physicians on recommended guidelines of care, called the Physician Asthma Care Education program, and communicating effectively with patients with asthma within the context of clinical visits, says Minal R. Patel, PhD, MPH, assistant professor of health behavior and health education at the University of Michigan. These two-hour trainings took place twice, two weeks apart. This intervention reduced urgent care visits and improved patient satisfaction. Physicians did not spend more clinical time with their patients, but merely implemented better communication techniques—such as asking more pointed open-ended questions, Patel says. Patel also is working on a culturally tailored version of the Physician Asthma Care Education program that relays culturally-sensitive communication techniques. “It taught physicians how to work cross-culturally,” she says, in particular how to ask questions so patients can communicate their beliefs about asthma. In cases, physicians would work with a translator or a third party who knows the patient well to better facilitate the conversation. “With people managing multiple chronic diseases, the individual, his or her family, the provider and the community all have to communicate, but I’m not sure we’re quite there yet,” she says. “Technology has the potential to facilitate that.” Outlook Chronic disease self-management programs are showing promise. But, even with the well-studied Stanford program, challenges remain in two areas: letting people know that programs exist and lack of a payment system supporting them. Stanford’s programs are paid for by a patchwork of sources: federal or foundation grants, employers and health systems. Lorig argues for a systematic, one-payment mechanism and a national network so anyone can find a class within six weeks. Those are the missing pieces, she adds. But, if providers continue to reap gains from such programs, expect solutions. Topic Category: Clinical Practice [2] ________________________________________ Source URL: http://www.clinical-innovation.com/topics/clinical-practice/engaging-patients-chronic-disease-management Links: [1] http://www.restartliving.org [2] http://www.clinical-innovation.com/topics/clinical-practice TSH Editors Note: Great recap and we appreciate the opportunity to share. BB

Technology for Seniors Gets National Attention

With the number of seniors in the U.S. expected to reach more than 85 million by 2050, technology companies are beginning to focus on developing products suited for that burgeoning market. In a recent segment on PBS's NewsHour, correspondent Cat Wise interviewed a number of entrepreneurs whose start-up companies are designing products or offering services to improve the lives of older adults. Among those interviewed was David Glickman, co-founder of Lively, a company that produces motion sensors that wirelessly transmit information to a Web-based app. Glickman noted that he, himself, uses this technology to monitor his 81-year-old father. But he also explained how technologists are now approaching the growing needs of a senior population. "People are spending money, meaning families are spending money caring for their adults. And we didn’t see anybody really kind of creating beautiful products, super simple, easy to use, and affordable, using today’s technology, not technology 10 years ago," he said. Another entrepreneur interviewed on the show was Katy Fike, co-founder of Aging2.0, an organization that brings together and mentors other entrepreneurs under the roof of the Institute on Aging—a Bay Area non-profit senior center. "We wanted to immerse the entrepreneurs in who they’re designing for. We didn’t want them to have to guess about what’s needed or about what would work," Fike said. "You know, there’s all these folks that are really living every single day either as the older adult themselves or the care providers. They know the needs. We just need to pair them with people who know how to make the solutions." Cindy Kauffman, chief operating officer of the Institute on Aging also noted: "As someone gets older, we have a tendency to do for them. And we have their best interests at heart, but we take away their dignity, we take away their purpose. And so part of what this Aging2.0, and Institute on Aging does is, we get their opinion, and then we have a conversation as to what’s available, what’s not available. "But it’s really important. I want my opinion to be heard, and it doesn’t change as we get older." Watch a video of the program segment on PBS. April 7, 2014 by Richard R. Rogoski TSH Editor's Comment: Those of us who have been reporting on Technology for Seniors since the mid-1990s are always amused when this topic surfaces from time to time in the mainstream media as a news event. Back in 1996 when only 2% of seniors were online, and well before the Netscape IPO and the emergence of then-novel America On-Line (AOL) this information was groundbreaking. The sad part is that so many senior housing owner/operators still have not tasted the Kool-Aid, much less drunk it. The bottom line is that kudos need to go out to PBS for resurfacing an old story that still needs telling, because even now the percentage of seniors online is far behind that of other age groups. Devices have changed and bandwidth is more ubiquitous than ever, so as time goes on we will see more of these stories in the mainstream as Boomers demand high-speed connectivity and hardware/software products that allow them to age in place while maintaining a high degree of "connectedness" to the rest of society. BB