Technology in Support of Campus Living

Established in 1970, Country Manor has grown from a 64-bed skilled nursing facility to a 25-acre campus that houses a 172-bed skilled nursing facility, a 155-unit apartment complex for seniors and a new 45-unit assisted living facility. We've also added a Medicare-certified home health agency, a 5,000-square-foot pharmacy, a general store and gift shop, a child care center licensed for 150 children and a regional bank branch. In short, there's plenty of variety for residents-but also a lot of territory to cover for staff.

Our clients wanted us to help meet their desire to maintain independence and "age in place." Seniors typically move to our apartments for social reasons. Over time, their need for medical services or assistance with activities of daily living might increase, but rather than move to another portion of our campus, clients make their desire very clear: They want us to bring the service to them.

In some instances, resident couples' medical or personal assistance needs have varied within the couple, resulting in a need for flexibility in how we assist with their care. Often one of the spouses has been the primary caregiver, and that person wishes for additional support in this role. Other clients desire assistance with their activities of daily living only when they need it, not on a predetermined schedule. This means that clients should be able to summon us for assistance, if needed, from wherever they might be on campus.

Our home health agency sought out a communication system flexible enough to work within our campus structure-an electronic or wireless system that would allow clients the freedom they desire but also the ability to contact staff as needed. We determined it must:

'Allow for direct communication from resident to staff
'Allow for staff-to-staff communication
'Meet the needs of our existing campus infrastructure and the various architectural and interior design variations that had been incorporated over the years
'Not dramatically interrupt our operational efficiency or clients' lives during installation
'Be aesthetically pleasing
'Allow us to control certain system settings, such as alert signal volume, and reset and reporting capabilities
'Meet the needs of differing populations, from those in independent living apartments to those needing intermittent care

The wireless call system we ultimately selected* could be used by ambulatory and independent residents who need occasional unscheduled staff assistance, while the tracking system from that vendor could provide greater reassurance for our memory-impaired clients. These systems are integrated. Hardware includes a central computer, emergency call pendants for residents (more than 100 currently), door alarms in several locations and repeaters that boost the signal throughout the campus.

The system not only allows clients to call for assistance, it also helps staff and clients move efficiently around our large community. For example, the Country Manor campus is segmented among our staff by territory. When a resident presses the call system pendant, pages are relayed to the correct person for assistance. The staff person receives a text message indicating the resident's name and location. We also position pendants in our pharmacy, child care center, beauty salon and elsewhere for residents who might need an escort back to their apartments.
The system allows for staff-to-staff text messaging, also. This is especially helpful for our home care agency, which regularly visits with residents on campus.

Importantly, the central computer records all activity. These records are valuable for our nursing staff, clients and families. We have found that the documentation and reporting capabilities help when we have a discussion about increased needs of a client. When a report shows numerous calls for assistance, our discussion about need is based on fact, not conjecture. The reports also show trends of when staff is most often needed, and we schedule accordingly. Nurse supervisors can definitively measure staff response time from the moment the system is activated until the time a staff per-son arrives to assist-important information for communicating with family.

Although we were initially skeptical about the reliability of a wireless communication system, we found that because our system uses a high frequency and a large bandwidth, interference is rarely, if ever, an issue. We've since added more repeaters for other areas of our campus, and these increase the coverage area and boost the alert signal.

Today, thanks to available technology, we have opened up more of the world for residents and staff and given them greater mobility while maintaining their link to help, if needed. I believe technology will continue to advance in this way to impact how we handle our customers' changing needs. NH

Anthony Fenstad, LNHA, is administrator of Extended Services, Country Manor, St. Cloud, Minnesota. For further information, phone (320) 253-3343, fax (320) 656-5922 or e-mail agfenstad@bhshealth.org.