Nursing home technology for the night: Finding a balance between safety and freedom of movement

AMSTELVEEN Amstelveen will age in the coming years. The group of 75 years and older in particular will increase, namely from 9 to 12 percent in 2040. This means that there is a need for more places in nursing homes. Many seniors are currently waiting for a place in a nursing home. In 2020, there were 1,286 clients who received a referral to a nursing home, while there are 753 places in Amstelveen. Anyone who was not placed came on the waiting list. It is expected that there will be a need for 315 additional places in 2040. This is the fourth and final part in a series of articles on new technology in Amstelveen elderly care: Technology for the night at the nursing home.

With smart alarm systems, nursing homes are working in new ways to give residents a safe night despite staff shortages. But technology can also create a false sense of security. “It’s not like residents are not falling if we use more technology at night.”

In fact, Jeanine Korte was immediately thrilled when she heard that her husband had a smart alarm system in his room. Until 2020, he lived in Zonnehuis Juliana in a ward for people with dementia. It gave Korte a sense of security that the staff was on site quickly if her husband needed help. Korte was a member of the customer council for Zonnehuisgroep Amstelland and the innovation working group. She agreed to have the smart sensors in every room in the nursing home. Once the alarm system was installed, she noticed a difference in the mood of her husband and the other residents. They got a better night’s sleep because they were disturbed less frequently during the night. “Everyone – including the staff – benefits from the smart alarm. My husband was much more cheerful and cheerful during the day. I think family members and loved ones are wondering why the camera is not on 24 hours a day. “

NOT ONLY This is because healthcare organizations are not allowed to work with this type of new technology just like that. According to the new care and coercion law, a care organization must first look for a less drastic measure. For example, smart sensors can only be used if they do not exist. In addition, the sensors are only used for residents who are ‘at risk of falling’. There must be a valid reason to install a sensor. Permission must also be sought from the client and the family. It is also important that the anonymized images that employees see are also removed. “It is not the intention that once you have bought sensors, they are always on,” says project manager digital innovation Aukje Mesken from Zonnehuisgroep Amstelland. “Privacy and self-management are crucial for us. If it becomes a control system, we are on the wrong side of what we are actually aiming for. “

BLURRED The two health organizations’ smart alarm system works as follows. A camera with smart software is located in the attic of a resident’s bedroom. Via software, employees draw in the zone where the bed is located, the door to the hallway and the door to the bathroom. When the sensors detect movements indicating ‘leaving a zone, the camera makes an anonymized recording that is sent to healthcare professionals’ smartphones. The employee sees room number, date, time and anonymized photos. Based on these images, the employee decides whether help is needed. If it appears from the pictures that there is nothing wrong, the employee will not look either. The images are deleted after 12 hours. In the past, staff went for a walk three times a night, and residents sometimes woke up three times a night, even though the staff was very quiet.

URGENT Since 2018, Zonnehuisgroep Amstelland has used more than seventy cameras from this smart alarm system in four different nursing homes in the rooms of nursing home residents who have been identified as in need of extra care. There are cameras in all bedrooms but also in the living rooms, but in principle they are off. The system is only switched on when necessary and the employee can see pictures from the room, but only when a report comes in.

At the Amstelring care organization, care workers can even be notified if a resident is sitting up during the night. This is set only if there is a high probability that someone will fall. By going there immediately, employees can avoid a trap.

SCREAMS The fact that sometimes help is also needed at night is due to the fact that more and more people with dementia live in nursing homes. Alzheimer’s disease, for example, can disrupt sleep patterns. But even without dementia, falls are a risk for nursing home residents. Hip fractures in the elderly due to falls are common. Recovery is often a pain. In addition, research shows that almost half of the elderly can no longer get up after a fall, even if they are not injured. Due to staff shortages, night care in some nursing homes has been ‘stripped down’, according to Mesken. That someone lies on the cold ground for hours at night without being noticed is a nightmare for everyone.

LOOK DIFFERENT Both Amstelring and Zonnehuisgroep Amstelland note that the new technology often raises the wrong expectations of family and friends. It can create a sense of false security. According to Zonnehuis Juliana’s location manager, Margreth Chel, the best technology in the world can not yet prevent anyone from falling. “When we talk to a client’s family and relatives, we as an organization must be ready for expectations. We all want to feel good when we take our mother or father to the nursing home, but there is always a risk of falling. If someone falls a lot at home, he will also fall a lot at the nursing home. Accidents can never be completely prevented. ”

ICT manager at Amstelring Yoanette den Boer knows that you are looking for security for your family and freedom for yourself. “If we had the motion sensors turned on day and night, it would mean that we think it’s strange that people are moving. We need to look at security differently. We want people to keep moving and walking, to be able to go to restaurant independently. If someone has fallen and it takes ten minutes before an employee arrives, it does not mean we are providing poor care. We offer security, but also freedom. ”

This series was made possible by Mediafonds Amstelveen.

Text: Suzanne Bremmers
Photo: Naomi Heidinga

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