Technology & Dementia Care - Why Newer Isn't Necessarily Better
Tam Cummings, Gerontologist
I noticed another of the "techno" buildings is opening I encourage families to avoid this type of care. The selling feature of these buildings is based on the alarm systems in place in each room, bed, hallway, ect. Families are assured these buzzers alert staff to problems or issues with their loved ones, such as incontinence or falls, theoretically allowing for a higher level of care.
The reality is that the care received by residents in these buildings is actually quite the opposite. Research on the response times and training in dementia care these staff members receive is rather frightening. Results indicate the "caregiving" staffs in techno buildings develop a dangerous habit of relying on the alarms to alert them to the needs of the residents, rather than on positive nursing/caring standards. Because they are not checking on the residents face to face, the staffs congregate away from the residents and wait for the alarms to indicate care is required.
As a result, the techno staff members spend less one on one or group time with residents, and fail to develop their skills as a caregivers. This lessening of social interaction leads to poorer quality of care and a more rapid decline of the residents. Rather than interactive care geared towards keeping residents socially alert and physically as active as possible, the residents have reduced social interaction and staff members have a tendency to view the residents in a less positive light. A person with dementia ceases to be seen as a declining older adult and becomes that "old woman whose alarm goes off three times a night." Depending on alarms to alert them to the care needs of the residents, these staff members are not responsive to the resident's needs, stories, history, or the requirement of human interaction critical to quality care.
The staff members tend to isolate themselves from the residents, expecting the alarm systems will "tell" them when care is required. As you are aware, but families new to dementia may not be, care for the dementia population requires so much more. Caregivers in memory communities are responsible for observing so many changes in our residents, responses that cannot be detected by mechanical devices. Their training to be aware of the persistent deterioration of the dementia process in residents cannot be countered by electronic "smart" systems measuring moisture or movement or lack thereof in an environment.
For example, aggressive or lethargic behaviors, possibly indicative of delirium stemming from UTIs, fractures, infections, etc., cannot be detected by a moisture alarm on a bed or chair. Only a trained care professional, alert to the subtle start of infection, can spot a care issue of vital importance in dementia.
Response time studies of staff in techno buildings are also judged to be much different than a traditional memory care community. Research indicates that rather than staff taking the initiative to check on residents, the expectation is that unless an alarm goes off, the resident doesn't require care. The constant ringing of alarms also dulls the staffs' response time to the residents, as the buzzers tent to become more of a white noise and therefore sometime to be ignored. As a result, ADLs such as grooming, toileting and eating for these residents are adversely affected.
Another area of concern is the decline of social skills. Because the staffs in techno buildings are not following a social-medical model of care, residents are more likely to decline more rapidly. We recognize dementia in any form is a terminal disease. But we also believe in the "use it until it's lost" model of care, not the "ignore it until an alarm goes off" model. Residents involved in social settings and activities continue to decline certainly, but the decline is more humane and often somewhat slower.
The demonstration and enforcement of routine social skills are a key element of care in memory communities, but sadly the techno buildings lose this valuable tool. The alarm systems simply encourage less interaction, less touch, less human care and contact. Another reason to be concerned about the lack of care in these buildings is touch. This is because our elderly population is the least likely group to receive human touch. Generally because an aged person may have lost his or her spouse and the children are no longer at home, etc., there are less opportunities to be hugged or touched. For persons with a dementia, the possibility of being touched is even lower, unless he or she resides in a traditional memory community. As I have already pointed out, the lack of interaction between caregiving staff and residents underscores another critical level of care being overlooked.
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We offer support, education and information for caregivers and family members. If you have questions about Alzheimer's or a related dementia and the types of care available contact an Arden Courts near you.