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

AMSTELVEEN Amstelveen is aging in the coming years. The group of 75 years and older in particular will increase, namely from 9 to 12 percent in 2040. As a result, more places are also needed in nursing homes. Many elderly people are currently waiting for a place in a nursing home. In 2020 there were 1286 clients who received a referral for a nursing home, while there are 753 places in Amstelveen. Anyone who was not placed was placed on the waiting list. It is expected that 315 additional places will be needed by 2040. This is the fourth and final part in a series of articles about new technology in Amstelveen elderly care: Technology for the night in the nursing home.

With smart alarm systems, nursing homes are working on new ways to give residents a safe night despite the staff shortage. But technology can also create a false sense of security. “It’s not that residents don’t fall if we use more technology at night.”

In fact, Jeanine Korte was immediately enthusiastic 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 staff would be on site quickly if her husband needed help. Korte was a member of the client council of Zonnehuisgroep Amstelland and the innovation working group. She agreed to have the smart sensors in every room of the nursing home. Once the alarm system was installed, she noticed a difference in her husband’s mood and that of the other residents. They got a better night’s sleep because they were disturbed less often during the night. “Everyone – including the staff – benefits from the smart alarm. My husband was much more cheerful and cheerful during the day. I do think that family members and loved ones wonder why the camera is not on 24 hours a day.”

NOT JUST 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 Act, a care organization must first look for a less drastic measure. Smart sensors, for example, can only be used if it is not found. The sensors are also only used with residents who are ‘at risk of falling’. There must be a reasoned reason for installing a sensor. Permission must also be sought from the client and the family. It is also important that the anonymized images that the employees see are also removed. “It is not the intention that once you have purchased sensors, they are always switched on,” says project leader digital innovation Aukje Mesken of Zonnehuisgroep Amstelland. “Privacy and self-management are decisive for us. If it becomes a control system, we’ll be on the wrong side of what we’re actually aiming for.”

BLURRED The smart alarm system of the two healthcare organizations works as follows. A camera with smart software is placed on the ceiling 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 that indicate ‘leaving a zone, the camera makes an anonymized recording that is sent to the smartphones of healthcare workers. The employee sees the room number, date, time and anonymized images. Based on these images, the employee decides whether help is needed. If it appears from the images that nothing is wrong, the employee will not look either. The images are deleted after twelve hours. Previously, employees made a round three times a night and residents sometimes woke up three times a night, even if the employees were very quiet.

UPRIGHT Since 2018, Zonnehuisgroep Amstelland has been using 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 needing extra care. There are cameras in all bedrooms, but also in the living rooms, but in principle they are turned off. The system is only turned on when necessary and the employee can see images from the room, but only when a report comes in.

At the Amstelring care organization, care employees can even receive a notification if a resident sits up during the night. This is only set if someone is very likely to fall. By going there immediately, employees can avoid a trap.

SCREAMING The fact that help is sometimes also needed at night is because more and more people with dementia live in nursing homes. Alzheimer’s disease, for example, can disrupt sleep patterns. But even without dementia, falling is a risk for nursing home residents. Hip fractures in the elderly due to falls are common. Recovery is often a pain. Research also shows that almost half of the elderly can no longer get up after a fall, even if they are not injured. Due to the staff shortage, night care in some nursing homes has been ‘stripped down’, according to Mesken. The fact 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 notice that the new technology often raises the wrong expectations among 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 cannot yet prevent someone from falling. “When we talk to a client’s family and caregivers, we as an organization must be clear about expectations. We all want to feel good when we take our mom or dad 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 in the nursing home. Accidents can never be completely prevented.”

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