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creams echo through the hall of a quiet nursing home in Colorado: “Ma’am, I have to get up and drive to Memphis today!” An overworked nursing home staff could easily ignore comments like that from “Charlie,” an elder in the later stages of dementia. Charlie would most likely be lead politely back into his room or into some other diversionary activity, maybe plopped in front of a television, but hopefully not sedated.
       How about, instead, the staff reply, “Charlie, let’s get the big rig out and let her roll!” I like that answer, or at least I would like that answer if my dad were Charlie. It can be done, and we are seeing it happen every day.
       Technology, whether you are ready or not, is exploding in the world of long-term care. It is exploding in a variety of applications that are destined to make the world of nursing homes more efficient. Browse through any trade journal, wander through an exhibit hall at a long-term care conference, or talk to the CFOs at large nursing home chains and the message is clear: technology has the potential to improve the fiscal heath of nursing homes and improve the efficiency of the mounds of data that need to be collected and distributed. Look at the innovations creeping into the mainstream world of nursing homes; a potpourri of solutions abound. There are electronic medical records, Health Insurance Portability and Accountability Act (HIPAA) compliance, Minimum Data Set (MDS) documentation and assessments, incident report software, infection control monitoring, and benchmarking. Think about how efficient your operation can be run and how much money you can save by implementing many of the aforementioned technologies.
       But is there something missing in all of this? Is there a group of people that seems left out of the equation? Our answer, speaking from experience, is yes. The person left out of the equation is the person whose life the industry is supposed to be trying to improve, to sustain, to grow—the person who actually calls the nursing home his or her home.
       The mission of our company, It’s Never 2 Late (IN2L), over the past 6 years has been to set up adaptive computer labs that provide activities, engagement tools, and unique experiences for older adults with physical and/or cognitive disabilities. All over the country we have seen how these types of experiences can improve the lives of the thousands of older adults who have lived full and meaningful lives and deserve to have their last few years be as rich as possible. We have been delighted and astounded at the success that our systems have had in places where the staff have embraced the technology. This article is not about IN2L and what we do. Rather, it is about how today’s existing technology has the ability and capacity to dramatically improve the lives of those whom a lot of you reading this article are caring for. However, our big disclaimer is that the system only works in environments where staff and management teams are committed and willing to embrace the initial extra work required to make it happen.

Beyond the Typical Approach

       The following is a typical scenario a nursing home or assisted living community may experience when trying to set up a computer lab for residents: a well-meaning company or individual is upgrading a computer and is happy to donate the used machine to a nursing home. An enterprising activity director takes that computer and, as inexpensively as possible, tries diligently to get residents to try it out. A few extraordinarily motivated residents will stick with it, and they have very positive experiences. The other 98% of the residents either do not try it or give up after a couple of frustrating experiences. The general consensus after this experience plays out is that, “the residents were not interested,” or “it was just too difficult,” and the program usually dies a slow death without any further investment. We have seen that play out in dozens of senior living communities throughout the country. But it does not have to be that way.
       We have been fortunate to work with several organizations that have been willing to try another way. They have embraced our platform and are applying our systems in ways we never could have imagined. They have given their staff leeway to try something new. Here are some of their stories.
       Piñon Management, based in Lakewood, Col, was the first multisite user to embrace our work and set up programs throughout its entire network. Its CEO, Jeff Jerebker, proclaims that the ability to stay connected with the outside world through technology is not a privilege for the few—it is a right for all of his residents. Beth Irtz, Piñon’s vice president of life enhancement, says, “Piñon has a culture of change that resonates throughout all of our communities. A person-centered model of care,” explains Irtz, “provides access to the outside world for elders living in nursing homes. An elder can e-mail family and friends, stay in touch with grandchildren, receive photographs, find fun or educational websites, listen to his or her favorite music, and continue to learn and grow.”
       We have also worked with the The Good Samaritan Society to set up systems in Iowa, Kansas, Colorado, Idaho, and Minnesota. Our relationship with Good Samaritan started in Ft Collins, Col, when an innovative activity director, Donna Gruis, was looking for ways to engage many of her residents who lamented that the outside world had been shut off to them. The success that Donna had with her lab caught the attention of the Good Samaritan headquarters, which led to the successful implementation of pilot programs throughout the country. Barb Hartman, activity program consultant and the person who has managed IN2L rollouts, says, “Adaptive computer equipment provides successful means for persons with disabilities to not only communicate with family and friends, but also to engage in life-long interests and learning opportunities. We’re seeing examples of how those experiences positively impact the health and well being of these individuals.”
       Lutheran Homes and Services, based in Arlington Heights, Ill, has been ahead of the curve for years in terms of embracing culture change. It converted a conventional nursing home model into neighborhoods in 2002 and has since added IN2L systems into each of its neighborhoods, specifically the neighborhoods focusing on dementia.
       These types of stories and anecdotes, replicated all over the country, are living proof that organizations and individuals willing to think outside the box can look at the computer/resident experience in entirely different ways. We are particularly excited to be launching a national partnership with the Eden Alternative, an organization based in Shernburne, NY. Its commitment to positively impact the lives of elders in long-term care is unparalleled, and its input into our development process will be crucial in our continued growth.
       One of the primary goals of our company has been to find creative ways to embrace the world of dementia from a technological perspective. In a world where millions of dollars are rightfully being spent to find a cure for the disease, our efforts are 100% focused on making today’s experiences more meaningful and engaging. Our preliminary results, we are delighted to say, have been encouraging. The exploding world of high-tech multimedia (integrating pictures, video, and music) provides limitless opportunities for enhancing the quality of life for the “greatest generation.” Our touch-screen systems allow users to simply touch pictures of Frank Sinatra for the crooning to start, touch a picture of their granddaughter to hear her singing “Happy Birthday,” or touch a picture of a waterfall to launch a musical screensaver of waterfalls. The possibilities are endless. Our first lab customer, the Christian Living Campus (CLC) in Denver, Col, recently set up a system in its dementia-specific assisted living unit. The results have been positive, especially from the family’s perspective. “When we first set up the lab,” says Mary Grace Smigiel, executive director of CLC, “we weren’t sure of how it would be perceived by the residents. We brought the families into the experience from the first day, and several family members have remarked that they finally have a stress-free activity to come in and experience with Mom and Dad.”
       It is a delight to see what is being accomplished at innovative organizations throughout the country. As excited as we are at what we are experiencing today, we are just starting to scratch the surface of where we can go. Continuing advances in computer technology, new applications for virtual reality, and new platforms of distributing content via broadband connectivity are just a few examples of how technology can benefit the greatest generation.
       Our primary research partner, the Myers Research Institute in Beachwood, Ohio, has worked on several projects with us that are starting to provide outcome-based research tools from our systems. Dr. Jeanne Mattern, senior research associate at Myers, explains, “Adaptive technology systems have provided long-term care residents opportunities for activities that go beyond the standard group format in that they are easily customizable and allow for individual activities as well as group activities. Residents can stay connected with family and friends and interests through high-touch systems.” (A grant from the HCR Manor Care Foundation helped launch our initiatives with Myers.)

Conclusion

       Many of you are making the right decision to embrace technology. Keep making those infrastructure investments to help your operations run more efficiently. Keep looking for ways that technology can improve your healthcare delivery and your medical records. However, at the end of the day, reflect on how to direct some of those investment dollars at improving the quality of life of the individuals under your care. This generation of elders developed the infrastructure for all of these technologies. From vacuum tubes to transistors to complex semiconductors, the greatest generation invented all of the tools that we now take for granted and use every day. Since they invented the technology, they certainly deserve to enjoy it.
       And, hey, Charlie: Send me an e-mail when you get to Memphis!