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o most of us, country life has an idyllic image, with its gentle breezes, calm fields of grain, and docile cattle. But to farmers who make their living in rural America, it is a slightly different story. Sure, there are extended moments of solitude and sounds of nature. But there is also a bevy of onsite noise generation, with everything from livestock to machinery creating a day-long cacophony of sound. Agricultural engineers at The Pennsylvania State University peg farm noise at between 90 and 140 decibels, which they say is well above the 85-decibel limit at which industrial employers must provide hearing protection for workers. Compared to farmers, even rock musicians, who are bombarded with 115-decibel levels on average, are occupationally advantaged when it comes to hearing.
       And as farming gets increasingly mechanized and farms get bigger, noise grows. At the end of the day, a farmer’s sanctuary is the home he or she values as a quiet, restful respite. So it follows that when farmers retire from farming and eventually look for an extended care facility, peace and quiet is high on their list of priorities. They want their prospective residences to remind them of home, in the way it looks, feels, and sounds. And those sounds must include the elusive sounds of silence.
       Farmers are not the only professionals looking for peaceful accommodations. But they are one of the chief constituencies served by The Pelican Rapids Good Samaritan Center, located in the quiet town of Pelican Rapids (population 2,000), Minnesota. The facility, which lies on the western edge of the state, is just 45 miles south of Fargo, North Dakota, in the heart of the Midwest’s prime agricultural land. Peaceful lake habitat surrounds the 55-bed center, which offers skilled nursing services around the clock, including physical, occupational, and speech therapy. The center is owned and operated by The Evangelical Lutheran Good Samaritan Society, a Christian, not-for-profit organization.
       It might seem that quiet is a natural phenomenon for an extended care facility in serene Pelican Rapids. But that is not so. The center is subject to as much environmental noise as other facilities, with persons coming and going, deliveries constantly arriving, and staff carrying out the myriad of duties that are intrinsically a part of extended care. It is nowhere near as loud as a farm. But it is work to keep it quiet.
       So like a growing number of residences, Pelican Rapids is approaching practically every facility management decision it makes with solitude in mind. Charged with that task is Gery Ehlert, the facility’s environmental services supervisor. He is in charge of the 37,000-square-foot, two-story facility’s laundry, maintenance, housekeeping, and security. And every day for the past 17 years he has worked on establishing, and then reinforcing, the center’s peaceful ambiance.
       Ironically, technology—the traditional source of a lot of noise—has become an important tool for keeping excessive sound in check. With each new technological application that has been adopted by the center, Ehlert has been challenged to learn it, master it, teach it to others, and blend it into the infrastructure. And it is that blending that has become one of his toughest tasks. Consider what the extended care world looked like back in the early 1990s when Ehlert began at Pelican Rapids. Computers were still not on stream for facility management. Even monolithic, cumbersome software programs were out of reach. And when extended care technology was created, administrators like Ehlert had to find ways to make the various technologies talk to each other—old with new, one company’s technology with another, etc. And still the job was not done, as the staff then needed training to become proficient technology users.
       Ehlert found the best training approach was the small-group seminar. And when he says small, he means it—no more than two or three staffers paired with one administrator. Usually, that is Ehlert or the human resources director, depending on the topic or the technology. Sometimes he will even hold one-on-one meetings with staff if, as is often the case, the technology is unusually complex. “People who are new to the nursing field are amazed at the level of technology,” says Ehlert. “A few years ago this would be James Bond type of stuff.” Now, the future has arrived, and it is playing out in extended care facilities.
       To sort out the new technology, Ehlert counts on sales and technical representatives more than ever. After all, he has 35 nursing assistants who need the facility’s latest technological additions explained, so he must be fully conversant before he begins his seminars. To that end, he will spend a day or two with company personnel, asking questions, taking notes, walking through a new system, and generally getting to know all facets of its operation.

Implementing a Door Security System

       When Pelican Rapids decided to go with the RoamAlert^® door security system, Ehlert spent the day with the system’s installer so that he could later help the staff implement the technology. Among his tasks were to work with the installer to determine the location of the sensors for the seven armed doors that respond to patients’ security pendants and prevent them from wandering. Once Ehlert understood the system, the challenge was to train staff to get used to the door monitors and learn how to control them at the computer terminal where the system is controlled.
       With previous technology, whenever a door was violated, a timed alarm would sound, and a staff member would have to physically disarm it at the point of entry. With RoamAlert, when a pendant-wearing resident approaches a door, his or her pendant sends a signal to the security sensor on the door to lock it. The only sound heard is a quiet click of the door locking—there is no buzzer, no alarm, and no siren. If the resident is confused or does not move along, staff can attend to him or her. But they often do not need to do anything.
       “Senior care organizations of all kinds are concerned about maintaining a friendly, noninstitutional atmosphere,” notes Diane Hosson, vice president of marketing for VeriChip, which manufactures the RoamAlert system. “It’s all about respecting residents’ dignity while helping staff do their jobs.”
       Pelican Rapids has five residents prone to wandering. “Those five used to take up as much staff time as the other 45 put together,” says Ehlert. Now, with the RoamAlert system, staff has more time to care for residents. Staff members can spend their efforts brushing the residents’ hair, taking them for walks, and putting on cosmetics—activities that are curtailed when a wandering patient must be retrieved.
       It also leaves more time for staff training. Ehlert figures he spends about 30 minutes a day on one-on-one staff training, between the fire alarm system, the patient security alert, the nurse call system, and hand-held data entry palm pilots. And Pelican Rapids is not finished with adding technology. Its latest acquisition is a new wheelchair washer that requires staff training to operate, and the facility is always tweaking its food offerings as staff members learn more about diet and health.

Conclusion

       Pelican Rapids has grown incrementally. And really, that is its only option. It is built into a hill on a half-block of land and cannot expand physically because it is a part of a neighborhood, surrounded by houses. So rather than grow out, it grows in. The owners embarked on a major remodeling in 1981 and continued with aesthetic and cosmetic changes, such as softening the wall coverings to get away from an institutional look. “No cement bricks are visible here,” says Ehlert.
       But many of the building improvements, such as the RoamAlert system, have been technological and practically invisible. Electronically, 12 computers are networked through the facility, with ports for another 24. Ehlert uses electronic communication extensively, for everything from the nurse call system to ordering supplies. The quiet tapping of a computer is consistent with the center’s goal of providing a peaceful atmosphere. Says Ehlert, “We continue to keep finding ways to make the center quiet and give it as much of a home-like atmosphere as possible.”