As the percentage of senior citizens grows, so does the amount of people moving into retirement communities. Tim Kridel explores how AV can help make residents safer and more comfortable while supporting overstretched healthcare staff.
If you feel old, you’re not alone. At least 20% of the population in countries such as Finland, Germany and the Netherlands is 65 or older, according to the World Bank. Even with continued mass immigration of younger demographics, that share will continue to grow through at least 2050 for reasons such as life-prolonging advances in health care.
The growing amount of retirees will exacerbate the chronic shortage of skilled workers — not only in pro AV, but also the other professions that poach from pro AV, such as IT. On the plus side, this trend also means new business opportunities in senior living communities.
Part of the reason is that many of these communities have their own chronic shortages, particularly those in the skilled nursing, memory care and assisted living sectors, which are more hands on than independent living. AV technology can help their staff work more efficiently.
For example, the same artificial intelligence (AI) technology used in malls and airports to detect dropped bags, brawls and other security issues can be used so cameras can alert staff that a resident has fallen. Besides enabling a faster response, AI also eliminates the need for staff to sit and stare at a dozen or more camera feeds when they could be doing other things.
“The staffing levels are so low, and that problem is not going away,” says Matt Kijn, Axis Communications segment development manager for healthcare.
This challenge is also helping drive demand for smart home systems such as motorised shades and networked lighting, which enable residents to do many routine things on their own that otherwise would require continual help from staff.
“In the UK, the pandemic revealed how technology could assist with social care — not only for the residents but also helping and assisting the caregivers,” says Dan Sanderson, Crestron senior business development manager for residential and hospitality. “The sheer volume of care required to meet demand and the shortage of caregiving resources demonstrates a stretched healthcare service, which meant residents could be left in isolation for hours. That further adds to negative conditions such as poor mental health, mobility and general well-being.
“Technology cannot replace the shortfall in human resources but can assist with effective solutions that can support the needs of residents and caregivers, allowing more efficient management of time — time that’s better spent on the individual in need of care.”
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Another benefit is that technology enables residents to safely do things that otherwise might risk injury, such as falling and breaking a hip while fumbling for a shade cord or crossing the room to adjust a thermostat. For some residents, those tasks might be impossible. This limitation highlights why and how senior living communities can adopt use cases and technologies from other verticals, such as hospitals, hotels and rehabilitation facilities. One example is Queen Elizabeth's Foundation for Disabled People (QEF), whose Care and Rehabilitation Centre in Surrey, UK, serves people who have brain injuries due to accidents, strokes, neurological illness or spinal cord injuries.
“They have reduced independence and reduced ability to physically interact with and manage their environment,” says Chris Thorne, director of Imperium, the integrator that worked at QEF.
“It's a similar scenario in terms of when we think about assisted living. The motivators and the needs are essentially very similar.”
One example is adding technology that enables residents to control lighting, shades, HVAC and other systems with speech.
“Within these rooms, we basically set up a smart environment, which is fundamentally based on Creston technology,” Thorne says. “As a secondary kind of piece to that, we use Amazon Alexa devices to provide a voice control platform that hooks into those technology systems.”
Speech control is a particularly good fit because seniors can just say what they want rather than learning how to use a touchpanel. A shallow learning curve for residents helps make staff more productive.
“A large portion of their time is spent checking in on them, making sure they're comfortable: Is the sun in their eyes? Do they need the TV turned on or a channel to be changed?” says Casey Levy-Tulloch, Josh.ai director of business development. “With voice control, not only does it empower the person in that room to take care of things themselves, but it also gives back that caregiver, a large section of their day to do more impactful tasks, [such as] administering medication.”
Growing old doesn’t have to mean loss of control
Whether it’s with speech control or touchpanels, enabling residents to do things on their own helps create a sense of independence. That means there’s also a psychological benefit to smart home technologies in addition to business drivers such as freeing staff to focus on care.
“Automation technologies can certainly deliver meaningful value to senior living communities,” says Miguel Aguado, Lutron Electronics EMEA marketing and technology manager. “However, we need to also consider personal preferences and preserving a level of personal autonomy. Having a sense of control over one’s environment can be just as beneficial as automated control. When it comes to lighting and shades, I would say that having a control system that can automate the use of lights and shades while allowing for manual overrides in a simple way, like using wireless remotes, can give senior living occupants, residents and staff alike the best of both worlds.”
That’s the case at QEF, but unfortunately not in many other places.
“If you talk to people [in] elderly care or about assistive technology for people with disabilities, there's a kind of a stereotype of mentality around systems such as medical beds or wearable devices that tell someone if someone's fallen over,” Thorne says. “That tends to be the kind of deep default thought pattern of people that are looking at assistive tech.
“We took a very different spin and — I think this is what the QEF were particularly interested in — which is around enabling people's potential. A huge part of that in elderly patients or people with disabilities is ensuring that they can live independently. When you look at the research, one of the one of the most debilitating factors with people who have decreased cognitive or physical ability is their ability to interact with their environment: turn on a light, turn on the TV.
So for us it was around technology systems that we can offer that can bring that freedom to people who have reduced cognitive or physical ability.”
Another unhelpful stereotype is that the older you are, the less willing and able you are to use technology. But if speech control is any indication, that stereotype doesn’t always reflect reality in both senior living communities and private homes.
“We've gotten some great reviews from our elderly clients, the grandparents that have a forever home,” Levy-Tulloch says. “They install Josh with all their smart home technology. For them, just being able to walk into the room, have a conversation with Josh and not have to memorise what to say, just being able to use the diction, the syntax that makes sense to them. Our natural language understanding has been a game changer.”
Preventing injury rather than just detecting it
Senior living communities also need a host of traditional AV technologies. One example is digital signage in common areas with information about activity schedules and dining menus. Surveillance cameras are another example — and one where the use cases vary by resident type.
For instance, assisted living and memory care communities are particularly interested in using surveillance to catch residents who are eloping or who are outside in a courtyard but now can’t open the door to get back in. AI-enabled cameras can alert staff that a resident is locked outside or has fallen in a part of a hallway that’s not visible from the nurse’s station.
AI-powered fall detection is also a key use case in resident rooms and apartments, one that can be addressed with thermal cameras or radar sensors to balance the need for privacy. But with some types of residents, the goal is different.
“If that patient population is a high fall risk, we want to get alerts when they're out of bed,” says Axis’ Kijn. “We don't want to know when they fall. We want to prevent [that]. There are ways to set thresholds so if somebody is in the bathroom for an extended period, they may need help. We can set some dwell times based around known patient behaviour.”
Audio also provides valuable insights, such as residents who have developed sleep apnoea but haven’t been diagnosed yet. Another example is crying out because they’ve been immobilised by a stroke but unable to use the call button or cord. Helping them right away rather than hours later can mean the difference between life and death.
“We get into a lot of processing of care sleep,” Kijn says. “Is there a lot of ambient noise? If so, why?”
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In the independent living segment, the camera use cases are as much about convenience as security.
“We see a lot of people demanding video doorbells everywhere,” Kijn says. “They want footage everywhere. They want to be able to pull up to their garages and have their car’s license plate open up the overhead door.”
See the light
Lighting is another opportunity — and not just the networked type that can be controlled with speech or from a touchpanel. A Creston blog post discusses the emerging use case of lighting whose colour temperature can be adjusted to mimic the absence or presence of sunlight to improve sleep.
“There was a stat in that blog post that came from a Harvard study: The right lighting appears to dramatically reduce falls in seniors — not necessarily because footpaths are lit in the nighttime, but because Circadian lighting cycles encourage better sleep,” Sanderson says. “It’s one of the benefits of automation that dealers should be informed about.”
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Another market driver is that some of the people moving into independent and assisted living communities are coming from homes that have networked lighting and motorised shades. Their smart home experiences set expectations about what’s possible and preferable, which affects the competitive environment.
“We are now seeing people moving into senior living communities that have had the benefit of living with these technologies, so that sets an expectation and a desire to continue to enjoy them in their new setting,” says Lutron’s Aguado. “This in turn forces facility operators to offer these technologically enhanced solutions if they want to meet their prospective customer’s modern expectations.”
Even so, this isn’t obvious to many operators, so AV integrators, consultants and vendors have to do some educating to make the sale.
“At Lutron, we certainly educate our customers and partners on the capabilities of our systems and how they can help them achieve their goals, but we are not experts or qualified to provide education on how to support or take care of our senior population, so a collaborative, holistic approach to this topic is needed,” Aguado says. “At the same time, AV firms that currently focus on the residential market could leverage their smart home expertise to expand into the commercial sector of senior living communities.”
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