In “A potential lawsuit in every worker’s pockets?”, McKnight’s Editorial Director John O’Connor describes two of many recent incidents of long-term care workers using their cell phones to record residents in embarrassing situations and post the photo or video to social media.
Despite leading to termination of employment and lawsuits, some of the employees involved appear to have no idea that this behavior is a serious ethical breach. Staff writer Emily Mongan offers the following quote in her article on this topic: “They just blew everything out of proportion,” [the offending employee] said. “It was just a picture of her butt.”
Wondering how an employee could possibly think posting a photo of a resident’s behind to social media would be a reasonable action to take, I contacted psychologist and social media expert Keely Kolmes, PsyD , to find out.
Changing expectations of privacy
Dr. Kolmes notes that it’s become commonplace for people to record moments from their lives and post them to social media, generally without consent from others who might be captured in the photos or videos that are shared.
For example, while I get my daughter’s permission before I post anything about her to my private Facebook page, I occasionally find her featured in photos with friends on their pages without prior approval. Posting friendly pictures is considered acceptable in one’s personal life (and a parent who asks permission from their child is, I suspect, unusual).
One might argue that there’s a distinction between personal and professional situations, yet similar situations frequently occur in professional settings as well, such as discovering you’ve been featured in a photo on the website of an organization after attending their conference or on your facility website after the holiday party.
Most people are pleased to be highlighted in such photos, but if an organization expects employees to follow their social media policy, these situations are a prime opportunity to show workers that the policy is being followed at the corporate level as well. At facility events, for instance, notify staff members that photos will be taken and may be posted.
In To Reach Seniors, Tech Start-Ups Must First Relate to Them, Paula Span discusses the need to create “silvertech” based on what seniors really want, need and are able to use, rather than what younger people devise without consulting them.
In my experience in nursing homes and rehabs, residents would appreciate devices that help them to be more independent. To be able to open and close the windows, adjust the thermostat, and bring the tray table within reach would be a boon for them as well as for the staff otherwise called to their rooms to assist.
Elders living at home would undoubtedly be pleased to have insurance cards with print large enough to read — not a tech device per se, but a more user-friendly interface with their insurance company. Other aspects of interfacing with corporations are important as well. Span reports that a debit card geared toward seniors found that they prefer to be routed to the appropriate customer service representative rather than to be directed to a website or app when problems arose.
Here’s an except from Paula Span’s article:
Daily, breathless announcements arrive in my inbox, heralding technology products for older adults.
A “revolutionary” gait-training robot. An emergency response device said to predict falls. A combination home phone and tablet system that “transforms how older seniors connect with and are cared for by their loved ones.”
Daily, too, I hear tales of technology failing in various ways to do what older people or their worried families expect. I hear about frail elders who remove their emergency pendants at bedtime, then fall in the dark when they walk to the bathroom and can’t summon help.
About a 90-year-old in Sacramento who stored his never-worn emergency pendant in his refrigerator. About a Cambridge, Mass., daughter who has tried four or five telephones — not cellphones or smartphones, but ordinary landlines — in an ongoing effort to find one simple enough for her 95-year-old mother to reliably dial her number and have a conversation.
Which scenario represents the likelier future for senior-oriented technology? It depends on whom you ask.
Mr. Johnson was in his 90s and had lost his vision many years ago. His great joy in life now was listening to the radio.
When I first came to see him, he had many different types of radios in his room. There were several radio alarm clocks and complicated boom boxes with too many buttons and functions he didn’t need. There was a transistor radio that required expensive batteries and somebody to run to the store to buy them.
All of these devices had crashed to the floor more than once during Mr. Johnson’s attempts to use them. None of them worked.
In long-term care, objects such as radios, telephones, and remote controls are always falling off tray tables and nightstands. I’ve often wished for rubber devices, preferably with a boomerang function that brings them back to the user immediately.
Seeking a replacement for Mr. Johnson, I found a simple, rugged radio that’s perfect for people who are visually impaired and need a fall-proof device. It’s a bit heavy at 6 pounds 9.8 ounces, so take that into consideration, but it’s impact-resistant, water-resistant, has five easy-touch AM/FM preset buttons, no extraneous functions, and has a power cord so no batteries are needed.
Mr. Johnson bought his through Amazon with my help (“Where is this store exactly?” “It’s on the computer, Mr. Johnson.” “But where is it?” “It’s hard to explain. But your radio will get here very quickly.”)
The radio doesn’t have a boomerang function, but at least if it falls, Mr. Johnson can pick it up by its handle and use it again.
I wrote about the White House Conference on Aging last October, noting that it was a “once-a-decade” national conference about the needs of our aging population.” (McKnight’s LTC News, October 2014)
Below, LeadingAge summarizes the 2015 White House Conference on Aging, which took place on Monday:
After a year’s worth of collecting data and opinions, experts from the field of aging presented new ideas and initiatives at the 2015 White House Conference on Aging (WHCOA).
The White House Conference on Aging facilitated a national conversation on growing older in America through live-streaming social media. LeadingAge hosted a watch party and found the following highlights noteworthy:
A Call for Caregiver Support Systems: Panelists stressed the importance of establishing support systems for the nation’s 50 million professional and family caregivers, whose numbers will double by the year 2050.
CMS Proposed Rule: CMS proposed Reform of Requirements for Long-Term Care Facilities, which would affect more than 15,000 nursing homes and skilled nursing facilities. A element of the proposal is new standards for coordinating facility-to-facility patient transfers in order to improve quality of life, enhance person-centered care and services for residents in nursing homes, and improve resident safety.
HHS Secretary Announces Funding for Workforce: Sylvia Burwell, secretary of the U.S. Department of Health and Human Services (HHS) announced $35.7 million for a new Geriatric Workforce Enhancement Program, preparing the health care workforce to respond to the needs associated with advancing age.
Dementia Friendly America: A coalition of private sector organizations announced the Dementia Friendly America initiative, which was created to foster communities that are equipped to support people with dementia and their families. There are currently plans to build 15 new pilot sites across the country.
Since I now Skype regularly with my 94-year old father-in-law and his wife, the concept of telemental health doesn’t seem as futuristic to me as it used to seem. I was shocked to discover, however, that the American Telemedicine Association (ATA) was established 20 years ago, with the first applications of telemedicine occurring over 40 years ago. Apparently, I’ve been behind the times.
According to the ATA, telemedicine is “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.”
Telemental health, or telepsychology, as the American Psychological Association refers to it, is simply “the provision of psychological services using telecommunication technologies.” I turned to psychologist Dean Paret, PhD, senior vice president of clinical operations of Brighter Day Health, a provider of telemental health services in long-term care, to answer some of my questions about telemental health.
How telemental health works
According to Dr. Paret, telemental health includes not only psychiatric evaluations and medication management sessions, but psychotherapy as well. Providers use a two-way video system over a secure line to “visit” with LTC residents.
The equipment used includes a camera and a video screen that allows the clinician to see the resident and vice versa. The service is similar to Skype or Facetime, but it involves a secure, encrypted network that leaves nothing on the computer and is HIPAA-compliant. Brighter Day Health works with its facilities to set up the proper equipment. “The big challenge is the Internet speed,” Paret stated, “and the ATA has information on funding sources to upgrade rural systems.”
Once again, McKnight’s will host its annual online expo, which is a chance to attend a conference without leaving your desk. Register for the conference in advance, and then log in to hear the talks, visit the vendors, and chat with the reps and attendees. This year’s topics are:
PAYMENT An MDS 3.0 Update March 20, 10 am EST / 7 am PST
QUALITY Immediate Jeopardy: What You Can Do March 20, 11:30 am EST / 8:30 am PST
TECHNOLOGY Avatars In Senior Care Settings March 20, 1 pm EST / 10 am PST
WOUND CARE Wound Care Update: Lessons We’ve Learned March 21, 11 am EST / 8 am PST
CAPITAL Finding Capital in 2013 March 21, 1 pm EST / 10 am PST
You can create your own avatar when you log in, so your avatar can chat with others about avatars!
Last weekend I was in Orlando, Florida for the American Psychological Association conference, where I spoke as part of a symposium on Social Media in Long-Term Care Settings. We discussed concerns around maintaining privacy and confidentiality, as well as the use of social media to improve care. Of course, I talked about my blog, how it developed, recommendations for those considering beginning their own blogs, and ways in which I’ve used my blog for therapeutic purposes with the residents. Below you can see me with co-presenters, Drs. Keely Kolmes, Geoff Lane, Mary Lewis, and Pat Bach, who are all psychologists experienced in the use of social media in health care.
Ms. Williams was humming a tune as I rolled her wheelchair toward her room for our session. “What’s that you’re singing?” I asked her.
“I’m not singing, I’m humming. It’s a song I heard as a child. I can’t remember the words.” 84-year old Ms. Williams had been worryingly depressed for several weeks, and our sessions tended to be a litany of complaints that were somehow never resolved despite the best efforts of the staff.
“Do you remember any of the words?” I asked.
“Something, something, they tell me of a home far away…” She hummed a little. “That’s all I remember.”
I pulled out my iPhone and entered “a home far away” in the YouTube search box. Moments later I had the lyrics and music to her song. I turned up the volume and held the small screen in front of her. She hummed along, and smiled. “Yes, that’s the one! My father used to sing that to me.” She began singing, and seemed content for the first time in months. The song ended, and she beamed at me. “I haven’t heard that in a long, long time. Thank you!”
“My pleasure.”
“That’s a shame about Whitney Houston,” she remarked. “Such talent, wasted.” Then she told me for the first time about the alcoholism in her family, and the effect it had on her life.
I recently read an article about how the aging of baby boomers is causing some technology companies to focus on products geared toward older adults, often with the goal of helping them remain independent and at home for longer periods of time. But what about those older adults already living in nursing homes? What would help them be more independent? Here are products I thought residents would appreciate, and ones I’d like myself when it’s my turn. Please add your suggestions in the Comments section:
A motorized wheelchair
A remote control for the air conditioner/heating system
Windows that can open and shut by remote control
A rubberized telephone that can withstand frequent dropping
Wi-Fi
Any adaptive equipment I need to use my laptop
A staff paging system that doesn’t involve overhead announcements
The saying in 12-Step programs such as Alcoholics Anonymous (AA) is that alcoholism is a three-fold disease: physical, mental, and spiritual. The only-half-kidding joke is that alcoholism is a three-fold disease: Thanksgiving, Christmas, and New Year’s. The holidays can be a particularly stressful time for nursing home residents as their celebrations have often changed significantly from those in the past. The loss of family members, the inability to get around independently, and the lack of opportunity and funds to shop for gifts can take their toll on residents who may have had trouble with the holidays even before they entered the nursing home.
In case you haven’t been persuaded by my previous arguments for holding AA meetings in nursing homes (or in case you’ve been persuaded but your administration hasn’t) there are also telephone meetings available to residents for the cost of a phone call. Callers can listen in, or share their story if they wish, in an anonymous environment. Below are links to the telephone meeting lists of several 12-Step programs.
Ms. Williams was humming a tune as I rolled her wheelchair toward her room for our session. “What’s that you’re singing?” I asked her.