There’s no doubt that a revolution is underway in long term care. The question is whether that revolution should be televised.

 

Today, thousands of seniors are plugging themselves into digital music players, electronic tablets, flat-screen televisions, and complex video game consoles as part of their daily routine. Studies are being undertaken right now, wondering whether robots can replace caregivers, and pharmaceutical companies are pouring chemicals to find the right pill—all in the search for the cure for loneliness.

For all the promises of technology, there are some who worry that providers will be dazzled by the glitter and lose sight of their true goals. And this isn’t mere “Future Shock,” says Bill Thomas, MD.

“What’s always important to me is that the tools are always used for the right purpose,” he says. “Creating and maintaining relationships between human beings is exquisitely complex and demands work. Washing dishes, making beds, vacuuming the floors—those are the things that are perfect for robots to do. I want them to make robots so that people can have the time making the human connections that we all need.”

Thomas and others say they are open to technological innovation, but they’re wary of futurists bearing strange gifts. Because there is only so much time and money to spend—and the residents themselves can’t wait to hear back from the lab when they’re suffering.

“The absurdity of this,” he says. “To spend all this money making a baby seal robot and then putting the robot in the room with the elders, while a human being is in the next room making the beds? That’s insane.”

No one denies that technology can work miracles in connecting seniors with each other and with the larger world, even in the darkest moments of their decline.

“This technology really allows us to take folks with dementia to places where they can no longer go,” says Juliet Holt Klinger, Brookdale’s vice president for dementia care. “We had a woman who, at 104, this was the first year that she couldn’t accompany her family on their annual Hawaiian vacation. And so they Skyped while the family was on vacation and she was able to see the beaches. She just cried. It was a very powerful, meaningful experience for her that we could not have provided without the technology. We have a woman who spent her 102nd birthday on the computer, playing games and working on puzzles. At 102, that’s a pretty amazing quality of life.”

Brookdale has made “a major investment” in its technology, Holt Klinger says. One of the biggest tickets is It’s Never 2 Late, a Colorado touch-screen computer and software application company that has found a niche in dementia care.

The company sells touch-screen computers with access to thousands of applications—from virtual tours of world heritage sites to flight simulators, to personalized folders where families can post e-cards, photos, videos, music clips, puzzles, news stories, or just about anything that matters to their loved one.

“We’ve really found the technology [to be] just remarkable,” Holt Klinger says. “We couldn’t reach the heights we have without it.”

It’s Never 2 Late founder Jack York says he’s glad to hear it, but he’s sure that his company is merely the tip of the spear.

“Senior living conferences, there are row after rows of electronic medical records, and laser this and laser that, but there’s maybe only one or two companies like ours out there that are focusing on what it’s like for the person at the center of all this,” he says. “But I guarantee that the kind of work that we’re doing will be absolutely demanded in a relatively short term, because the kids are going to demand it.”

York, a self-described former Silicon Valley super-brat, began donating old computers to skilled nursing centers in the late 1980s. He was thrilled by the results.

“I fell in love with the potential—what it could do for those people,” he says. “One of my favorite lines is that this whole generation, they invented the vacuum tube and the transistor—the whole infrastructure that gave the iPhone—and they have a right to enjoy it. Now.” Seven years ago, he went all-in and founded It’s Never 2 Late.

“If I had to put my mom into a dementia care center, the big question I would have is, how do I connect with her?” York adds.

He’s also certain that companies like his can help providers tackle difficult quality matters.

“There’s a huge push to reduce drugs in nursing homes,” he says. “It’s so tempting, when that person is screaming at 2 in the morning, just to get them the drug and get them to check out. But if you can get them a screen of a priest they know saying the rosary, if you can show them a concert, then maybe you can change things in a really positive way.”

Holt Klinger is happy to give testimonials about the gadgets. But she’s also clear that their work isn’t done when a switch is flipped.

“If we’re doing person-centered care the right way, then it’s all going to be relationship-based,” she says. “Senior living can be a great prescription for loneliness.”

That means one has to commit to knowing one’s residents, and caring about them, Holt Klinger says. Once that has been laid out as a blueprint, the tools will present themselves—and they don’t have to be hi-tech.

“We have folks who ride horses, and we have folks that help the maintenance people painting the fences, and they’re people with mid- and late-stage dementia doing things that we wouldn’t have trusted them to do” before, Holt Klinger says.

Holt Klinger enjoys telling the story of one of her centenarian residents, who had in her younger years been one of Slovakia’s first pilots. The company hooked up with a nonprofit group and arranged for the woman to take a flight in a vintage biplane. Two weeks later, the woman died, a smile on her face.

“I’m all about changing what it means to live with dementia,” Holt Klinger says. “Not everything that we do is that extravagant, but we really are changing the definition of what it is to live with dementia.”

Vetter Health Services Life Enrichment Coordinator Cameo Rogers has a similar goal. Like Brookdale, Vetter uses It’s Never 2 Late, but it’s one tool among many (including knot-baby clubs, or even forming

a community service club residents have dubbed, “The Owls”).

“It’s not what you do, it’s how you do it,” Rogers  says. “I think the most horrible feeling you can have if you work in a facility and you go to the end and you look through [the resident’s] obituary and go, ‘I wish I would have known that.’”

Maria Nicora, 22, is taking the low-tech road. A volunteer at the Chicago chapter of Little Brothers—Friends of the Elderly, Nicora is nearly halfway through a yearlong fellowship with the group. She has a list of 30 seniors, scattered throughout Chicago, whom she visits at least twice a month.

“I love it,” she says. “They tease me about my dazzle jeans, saying, ‘Why can’t I wear your jeans, too?’ I can’t tell you how many bar recommendations I’ve gotten.” (It is Chicago, after all.)

Nicora, originally of California, gravitated toward the work seeing how her grandmother was treated in a local nursing home. She decided that she wouldn’t leave elders feeling alone.

“They’re people, too,” she says. “I consider myself lucky to have so many friends.”

It’s a busy job, and it can be have its unique hardships. It’s difficult, for instance, to convince seniors that just because they have a doctor’s appointment in the morning, they can’t still go out for lunch or a movie in the afternoon, Nicora says.

Four months into her fellowship, Nicora said, one of her new friends died. The woman had trouble speaking for most of the last years of her life, and Nicora admits that much of their conversations were lost. One sentence came through, however, again and again: “She said, ‘I’m so grateful that you come and see me.’”