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Behavioral telemonitoring

March 1, 2010
by David J. Stern
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How the modality is changing senior care
David j. stern
David J. Stern


Behavioral monitoring offers senior living communities a unique tool to enhance resident safety and independence, and can help providers give more efficient, timely, and responsive resident-centered care. The technology is already allowing providers to place greater emphasis on prevention and wellness promotion through a better understanding of each resident's needs. Information from behavioral monitoring can be used in an iterative process of care planning and the monitoring of care delivery.

Data collection

These systems collect data on each person's patterns of daily living (such as sleep, toileting, eating, or general activity levels), analyze the data, and automatically generate individualized baselines for these behaviors. When there are noteworthy changes in these norms, they automatically alert caregivers. The systems also passively identify potential emergencies, such as falls, wander events, bed exits, extremes of household temperatures, or failure to get out of bed by a predetermined usual morning wake-up time.

Consider this example: Between 11 p.m. and 7 a.m., Mr. B had nine bathroom visits. The behavioral monitoring system (in this case, GE QuietCare) automatically notified staff, who promptly checked on him. They found a very sick person requiring immediate medical attention. He was taken to the hospital where he underwent emergency gall bladder surgery. No one had known that he was ill. He is a fiercely independent person who is reluctant to ask for help; but in a sense, the system asked for him.

At a glance…

Behavioral monitoring systems collect data on each resident's patterns of daily living, analyze the data, and automatically generate individualized baselines for these behaviors. They offer senior living communities a unique tool to enhance resident safety and independence and can help providers give more efficient, timely, and responsive resident-centered care.

Three components

There are generally three components of typical behavioral monitoring systems:

  • Passive, wireless sensors strategically located around the home that gather data on the movement and activity level of the resident.

  • A transmitter or base station that receives, organizes, and then transmits the data to a central file server.

  • The server that analyzes the data, generates norms, identifies potential emergencies, and alerts caregivers.

Typically, a password-protected Web site provides caregivers with a one-page summary of all their residents/clients with graphs and color-coded alerts facilitating ease of use. The caregiver can drill down for additional information on any client. In addition, alerts for potential emergencies or noteworthy changes in behavior may be sent via text messaging, e-mails, pagers, or through professionally staffed call centers.

The information provided through behavioral monitoring is not new. Clinicians have historically incorporated data on changes in behaviors as integral components of their assessment/diagnostic processes. Generally this information has been obtained episodically (usually around periods of illness) and relies heavily on patients' self-reporting. What is new about behavioral monitoring is that it captures data continuously, 24-hours a day, seven days a week. And it does so unobtrusively and passively. The resident does not have to wear anything or interact with the technology and the ability for the system to work does not depend on his or her physical, mental, or visual capacities. It is thereby able to provide 100% compliance and offer a unique insight as to how individuals are really managing in their homes.

According to The Commission on Aging Services Technology (CAST) of the American Association of Homes and Services for the Aging, behavioral monitoring impacts each of the major stakeholder groups in senior living communities. Among the values they cite are:

  • To the resident: Heightened sense of security, prolonged/enhanced independence, and improved quality of life.

  • To the provider: Ability to dispatch services more timely and appropriately; improved caregiver efficiency and accountability; improved customer satisfaction; enhanced revenue opportunities (more robust recruitment and documenting need for higher care levels); and strengthened communication among staff, residents, and families.

  • To healthcare professionals: Objective behavioral information that may enable earlier detection of potential health problems; proactive, preventive interventions; improved efficiency; and more resident-centered care.

In addition to these values, assisted living communities have found behavioral monitoring enables them to respect their residents' desire for independence and privacy. At the same time, it addresses the concerns of regulators and families that the assisted living facilities provide for resident safety and well-being 24/7.

David J. Stern is Marketing Manager, Home Health at GE Healthcare. He was formerly Chief Professional Officer with Living Independently Group Inc., the developers of the GE QuietCare behavioral monitoring system. GE Healthcare acquired Living Independently in 2009. He has more than four decades of experience in geriatric social work. Mr. Stern has served as Executive Director of the Jewish Association for Services for the Aged, a New York City-based geriatric social service agency serving more than 52,000 older adults annually. He is a CAST commissioner, a fellow of the Brookdale Center on Aging, and a recipient of the Family of New York State Award.

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