It's not news that older Americans are using the Internet in unprecedented numbers, but recent statistics are striking. A June 2008 survey conducted by the AARP and the USC Annenberg School for Communication found that nearly half of seniors 70 and older rely on the Internet to help maintain the fabric of their social lives.
For these wired and wireless seniors, the already disorienting prospect of leaving home for a long-term care (LTC) facility is compounded by an unpleasant possibility: What if they don't have Internet access?
Orange County Register (California) published a column about the AARP survey in August 2008, senior readers clamored in agreement with the survey's findings. Internet access, they said, was not a luxury item but an essential tool for staying connected with friends and family. “I'm 84 and when I decide to go to a retirement community, they'd best have Wi-Fi [wireless Internet access],” said “Edie,” one of the readers who responded to the column.
Unfortunately, some seniors learn the hard way that Internet access is not a given in the LTC setting. Count Peter Reilly among them. Reilly, a Vietnam War veteran, is paralyzed on the right side of his body. Confined to a wheelchair and limited to use of his left hand, he relied upon the Internet to stay in touch with old Army buddies and other friends. “I did it every morning, sometimes longer. It beat the heck out of sitting in front of the boob tube all day,” Reilly says.
In 2005, when his need for care exceeded the capabilities of his family, Reilly, 67, entered a nursing home. At the time, neither Reilly nor his family thought to consider whether the facility had Internet access for residents. “I took it for granted,” Reilly says. “It seemed like a basic thing to have.”
In fact, it's not quite so basic. As Reilly and others have discovered, many LTC facilities are reluctant to confront the array of challenges typically associated with providing the Internet to residents. Though the positive effects of Internet usage on the mental and emotional well-being of LTC residents have been well documented, concerns about network security, maintenance overhead, and runaway costs have dissuaded many facilities from seriously investigating Internet access.
As more Internet-savvy seniors make the transition to long-term care, various firms are developing services to bridge the gap between those residents' expectations of connectivity and the practical limitations of the typical LTC provider. Bob Kelly, vice president of operations for one of those companies, Vector180, says the problem is that most Internet access solutions require the facility to wear an additional, unwanted hat-that of an Internet service provider.
“Providing Internet access is not part of the core mission for a long-term care facility, or for any healthcare facility. Any setup that requires them to dedicate significant human or financial resources in support of a patient amenity is really not optimal,” Kelly says.
For those who go it alone, he says, one of their first questions is how to provide residents and patients with network bandwidth. Those who don't yet have Internet access must contract for it from a telecommunications company, a process that can take anywhere from two to ten weeks. If a facility already has Internet access for staff and internal use, one option is to allow residents access to the existing bandwidth.
“It's relatively easy to give the patients access to the network that's already in your facility, but doing that introduces two significant risks,” Kelly says. The first involves supply and demand. Will a network that was designed for the requirements of a facility's staff be able to support the additional traffic generated by residents and their visitors? Even if the facility's network was installed recently, Kelly says that the answer is almost certainly no. “As soon as the general population gets access to the network, performance is going to take a big hit-particularly any applications that need to access resources outside the facility. In the middle of the day, when everyone is awake and business is taking place, you're going to have a major bottleneck as everyone competes for access to the outside connection.”
Kelly's second potential pitfall is less obvious, but fraught with even greater danger: network security breaches. “You may have a wonderful IT staff, but they won't be able to guarantee the security of every device or application that will be used on the network.”
Even with hardware or software-based safeguards in place, allowing resident or patient computers on an internal network could cause a facility to run afoul of HIPAA guidelines on network security. Malicious applications could potentially be used to gain access to patient data or other sensitive information on the provider's network. It is even possible for a resident's computer to be maliciously used by a third party without the resident's knowledge. “Once you have a malicious actor or program operating from within your network, you could be partially liable for any illegal activity that takes place,” Kelly says.
Kelly recommends that LTC facilities look for a vendor who is willing to shoulder the administrative and security burdens of providing Internet access. For example, Vector180's approach “takes the problem completely off the plate” of the facility. In exchange, the LTC provider gives the company the opportunity to sell wireless Internet access to its residents and visitors on a subscription basis. “Facilities don't need to pay for full-time bandwidth,” says Kelly. “The residents buy what they need directly from us, while the provider gets to advertise that they offer Internet access.