Melbourne School of Engineering senior lecturer and ARC Future Fellow Dr Jenny Waycott answers our questions on technology supporting care.
AAA: What technologies are being used to support care in residential aged care homes?
JW: There are different kinds of technologies being used in aged care homes to support different aspects of care. Some technologies aim to ensure residents are safe and to detect any incidents that require a timely response from care providers.
For example, in some aged care facilities smart flooring is used in residents’ rooms with sensors embedded in the floor to detect when someone is getting out of bed. Smart flooring sensors can identify when a person is at risk of falling and provide an alert to care staff, thereby helping to monitor and prevent falls.
Other new healthcare technologies that focus on monitoring and identifying older adults’ care needs include pain identification apps, which use facial analysis to detect if someone is experiencing pain.
In my work, I am more interested in technologies used to support psychosocial caregiving in aged care, which are technologies that support people’s social connectedness and engagement in the world.
In the last few years there has been a lot of interest in the use of immersive virtual reality, which is used to give people the sense that they are travelling to another place or experiencing new activities. Because it is immersive, this technology can make people feel like they are really there and can be calming for people who might be agitated or anxious.
Similarly, a lot of aged care homes use robot pets that respond to touch. There is Paro the seal, which has been in use for many years, as well as simpler and more affordable toy cats and dogs. These help to provide a sense of companionship and can be comforting for many people.
There are also robots that talk and are more interactive. They can facilitate games, tell stories and initiate sing-alongs. But I have found that these are not as commonly used as robot pets in aged care homes.
I have not yet seen many examples of smart speakers or virtual assistants used in aged care homes in Australia, but these are becoming more common in the United States. They respond to voice commands and can be used to play music or provide information when requested.
A technology that has been available for a while but is being used a lot more now, thanks to Covid-19 restrictions, is video conferencing to connect residents with loved ones.
AAA: Which new technologies offer social and emotional enrichment for aged care residents, and which fail to do this?
In the technologies listed above, those that are designed to meet people’s social and emotional needs, rather than to monitor people’s activities, work best for offering enrichment in aged care. Technologies can offer different kinds of enrichment. Which technologies work best will depend on the kinds of enrichment different people need.
For those who need to feel connected to family and friends, technologies that enrich personal connectedness, such as video conferencing, work best. For those who want comfort and companionship, robotic pets seem to be very effective.
Some technologies, such as video games or virtual reality, can be used in group settings to provide a sense of fun and to help enrich social connectedness within the group in the care home. Some people want to feel connected to the world, not just to other people, and to feel like they are engaged in meaningful activities.
In my research, I have found that virtual reality works well for some residents for alleviating boredom and helping them to visit places or relive experiences that have personal significance.
Virtual travel in VR can support reminiscence and help the care staff learn more about the resident’s interests and experiences. But immersive VR is not suited to everybody. VR can be uncomfortable and frightening for some people due to the weight of the head-mounted display and the fully immersive experience it offers. And it can be difficult for care staff to facilitate.
AAA: COVID-19 has seen a surge in technology to help residents remain connected to their loved ones, what works best and what doesn’t work well?
Facilitated video conferencing can work well for connecting residents to loved ones. Personal communication tools, such as tablet devices and smart phones, can be effective for making video calls, using applications such as Zoom, Skype or WhatsApp.
Being able to see the other person can help people feel more connected and the conversation can include other family members, such as grandchildren and great-grandchildren, so it can provide more of a group connection. But this can also be overwhelming.
In aged care, staff facilitation is often required to ensure the resident is comfortable with the set up and to make sure that the connection works well. Also, Wi-Fi connections can sometimes be unreliable and this can result in confusion and frustration, so it needs to be carefully managed.
There are also some specially designed simple messaging tools and touch-screen devices available for use in aged care. These tools can be useful for enabling frequent low-key communication, such as sending messages or photographs. There are also opportunities to use technologies for more playful communication, such as playing games together, but I have not seen examples of technology used in this way for people in aged care during COVID-19.
AAA: What are the biggest challenges to effectively using technology with aged care residents?
The biggest challenge is that using technology effectively requires staff time. There is a common belief that technology will help to make caregiving more efficient. But when technology is used for social and emotional enrichment, it augments rather than replaces care activities.
Some technology-based activities require more staff time when compared with other activities used for enrichment in aged care, such as listening to music or participating in group games such as bingo).
Using immersive virtual reality effectively, for example, requires one-on-one support and careful facilitation. A staff member would normally sit close to the resident and make sure they were comfortable and that they were enjoying the experience. There are some services that offer group VR sessions.
These can be more efficient than one-to-one VR and can foster connectedness within the group. But for individual sessions, staff time is a significant barrier to ensuring the technologies are used effectively to achieve the promised social benefits.
AAA: What tips do you have for the successful use of technology in residential aged care?
My key tip, which comes from interviews I have conducted with aged care staff before COVID-19, is that it’s about the people, not the technology.
The best way of using technology for care and connectedness in aged care is to understand people’s individual needs and to identify tools and solutions that respond to those needs. This, of course, takes time. It means that a one-size-fits-all solution will probably not work.
Many care staff already provide person-centred care. Technology that augments social care, as opposed to technology used for monitoring purposes, works best when it is used as part of a person-centred approach to care.