Helpers and family. Residents are not the only people at risk at an LRC facility. Caregivers and loved ones have become the victims of outbursts by residents who are angry, frustrated, and afraid. Sometimes assaults are also the result of neurological or pathological behaviors.
Facilities that train staff to recognize and respond to early indicators of aggression may be able to minimize the potential for injury. Staff should be trained in what to look for and in remediation steps, such as how to implement physician-ordered limited physical restraint and when and how to administer medication.
In the realm of technology, wireless alarms and nurse call systems as well as CCTV cameras in the facility’s common areas can help quickly end assaultive incidents. Additionally, consideration should be given to the limited use of covert CCTV to protect residents when abuse is suspected. The decision to use this type of technology should be fully reviewed before it is undertaken.
Policies and technologies. After the assessment is completed, recommendations should be compiled to remedy problem areas. To be most effective, the security program must be integrated into the organization’s mission, vision, and values.
There is often, in general, an urge to solve problems by the installation of security systems, but it is important to note that security technology, in and of itself, is not the answer. It must be coupled with appropriate policies, processes, and procedures, the assignment of security responsibilities, adequate staffing levels, staff training and supervision, drills, audits, and ongoing quality improvement efforts.
This having been said, several up-and-coming technologies are worth noting that are either just becoming available or will be available in the near future. Among these are GPS-based wearable devices to account for residents when outside buildings. Unlike current patient-elopement systems that generally only alert staff to a resident leaving (or attempting to leave) the facility, these systems will provide real-time information about the whereabouts of the resident whether on the premises or not. Other information, including respiration and heart rate, may also be available.
Radio frequency and infrared technologies offer promise as a way to track residents, as well as their valuables, within facilities. In addition, Wi-Fi network advances may soon facilitate the setting up of temporary alarm systems needed to closely manage residents who are episodic, wandering, or elopement risks. Similarly, the use of secure Wi-Fi technologies in resident and patient rooms may help to reduce the amount of time staff spend at charting stations.
Also noteworthy is the potential use of behavioral recognition algorithms with digital video recording technologies, which would enable a CCTV system to identify behaviors associated with wandering residents in parking lots and other exterior areas. The system could then sound an alert to let staff know that this behavior was occurring and where.
To protect residents, family, and staff, LTC facilities should assess their needs, understand the risks and threats inherent in their unique environment, and develop strategies to address them. Following this course of action will help to ensure that the residents’ golden years will not be tarnished.
Elliot A. Boxerbaum, CPP, is president of Security/Risk Management Consultants, Inc., in Columbus, Ohio. Boxerbaum currently serves on the ASIS International Healthcare Security Council. Patrick F. Donaldson is a principal of Metsger/Forbes in Portland, Oregon. Donaldson also serves on the ASIS Healthcare Security Council. Both have more than twenty-five years of experience in healthcare security.