Safety for the elderly — digital night monitoring

Users with cognitive impairment or some form of dementia could become upset if they wake up during a physical visit.

Physical visits also require a lot more staff as they are very time consuming. It is difficult to recruit staff and in the future we will have an older population with increased needs. It will be difficult to match such needs with the same workforce we have today. Thus, new work models are needed.

It is rare for a camera to malfunction. When this occurs the most common reason is that the camera has been unplugged due to cleaning. Digital checks take place at specific times during the night, as agreed with the user, by an assistant nurse at a central unit in the municipality. In Kramfors, a central unit handles all digital checks. The unit makes 30 checks per night, which takes a total of around 15 minutes. This constitutes around 26% of all night checks in Kramfors. In comparison, driving to remote parts of the municipality can take 50 minutes, one way. In other municipalities, for example, Skellefteå, the same night patrol that makes physical visits is also responsible for the digital checks and makes 92 digital checks each night. About 46% of all Swedish municipalities offer some form of digital night monitoring.

Almost all physical checks have to be physical as other tasks must be performed, e.g. help visiting the bathroom, changing incontinence aids, etc. 

The equipment is leased from the service provider and costs SEK 450 per month, per user. In Kramfors this is paid for by the municipality.

It is much more efficient for the municipality to use digital monitoring than make physical visits as there is no need to use transport. A digital check take significantly less time.

Training for staff who will be conducting the monitoring takes one hour and training for technicians takes three hours. Naturally, staff training is not very time consuming. More time will need to be spent on information and marketing. It is very important to notify potential users and the public early in the process and it will be a challenge to do this in the most optimal way, e.g. marketing via different channels, attending meetings with elderly people, being proactive with the media. Dealing with negative articles and comments can be difficult so it is best to engage the media early in the process and provide examples of positive cases. You could perhaps provide information or write articles yourself. Information meetings must be also held with staff who work within elderly care so that they, in turn, can be good ambassadors.

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This issue concerns both the general population and potential users, politicians and the media. It is important to attend meetings and answer all questions posed by worried users and their relatives.

There are also obvious positive effects for the environment. 173 kilometres of car travel can be replaced by digital checks every night and 63,080 kilometres per year.

Patients can enjoy an undisturbed night’s sleep and still feel safe using this solution, knowing that if something happens it will be noticed by staff via the camera, and that the patient’s needs will be addressed via a physical visit. Assistant nurses in home care can dedicate their time to patients that really need a physical visit, i.e. meet the patient’s needs in situ, using the appropriate measures.

Effects for the patient

• Patients can be checked but still enjoy an undisturbed night’s sleep
• Patients with cognitive impairment or dementia might be worried about a physical visit. This cannot happen with digital monitoring.
• Reduced risk of fall injuries
• In some cases, medication might be reduced (reported from Skellefteå)
• The checks can be adapted to suit individual needs

Effects for the care giver

• Work model that will work in the future
• Less time-consuming journeys
• Fewer hours spent in cars driving at night on dark roads
• Frees up time for patients who really require a physical visit

Other effects

• A reduction in driving is good for the environment