Fostering connections in long-term care: A digital solution

COVID-19 has shaken the lives of every person, changing how we work, play, travel and communicate. Among the most heart-wrenching stories is the confusion suffered by residents in long-term care homes. News broadcasts revealed stark images of family members standing on ladders to see their mothers, fathers and grandparents through the windows of their care homes. Ontario’s Ministry of Health recognized the extreme pressures on the residents, their families and the long-term care staff and undertook a study to find a solution.

A critical need during an uncertain time

The pandemic escalated the anxieties and depression already felt by many long-term-care residents and worried family members felt helpless in the face of the necessary visiting restrictions. Care workers endured formidable challenges as well, fearing not only for the safety of the residents, but also for their own health. Finding a way to boost morale became an essential part of caregiving.

The Ministry launched a project to investigate how digital access could support not just the residents and their families, but also benefit the dedicated staff overwhelmed by the demands and uncertainties of the pandemic. Together with Rogers and Samsung, the project combined the analysis of infrastructure and internet capacity, delivery of tablets, training of on-site tech champions and data collection–with the ultimate goal of improving life inside long-term care homes, during one of the most difficult times in their history.  

The need for digital access at home, no matter the home

We’ve traditionally seen digital equity as an issue affecting rural and remote or financially disadvantaged populations, but elder community members also need equitable access. Though residents may enter a long-term care facility to receive medical or physical support, the resource isn’t a hospital but instead a home where tenants can live comfortably. This includes the opportunity to access to the internet. The Ministry’s initiative aimed to provide such digital equity to this vulnerable demographic.

While there are still lessons to be learned, the program exceeded initial expectations. Survey results demonstrated many residents were proud of learning to use their new devices. In turn, their family members were able to connect with them more easily, through virtual face-to-face chats at any time of the day, giving both peace of mind during the uncertain time.

While the staff members acknowledged that the time required for training and technical support added to their workload, most felt that the benefits far outweighed any small difficulties. Many saw happier and more engaged residents, as well as gaining greater insight into each individual’s interests and hobbies. Survey responses such as these reveal the staff’s satisfaction.

“This demographic didn’t come from a technology-based background, but they’re never too old to learn something new. It was wonderful to take part in this study, and to be able to give something back to our seniors.”

“It was so rewarding to see the residents venture beyond their comfort bubble: asking to join more programs and sharing them with their friends.”

This study proved the positive impact of digital inclusion on the lives of residents, families and staff in long-term care homes as well as the potential for more trials. The advantages of choice and independence were deeply felt among residents who could watch their favourite television shows privately, rather being limited to the common-room selection. The experiment heightened concentration and focus, revived energy through mental stimulation, improved cognitive function by acquiring new skills, and decreased behavioural issues.

Edna’s story: A 96-year-old resident masters the Samsung tablet

Shannon O’Connor, the Life Enrichment Director at Mariann Home in Richmond Hill, Ontario was thrilled when the Ministry of Health and Rogers first approached with the opportunity. Because of the way their building was constructed, they had struggled with offering consistent WiFi access throughout the facility. “Rogers was amazing with coming on site … looking at our modems and routers and seeing where they can give us more Internet and WiFi access,” she explains.

Shannon selected 96-year-old Edna Coutinho as a participant in the program. A new resident in the home, Edna was just coming out of the 14-day isolation period mandated by COVID-19, and Shannon wanted to help her transition by providing her with stimulation and engagement. Edna had never used a tablet before and needed some encouragement at first; but Shannon watched her progress with pleasure, as Edna became more comfortable connecting with her family, taking part in online art classes and exploring new territory. “This is Edna’s home,” says Shannon. “This is where she lives; this is her space to enjoy her time.”

Behind the scenes

Extensive planning and preparation informed the approach taken by the Ontario Ministry and its partners to equip them with the tools for success.

The study included:

• The selection of four long-term care facilities to serve as trial subjects
• An environmental scan of the digital capabilities in each home
• The selection of resident participants, based on staff assessment with rationale for the choices
• Training of on-site ‘Tech Champions’ to monitor the program
• Development of surveys to collect detailed data and analysis on the results
• Provision of a Samsung tablet to each participant

The project was launched in May 2021, pinpointing the steps to a positive outcome. The staff chose the participants, summarizing their status and personalities: their general mental and physical health, cognitive and manual capabilities, hobbies and social connections, and familiarity with devices.

Preparing the way

Basic logistical concerns were addressed, such as the location of electrical outlets, longer charging cords or mobile stands for the devices. The tablets were staged for easy ‘out-of-the-box’ use, and customized to align with the residents’ personal interests and cognitive capabilities. Apps could be either added or eliminated, with various options made available for music, arts, news, videos, games, movies, or culturally diverse assets. The staff were coached to implement the study, which included an assessment of their own digital literacy, enabling the transition to new technology and competent device management.

Rogers helped to lay the groundwork for success by evaluating the quality and capacity of the digital environment. A comprehensive investigation and analysis of each facility detailed the status of the facilities’ computers, internet and WiFi capabilities, with recommendations for upgrades, such as replacing aging infrastructure to accommodate increased bandwidth or adding access points. A robust connection was established from the source through to the individual rooms and spaces to prevent ‘dropped’ Internet issues from derailing the program.

Key findings

The staff members observed that varying degrees of assistance were required. In some cases, the residents embraced the learning curve, but others needed a great deal of encouragement. While their daily tasks were increased, few of them felt that it affected their level of stress and burnout. Staging the devices was critical to user buy-in, with simplicity as the key: limiting the apps and building skills so that more activities could be added gradually.

Several enhancements were recommended, such as complementing hands-on support with simple video and visual training aids, selecting larger tablets to accommodate increased font size, with a locked home screen and reduced screen sensitivity, and establishing a routine for device charging.

Acknowledgments

This important project owes thanks to the many staff and residents who supported the study across all four facilities. Thank-you also to the Ontario Ministry of Health Central for identifying the need for this important, person-focused work, for bringing us together and for leading the evaluation with the LTC homes. Samsung Canada also deserves special mention for providing the tablets used to conduct the study. Without the key contributions of all these people, this study would not have been possible.

Rogers has a deep commitment to ‘making more possible’ and this project reflects this high level of dedication and concern: making digital equity possible, making independence possible, making choice possible. With today’s strong societal focus on equity and justice for everyone, including older adults and diverse cultures, the program holds great promise for the future, benefitting not only long-term care facilities, but also extending its reach to making more possible for other organizations across the country.

To learn more about the different ways Rogers supports our communities, click here. To see more stories from communities and businesses working with Rogers, see our customer stories blog.  Click here to contact us or to find out how you can tell your story with Rogers.

Note from Ontario Health: Due to the urgency and impact of COVID-19 on LTC residents, Ontario Health Central engaged willing organizations from November 2020 to August 2021 in a series of four different studies to help improve the social isolation and mental health of residents in LTC homes. Activities described in all studies were the result of philanthropic donations of both staff time and technology from all organizations involved. Ontario Health looks forward to formally engaging organizations to broaden this work in the future.