Technology's 'Declaration of Independence' at the Boston Home: this historic facility exploits modern technology to give wheelchair-bound residents a hands-free environment

Nursing Homes, August, 2006 by Marva Serotkin

The Boston Home--a historic residence in Dorchester, Massachusetts, that sits high on a hill among the neighboring triple-decker houses--is a not-for-profit long-term nursing care facility that is home to adults with multiple sclerosis and other progressive neurologic diseases. Dorchester is a part of Boston with a history as old as America, and The Boston Home is part of the fabric of that community. It was the founders' mission that our residents would maintain an active role in the community and not be shut off from the outside world. We strive to meet this goal by hosting events that welcome neighbors into our home and encouraging volunteers to spend time with our residents.

Our service model includes exceptional clinical care, as well as services that address the physical, psychosocial, recreational, and spiritual needs of our residents. As the only facility of its kind in New England and one of only a few in the country, The Boston Home has created a "home healthcare" model in which our nursing staff helps residents to maintain independence.

In all of this, and more, assistive technology plays a key role. The Boston Home has been a pioneer in assistive technology, and we were eager to adopt these advanced systems to raise the bar in boosting residents' comfort, convenience, and control.

Celebrating Advanced Technology

Recently, we invited the community to help us celebrate a major building renovation and expansion that integrated technology into our residential community. Our upgrades include wireless elevator and door access*, which give residents hands-free control of their environment. The renovation also added overhead lifts* to each room to efficiently transport residents, freeing staff to spend more time providing care. We added new patient rooms, as well as new and expanded areas for group activities.

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Our renovation plan was the result of an initiative of our board of trustees' Strategic Planning Committee, whose objective is to establish The Boston Home as a center for excellence in clinical and residential services. Committee members met with trustees, staff, and building experts during an 18-month planning period. In addition to adhering to a tight budget, the most important challenge members faced was to maintain the same level of resident care throughout the two-year building process. To ensure that resident care wasn't disrupted, the committee set up meetings between the build-out team and resident representatives to address concerns and update residents as the project progressed.

When reviewing the budget, we determined which new technology applications would help to maximize our residents' comfort and control in their wheelchairs. We use terms like "functionality" and "mobility" when discussing assistive technology, but we consider technologies that help nurture the mind and spirit, as well. We embrace a philosophy that looks at the "bigger reality" for people who must deal with chronic disabilities. We put much thought and energy into finding technologies that would positively affect our residents' well-being.

Promoting Independence

Our wireless elevator and door access system allows residents to travel independently from floor to floor. The elevator uses radio frequency identification (RFID) technology--a tag attached to the wheelchair enables the unit to receive and respond to radiofrequency queries from a transceiver. The long-range RFID reader is capable of reading tags from a distance of 9 to 11 feet. The tag automatically sends a signal to call the elevator when the resident approaches. Our residents have hands-free freedom to attend classes, socialize in the Cyber Cafe (figure 1), and visit other residents without staff assistance. The tag also opens our facility's back door, which leads to a serene garden area complete with a goldfish pond (figure 2).

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We use an overhead lift system consisting of a mechanism and a sling that descends from a ceiling track, ready to raise, lower, and move the resident to and from bed, wheelchair, physical therapy mat, and shower chair (figure 3). In addition, residents are transferred in a sitting position, which means that less physical maneuvering is required, saving time and reducing the risk of injury to both residents and staff. Because of the efficiency of this overhead lift, aides can spend more time providing care, an important consideration since many residents have complex medical conditions, and aides need every moment to attend to them. This creates a more rewarding environment for our nursing staff, leading to high retention rates.

Our facility is also home to a host of hands-free equipment in addition to wheelchairs, including computers and environmental controls for beds, nurse call devices, phones, and TVs. According to Don Fredette, our assistive technology specialist, also known as "the wheelchair doctor" at The Boston Home, "These systems make a resident's wish technology's command."

Expanding Our Space, Overcoming Challenges