Making Tockwotton more like a home

A PLACE TO CALL HOME: Kevin McKay, executive director of Tockwotten, in front of the $52.3 million project on Narragansett Bay. It's slated to open Dec. 15. / PBN PHOTO/NATALJA KENT
A PLACE TO CALL HOME: Kevin McKay, executive director of Tockwotten, in front of the $52.3 million project on Narragansett Bay. It's slated to open Dec. 15. / PBN PHOTO/NATALJA KENT

As the population ages, people are forced to make difficult decisions regarding the care of loved ones. The choice can become harder for many when memory loss and dementia are a factor.
When their new East Providence facility is complete, the staff at Tockwotton on the Waterfront will be using a new technology to ensure the best possible care of such residents. The $52.3 million, 156-bed nursing home on Narragansett Bay will be the first facility in Rhode Island to house the Vigil Dementia System, a silent electronic-monitoring system that relies on passive sensors rather than just call buttons and audible alarms to detect patient distress. The new facility is slated to open Dec. 15.
“Right now, if we have someone who we use alarms with because they’re a high fall risk, the alarm goes off and everybody hears it,” said Brenda Toll, Tockwotton’s director of nursing, adding that the attention can, at a minimum, be embarrassing. “I think a lot of the time it startles the resident – if that person has dementia, they don’t know what [the noise] is.”
Rather than sounding an alarm or flashing a light, the Vigil System – from Victoria, British Columbia-based Vigil Health Solutions Inc. – sends an alert directly to a pager or smartphone on the hip of a staff member. If that staff member doesn’t respond in an appropriate time – one to two minutes – then the system sends a second alert as well as alerting a second staff member.
“As I get older, all that background noise just drives me crazy,” said Tockwotton Executive Director Kevin McKay, “So imagine if you’ve got some form of dementia or have a cognition issue, all these nurse call bells going off. The quality of life can’t be good.”
In addition to being completely silent, the Vigil System provides a constant watchful eye over residents. The noninvasive system uses no cameras and includes a bed-exit sensor that detects when a resident is out of bed, an incontinence sensor to detect whether or not the patient has had an accident, infrared motion detectors located in the entry and restroom door frames to monitor resident movement through doorways and an infrared motion detector located in the ceiling of the room that detects resident movements. At night, the nursing staff now routinely checks patients every hour to make sure they are in bed and have not had an incontinence problem, but they can’t be with every patient at every moment. “Let’s say we go in the room at midnight and the person’s been incontinent. We change them and they’re all set. We check them every hour and at 4 a.m. they’re incontinent again. We don’t know if they had an accident at 3:55 a.m. or 3:05 a.m.”
The Vigil System’s incontinence sensor will immediately alert staff of an accident, minimizing the possibility of skin breakdown and discomfort.
The system, which checks on every resident multiple times a minute, will also allow Tockwotton staff to customize the system for each room, depending on the needs of the resident. “It’s not one size fits all,” said McKay. “Through decisions with the family, we can turn these systems on or off based on what the patient needs are.”
“[The system] collects data for us. We can see how many times nurse call bells are being pulled, we can see what the response time is,” said McKay. “The technology will help us anticipate the needs of the residents.”
If a patient gets up to use the bathroom every night at 3 a.m., the staff can program the system not to send an alert between 2:45 and 3:15 a.m. Similarly, if that same patient is incontinent around 3 a.m. every night, the system documents that and alerts the nurses, allowing them to wake the patients before they wet the bed. “The Vigil System will give more dignity to the residents,” said Toll.
“The main thing to always remember is that the residents don’t live where we work, we work in their home,” said Toll. Of the 156 beds at Tockwotton on the Waterfront, 73 will be regular assisted-living apartments, 31 will offer memory-care assisted living to those dealing with dementia issues, 52 apartments are designated as “skilled nursing” or nursing home apartments. Seventeen Tockwotton apartments will be for short-term rehabilitation patients recovering from surgery such as knee or hip replacements. Not every room in Tockwotton’s new facility will include the Vigil System. The monitoring system will be present in all of the nursing-home apartments, as well as the 31 memory-care assisted-living apartments. For mild dementia patients that can walk around the building, Tockwotton staff can issue a pendant to wear. If a patient presses the pendant, it will alert staff to their general location and that they need assistance. “It’s going to give the resident independence and a sense of security,” said McKay.
The idea for the Vigil System was born almost 14 years ago in Australia.
“A nurse understood that people with memory impairment don’t often equate pushing a red button with getting help. When they need help they don’t often push it and when they don’t need help, they see this interesting red button to push,” said Tony Griffiths, president and CEO of Vigil Health Solutions Inc. His company bought the technology and the first system was installed in 1998 in Victoria, British Columbia. “We saw a great technology that made a difference in people’s lives,” said Griffiths. “We knew the reality was that we were all getting older and the need [for good health care systems] was more, not less.” Around North America, there are roughly 350 installations, though Tockwotton will be the first facility in Rhode Island to use the state-of-the-art system.
“A lot of people want to think about technology about being really loud, with bells and whistles, and ours is the opposite,” said Griffiths. “Our mission is to improve the quality of life. These places are people’s homes.” &#8226

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