Digital for care homes: good practice guide

Digital technology is playing an increasingly significant part in enabling families to be connected to their loved ones, providing a platform for virtual consultations with health services and keeping residents occupied and engaged in meaningful activities.

Digital technologies are tools that enable us to do things differently and, in some cases, more effectively and efficiently. Whenever we think about using technology it is good to start with ‘why’, and what benefits it can give us. In terms of care homes there are several reasons why investing resources and staff time can help. They include:

• NHS and other care services are now available digitally, bringing care support into the home via apps and online video calls
• loneliness and isolation can cause stress and anxiety, digital tools can help residents maintain relationships with loved ones outside of the home
• assistive technologies including smart speakers (Alexa, Google Home) and Virtual Reality (VR) can support daily care and help to keep people occupied
• digital tools can bring in fun too through reminiscence, music, and games

Last week we used the tablets to celebrate Sir Tom Jones’ 80th birthday. We did a virtual quiz about him and watched his music videos from over the years so we could see how he has changed over time. This type of activity just would not have been possible before.

The benefits to residents include:

• maintain relationships
• calming
• entertainment
• potential physical health improvements
• improved well-being
• keeping occupied

Building blocks

To benefit from using technology, the building blocks need to be in place to create a positive and quality experience for everyone. Please see Appendix 2 for the digital building blocks checklist.

Staff and leadership buy in

Not everyone is comfortable using digital technology and some may feel they are not very confident using it.

Internet connection

To ensure everyone has the best experience, a quality connection to the internet is crucial. This can be a challenge especially when you do not know where to start or how it can be improved. Choosing an internet connection for your care home.

The UK Government also provide guidance for voucher schemes that could benefit your care home.

Digital devices

You may have digital devices such as tablets (iPads/Samsung Tabs) to use within the home.

Digital Champion

Digital Champions help others to build confidence and skills to get online. They do not need to be experts. They just need to have basic digital skills, and key skills to help others including patience, enthusiasm, and a passion to help others. Maybe there is already someone in the home that is a Digital Champion or someone that is willing to take on that role.

Training and guides

There are other organisations that can help (Appendix 1).

Digital checklist

The checklist at Appendix 2 can assist you at the start of your digital journey so that your residents can benefit from the many things’ technology has to offer.

The digital tablet has enabled our staff to be able to connect more of the residents with their families, which has a wonderful impact. Over the past couple weeks, we have hosted live video concerts from the lounge for friends and family and held regular video calls with loved ones.

It is important for residents to maintain contact with friends and family especially when they cannot receive regular visitors. One of the ways to maintain contact is through video calling services such as WhatsApp, Zoom, and Facetime. Investing staff time in getting to know how to use these various platforms and feel comfortable with them can result in saving time in the longer term and ensure that residents have contact with their families. Keeping your residents connected to their loved ones can have such a positive impact on their sense of well-being.

Other ideas you may wish to try include:

• loved ones reading to residents, maybe at bedtime
• family video call tea parties
• virtual coffee mornings

Attend Anywhere/NHS Video Consulting Service (Video Calling)

The NHS in Wales has rolled out a video consultation service so your residents can contact their doctor and other health professionals. Essentially, this is a video calling service for your residents to contact your doctor or hospital when it is not possible to do so in person.

The service is now available across the NHS in Wales including primary care/GPs, secondary and community care, pharmacy, and dentistry. This may be a preferable option during times where a face-to-face appointment may not be possible or appropriate. 

More information on this service can be found on the TEC Cymru Website.

Digital technology can offer many ways to keep residents entertained and engaged. Here are a few reasons why this is important (and fun).

Music

Music is believed to activate the brain, causing whole regions to communicate. Have a think of important times in your lives, there could be a certain song of piece of music that evokes special memories. It could be the first dance at your wedding, songs from your childhood that you remember all the words to, or a particular artist. This will be the same for the residents in your care.

Reminiscence

Welsh Government’s Digital Inclusion and Health Procured Service used digital reminiscence as a tool to improve the experience of patients in hospital and other care settings by generating interest, curiosity, and conversation. It improves rapport-building, communication, and engagement. Other benefits include reducing anxiety and agitation levels for distressed patients by providing a means of stimulation and distraction that can help with their symptoms.

Hobbies

From learning new skills to reviving old hobbies, the internet is full of guidance, how to videos and forums to speak to people with the same interests.

TV shows/sporting memories/entertainment

Being online means having endless entertainment at your fingertips.

Religious services

Many services are live streamed using Zoom/Facebook/YouTube. If your local service is not available live, YouTube can be a great resource for accessing services from the past, or from around the world. This opportunity to experience regular religious services can give people routine and the opportunity to maintain their faith.

One of the barriers to digital technology can be the concern over safety and security. It is important to understand these issues and put safeguards in place to protect everyone.

Training providers and support services sometimes deliver their support and training to care homes online. You may need to check that your home is set up to facilitate this. The following steps need to be taken in advance of the training:

1. Ensure you have a TV/monitor and laptop or tablet device available along with the appropriate connecting cables.
2. Ensure there is good internet connectivity in the room or office where you will receive the training/support.
3. Find out what programme or tool you need to access the training/ Support such as Zoom or Microsoft Teams. Download official software onto the device you will be using to connect to the TV or monitor. You will want to make sure there is an email account set up on the device as you may be sent a website link to access the training.
4. Check with the training provider what video calling platform they will be using and give them the email address of the account set up on the connected device, so it makes things easier.

Digital technologies (including Virtual Reality headsets) are being used to enable people with dementia to connect with positive memories. Reminiscence sessions in care homes for staff, families and people with dementia are using digital media (internet, tablet computers) to help people compile their life stories, through initiatives like Book of You.

Although this guide provides and overview of digital tablet devices there are many other devices that may work within your home. These include:

Virtual reality (VR)

VR provides a fully immersive experience. Wearing a headset can transport the user to other places/worlds. The type of experience is almost limitless due to the many different VR apps you can download anything from relaxing on a desert island to riding a rollercoaster to going back in time to the place you grew up. This technology can be extremely effective when used alongside a therapeutic tool.

Smart speakers

Such as Alexas, Google home, etc. are voice controlled devices that allow you to engage with the internet without having to learn technical skills. These devices can be used to play music, find out information, play games/quizzes, set reminders and much more; an excellent way for someone with no digital skills to get online. Some models now come with a video screen.

Smart TV

A television that is connected to the internet can show online content, for example Netflix, Amazon Prime, YouTube, BBC iPlayer. You can also browse the internet, send emails, etc. Smart TVs use an app-based system similar to the one on a tablet or smartphone, it can still be used as a normal television.

Activity tables e.g. RITA

These devices are tablets/touchscreens that run bespoke software designed to be accessed by certain groups of people. For example, RITA which stands for Reminiscence Interactive Therapy Activities is a digital therapy system which allows patients to use apps, games, and other leisure activities as part of their hospital recovery. It uses the same technology as a standard tablet with some specialist software focussed on participants with certain conditions.

Disabled people are often at greater risk of digital exclusion, yet they could potentially benefit the most. As a result of the rapid development of technology there is a wide range of mainstream devices that work well in assisting people to get online, without having to resort to specialist software or hardware that can be expensive.

Accessibility features are built into all smart devices. Options such as increasing text size or activating a zoom mode can make the world of difference to a digital experience. There are also many excellent free apps available such as Seeing AI (For both Android and Apple devices) or Google Live Transcribe (for Android Devices) that can help someone with sensory loss to not only use the device itself but achieve new things offline as well. The internet should be accessible to everybody, and this is increasingly the case whether you use a laptop, tablet, or smartphone.

Woffington House

Woffington House in Tredegar was the first care home in Wales to sign up to the Digital Inclusion Charter, an accreditation that previously existed through the Welsh Government’s former Digital Inclusion and Health Procured Service. The Manager wanted to change the culture at Woffington House, reduce the use of medication and find new ways to keep residents occupied and improve their health and well-being. Care home staff were trained to use iPads with residents to research their hobbies and interests and keep in touch with their loved ones.

One of the residents at Woffington House who had no family or visitors suffered with anxiety, mild depression and was living with dementia. At times, because of his frustrations and physical outbursts he was prescribed Lorazepam. Using an iPad and Virtual Reality, he was able to revisit where he grew up as well as going on rollercoaster rides and researching pigeon racing which had been a hobby all his life. He also loved looking up songs using YouTube. All the activities had a calming effect and his health and well-being improved dramatically.

Three residents who used to belong to a local male voice choir were amazed to be shown old footage on YouTube of the choir singing, and were delighted to see themselves singing together again. One of the gentlemen loved listening to music on the iPad and finding different renditions of his favourite song Calon Lan, which he sang along to and encouraged other residents to join in. This gave him the confidence to use the iPad to chat to his daughter on Facetime, because he can see her, he speaks to her as if she is in the room, which makes a big difference to them both.

The enjoyment that residents have from the devices has meant that these pieces of technology are vital resources for staff to help calm residents when they become distressed and help keep them occupied and engaged. Upon seeing the change in well-being of her mother, one family member said, ‘I’ve got my mum back’, showing how much difference technology can make in people’s lives.

The use of technology in the home brought about significant change, with the Manager reporting a 30% decrease in the number of falls and 100% reduction of PRN medications. They said:

“Our residents can get very upset and confused, they might bang on doors and shout at the windows, wanting to know why they are here. Before we began on our digital journey, the response was to reach for the medication. Now, we reach for the iPad.”

When you have the building blocks in place you may want to reach out to organisations who are ready to support you. Here are a few examples of the organisations you may wish to contact, but it is in no way an exhaustive list.

Book of You

Create a life story using words, pictures, music, and film. Bring family, friends, and carers together in one place to show who a person was and who they are now. If you are a carer, creating a Book of You will provide the opportunity for a shared, fun activity that lets you spend quality time together.

TEC Cymru

Training on the new NHS Video Consulting Service to enable you and your residents to access health professionals. 

Forget-me-not Chorus

The Forget-me-not Chorus brings joy into the lives of those living with and those affected by dementia through the power of song. They reach over 300 people every week through choirs in the community, care homes and hospitals in Wales.

Live Music Now

Live Music Now provides music sessions for thousands of older people every year, including those living with dementia, and their carers.

Music in Hospitals and Care

Music in Hospitals and Care (MiHC) are a charity providing live music sessions for people who are receiving care or treatment in health and social care settings across the UK.

Playlist for Life

Playlist for Life’s aim is for everyone living with dementia to have a playlist of personal music and for everyone who cares for them to know how to use it effectively.

Download the checklist.