Wired and Retired:
How An Assisted Living Provider
Successfully Got Their Residents Online

by Jeff Pepper
Founder and CEO, ElderVision

Based on an article to be published in the October issue of
Nursing Home and Long Term Care Management Magazine.

 Joan Gloe is a resident of Country Meadows’ Leader Heights assisted living facility in central Pennsylvania.  She’s a retired math teacher with no prior experience with computers.  Nerve damage to her hand makes her unable to use a keyboard.  All of her children and three of her grandchildren use computers, and Ms. Gloe says her family “stays in touch constantly through email.”  Until recently, Ms. Gloe was the only family member who could not participate in these email conversations.

An Elder-Hostile Internet? 
Ms. Gloe’s story is not unique.  Residents of senior living have the lowest internet usage rate of any demographic in America, with the possible exception of people living in prisons.  A recent study by the U.S. Department of Commerce shows that internet usage is highest among the young, with nearly 95% of American sixteen-year-olds online. 

Seventy percent of adults aged 20 to 50 use the internet.  But connectivity drops off dramatically for seniors, with only an estimated 40% of 65-year-olds connected, 20% of 75-year-olds, and under 10% of the “oldest old” (age 85+).   

There are no reliable usage statistics for senior living residents, but our own informal surveys have led us to conclude that 5% of assisted living residents use the internet, and fewer than 2% of residents of skilled nursing facilities.

A Stranger in a Strange Land
These low numbers are not surprising, given that many seniors feel like a “stranger in a strange land” when they sit down to use a computer.  To them, the internet often seems like a clubhouse created by 20-year-olds for other 20-year-olds, with an “Old folks not welcome” sign posted out front. 

This anti-senior bias appears in many ways.  Designers of software and websites assume their users have good vision and want to see a lot at once, so they pack lots of small text, cryptic icons and complex graphics onto a page.  They assume their users can discriminate between program content and banner ads, so they scatter flashing ads all over the screen.  And of course, they assume that their users can type, can handle a mouse, and are familiar with web conventions such as underlined hyperlinks, forward and back buttons, and multiple overlapping windows.

The result of all this, not surprisingly, is a frustrating computer experience for older users, especially those who are coping with age-related disabilities such as dementia, short term memory loss, low vision, arthritis, or who are simply unfamiliar with computers and the web.

And beyond these barriers are other, more subtle impediments.  The internet culture is edgy, hip, going in a thousand directions at once.  For an elderly resident raised in a culture of Norman Rockwell, Gary Cooper and Radio City Music Hall, the “MTV look” of most software and websites is confusing and disturbing.

So although most senior living communities have computers for residents to use, they generally end up gathering dust.  The computers are used by occasional hobbyists, by staff in their off-hours, and for visiting family members (often kids) who surf the web when they come to visit.

Breaking the Mold
In late summer of 2001, Country Meadows decided to do something about this.  A family owned provider of assisted living with 12 locations in Pennsylvania and Maryland, they made a top-management decision to find a partner that could help them transform the internet from a “young people only” medium to one that could provide real value for residents, families and staff.  They wanted their residents to have an improved quality of life, and they wanted the competitive edge that could come from being a truly wired retirement community.

In July 2001 they contacted ElderVision (www.eldervision.net), a Pittsburgh-based software company that was just beginning a complete redesign of their Touchtown software product to meet the needs of LTC providers.  ElderVision had formed a consortium of senior living providers, the Senior Connect Partnership, to guide the design and development of the new product so it would meet the needs of senior living providers as well as seniors themselves.  Country Meadows joined the Partnership and soon became one of its most active members.

For several months Craig Dieck, Country Meadows’ manager of information technology, participated in weekly Partnership conference calls and worked with ElderVision’s design staff to help design the new software product.  The design phase was completed in October, ElderVision’s programmers and graphic artists took over, and in May 2002 the finished Touchtown product was ready to use.

Elder-Friendly Features
Touchtown is designed to help senior living providers meet two objectives: to get their residents (and homebound clients) the benefits of the internet, and to give their organization a significant marketing edge and revenue opportunity.  The product’s most important feature is a powerful, voice-enabled email system that residents can use to successfully exchange email even if they cannot type or suffer from low vision, arthritis, dementia or short term memory loss.  Touchtown’s email system has many senior-friendly features, including independent adjustments for text size and overall complexity.

The program also provides a scrapbook for handling email attachments, a message board system for discussion topics ranging from soap operas to current events, and a simplified web browser to enable residents to access billions of web pages around the world.

Family members can become “Touchtown Buddies” at no charge, performing routine account management for their older relatives while staying in close touch through email.

And Touchtown provides a range of business-related features, including integration with intranets and other proprietary software applications; integration with census systems; automatically managed email distribution lists; and message boards and notices that can be tailored to the needs of residents in specific campuses and buildings. 

Making It Happen
Country Meadows was the first senior living provider to systematically deploy Touchtown, introducing it at their Leader Heights and Allentown assisted living facilities. 

Key to their success was the commitment from top management, with CFO Ted Janeczek personally sharing with employees, vendors and residents his company’s commitment to the project’s success.  According to Janeczek,  they selected Touchtown because “it allowed us once again to provide our residents with an opportunity to be part of the larger community.  Touchtown provides a different type of social wellness.”

The project also had a highly skilled and dedicated manager, Patty Marrero, the company’s Director of Technology Training.  And each facility’s activities director was given ultimate responsibility for the project’s success within that facility.

Here are the six steps that Country Meadows followed as it created its Touchtown Community:

 Step 1: Brief the Staff – Once corporate headquarters selected a facility to use Touchtown, a team from corporate came out and gave the facility’s management team a complete project briefing – an overview of the project objectives, the potential benefits in marketing and quality of life, and the specific details of the rollout process itself.  The meeting was chaired by CFO Ted Janeczek and project owner Patty Marrero, and was attended by the facility’s administrator, the directors of activities, wellness, marketing and maintenance, and even the dining services supervisors.

  Step 2: Create the Infrastructure – Meanwhile, the company’s IT staff  was getting the computers, furniture and locations ready.  “We wanted to make sure we had good computer equipment,” says Marrero, “so we invested in touchscreen monitors, telephone handsets instead of microphones, and nice furniture.”  Location was a key consideration, as the team tried to strike a balance between high visibility to promote easy use, and enough privacy so residents could actually use the system without being distracted.  At Leader Heights they ended up placing the system in an alcove just outside the chapel, a high traffic area that would ensure that every resident would see the system often. 

 Step 3: Build the Coaching Team – Since Touchtown training is done by residents instead of staff, the next key step was to identify the resident Coaches.  Marrero and the local activity director sought out active residents who were already involved in other activities, had been living at the facility for at least two years, and (if possible) already had some computer experience.  They decided on a ratio of one Coach for every seven Touchtown members.  Coaches received their Touchtown accounts free of charge, and agreed to actively work with their assigned residents to get them up to speed.  Marrero trained the Coaches herself, using ElderVision’s multimedia training materials over five 45-minute sessions.

Step 4: Promote It – To make sure there was enough excitement in advance of the rollout, Country Meadows sent out letters to each resident, letting them know that Touchtown was coming and what it would mean to them.  They also sent letters to each family, letting them know their loved ones would soon be able to stay in touch via email.  Both sets of letters went out in May, a full two months before the kickoff reception.

Step 5: Launch It – At a wine and cheese reception on Saturday afternoon, July 13, Touchtown was officially launched at Leader Heights. Unfortunately the reception overlapped with a bingo event. But even so, 25 people came to the reception, where they heard brief speeches from the administrator, the corporate training staff, and the president of ElderVision.  Then everyone got a chance to sit down at a computer, log in, and send an email by just speaking into a handset.  Signup sheets were handed out at the reception, and over half the attendees registered for a Touchtown account.

Step 6:  Grow It – After the launch, responsibility shifted to the resident Coaches.  Each Coach was given the names of several residents who had signed up for accounts, and those Coaches worked with their assigned residents for several weeks.  The goal was to make sure that each resident could walk up to a computer, log in to their Touchtown account, and check their email.  Marrero also plans to start monthly classes, one for existing Touchtown members and another one for people who are not yet members but are interested in learning more about computers and the internet. 

Status of the Project
A month after the kickoff receptions, computer usage is growing steadily at the two Country Meadows facilities.  In the first month, 20 residents logged in to their Touchtown accounts a total of 402 times.  They sent 128 email messages, 58 of them dictated into a microphone.  They received 425 email messages from friends and family, including 52 voice messages they listened to through their computer speakers.  Nine of the residents accessed Touchtown’s seniors-only message board system, and a few of them have ventured out for the first time onto the world wide web.

One of the most active members is Joan Gloe, the retired math teacher.  Ms. Gloe is now a Touchtown Coach, helping other residents at Leader Heights learn to use email and get reconnected with their family, friends and community.  She still cannot use a keyboard, but that’s not a problem anymore.  She sends email regularly by just dictating it.  “My children are very impressed that they can hear my voice,” she says.  She is fully engaged as a Coach, spending five hours a week coaching fellow residents.  “I find it interesting. I enjoy working with other people and helping them learn how to use computers,” she says.

Country Meadows CFO Ted Janeczek is delighted with progress so far, and sees a bright future for resident internet use.  “Five or ten years from now what we are doing at Country Meadows will be commonplace,” he says.  “This is just one more way for us to help seniors experience a higher quality of life.”

*          *          *

Jeff Pepper is the founder and President of ElderVision (Oakmont, PA), a provider of resident oriented software to the senior living industry.  Jeff has authored two books, holds two U.S. software patents, and has given hundreds of talks at technology and senior living conferences around the world.  You can contact him at jpepper@eldervision.net, or (412) 826-0460 ext. 202.  ElderVision’s website is www.eldervision.net

Back