Alexa, When’s Therapy? Skilled Nursing Operator Pilots Virtual Assistants

Most of the talk surrounding the potential for consumer-grade gadgets in long-term care focuses on the lower-acuity world of assisted and independent living, where residents generally have more mobility and autonomy. But one skilled nursing provider says it’s seeing success with its fleet of Amazon Echo devices — both for residents and employees.

The New Jewish Home rolled out a pilot version of a virtual assistant program for skilled nursing residents at its Sarah Neuman campus in the New York City suburb of Mamaroneck, N.Y., back in March, and administrators are already set to expand it beyond the initial group of about 40 participants.

The goal, according to administrator Sandra Mundy, was to reduce the barriers to using technology for residents.


“What’s been challenging for the elderly population is having to log into things — there’s a lot of entering, typing, remembering. That can be challenging,” Mundy told Skilled Nursing News.

Staffers at Sarah Neuman handle the initial programming of the Echo Show devices, syncing them with the building’s calendar of events and individual residents’ therapy and doctor-appointment schedules —  allowing the residents to simply ask the Alexa voice assistant the questions they may have on a day-to-day basis. The non-profit New Jewish Home markets the program as a “Virtual Concierge,” a guiding voice that can help keep residents on track and engaged with their care plans.

The provider also teamed up with a Brooklyn-based company called Soundmind to implement its Alexa-based Memory Lane program, a kind of multimedia software that provides historical audio clips and other information to help trigger residents’ memories.


But injecting Alexa into a skilled nursing facility just doesn’t pay dividends for the residents. Leaders at Sarah Neuman decided to pilot the program at three of the facility’s “small house”-style communities, where 13 residents live and eat together in a more intimate residential setting. The certified nursing assistants who work in these small houses serve as both caregivers and cooks, preparing meals and coordinating group activities for the residents.

So far, according to Mundy, these employees have praised the way the Echo devices allow them to multitask while on the job, calling up memory games and other engaging activities while they prepare dinners. That solves a problem that the New Jewish Home and other facilities had encountered when attempting to incorporate new technologies into their day-to-day operations: the sheer clunkiness and learning curve that comes with setting up new hardware and software.

“With the challenging times in health care, and everybody needing to maximize every minute of every day, asking a staff member to stop and log in — as simple as it may sound, it’s extra time,” Mundy said. “So I think it’s not something they would do voluntarily because of the time.”

That sense of seamless partnership between user and machine is important when considering the introduction of new tech in long-term care facilities, according to researchers from the Human Factors and Aging Laboratory at the University of Illinois. It’s not enough to just plop a product into a resident’s room and watch the digital magic happen: Elders and workers need to understand why they’re using the products and learn their full potential, lab director Wendy Rogers told an audience at LeadingAge Illinois’s annual conference back in April.

“There are all kinds of amazing things that are developed in research laboratories all over the world, but very few of them get to be in your communities,” Rogers said at the time. “And that’s where we fail.”

At the New Jewish Home, part of that buy-in comes through involving family members as well as residents and staff. Caregivers at Sarah Neuman encourage residents to call and video-chat with loved ones who also own Echo Shows, and Mundy says the next major initiative in the program involves using Alexa as a post-acute care assistant.

Since nurses in the post-acute unit at Sarah Neuman spend significant amounts of time answering calls from family members about when residents’ doctor and rehab appointments are scheduled, administrators want to let Alexa take over.

“Then the family member that has the Alexa device at home can actually say, at home: Alexa, what time is Mom’s rehab today?” Mundy said.

The New Jewish Home used about $30,000 in donations to cover the costs of the program, and Mundy reports that aside from some concerns about privacy — which were assuaged with an FAQ brochure explaining how Amazon does and does not use the data it collects from its Echo devices — the introduction has been significantly smoother than previous tech roll-outs in the past.

“It’s a small device, the volume is adjustable, [and] a lot of technology of the past required a lot of space,” Mundy said. “It’s able to sit at the resident’s bedside.”

Written by Alex Spanko

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