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Service Delivery Innovation Profile

Messaging System Enables Nursing Home Residents to E-mail Loved Ones Without a Computer, Leading to Enhanced Quality of Life


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Snapshot

Summary

The Good Samaritan Society, a nursing home in Tyndall, SD, has a messaging system that enables residents to easily correspond with friends and family by e-mail without using a computer. Residents receive printouts of incoming e-mails and respond by writing handwritten notes. Staff members place each note in a modified scanner and push a button that automatically creates a digitized version of the note and e-mails it to the intended recipient. More than one-third of the facility's residents use the system. Anecdotal reports suggest that improving communication with the outside world has enhanced residents' quality of life.

Evidence Rating (What is this?)

Suggestive: Although quantitative evidence demonstrating improvements in mental health or quality of life is not available, anecdotally, residents report enhanced quality of life and staff reports satisfaction with the process.
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Developing Organizations

Good Samaritan Society, Tyndall, SD
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Use By Other Organizations

Other nursing homes and assisted living facilities that use the same messaging system include:
  • Augustana Care (Minneapolis, MN)
  • Elim Care (Edin Praire, MN)
  • Good Samaritan Society (DeSmet, SD)
  • Good Samaritan Society (Sioux Falls, SD)
  • Oak Meadows Senior Living (Oakdale, MN)
  • Presbyterian Homes and Services (Roseville, MN)
  • Stoneybrook Suites (Huron, SD)

Date First Implemented

2007
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Patient Population

Age > Aged adult (80 + years); Vulnerable Populations > Frail elderly; Age > Senior adult (65-79 years)end pp

Problem Addressed

Nursing home residents often feel isolated from friends and family; loneliness leads to poor quality of life and is associated with a number of physical and mental health issues. One factor contributing to residents' isolation is lack of access to e-mail, a problem exacerbated by modern society's reliance on this tool for communication.
  • Loneliness associated with negative health outcomes: Nursing home residents often feel lonely and isolated from friends and family; over time this can cause or worsen depression, which in turn leads to an increased risk of both physical ailments (e.g., heart disease, cancer) and additional mental health issues, including anxiety, substance abuse, and suicide.1
  • Lack of connectivity exacerbates loneliness: Residents typically do not have access to e-mail, a common communication tool used today. Residents are often left out of the loop because they lack easy access to a computer with an internet connection, do not know how to use a computer to send e-mail, or can no longer use a computer due to physical or cognitive limitations (e.g., poor eyesight, mild dementia).

What They Did

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Description of the Innovative Activity

The messaging system enables residents to easily correspond with friends and family by e-mail without using a computer. The system is very straightforward and does not require that either staff members or residents know how to use a computer or e-mail. The system works as follows:
  • E-mails come in from outside: Friends and relatives are made aware of the system and send e-mails to a resident, using addresses set up specifically for the system.
  • Computer printouts: Every 10 minutes, a computer designated for use with the system downloads incoming e-mails and automatically prints them out, along with any attachments (e.g., photos, documents).
  • Message delivery: Staff members who have volunteered to help administer the system deliver printouts to residents, along with blank stationery coded with the senders' e-mail addresses. To ease delivery, the computer is located in a frequently traveled hallway near the dining room.
  • Handwritten responses: Residents write handwritten replies to incoming e-mails on the stationery and give them to staff members.
  • E-mail responses: Staff members place each reply in a modified scanner connected to the computer and push a button that digitizes the reply and sends it by e-mail as a PDF attachment to the original sender.
  • Ongoing administration: Senior staff keep the messaging system updated by adding new residents' names and deleting residents who have died or moved away.

Context of the Innovation

The Good Samaritan Society is a 71-bed, nonprofit nursing home in Tyndall, SD. Most residents are over 80 years old and do not use e-mail because they lack computer skills and/or have physical or cognitive limitations. The nursing home's leadership learned of the messaging system from a Good Samaritan facility in DeSmet, SD that was already using it and also saw a demonstration at a local trade show. The facility's leaders decided to implement the messaging system as part of its ongoing effort to use technology to enhance residents' quality of life.

Did It Work?

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Results

The nursing home has not formally evaluated the messaging system's effects, but the facility's administrator reports that it boosts morale and quality of life among users. Indicators of success include the following:
  • High levels of usage: Eight months after the system was implemented, about one-third of the facility's residents were using it to send messages. The percentage of users continues to rise, and use is especially high around holidays, as residents respond to family members who send photos. One resident who is unable to communicate by telephone (due to damaged vocal chords) now uses the messaging system to communicate daily with family members.
  • Anecdotal reports of enhanced quality of life: Residents report that they enjoy receiving and writing messages and appreciate being remembered by friends and family.
  • Staff satisfaction: The system has not significantly increased staff members' workload because it is so easy to use. Without prompting, staff members have volunteered to deliver and send messages because they enjoy helping residents communicate with loved ones.

Evidence Rating (What is this?)

Suggestive: Although quantitative evidence demonstrating improvements in mental health or quality of life is not available, anecdotally, residents report enhanced quality of life and staff reports satisfaction with the process.

How They Did It

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Planning and Development Process

Key steps in the planning and development process included the following:
  • Fundraising campaign: The nursing home held a community fundraising campaign to raise money to buy the system—a computer and a specially made scanner/printer.
  • Initial training: Three senior staff members attended a 2-hour training course to learn to set up and operate the messaging system. These three employees are the only staff members who can modify the system (e.g., change features, delete e-mail addresses).
  • Subsequent training: Staff members who help run the system were shown how to send messages. This training took only a few minutes because employees need only learn how to place residents' handwritten notes in the scanner and push a button.
  • Building awareness: To make residents and their family and friends aware of the new system, senior staff publicized it in the facility's newsletter, sent letters about it to families, and explained it during family visits. Employees also told residents about the system in small groups and during one-on-one contacts that occur naturally during the course of the day.

Resources Used and Skills Needed

  • Staffing: The system requires no new staff.
  • Training: The system requires minimal training to implement and use, consisting of a few hours for those who oversee it and a few minutes for those who deliver messages.
  • Costs: The system cost about $2,000 to purchase. In addition, there is a monthly $99 Caregram subscription fee and a monthly internet access fee.
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Funding Sources

Good Samaritan Society, Tyndall, SD
A fundraising campaign raised money to purchase the system. The nursing home pays the monthly fees from its internal operating budget.end fs

Adoption Considerations

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Getting Started with This Innovation

  • Get the word out: To encourage use, the facility needs to make family and friends aware of the system. The most frequent users are not necessarily those closest by blood to the resident. For example, a resident's grown children may not use the system if they live close enough to visit frequently, whereas nieces and nephews who live far away may become frequent users. Informal interviews with residents and their visitors may yield additional names to add to residents' contact lists.
  • Emphasize simplicity to staff: Staff members may initially be reluctant to help with the system because they already have a heavy workload and do not want to take on additional work. Demonstrating how easy the system is to use (literally one push of a button) can help overcome such feelings.

Sustaining This Innovation

  • Incorporate the system into the admission process: To increase use over the long term, ask residents' relatives to sign up to use the messaging system during the admission process.
  • Stay on top of system maintenance and updates: Administrators need to make sure they promptly update the system and understand all its features. For example, one optional feature allows the facility to automatically send reminders to residents' contacts who have not e-mailed recently. Failing to remove deceased residents' from the system risks angering or upsetting relatives if they receive these reminders.

Use By Other Organizations

Other nursing homes and assisted living facilities that use the same messaging system include:
  • Augustana Care (Minneapolis, MN)
  • Elim Care (Edin Praire, MN)
  • Good Samaritan Society (DeSmet, SD)
  • Good Samaritan Society (Sioux Falls, SD)
  • Oak Meadows Senior Living (Oakdale, MN)
  • Presbyterian Homes and Services (Roseville, MN)
  • Stoneybrook Suites (Huron, SD)

More Information

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Contact the Innovator

Julie Schenkel
Administrator
Good Samaritan Society – Tyndall
2304 Laurel St.
Tyndall, SD 57066-2214
Phone: (605) 589-3350
E-mail: jschenke@good-sam.com

Innovator Disclosures

Julie Schenkel has not indicated whether she has financial interests or business/professional affiliations relevant to the work described in this profile.

References/Related Articles

Boelk B. Seniors learn how to send love over the wires. Lake Elmo Leader. 2007 Feb 21. Available at: http://www.caregram.com/files/lake_elmo_leader_2007_02_21.pdf (If you don't have the software to open this PDF, download free Adobe Acrobat ReaderĀ® software External Web Site Policy.)

The Caregram Web site is available at: http://www.caregram.com/

Footnotes

1 Aina Y, Susman J. Understanding comorbidity with depression and anxiety disorders. J Am Osteopath Assoc. 2006;106(Suppl 2):S9-14. [PubMed] Available at: http://www.jaoa.org/cgi/content/full/106/5_suppl_2/S9
Comment on this Innovation

Disclaimer: The inclusion of an innovation in the Innovations Exchange does not constitute or imply an endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality, or Westat of the innovation or of the submitter or developer of the innovation. Read more.

Original publication: April 28, 2008.
Original publication indicates the date the profile was first posted to the Innovations Exchange.

Last updated: September 11, 2013.
Last updated indicates the date the most recent changes to the profile were posted to the Innovations Exchange.

Date verified by innovator: July 16, 2013.
Date verified by innovator indicates the most recent date the innovator provided feedback during the annual review process. The innovator is invited to review, update, and verify the profile annually.

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